Reliability and validity of the Pittsburgh Sleep Quality Index among frontline COVID-19 health care workers using classical test theory and item response theory.

STUDY OBJECTIVES: The applicability of sleep-related scales to frontline medical staff for the COVID-19 pandemic has not been fully proved, so sleep survey results lack credibility and accuracy, creating difficulties for the guidance and treatment of frontline medical staff with sleep disorders, which is not conducive to the prevention and control of COVID-19. This study sought to analyze the reliability and validity of the Pittsburgh Sleep Quality Index (PSQI) among frontline medical staff fighting the COVID-19 pandemic. METHODS: A network questionnaire survey was used to investigate the PSQI among frontline medical staff who fought COVID-19 in Wuhan, China from March 19 to April 15, 2020. Combined with classical test theory and item response theory, the content validity, internal consistency, construct validity, and other aspects of the PSQI were evaluated. RESULTS: According to classical test theory, content validity, criterion validity, and construct validity of the PSQI were good. But the internal consistency was better after the deletion of the "daytime dysfunction" subscale. With regard to item response theory, difficulty, the differential item function, and the Wright map performed well. CONCLUSIONS: The original PSQI showed acceptable applicability in frontline COVID-19 medical staff, and its characteristics moderately improved after the "daytime dysfunction" subscale was removed. CITATION: Wang L, Wu Y-X, Lin Y-Q, et al. Reliability and validity of the Pittsburgh Sleep Quality Index among frontline COVID-19 health care workers using classical test theory and item response theory. J Clin Sleep Med. 2022;18(2):541-551.

Weekday and weekend sleep deprivation are associated with recurrent nightmare in adolescents: a cross-sectional study.

OBJECTIVE: Our study aimed to investigate the association between sleep deprivation and parasomnias including nightmare and sleepwalking in Chinese adolescents. METHODS: A total of 19,229 high school students aged 10-20 in Fuzhou were invited to complete questionnaires regarding sleep duration, parasomnias including nightmare and sleepwalking, and emotional problems. Subjects with sleep deprivation (SD) defined as sleeping less than 8 h either on weekdays or on weekends were categorized as three groups: weekday SD, weekend SD and habitual SD. RESULTS: The prevalence of recurrent nightmare was significantly higher for subjects with SD (SD vs non sleep deprivation (NSD): 7.6% vs 3.7%). In all subjects, habitual SD was associated with the highest risk of recurrent nightmare [Odds ratio (OR) = 2.19, 95% Confidential interval (95% CI) = 1.73-2.75, P < 0.001], followed by weekday SD (OR = 2.06, 95% CI = 1.64-2.61, P < 0.001) and weekend SD (OR = 1.45, 95% CI = 1.01-2.08, P = 0.045). No significant association was found between sleepwalking and sleep deprivation. In further age-based (10-13/14-17 years) and sex-based subgroup analyses, the findings were consistent except that association between weekend SD and recurrent nightmare disappeared among subjects aged 14-17 or among girls. CONCLUSIONS: Our study found a significant association between recurrent nightmare and sleep deprivation either on weekdays or on weekends in adolescents, which was stronger with more deprivation episodes. No significant association was found between sleepwalking and sleep deprivation. Association between weekend SD and recurrent nightmare disappeared among subjects aged 14-17 or among girls.

Coordinative-to-covalent transformation, isomerization dynamics, and logic gate application of dithienylethene based photochromic cages.

Photochromic coordinative cages containing dynamic C[double bond, length as m-dash]N imine bonds are assembled from a dithienylethene-based aldehyde and tris-amine precursors via metallo-component self-assembly. The resulting metal-templated cages are then reduced and demetalated into pure covalent-organic cages (COCs), which are otherwise difficult to prepare via de novo organic synthesis. Both the obtained coordinative and covalent cages can be readily interconverted between the ring-open (o-isomer) and one-lateral ring-closed (c-isomer) forms by UV/vis light irradiation, demonstrating distinct absorption, luminescence and photoisomerization dynamics. Specifically, the ring-closed c-COCs show a blue-shifted absorption band compared with analogous metal-templated cages, which can be applied in photoluminescence (PL) color-tuning of upconversion materials in different ways, showing potential for constructing multi-readout logic gate systems.

