Daily routine disruptions and psychiatric symptoms amid COVID-19: a systematic review and meta-analysis of data from 0.9 million individuals in 32 countries.

BACKGROUND: There is currently a deficit of knowledge about how to define, quantify, and measure different aspects of daily routine disruptions amid large-scale disasters like COVID-19, and which psychiatric symptoms were more related to the disruptions. This study aims to conduct a systematic review and meta-analysis on the probable positive associations between daily routine disruptions and mental disorders amid the COVID-19 pandemic and factors that moderated the associations. METHODS: PsycINFO, Web of Science, PubMed, and MEDLINE were systematically searched up to April 2023 (PROSPERO: CRD42023356846). Independent variables included regularity, change in frequency, and change in capability of different daily routines (i.e., physical activity, diet, sleep, social activities, leisure activities, work and studies, home activities, smoking, alcohol, combined multiple routines, unspecified generic routines). Dependent variables included symptoms and/or diagnoses of mental disorders (i.e., depression, anxiety, post-traumatic stress disorder, and general psychological distress). RESULTS: Fifty-three eligible studies (51 independent samples, 910,503 respondents) were conducted in five continents. Daily routine disruptions were positively associated with depressive symptoms (r = 0.13, 95% CI = [0.06; 0.20], p < 0.001), anxiety symptoms (r = 0.12, 95% CI = [0.06; 0.17], p < 0.001), and general psychological distress (r = 0.09, 95% CI = [0.02; 0.16], p = 0.02). The routine-symptom associations were significant for physical activity, eating, sleep, and smoking (i.e., type), routines that were defined and assessed on regularity and change in capability (i.e., definition and assessment), and routines that were not internet-based. While the positive associations remained consistent across different sociodemographics, they were stronger in geo-temporal contexts with greater pandemic severity, lower governmental economic support, and when the routine-symptom link was examined prospectively. CONCLUSIONS: This is one of the first meta-analytic evidence to show the positive association between daily routine disruptions and symptoms of mental disorders among large populations as COVID-19 dynamically unfolded across different geo-temporal contexts. Our findings highlight the priority of behavioral adjustment for enhancing population mental health in future large-scale disasters like COVID-19.

Savoring mediates the mental health benefits of positive coping processes: A prospective population-based analysis.

Positive coping (e.g., self-efficacy and positive reappraisal) and savoring could bear mental health implications under large-scale disasters such as COVID-19. The integrative affect-regulation framework of psychological resilience proposes that evaluative efforts regulate affect, which then predicts positive short-term consequences and better mental health. This two-wave study was done during the prolonged, intensive COVID-19 control rules in Hong Kong and examined (1) the prospective associations of positive coping processes (i.e., self-efficacy and positive reappraisal) (T1, March-August 2021) with subsequent psychiatric symptoms (T2, September 2021-February 2022) and (2) the mediating effect of T2 savoring in the associations. Path analyses revealed that T1 self-efficacy and positive reappraisal were inversely related to T2 psychiatric symptoms. T2 savoring partially mediated the effect of T1 self-efficacy but fully mediated the effect of T1 positive reappraisal. Self-efficacy could have more sustainable direct positive associations with mental health, whereas the benefit of positive reappraisal might need to be catalyzed by savoring over time. Our study offered concrete illustrations of the conceptual tenets of the affect-regulation framework.

Effects of mindfulness on stress, life satisfaction, and savoring beliefs among Hong Kong Chinese adolescents during the COVID-19 pandemic.

