Associations between eHealth literacy, mental health-seeking attitude, and mental wellbeing among young electronic media users in China during the COVID-19 pandemic.

Objective: This study aimed to examine the associations among mental health related eHealth literacy (eHL), mental health-seeking attitude, and wellbeing among Chinese young electronic media users during the COVID-19 pandemic. Methods: A web-based cross-sectional survey was conducted in Guangzhou, China. The modified eHealth literacy Scale, Mental Help-Seeking Attitudes Scale, and Short Warwick-Edinburgh Mental Wellbeing Scale were used. Structural equation modeling (SEM) examined the associations between them and was adjusted by several controlled variables. Results: Totally, 1,008 participants completed the questionnaire and provided valid responses. The eHL showed a statistically significant and direct effect on mental wellbeing in this sample. The higher the level of eHL, the better wellbeing of the participants. The mental health-seeking attitude is also positively correlated with mental wellbeing, indicating that the more positive attitude toward seeking mental health services, the better the wellbeing participants reported. The higher level of eHL is significantly associated with a more positive attitude toward seeking mental health services. Conclusion: Training to improve eHL may optimize young electronic media users' mental health outcomes. Development and use of a mental health specific eHL instrument in future studies should be encouraged.

The relationship between COVID-19-related prevention cognition and healthy lifestyle behaviors among university students: Mediated by e-health literacy and self-efficacy.

BACKGROUND: At present, few studies have explored the mediating effect of e-Health literacy and self-efficacy on prevention cognition and healthy lifestyle behaviors during the normalization stage of COVID-19 prevention and control. This study aimed to determine the associations among COVID-19-related prevention cognition, self-efficacy, e-Health literacy, and healthy lifestyle behaviors at university students. METHODS: By using a stratified cluster random sampling method, 971 students from five universities were recruited between May and August 2021 in Guangzhou, China. We collected participants' demographic characteristics, and assessed self-efficacy, COVID-19-related prevention cognition, e-Health literacy, and healthy lifestyle behaviors. A structural equation model was used for mediation analysis. RESULTS: The overall mean value of healthy lifestyle behaviors of college students was 0.307 (SD 0.389). Between COVID-19-related prevention cognition, e-Health literacy, self-efficacy, and healthy lifestyle behaviors (r = 0.132-0.505, P < 0.01) were a significant positive correlation. The COVID-19-related prevention cognition had a direct and positive predictive effect on healthy lifestyle behaviors, with a direct effect value of 0.136. e-Health literacy and self-efficacy played both an independent mediating and serial-multiple mediating roles in the association between COVID-19-related prevention cognition and healthy lifestyle behaviors, and the indirect effect values were 0.043, 0.020 and 0.035, respectively. CONCLUSIONS: The results showed that the emphasis on improving college students' prevention cognition, supplemented by improving e-Health literacy and self-efficacy, could improve college students' healthy lifestyle behaviors. LIMITATIONS: This study was a cross-sectional investigation with no causal relationship between variables.

Distributive Justice and Turnover Intention Among Medical Staff in Shenzhen, China: The Mediating Effects of Organizational Commitment and Work Engagement.

Background: Turnover of medical staff is a vital issue in the global healthcare system. Previous evidence has confirmed the critical effect of distributive justice on turnover intention, but few studies have focused on the mediating mechanism behind this relationship or the medical staff. This study aimed to examine the mediating roles of organizational commitment and work engagement in the relationship between distributive justice and turnover intention of medical staff, and explore potential occupational differences. Methods: Stratified random sampling was adopted to select qualified medical staff from each clinical department of a large general hospital in Shenzhen, China, at a physician-to-nurse ratio of 1:1.5. The medical staff were surveyed using the Distributive Justice Scale, the Organizational Commitment Scale, the Work Engagement Scale, and the Turnover Intention Scale from May to July 2020. Of the 500 medical staff sampled, 480 responded (response rate: 96.00%), and 457 were finally included for analysis (effective response rate: 95.21%). A mediation analysis was performed using Model 6 of the SPSS macro PROCESS program. Results: There were significant positive correlations among distributive justice, organizational commitment, and work engagement and significant negative correlations among distributive justice, organizational commitment, work engagement, and turnover intention. Distributive justice directly and negatively affected the turnover intention of physicians and nurses, but there were occupational differences in the underlying mechanism between distributive justice and turnover intention. Distributive justice indirectly affected turnover intention among physicians mainly through the mediating effect of organizational commitment, and indirectly among nurses through three different pathways: the mediating effect of organizational commitment, the mediating effect of work engagement, and the chain mediating effect of organizational commitment and work engagement. Conclusion: The relationship between distributive justice and turnover intention was found to be mediated by organizational commitment and work engagement among medical staff in Shenzhen, with variations between physicians and nurses. Thus, appropriately targeted interventions are needed for physicians and nurses to reduce turnover intention.

Leukocyte Telomere Length Shortening Implies Plaque Instability and Major Adverse Cardiovascular Events in Patients With Angiographically Intermediate Lesions.