Reduced Sleep Duration and Sleep Efficiency Were Independently Associated With Frequent Nightmares in Chinese Frontline Medical Workers During the Coronavirus Disease 2019 Outbreak.

OBJECTIVES: Nightmares were related to emotion and behavioral problems and also emerged as one of the core features of post-traumatic stress disorder (PTSD). Our study aimed to investigate the associations of frequent nightmares with sleep duration and sleep efficiency among frontline medical workers in Wuhan during the coronavirus disease 2019 (COVID-19) outbreak. METHODS: A total of 528 health-care workers from the province of Fujian providing medical aid in Wuhan completed the online questionnaires. There were 114 doctors and 414 nurses. The age, sex, marital status, and work situation were recorded. A battery of scales including the Pittsburgh Sleep Quality Index (PSQI) and the 12-item General Health Questionnaire (GHQ-12) were used to evaluate subjects' sleep and general mental health. Frequent nightmares were defined as the response of at least once a week in the item of "nightmare" of PSQI. RESULTS: Frequent nightmares were found in 27.3% of subjects. The frequent nightmare group had a higher score of PSQI-sleep duration and PSQI-habitual sleep efficiency (frequent nightmares vs. non-frequent nightmares: PSQI-sleep duration, 1.08 ± 0.97 vs. 0.74 ± 0.85, P < 0.001; PSQI-habitual sleep efficiency, 1.08 ± 1.10 vs. 0.62 ± 0.88, P < 0.001). Reduced sleep duration and reduced sleep efficiency were independently associated with frequent nightmares after adjustment for age, sex, poor mental health, and regular sleeping medication use (reduced sleep duration: OR = 1.96, 95% CI = 1.07-3.58, P = 0.029; reduced sleep efficiency: OR = 2.17, 95% CI = 1.09-4.32, P = 0.027). Subjects with both reduced sleep duration and sleep efficiency were also associated with frequent nightmares (OR = 2.70, 95% CI = 1.57-4.65, P < 0.001). CONCLUSION: The present study found that sleep duration and sleep efficiency were both independently associated with frequent nightmares among frontline medical workers in Wuhan during the COVID-19 pandemic. We should pay attention to nightmares and even the ensuing PTSD symptoms among subjects with reduced sleep duration or sleep efficiency facing potential traumatic exposure.

The Construction of Unsmooth Pulse Images in Traditional Chinese Medicine Based on Wave Intensity Technology.

Unsmooth pulse is one of the most important pulses in TCM diagnostics. We constructed the wave intensity (WI) images of unsmooth pulse based on the pressure wave (P), flow velocity wave (U), and WI [(dP/dt)(dU/dt)] by ALOKA Prosound α 10 Color Doppler. The characteristic of Cunkou normal pulse could be summarized as follows: compared to Renying pulse, its W1 amplitude is smaller and NA wave is more obvious, while the W2 wave is indistinct or even invisible, and the R-1st is longer than that of Renying pulse. The principal U wave of Renying pulse looks like "Λ" shape, while it looks like an arched blunt "∩" shape in Cunkou pulse, and the amplitude of U wave in Cunkou pulse is smaller. The direction of the principal U wave in Cunkou unsmooth pulse is up, which shows hoof boots "h" shape with high amplitude and a significant notch on declined branch; the amplitude of predicrotic wave in unsmooth pulse P wave is significantly higher, which could be even higher than that of h1, resulting in early appearance of h3 or integrating with h1, which forms a wide and blunt peak. Unsmooth pulse shows poorer vascular elasticity and greater vascular stiffness.

Creating coordination-based cavities in a multiresponsive supramolecular gel.