Adolescents all over the world are vulnerable in facing developmental challenges. Recent studies have evidenced that the unexpected interruptions of school learning during the COVID-19 pandemic have raised concerns about the well-being of adolescents. This present study sought to investigate the relationship between mindfulness, stress, savoring beliefs, and satisfaction of life among adolescents in Hong Kong during COVID-19. A total of 240 Hong Kong Chinese adolescents between 15 and 19 years of age (M = 15.60; SD = 0.70) from schools with different religious backgrounds completed an online survey. Findings from hierarchical linear regression indicated that statistically, mindfulness negatively predicted stress and positively predicted life satisfaction and savoring beliefs. Students with faiths did not show any significant differences in mindfulness and other variables in this study from students without faiths. In terms of implications, these findings provide positive evidence that mindfulness may be an important aspect for interventions designed to enhance life satisfaction and savoring beliefs, and reduce stress of adolescents over challenging times. Overall, this study suggests youth service providers to develop effective strategies in schools and communities for further promoting wellbeing and resilience of adolescents.

Predictors of linkage to hepatitis C virus care among people living with HIV with hepatitis C infection and the impact of loss to HIV follow-up.

Objective: Half of the people living with HIV (PLWH) with hepatitis C virus (HCV) remain untreated for HCV. We examined predictors of HCV linkage to care among PLWH and the impact of HIV lost to care. Design and methods: We conducted a retrospective review of PLWH/HCV from our HIV clinics between 2014 and 2017, and examined predictors of HCV linkage to care. We used the Kaplan-Meier method to estimate the probability of HIV retention and HCV linkage over time. Results: Of 615 PLWH/HCV, 34% linked to HCV care and 21% were cured. Higher odds of linkage to HCV care were among blacks (adjusted odds ratio [aOR]: 2.95, 95% confidence interval [CI]: 1.59, 5.47), prior injection drug users (IDUs; aOR: 2.89, 95% CI: 1.39, 6.01), Medicare (aOR: 3.09, 95% CI: 1.56, 6.11), and cirrhotics (aOR: 2.80, 95% CI: 1.52, 5.14). Reduced odds for linkage were in active IDU (aOR: 0.16, 95% CI: 0.05, 0.45) and those seen by an advanced practice provider (aOR: 0.53, 95% CI: 0.30, 0.92). The main reason for failure to link to HCV care was lost to HIV care. At 3 years, the overall probability of being retained in HIV care was 53%; among those who had an HCV evaluation visit, it was 75% vs. 41% with no HCV evaluation visit. Accounting for loss to follow-up, PLWH/HCV had a 65% probability of having an HCV evaluation at 3 years.

Toxoplasmosis Encephalitis: A Cross-Sectional Analysis at a U.S. Safety-Net Hospital in the Late cART Era.

Despite decreasing incidence of toxoplasmosis encephalitis(TE) among people living with HIV(PLWH) in the late antiretroviral era, U.S. safety-net hospitals still see significant numbers of admissions for TE. Little is known about this population, their healthcare utilization and long-term outcomes. We conducted an 8-year retrospective review of PLWH with TE at a safety-net hospital. Demographics, clinical characteristics, treatments, readmissions, and outcomes were collected. We used chi-squared test to evaluate 6-month all-cause readmission and demographic/clinical characteristics. Of 38 patients identified, 79% and 40% had a new diagnosis of TE and HIV respectively. 59% had 6-month all-cause readmission. Social factors were associated with readmission (uninsured (p = 0.036), Spanish as primary language (p = 0.017), non-adherence (p = 0.030)) and not markers of clinical severity (ICU admission, steroid-use, concomitant infections, therapeutic adverse events). Despite high readmission rates, at follow-up, 60% had a complete response, 30% had a partial response. Improving TE outcomes requires focus on culturally competent, coordinated care.

Sleep duration associated with body mass index among Chinese adults.