BACKGROUND: Telomere shortening, an indicator of aging, is associated with age-related diseases. This study aims to investigate the association between leukocyte telomere length (LTL) and thin-capped fibroatheromata (TCFA) and the impact of using LTL cutoff to determine the incidence of major adverse cardiovascular events (MACEs) in patients with angiographically intermediate coronary lesions. METHODS: This was a signal-center retrospective study focusing on patients who underwent coronary angiography and optical coherence tomography (OCT). The degree of coronary stenosis was assessed by angiography. The presence of TCFA was determined by OCT imaging. A total of 156 patients with angiographically intermediate coronary lesions were enrolled. RESULTS: Leukocyte telomere lengths were significantly shorter in the TCFA group compared with non-TCFA group [11.95 (10.56, 15.21) kb vs. 13.81 (12.06, 16.11) kb, p = 0.003]. The short-LTL group and long-LTL group were divided according to the optimal cut-off value which was determined by the receiver operating characteristic (ROC) curve analysis. Logistic regression model revealed that short-LTL was independently associated with TCFA incidence (odds ratio [OR] 4.387, 95% CI: 1.902-10.120, p = 0.001) after adjusting for confounding factors. Over a 24-months follow-up, the MACE incidence among patients with short-LTL was significantly higher than those in the long-LTL group (12.5 vs. 2.0%, p = 0.006 by log-rank test). Multivariable cox regression analysis indicated that short-LTL (hazard ratio [HR] 9.716, 95% CI: 1.995-47.319, p = 0.005) was an independent prognostic factor of MACE incidence in angiographically intermediate coronary lesions patients. CONCLUSIONS: Short-LTL was independently associated with the incidence of TCFA and may serve as a prognostic factor for MACE risk on top of conventional risk factors.

Design, synthesis and biological evaluation of novel fluoro-substituted benzimidazole derivatives with anti-hypertension activities.

A series of new fluoro-substituted benzimidazole derivatives were designed, synthesized and pharmacologically evaluated. All the target compounds were characterized by 1HNMR, 13CNMR, mass spectra and elemental analysis. The biological evaluation showed that most of the synthesized compounds displayed nanomolar affinity to the angiotensin II type 1 (AT1) receptor and could decrease blood pressure efficiently in spontaneously hypertensive rats. The maximal response of mean blood pressure (MBP) lowered 74.5 ± 3.5 mmHg (1g) and 69.2 ± 0.9 mmHg (2a) at 10 g/kg after oral administration, and the antihypertensive effect lasted beyond 24 h, which performed better than both losartan and telmisartan. So, compounds 1g and 2a may be considered as potential antihypertension drug candidates.

Design, Synthesis, and Biological Evaluation of 6-Benzoxazole Benzimidazole Derivatives with Antihypertension Activities.

A series of new angiotensin II receptor 1 antagonists were prepared. They displayed nanomolar affinity to AT1 receptor and could decrease blood pressure efficiently in spontaneously hypertensive rats. Among them, compounds 1b and 2b could reduce the blood pressure with more or equal potency compared to Losartan. So, compounds 1b and 2b could be considered as potential antihypertension drug candidates.

Design, synthesis, and pharmacological evaluation of 5-oxo-1,2,4-oxadiazole derivatives as AT1 antagonists with antihypertension activities.

A series of new 5-oxo-1,2,4-oxadiazole derivatives with 1, 4-disubsituted or 1, 5-disubsituted indole group was designed, synthesized, and pharmacologically evaluated. These derivatives displayed high affinities to the AT1 receptor at the same order of magnitude to losartan. The methyl ester with 1, 4-disubsituted indole group, 1 (5.01 ± 1.67 nM) showed high antihypertension activity on spontaneously hypertensive rats (SHRs). Its maximal response lowered 30 mmHg of mean blood pressure (MBP) at 10 mg/kg after oral administration, which was better than irbesartan, and the antihypertensive effect lasted beyond 24 h. These results made 1 deserve further investigation.

Design, synthesis and evaluation of novel potent angiotensin II receptor 1 antagonists.

