Prevalence and correlates of psychological distress in the front-line anti-epidemic medical staff during the COVID-19 outbreak in Wuhan.

BACKGROUND: Since the outbreak of the novel coronavirus disease 2019 (COVID-19), medical staff and affiliated healthcare staff are under both physical and psychological pressures. Due to this serious situation, it is extremely important to assess the prevalence and possible predictors of psychological distress in front-line, anti-epidemic medical staff. METHODS: A cross-sectional study was conducted through the use of the network crowdsourcing platform (which provides functions equivalent to Amazon Mechanical Turk) in Jilin, China. A total of 725 Jilin medical staff who had returned from Wuhan participated in the survey. The collected data included demographics and psychological responses to COVID-19, and the following tests were used to measure the data: (I) the Social Support Rate Scale (SSRS) was used to measure the types and levels of social support that were received by the medical staff; (II) the Stanford Acute Stress Reaction Questionnaire (SASRQ) was used to evaluate anxiety and dissociation symptoms in the aftermath of traumatic events; (III) the Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality; and (IV) the Kessler Psychological Distress Scale (K10) was used to evaluate nonspecific psychological distress. The χ2 test, Kruskal-Wallis test, ANOVA test and binary logistic regression were used to identify the factors that were correlated with psychological distress. RESULTS: In our study, 475 (65.5%) participants reported low psychological distress, and 72 (10%) participants reported high psychological distress. The results of the binary logistic regression analysis identified that the performance of physical activity in Wuhan (ß=-0.585; P<0.001; OR =0.557) and years of work experience (in contrast to approximately 0-5 years, approximately 6-15 years: ß=-1.258; P=0.008; OR =0.284, >15 years: ß=-0.562; P=0.016; OR =0.570) were protective factors for the possibility of having a mental disorder, whereas a high PSQI score (ß=0.106; P=0.024; OR =1.112) and a high SASRQ score (ß=0.242; P<0.001; OR =1.274) were risk factors. CONCLUSIONS: The high psychological distress (10%) of Jilin medical staff who returned from the front-line areas of Wuhan was higher than that in other studies. Medical staff with less physical activity and work experience in Wuhan, as well as high PSQI and SASRQ scores, had higher psychological distress.

The association of depression with use of prescription drugs in adults with noncommunicable diseases: Based on NHANES in 2005-2016.

BACKGROUND: It is not clear how the noncommunicable diseases (NCDs) performed in the association of depression with use of prescription drugs. METHODS: This cross-sectional study involved 20,836 participants with at least one NCDs who aged over 20 years old in the National Health and Nutrition Examination Survey (NHANES) from 2005-2016. Ordinal logistic regression under complex sampling was used to examine the association of depression with use of prescription drugs in patients with different categories of NCDs. RESULT: Among patients with respiratory diseases (OR: 1.41, 95% CI: 1.13-1.76), genitourinary diseases (OR: 1.59, 95% CI: 1.28-1.98), and cardiovascular diseases (OR: 1.43, 95% CI: 1.27-1.60), the risk of depression was higher among those who used prescription drugs than those who did not. The results showed that the association of depression with use of prescription drugs was significantly stronger, especially in patients with genitourinary diseases ≥65 years of age (OR: 1.91, 95% CI: 1.01-3.61). Trend analysis showed that the categories of prescription drugs used and the risk of depression was significantly statistically different (P for trend <0.001). LIMITATIONS: Self-reported prevalence of depression may differ from actual prevalence of depression. The categories of NCDs studied in this article are limited and the association between specific drugs and depression is not analyzed. CONCLUSIONS: In patients with NCDs, use of prescription drugs increased the risk of depression, and this risk increased significantly, especially in patients with genitourinary diseases who aged over 65 years. The risk of depression was increasing with the categories of prescription drugs used.

The Effect of Residential Environment on Respiratory Diseases and Pulmonary Function in Children from a Community in Jilin Province of China.

PURPOSE: Respiratory disease is a major and increasingly global epidemic that has a great impact on humans, especially children. The purpose of this study was to identify environmental risk factors for respiratory diseases and pulmonary function in children. PATIENTS AND METHODS: A population-based, cross-sectional survey of respiratory diseases and environmental risk factors was conducted in Jilin Province, China. Complete questionnaire information was available for 2419 children, while adequate pulmonary function data were available for a subgroup of 627 children. RESULTS: Our study found that environmental risk factors for respiratory health in children were mainly concentrated indoors. After adjusting for demographic factors, insecticide exposure and passive smoking were risk factors for respiratory disease and industrial pollutant sources, insecticide exposure and the use of a fume exhauster may be independent risk factors for recurrent respiratory infections. The main fuel for cooking in the winter and passive smoking were the main influencing factors of pulmonary function indicators. CONCLUSION: The primary risk factors differ in different respiratory diseases. Passive smoking remains a critical adverse factor for respiratory illness and pulmonary function in children, and it is important to reduce children's exposure to passive smoking to increase pulmonary health. Insecticide exposure may be a neglected environmental risk factor, and further investigations are still needed to explore the relationship and mechanisms between insecticide exposure and children's respiratory health.