OBJECTIVE: The objective of this study was to investigate the relationship between sleep duration and obesity among Chinese adults. METHODS: A community-based cross-sectional study was conducted among Chinese adults in 2008. In total, 3225 participants were selected by a multistage cluster sampling method. Self-reported sleep duration was measured by a standardized questionnaire. Logistic regression models were used to estimate the odds ratios (ORs) (95% confidence intervals, CIs) of obesity with sleep duration, separated by gender, and adjusted for age, education, occupation, marriage, smoking, drinking, body pain, and health status. RESULTS: The mean sleep duration was 7.8 h. Among the 2962 participants, 7.2% had short sleep duration (≤6 h/day). There were 171 obese participants (5.7%) in this population. After adjustment for age, short sleep duration (<6 h) was significantly associated with obesity among men (OR: 2.15; 95% CI: 1.193.90), but not among women; additional adjustment for potential confounders did not attenuate the association among men. Increasing sleep duration (a continuous variable) was significantly and negatively associated with obesity in women after adjustment for education level, occupation, marital status, smoking, drinking, body pain, and health status. The adjusted OR per-hour increase in sleep duration was 0.74 (0.56-0.97) for obesity, suggesting that for a 1-h increase in sleep duration among women, obesity risk decreased by 26%. CONCLUSION: Short sleep duration was associated with increasing obesity in Chinese men, and sleep duration was associated with obesity in Chinese women, although the underlying mechanism is unclear. This possible gender difference warrants further studies.

Sleep duration and quality among different occupations--China national study.

OBJECTIVE: To examine the associations between occupation, sleep duration and sleep quality. METHODS: The data for this study was extracted from data collected from the 2008 Chinese Sub-optimal Health Study. Our study sample consisted of 18,316 Chinese subjects aged 18-65. Occupation and other relevant characteristics to sleep were collected. We used the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality and multiple logistic regression models to examine the association of occupation with shortened sleep duration and poor sleep quality. RESULTS: Farmers had the longest sleep duration (mean=8.22 hours) while the civil servants had the shortest sleep duration (mean=7.85 hours). Farmers also had the best sleep quality (mean score=3.74) while professional workers had the worst sleep quality (mean score=4.87). Compared to civil servants, the OR of shortened sleep duration and poor sleep quality for blue collar workers is 1.39 (95%CI: 1.11-1.73) and 1.28 (95%-CI: 1.15-1.42), respectively, after adjusting for age, sex, marital status, education, area, smoking, drinking, pain, and health status. CONCLUSION: sleep duration and quality varied among different Chinese occupation populations. The blue collar workers are more likely to have shortened sleep duration and poor sleep quality.

Serum cystatin C level is associated with carotid intima-media thickening and plaque.

BACKGROUND AND AIM: Chronic kidney disease has recently been shown to be a major risk factor for cardiovascular disease and carotid intima-media thickness has been widely used as a biomarker for early detection of cardiovascular disease. The aim of this study was to confirm whether carotid thickening and carotid plaque are associated with preclinical chronic kidney disease in individuals without clinical cardiovascular disease and chronic kidney disease. MATERIAL AND METHODS: We conducted a cross-sectional study on participants from Maanshan City, China. All participants underwent carotid ultrasonography. Kidney function was measured using cystatin C, serum creatinine, blood urea nitrogen and blood uric acid. Demographics and risk factors for cardiovascular diseases were obtained from each participant. RESULTS: A total of 927 subjects were surveyed; 453 (48.87%) were men and 474 (51.13%) were women. A total of 525 (56.63%) of the participants were found to have carotid thickening of which 281 (53.52%) were men and 244 (46.48%) were women. Kidney function was strongly associated with carotid thickening and plaque in the unadjusted analysis. However, cystatin C was the only measure of kidney function that was significantly associated with carotid thickening and plaque in the adjusted analysis (in order to select risk factors from sex, age, BMI, hypertension, diabetes, smoking, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, apolipoprotein A, apolipoprotein B, cystatin C, creatinine, blood urea nitrogen, blood uric, estimated GFR). CONCLUSION: Cystatin C, an alternative measure of kidney function, was more strongly associated with carotid thickening and plaque than other measures of kidney function.

The impact of temperature and humidity measures on influenza A (H7N9) outbreaks-evidence from China.