A series of new angiotensin II (Ang II) receptor 1 antagonists were designed, synthesized and evaluated. All compounds showed nanomolar affinities for the angiotensin II type 1 receptor in radioligand binding assays and could reduce blood pressure significantly in spontaneously hypertensive rats(SHRs). From which, compound 2b displayed higher affinity binding to angiotensin II type 1 receptor at the same order of magnitude to irbesartan with an IC50 value of 1.26 ± 0.08 nM in radioligand binding assays. 2b showed an efficient and long-lasting effect in reducing blood pressure, the maximal reducing responses were 40.62 ± 4.08 mmHg of MBP at 15 mg/kg and 28.39 ± 2.09 mmHg at 10 mg/kg in SHRs, 39.56 ± 4.83 mmHg at 15 mg/kg and 29.05 ± 2.20 mmHg at 10 mg/kg in RHRs, the significant antihypertensive effect lasted beyond 12 h both in SHRs and in RHRs. In the single-dose pharmacokinetic experiments, compound 2b could be absorbed efficiently and metabolized smoothly in Wistar rats after oral administration. The values of Cmax, Tmax, AUC0-72 and MRT0-72 were 885.61 ± 432.7 ng/mL, 5.67 ± 1.51 h, 6110.28 ± 7398.33 ng/mL h and 7.87 ± 2.30 h at 10 mg/kg, 2945.55 ± 1543.67 ng/mL, 4.33 ± 0.82 h, 26473.62 ± 12217.16 ng/mL h and 10.24 ± 6.94 h at 15 mg/kg, 5759.03 ± 1331.75 ng/mL, 5 ± 1.10 h, 89488.44 ± 18413.15 ng/mL·h and 12.89 ± 2.0 h at 30 mg/kg respectively. The T1/2 values of the three groups were similar, about 9-10 h. Compound 2b was distributed into tissues rapidly and extensively after oral administration. The level of it was the highest in the liver, followed by in spleen, kidney, and the lowest in brain. The acute toxicity assays of 2b proved its low acute toxicity with an LD50 value of 1551.71 mg/kg, and no toxicity reaction appeared at dose of 1200.00 mg/kg. These encouraging results make compound 2b an effective, long-lasting and safe anti-hypertensive drug candidate and worthy of further investigation.

Synthesis and evaluation of novel angiotensin II receptor 1 antagonists as anti-hypertension drugs.

Three new angiotensin II receptor 1 antagonists, 1, 2 and 3 were designed, synthesized and evaluated. The AT1 receptor-binding assays in vitro showed that all the synthesized compounds had nanomolar affinity for the AT1 receptor. From which compound 3 was found to be the most potent ligands with an IC50 value of 2.67±0.23 nM. Biological evaluation in vivo revealed that all the compounds could cause significant decrease on MBP in a dose dependent manner in spontaneously hypertensive rats, and compound 3 especially showed an efficient and long-lasting effect in reducing blood pressure, whose maximal response lowered 41 mmHg of MBP at 10mg/kg and 62 mmHg at 15 mg/kg after oral administration, the significant anti-hypertensive effect lasted beyond 12 h, which is better than the reference compound losartan. The pharmacokinetic experiments showed that compound 3 could be absorbed efficiently and metabolized smoothly both in blood and in tissues in Wistar rats. The acute toxicity assay suggested that it has low toxicity with the LD50 value of 2974.35 mg/kg. These results demonstrate that compound 3 is a potent angiotensin AT1 receptor antagonist which could be considered as a novel anti-hypertension candidate and deserved for further investigation.

N-Phenyl indole derivatives as AT1 antagonists with anti-hypertension activities: Design, synthesis and biological evaluation.

The design, synthesis, in vitro and in vivo evaluation of 6-substituted benzimidazole with 1, 4-disubsituted or 1, 5-disubsituted indole derivatives as novel angiotensin II receptor antagonists are outlined. Radioligand binding assays showed that several 6-substituted benzimidazole derivatives displayed high affinities binding to the angiotensin II type 1 receptor at the same order of magnitude to telmisartan. The biological evaluation on spontaneously hypertensive rats showed that 2-[4-[[2-n-propyl-4-methyl-6-(1-methylbenzimidazol-2-yl)benzimidazole-1-yl]methyl]-1H-indol-1-yl]benzoic acid, 1c, could cause significant decrease on MBP in a dose dependent manner. Its maximal response lowered 53 mmHg of MBP at 5 mg/kg and 64 mmHg of MBP at 10 mg/kg after oral administration, and the significant antihypertensive effect lasted beyond 24 h, which was better than both losartan and telmisartan. A study designed to determine acute toxicity showed that 1c had low acute toxicity with no significant changes in the weight and no obvious untoward reactions. The encouraging results make 1c an effective and durable anti-hypertension drug candidate and deserve further investigation for therapeutic application.

Synthesis and pharmacological evaluation of a novel AT1 angiotensin II receptor antagonist with anti-hypertension and anti-tumor effects.

A new compound 2-(4-((2-butyl-5-nitro-1H-benzo[d]imidazol-1-yl)methyl)-1H-indol-1-yl) benzamide (1) was designed, synthesized and evaluated as a novel AT1 receptor antagonist. Compound 1 displayed high affinity to AT1 receptor with an IC50 value of 1.65 ± 0.2 nM in radio-ligand binding assays. It had an efficient and long-lasting effect in reducing blood pressure which could last for more than 12 h at the dose of 10 mg/kg in spontaneously hypertensive rats. Acute toxicity tests suggested that compound 1 was safe with the LD50 value of 2519.81 mg/kg. Besides, in vitro and in vivo tests suggested its anti-proliferative and anti-tumor activities, respectively. So compound 1 could be considered as a novel anti-hypertension, anti-tumor candidate and deserved further investigation.