The Effects of Metal Exposures on Charlson Comorbidity Index Using Zero-Inflated Negative Binomial Regression Model: NHANES 2011-2016.

BACKGROUND: With the rising incidence of chronic diseases, and the increase of aging population has led to multimorbidity a serious public health problem. The aim of this study was to explore the association between metal exposures and Charlson comorbidity index (CCI), which will provide valuable information for improving quality of life and reducing mortality. METHODS: The study sample consists of three continuous cycles (2011-2016) of the National Health and Nutrition Examination Survey (NHANES), and 4901 eligible subjects were included in the study. Zero-inflated negative binomial (ZINB) model was utilized to investigate the effects in metal exposures on CCI, which includes spot urine (arsenic, mercury, and cadmium), whole blood (manganese, selenium, and lead), and serum (copper and zinc). RESULTS: In count part (CCI ≥ 0), holding other variables constant, the expected change in CCI for a one-unit increase in blood selenium is 0.997 (RR = 0.997, p = 0.017). In logit part (CCI = 0), the log odds of having CCI equals zero would increase by 0.659, 1.073, and 0.963 for every additional urinary cadmium (OR = 0.659, p = 0.007), blood lead (OR = 1.073, p = 0.023), blood manganese (OR = 0.963, p = 0.025), respectively. CONCLUSIONS: Our findings indicated that cadmium and manganese were likely to increase mortality. Inversely, selenium and lead might be positive on people's health. The findings may be extremely essential for preventing diseases and improving life quality.

A meta-analysis: Does vitamin D play a promising role in sleep disorders?

BACKGROUND: Sleep disorders, one of the most common problems in the general population, have been related to a series of harmful health consequences. Vitamin D appears to be associated with sleep disorders. However, the difference in vitamin D levels between sleep disorder subjects and people without a sleep disorder is unclear. Simultaneously, the influence of vitamin D replenishment on sleep disorders remains controversial. METHODS: PubMed, MEDLINE, Web of Science, and Cochrane Library were searched for literatures published until October 2019. Using a random effects model, a meta-analysis was conducted to calculate the standard mean difference to evaluate the difference in vitamin D concentrations between sleep disorder subjects and normal people and the efficacy of vitamin D supplementation on sleep disorders. RESULTS: Our study found that the serum vitamin D levels in the sleep disorder subjects were lower than that in the normal people (SMD = -0.75 ng/ml, 95% CI = -0.93, -0.57 ng/ml). Moreover, the Pittsburgh Sleep Quality Index (PSQI)in the subjects with vitamin D supplementation was lower than that in the controls (SMD = -0.45, 95% CI = -0.76, -0.13). CONCLUSIONS: Vitamin D could play a promising role in sleep disorders. More data are required to confirm the efficacy of vitamin D supplementation for improving sleep disorders.

Incidence trend and age-period-cohort analysis of reported hepatitis C among residents aged 30 to 79 in northeastern China, 2008 to 2017.

The purpose of this study was to acquire the epidemic trend of age-standardized reported incidence and to analyze the age effect, period effect, and cohort effect on the reported incidence of hepatitis C in Jilin Province, China.We collected the annual reported incidence data of hepatitis C by gender (2008-2017). Annual percentage change and annual average percentage change were calculated by joinpoint Poisson regression analysis. The age effect, period effect, and cohort effect on the incidence of hepatitis C were estimated by an age-period-cohort model, and the relative risk was determined.Joinpoint regression analysis showed that the age-standardized reported incidence of hepatitis C indicated a declining trend integrally. Among people aged 30 to 44 (youth), the incidence trend declined the fastest, while trends declined the slowest among women and the overall population aged over 66 (elderly people) and men aged 45 to 65 (middle-aged group). The results of the age-period-cohort model showed that the reported incidence increased first and then decreased with age. Throughout the period, the risk of hepatitis C also increased first and then decreased. Compared with the median birth cohort of the same age group, the birth cohort of the patients with the highest incidence of hepatitis C was in the 1930s, followed by the 1940s and 1950s. The birth cohort of the patients with the lowest incidence was in the 1980s, followed by the 1970s and 1960s.Although the overall reported incidence trend of hepatitis C is declining and the risk of the young birth cohort is low, many factors affecting infection and testing with hepatitis C still exist in China. We should focus on high-risk population management and formulate corresponding public health strategies to accelerate the implementation of the global health strategy to eliminate hepatitis C published by the World Health Organization.