OBJECTIVES: To examine the non-linear effects of meteorological factors on the incidence of influenza A H7N9 and to determine what meteorological measure, and on which day preceding symptom onset, has the most significant effect on H7N9 infection. METHODS: We applied a zero truncated Poisson regression model incorporating smoothed spline functions to assess the non-linear effect of temperature (maximum, minimum, and daily difference) and relative humidity on H7N9 human case numbers occurring in China from February 19, 2013 to February 18, 2014, adjusting for the effects of age and gender. RESULTS: Both daily minimum and daily maximum temperature contributed significantly to human infection with the influenza A H7N9 virus. Models incorporating the non-linear effect of minimum or maximum temperature on day 13 prior to disease onset were found to have the best predictive ability. For minimum temperature, high risk was found to range from approximately 5 to 9°C and moderate risk from -10 to 0°C; temperatures of >9°C represented a low risk. For maximum temperature, high risk was found to range from approximately 13 to 18°C and moderate risk from 0 to 4°C; temperatures of >18°C represented a low risk. Relative humidity was not significantly associated with the incidence of infection. The incidence of H7N9 was higher for males compared to females (p<0.01) and it peaked at around 60-70 years of age. CONCLUSIONS: We provide direct evidence to support the role of climate conditions in the spread of H7N9 and thereby address a critical question fundamental to our understanding of the epidemiology and evolution of H7N9. These findings could be used to inform targeted surveillance and control efforts aimed at reducing the future spread of H7N9.

Assessing consistency in oral health-related quality of life (OHRQoL) across gender and stability of OHRQoL over time for adolescents using Structural Equation Modeling.

BACKGROUND: The Child Perceptions Questionnaire for children aged 11-14 years (CPQ(11-14) ) was developed in Toronto as a measure of the oral health-related quality of life (OHRQoL) for children/adolescents. The short form with eight items (RSF:8) was also derived. OBJECTIVES: (i) To investigate the consistency of RSF:8 in measuring the OHRQoL between boys and girls, (ii) to investigate the measurement invariance and stability of RSF:8 in measuring OHRQoL for Hong Kong adolescents over time, and (iii) to determine the latent mean differences across gender and over time. METHODS: The instrument was administered to 542 adolescents aged 12 years and re-administered to the same group of adolescents 3 years later. Structural Equation Modeling (SEM) was used to test the measurement invariance at different levels. A series of hierarchically nested models (configural structure, factor loadings, error variances, factor variances and covariance, intercept invariance) were tested by the chi-square difference tests, and the more restricted model would be accepted if the chi-square difference test was insignificant (P > 0.05). The latent means would be estimated if intercept invariance was not accepted. The stability of OHRQoL over time was investigated by computing the stability coefficients. RESULTS: For multiple group analysis, the model with the level of invariance up to factor variances and covariance was accepted (P > 0.05). The latent mean of girls was significantly lower (indicating better OHRQoL) than boys in social well-being (SWB). For panel data analysis, the model with the level of invariance up to factor variances and covariance was accepted (P > 0.05). The latent mean of the four domains decreased significantly (indicating improved OHRQoL) for adolescents aged 12-15 years. The stability coefficients ranged from 0.14 to 0.73 which demonstrated moderate stability except functional limitation (FL) with a relatively low stability. CONCLUSION: This study indicated that RSF:8 measured OHRQoL for adolescents in Hong Kong consistently across gender. The OHRQoL in SWB for girls was better than boys. Also, the OHRQoL for adolescents was in the same factor structure with moderate stability and improved significantly over time.

Confirmatory factor analysis on the health domains of the Child Perceptions Questionnaire.

BACKGROUND: The Child Perceptions Questionnaire for children aged 11-14 years (CPQ(11-14)) with 37 items (full questionnaire) and short forms with 16 and 8 items were developed in Toronto as measures of the oral-health-related quality of life (OHRQoL) for children. OBJECTIVES: To confirm the four hypothesized health domains (oral symptoms, functional limitations, emotional well-being and social well-being) of CPQ(11-14) in measuring OHRQoL for children in Hong Kong. METHODS: The instrument was administered to 542 children aged 12 years. Confirmatory factor analysis (CFA) was used to confirm the health domains of the full and short forms of CPQ(11-14). RESULTS: The usual goodness-of-fit measurements indicated that the model using all 37 items fitted the data below the acceptable level, while the models with 16 items and 8 items fitted the data well. CONCLUSION: The hypothesized factor structure with the four health domains of the short forms of CPQ(11-14) has been confirmed by CFA. The results in the current study indicated that the items used in the short forms contain sufficient information in measuring OHRQoL for children in Hong Kong.