Creating cavities in varying levels, from molecular containers to macroscopic materials of porosity, have long been motivated for biomimetic or practical applications. Herein, we report an assembly approach to multiresponsive supramolecular gels by integrating photochromic metal-organic cages as predefined building units into the supramolecular gel skeleton, providing a new approach to create cavities in gels. Formation of discrete O-Pd2 L4 cages is driven by coordination between Pd(2+) and a photochromic dithienylethene bispyridine ligand (O-PyFDTE). In the presence of suitable solvents (DMSO or MeCN/DMSO), the O-Pd2 L4 cage molecules aggregate to form nanoparticles, which are further interconnected through supramolecular interactions to form a three-dimensional (3D) gel matrix to trap a large amount of solvent molecules. Light-induced phase and structural transformations readily occur owing to the reversible photochromic open-ring/closed-ring isomeric conversion of the cage units upon UV/visible light radiation. Furthermore, such Pd2 L4 cage-based gels show multiple reversible gel-solution transitions when thermal-, photo-, or mechanical stimuli are applied. Such supramolecular gels consisting of porous molecules may be developed as a new type of porous materials with different features from porous solids.

Linear Dependence of Photoluminescence in Mixed Ln-MOFs for Color Tunability and Barcode Application.

Multicolored photoluminescence tuning in a single-phase material has invaluable potential in display and security applications. By deliberate design of a multifunctional antenna ligand and precise control of mixed metal ionic compositions in lanthanide metal-organic frameworks (Ln-MOFs), we achieved dichromatic fine-tuning among red, green, or blue primary colors through growth of a series of isomorphous Ln-MOF crystals·solvents of formula [LnnLn'1-n(TTP)2·H2O]Cl3 (Ln = Ln' = Eu, Tb, and Gd, 1-3; Ln = Eu, Ln' = Tb, 4-8; Ln = Gd, Ln' = Eu, 9-11; Ln = Gd, Ln' = Tb, 12-14; 0 < n < 1; TTP = 1',1″-(2,4,6-trimethylbenzene-1,3,5-triyl)tris(methylene)tris(pyridine-4(1H)-one)). The linear dependence of the emissions were analyzed, and the mathematical matrix models were established, which are useful to control the synthetic conditions and to predict the color chromaticity coordinates under varied excitation wavelengths. The potential relevance of these multicolored photoluminescent Ln-MOFs to barcoded materials was demonstrated.

[Methylation in Promoter Region of SLC6A2 Gene in Heart Failure Patients and Its Correlation with Qi Deficiency/Blood Stasis Syndrome].

OBJECTIVE: To explore the methylation status in promoter region of norepinephrine transporter gene (NET, SLC6A2) in heart failure ( HF) patients and its correlation with qi deficiency/blood stasis syndrome (QDS/BSS). METHODS: Thirty-six patients with heart failure (NYHA classification III to IV) were recruited in the study (as the heart failure group) and their scores of QDS/BSS were evaluated. Besides, a healthy elderly group (30 cases) and a healthy youth group (30 cases) were also set up. They were recruited from Physical Examination Center of Fujian Provincial Hospital. Pyrosequencing was applied to detect the methylation in promoter region of SLC6A2 gene, and the total methylation index (MTI) of CpG island was calculated. The correlation between the methylation status in promoter region of SLC6A2 and scores of QDS/BSS was assessed using Pearson and Partial analyses. Risk factors were screened and adjusted using Logistic regression. RESULTS: By one-factor analysis of variance, the total MTI in the HF group (219.72% ± 54.03%) was obviously higher than that in the healthy elderly group (194.47% ± 34.92%) and the healthy youth group (161.60% ± 41.11%) (all P < 0.05). Meanwhile, the total MTI was higher in the healthy elderly group than in the healthy youth group (P < 0.01). By covariance analysis , after controlling age and BMI, the total MTI was higher in the HF group than in the healthy elderly group (P = 0.041), while it was higher in the healthy elderly group than in the healthy youth group (P = 0.016). Age was found to play an essential role in affecting MTI of SLC6A2 gene promoter region among the 3 groups (F = 16.447, P = 0.01). The total MTI was quite lower in the healthy youth group. Results of Partial correlation analysis showed MTI was positively correlated with scores of qi deficiency and blood stasis respectively (r = 0.494 and 0.419 respectively, both P < 0.05). Logistic regression analysis showed after adjusting confounding factors, the relative risk (OR value) of total MTI of SLC6A2 gene in promoter region was 1.038 (95% CI, 1.006 to 1.071, P = 0.020). CONCLUSIONS: Abnormally elevated methylation of the promoter region of SLC6A2 gene is one of risk factors for HF. In addition, the degree of methylation of the promoter region of SLC6A2 gene was positively correlated with the severity of QDS/BSS.