Association between dietary mineral nutrient intake, body mass index, and waist circumference in U.S. adults using quantile regression analysis NHANES 2007-2014.

OBJECTIVE: Mineral nutrients play an important role in maintaining material and energy metabolism. Reports on mineral nutrient intakes and body mass index (BMI) and waist circumference (WC) are rare in the United States. This study examined the relationship between BMI, WC and dietary mineral intakes. METHOD: We used the data from National Health and Nutrition Examination Survey 2007-2014. Nutrient intakes were adjusted for energy according to the residual adjustment method. We used the quantile regression model to analyze the relationship between BMI, WC under different distributions and the average daily mineral intakes. RESULT: A total of 19,952 people were included in the study, including 9,879 men and 10,073 women (≥20 years old). The median BMI was 27.935 kg/m2 and the median WC was 97.700 cm. The results of quantile regression showed that calcium, magnesium, potassium, copper, zinc and iron intakes were negatively correlated with BMI and WC, after adjusting for age and gender. Sodium and phosphorus intakes were positively correlated with BMI, sodium intakes were positively correlated with WC. This correlation was enhanced with increasing quantiles of risk levels. In high BMI or high WC populations, mineral intakes had a greater impact on BMI and WC. The quantile regression coefficients of selenium intakes were not statistically significant at each quantile. CONCLUSION: Our results suggested that the mineral nutrient intakes were associated with BMI and WC in American adults. However, we also need to further study the longitudinal effects of mineral intakes and obesity.

Effects of fasting intervention regulating anthropometric and metabolic parameters in subjects with overweight or obesity: a systematic review and meta-analysis.

BACKGROUND: Previous studies have shown that fasting produces a potential effect in the prevention and treatment of many diseases. However, the role of fasting in people with overweight or obesity remains controversial. The aim of this study was to assess the intervention of fasting in the regulation of anthropometric and metabolic parameters of subjects with overweight or obesity. METHODS: The PubMed, Cochrane library, Web of science and EMBASE databases were searched from the inception dates to October 2019, identifying published literature evaluating the effect of fasting intervention on the people with overweight or obesity. RESULTS: Twenty-five studies with 1358 participants with overweight or obesity were included in the meta-analysis. Fasting was associated with the significant reduction of body weight, body mass index (BMI), fat free mass (FEM), fat mass (FM), waist circumference (WC), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), systolic blood pressure (SBP) and diastolic blood pressure (DBP). However, there was no significant difference in the variations in the total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), blood glucose and insulin concentrations. CONCLUSION: Our meta-analysis found that fasting was associated with a significant effect on the regulation of anthropometric (body weight, BMI, FEM, FM and WC) and metabolic parameters (LDL-C, TG, SBP and DBP) in people with overweight or obesity. Considering some limitations found in this study, additional data from large clinical trials are needed.

Associations between Omega-3 Fatty Acid Supplementation and Anti-Inflammatory Effects in Patients with Digestive System Cancer: A Meta-Analysis.

Purpose: Patients with digestive system cancer frequently over-express inflammatory cytokines after surgical operations or chemotherapy. Omega-3 fatty acids are key nutrients with numerous beneficial anti-inflammatory effects in cancer patients. The anti-inflammatory effect of supplementation with omega-3 fatty acids in patients with digestive system cancer requires further validation.Methods: The meta-analysis includes studies that compared the variations in inflammatory marker (interleukin-6, tumor necrosis factor-alpha, and C-reactive protein (IL-6, TNF-α, and CRP)) concentrations between patients with digestive system cancer who were supplemented with omega-3 fatty acids versus controls who were not supplemented with omega-3 fatty acids.Results: Our findings indicated that the variations in the IL-6 and CRP concentrations in patients with digestive system cancer did not differ between the supplementation groups and the controls. Statistically significant differences in the variations in the TNF-α concentrations were observed between the supplementation groups and the controls. However, there were no significant differences in the variations in the TNF-α concentrations according to the subgroup analysis.Conclusions: Omega-3 fatty acids may have an inhibitory effect on postoperative TNF-α elevation in patients with digestive system tumors, but additional supporting data require a large clinical trial.

Association Between Copper, Zinc, Iron, and Selenium Intakes and TC/HDL-C Ratio in US Adults.