Mutational analysis of 65 Wilson disease patients in Hong Kong Chinese: identification of 17 novel mutations and its genetic heterogeneity.

Wilson disease (WD), an autosomal recessive disorder of copper transport, is the most common inherited liver disorder in Hong Kong Chinese. This was the first local study to elucidate the molecular basis and establish an effective DNA-based diagnostic protocol. The ATP7B genes of 65 patients were amplified by polymerase chain reaction (PCR) and sequenced. Haplotype analysis was performed using D13S301, D13S314, and D13S316. The p.L770L/p.R778L status in 660 subjects was determined to estimate WD prevalence. Allele age of p.R778L was determined by the smallest homozygosity region between D13S301 and D13S270. We identified 42 different mutations with 17 being novel. p.R778L (17.3%) was the most prevalent. Exons 2, 8, 12, 13, and 16 harbored 70% mutations. Thirty-two haplotypes were associated with WD chromosomes. The estimated prevalence rate was 1 in 5,400. Three out of 660 normal subjects had p.L770L/p.R778L. In the remaining 657 individuals, neither p.L770L nor p.R778L was found. We characterized a Hong Kong Chinese-specific ATP7B mutation spectrum with great genetic diversity. Exons 2, 8, 12, 13, and 16 should be screened first. The perfect linkage disequilibrium suggested that p.R778L and its private polymorphism p.L770L originated from a single ancestor. This East-Asian-specific mutation p.R778L/p.L770L is aged at least 5,500 years.

Erratum to: Mutational analysis of 65 Wilson disease patients in Hong Kong Chinese: Identification of 17 novel mutations and its genetic heterogeneity.

The correct name of the eighth author should be given as Sik-To Lai, not Jak-Yiu Lai.

Abnormal expressions of the subunits of the UDP-N-acetylglucosamine: lysosomal enzyme, N-acetylglucosamine-1-phosphotransferase, result in the formation of cytoplasmic vacuoles resembling those of the I-cells.

Defects in the multimeric enzyme, UDP-N-acetylglucosamine:lysosomal enzyme N-acetylglucosamine-1-phosphotransferase (GNPT), result in the diseases of mucolipidosis (ML). This enzyme generates the mannose 6-phosphate residues on newly synthesized lysosomal enzymes for the efficient receptor-mediated transport to lysosomes. The enzyme contains alpha/beta and gamma subunits. Mutations in the alpha/beta subunit result in the classical ML II and IIIA, while defects in the gamma subunit results in the clinically milder ML IIIC. I-cells, a distinct histological feature characterized by the presence of abnormal cytoplasmic vacuoles, are detected in many cell types, most noticeably, in ML II patients. In this study, we investigated the interactions of the alpha/beta and gamma subunits in the pathogenesis of I-cells. We noted low and deranged alpha/beta subunit expressions in human mucolipidosis cell lines. Unexpectedly, high gamma subunit expressions were also observed. In normal mouse fibroblasts, when alpha/beta subunit was suppressed, abnormal cytoplasmic vacuoles were induced, and up-regulation of the gamma subunit was also observed. On the other hand, suppressing the gamma subunit resulted in biphasic responses of the alpha/beta subunit, while abnormal cytoplasmic vacuoles were not formed, regardless of the expression levels of the alpha/beta subunit. Our data suggest reciprocal feedback mechanisms between alpha/beta and the gamma subunits. A fine balance of the expressions of these subunits may play an important role in the formation of I-cells in this group of lysosomal storage disorders.