[Pharmacokinetic and pharmacodynamic characteristics of berberine and jateorhizine in Coptidis Rhizoma powder and their monomeric compounds in type 2 diabetic rats].

This article focused on a comparative analysis on the pharmacokinetic and pharmacodynamic characteristics of berberine (BER) and jateorhizine(JAT) in Coptidis Rhizoma powder (HL-P) and their monomeric compounds (BER + JAT, BJ) in type 2 diabetic (T2D) rats to explore the beneficial. effect of HL-P in the treatment of T2D. The T2D rats were treated with HL-P, BER, JAT and BJ, respectively for 63 d. The pharmacokinetic parameters, dynamic changes in blood glucose level and blood lipid values were measured. The results showed that, compared with other corresponding group, t(max), T(½ka) of BER and JAT in HL-P group were reduced, while C(max), AUC(inf), AUC(last), V(L)/F were significantly increased; compared with model group, blood glucose levels were decreased significantly in HL-P group since the 18th day, while those in BER or BJ group were reduced since the 36th day, however, blood glucose levels showed no obvious changes in JAT group; compared with model group, FFA values in all treatment group were decreased significantly. Moreover, TG, HDL and LDL value in HL-P group, LDL value in BER group and HDL value in BJ group were improved significantly. The above results showed that Coptidis Rhizoma powder showed excellent pharmacokinetic characteristics and excellent activity of lowering blood glucose and lipid. It provided a scientific basis for oral application of Coptidis Rhizoma powder in the treatment of T2D.

Intestinal absorption of berberine and 8-hydroxy dihydroberberine and their effects on sugar absorption in rat small intestine.

The intestinal absorption of berberine (Ber) and its structural modified compound 8-hydroxy dihydroberberine (Hdber) was compared, and their effects on the intestinal absorption of sugar by perfusion experiment were investigated in order to reveal the mechanism of low dose and high activity of Hdber in the treatment of hyperglycemia. The absorption of Hdber and Ber in rat small intestine was measured by in situ perfusion. High performance liquid chromatography (HPLC) was used to determine the concentrations of Hdber and Ber. In situ perfusion method was also used to study the effects of Hdber and Ber on sugar intestinal absorption. Glucose oxidase method and UV spectrophotometry were applied to examine the concentrations of glucose and sucrose in the perfusion fluid. The results showed that the absorption rate of Ber in the small intestine was lower than 10%, but that of Hdber was larger than 70%. Both Hdber and Ber inhibited the absorption of glucose and sucrose at the doses of 10 and 20 µg/mL. However, Hdber presented stronger activity than Ber (P<0.01). It is suggested that Hdber is absorbed easily in rat small intestine and that its inhibitory effect on the absorption of sugar is better than Ber.

Stepwise assembly of Pd(6)(RuL(3))(8) nanoscale rhombododecahedral metal-organic cages via metalloligand strategy for guest trapping and protection.

Stepwise synthesis of nanosized Pd-Ru heteronuclear metal-organic cages from predesigned redox- and photo-active Ru(II)-metalloligand and naked Pd(II) ion is described. The resulting cage shows rhombododecahedral shape and contains a 5350 Å(3) cavity and 12 open windows, facilitating effective trapping of both polar and nonpolar guest molecules. Protection of photosensitive guests against UV radiation is studied.

Lactoferrin inhibits apoptosis through insulin-like growth factor I in primary rat osteoblasts.

AIM: Excessive apoptosis of osteoblasts is the major cause of low bone mass, and bovine lactoferrin (bLF), an iron-binding glycoprotein, might protect osteoblastic cells from apoptosis induced by serum withdrawal. The aim of this study was to elucidate the mechanisms underlying the anti-apoptotic action of bLF in rat osteoblasts in vitro. METHODS: Primary rat osteoblasts were incubated in the presence of varying concentrations of bLF for 24 h. The expression of insulin-like growth factor I (IGF-I) and IGF-I receptor (IGF-IR) was measured uisng RT-PCR and Western blotting. Cell apoptosis was examined with flow cytometry. siRNAs targeting IGF-I was used in this study. RESULTS: Treatment of bLF (0.1-1000 µg/mL) dose-dependently increased the expression of IGF-I and IGF-IR in the osteoblasts. Treatment with bLF (10, 100 µg/mL) markedly inhibited the osteoblast apoptosis (with the rate of total apoptosis of 70% at 10 µg/mL), but the high concentration of bLF (1000 µg/mL) significantly promoted the osteoblast apoptosis. Knockdown of the IGF-I gene in osteoblasts with siRNA markedly increased the osteoblast apoptosis. CONCLUSION: Lactoferrin (10 and 100 µg/mL) effectively inhibits apoptosis of primary rat osteoblasts by upregulating IGF-I expression.