The trace minerals zinc, copper, iron, and selenium are essential micronutrients, and because of their antioxidant activity, they are hypothesized to improve cardiovascular health. However, their associations with different risk levels for cardiovascular diseases are less clear. Data from the National Health and Nutrition Examination Survey 2007-2014 were used. In this study, the ratio of total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) was used as a risk marker for cardiovascular disease, and a ratio ≥ 5 was considered to indicate high risk. A total of 7597 adults (3673 men and 3924 women) were included, and 15.9% of the participants had a high risk of cardiovascular disease. Using quantile regression analysis, we found the negative correlation between zinc, copper, iron, and selenium intakes and TC/HDL-C. The effects of copper and zinc were enhanced with increasing quantiles of risk levels. In addition, the difference in the associations of the trace minerals was sex-dependent. The correlation between iron and cardiovascular risk in males was stronger than those in females, while that of copper was weaker than that in females. Moreover, a significant nonlinear relationship between selenium and the TC/HDL-C ratio was only found in females, and this relationship was U-shaped. Our findings suggest that among healthy adults in the US, zinc, copper, iron, and selenium intakes are inversely associated with cardiovascular disease risk, and the effect is enhanced with increasing quantiles of risk levels, with magnitudes differing by sex. Therefore, trace minerals may have the ability to prevent cardiovascular disease.

Niacin, lutein and zeaxanthin and physical activity have an impact on Charlson comorbidity index using zero-inflated negative binomial regression model: National Health and Nutrition Examination Survey 2013-2014.

BACKGROUND: Combined with the increasing life expectancy, chronic medical conditions have gradually become the dominant cause of death and disability, and multimorbidity became an increasingly serious public health challenge. However, most existing studies have focused on the coexistence of specific diseases or relatively few diseases. Given one person may have multiple diseases at the same time, we applied Charlson Comorbidity Index (CCI) to systematically evaluate one's 10-year mortality. In this study, we explored the effects of nutrients and physical activity on CCI using National Health and Nutrition Examination Survey (NHANES) 2013-2014 data. METHODS: The study sample consists of one continuous cycle (2013-2014) of NHANES, and 4386 subjects were included in the study. Nutrients intake was measured by dietary recall, and physical activity was evaluated by the Global Physical Activity Questionnaire respectively. Besides, CCI was the sum of the scores assigned for each medical condition. We utilized zero-inflated negative binomial (ZINB) model to investigate the effects in nutrients intake and physical activity on CCI by adjusting for seven sociodemographic characteristics, smoking and drinking. RESULTS: Among the 4386 participants, 2018 (68.7%) are Non-Hispanic White, over half participants (78.6%) drink. In count part (CCI ≥ 0), holding other variables constant, the expected change in CCI for a one-unit increase in niacin is 1.621(RR = 1.621, p = 0.016), in lutein + zeaxanthin is 0.974 (RR = 0.974, p = 0.031), and in sedentary time is 1.035 (RR = 1.035, p = 0.005). Moreover, those who do not have vigorous work activity would be more likely to have higher CCI than those who have (RR = 1.275, P = 0.045). In logit part (CCI = 0), the log odds of having CCI equals zero would increase by 0.541 and 0.708 for every additional vigorous recreational activity (OR = 0.541, p = 0.004) and moderate recreational activity (OR = 0.708, p = 0.017) respectively. CONCLUSIONS: Lutein and zeaxanthin intake, vigorous work activity, vigorous recreational activity and moderate recreational activity may be good for one's health. Rather, increasing niacin intake and sedentary activity may be likely to raise 10-year mortality. Our findings may be significant for preventing diseases and improving health, furthermore, reducing people's financial burden on healthcare.

Association of multiple mineral and vitamin B group intake with blood glucose using quantile regression analysis: NHANES 2007-2014.

BACKGROUND: Hyperglycaemia and diabetes have become major public health problems worldwide. There is increasing evidence that minerals and the vitamin B group might play specific roles in hyperglycaemia and the pathogenesis and progression of diabetes or metabolic complications. OBJECTIVES: The main aim of this study is to investigate the effect of mineral and vitamin B group supplementation on the blood glucose levels of different populations. DESIGN: This was a cross-sectional study. Data from the National Health and Nutrition Examination Survey (NHANES) 2007-2014 were used in this study. A total of 8,322 participants (4,169 men and 4,153 women) were included in the study. Quantile regression (QR) was performed to identify the influence of mineral and vitamin B group intake on the level of fasting plasma glucose (FPG) in individuals in different quantiles of FPG. RESULTS: After adjusting for age, income, education, race, smoking, and alcohol consumption, FPG had a negative association with folic acid in individuals with normal or high FPG, with calcium in individuals with normal FPG, and with magnesium in males. FPG was negatively associated with folic acid and calcium in individuals with normal FPG, and magnesium in most of the quantiles for females. DISCUSSION: Hyperglycaemia and diabetes are currently becoming popular research topics. However, little is known about how the whole continuum of blood glucose is associated with commonly researched nutrient supplementation in terms of hyperglycaemia and diabetes. CONCLUSIONS: The intake of calcium, folic acid and magnesium was negatively associated with blood glucose levels in individuals in different quantiles of FPG. Appropriate prevention and treatment strategies should be developed for people with different blood glucose levels.