A multistimuli-responsive photochromic metal-organic gel.

A photochromic metal-organic gel with thermo-, photo-, and anion-responsive behavior is obtained. Unusually, heating of the Al-ligand solution leads to gel formation and cooling to room temperature reverses the process to reform the solution. The gel is sensitive to weakly coordinating anions. Additionally, reversible photochromic transformations take place both in the solution and gel states, accompanied by reversibly switched luminescence.

Nickel complexes with "click"-derived pyridyl-triazole ligands: weak intermolecular interactions and catalytic ethylene oligomerisation.

The ligands 1-(cyclohexyl)-4-(2-pyridyl)-1,2,3-triazole (1), 1-(2,6-diisopropylphenyl)-4-(2-pyridyl)-1,2,3-triazole (2), 1-(4-butoxyphenyl)-4-(2-pyridyl)-1,2,3-triazole (3) and 1-(methyl)-4-(2-pyridyl)-1,2,3-triazole (4) were synthesized by the Cu(I) catalyzed "Click" reaction between 2-pyridylacetylene and the corresponding azides. The ligands were then reacted with NiBr(2)·3H(2)O to generate the complexes (1)(2)NiBr(2) (1a), (2)(2)NiBr(2) (2a), (3)(2)NiBr(2) (3a) and (4)(2)NiBr(2) (4a). Structural characterization of 1a confirmed the mononuclear and distorted octahedral environment around the Ni(II) center, with the pyridyl-triazole ligands coordinating in a bis-chelating fashion. Bond length analysis inside the 1,2,3-triazole ring shows a short N=N double bond that is flanked by two longer C-N and N-N bonds pointing to the existence of "azo" character in the ring. The highly polar five-membered 1,2,3-triazole ring makes its C-H bond acidic, and these bonds participate in an extended weak intermolecular C-H···Br interactions with the Br-groups of neighboring molecules, resulting in a 3-D network. The nickel complexes with these "Click" ligands were tested as pre-catalysts for ethylene oligomerization, and the complexes showed moderate activity in that reaction with good selectivity towards C4 oligomers.

[8-hydroxy-dihydroberberine ameliorated insulin resistance induced by high FFA and high glucose in 3T3-L1 adipocytes].

The purpose of the study is to investigate the effect of 8-hydroxy-dihydroberberine on insulin resistance induced by high free fatty acid (FFA) and high glucose in 3T3-L1 adipocytes and its possible molecular mechanism. Palmic acid or glucose in combination with insulin was used to induce insulin resistance in 3T3-L1 adipocytes. 8-Hydroxy-dihydroberberine and berberine were added to the cultured medium separately, which were considered as treated group and positive control group. The rate of glucose uptake was determined by 2-deoxy-[3H]-D-glucose method. The amount of glucose consumption in the medium was measured by glucose oxidase method. Cell growth and proliferation of 3T3-L1 adipocytes were detected with Cell Counting Kit-8 (CCK-8) assay. After incubated with palmic acid for 24 hours or glucose with insulin for 18 hours, the rate of glucose transport in 3T3-L1 adipocytes was inhibited by 67% and 58%, respectively. The amount of glucose consumption in 3T3-L1 adipose cells was decreased by 41% after cells were incubated with palmic acid for 24 h. However, the above changes were reversed by pretreatment with 8-hydroxy-dihydroberberine for 24 and 48 h. Significant difference existed between groups. Insulin resistance in 3T3-L1 adipocytes, which is induced by high FFA and high glucose, could be ameliorated by 8-hydroxy-dihydroberberine.