Multi-target regulatory mechanism of Yang Xin Tang - a traditional Chinese medicine against dementia.

BACKGROUND: Yang Xin Tang (YXT) is a traditional Chinese herbal preparation which has been reported to improve cognitive function and memory in patients with dementia. As the underlying mechanism of action of YXT has not been elucidated, we examined the effects of YXT and its major herbal components in regulating gene transcription and molecular targets related to Alzheimer's disease (AD). METHODS: Aqueous and ethanol extracts of YXT and selected herbal components were prepared and validated by standard methods. A series of biochemical and cellular assays were employed to assess the ability of the herbal extracts to inhibit acetylcholinesterase, reduce ß-amyloid aggregation, stimulate the differentiation of neural progenitor cells, suppress cyclooxygenase, and protect neurons against ß-amyloid or N-methyl-D-aspartate-induced cytotoxicity. The effects of YXT on multiple molecular targets were further corroborated by a panel of nine reporter gene assays. RESULTS: Extracts of YXT and two of its constituent herbs, Poria cocos and Poria Sclerotium pararadicis, significantly inhibited ß-amyloid aggregation and ß-amyloid-induced cytotoxicity. A protective effect of the YXT extract was similarly observed against N-methyl-D-aspartate-induced cytotoxicity in primary neurons, and this activity was shared by extracts of Radix Astragali and Rhizoma Chuanxiong. Although the YXT extract was ineffective, extracts of Poria cocos, Poria Sclerotium pararadicis and Radix Polygalae inhibited acetylcholine esterase, with the latter also capable of upregulating choline acetyltransferase. YXT and its components significantly inhibited the activities of the pro-inflammatory cyclooxygenases. Additionally, extracts of YXT and several of its constituent herbs significantly stimulated the phosphorylation of extracellular signal-regulated kinases and cAMP-responsive element binding protein, two molecular targets involved in learning and memory, as well as in the regulation of neurogenesis. CONCLUSIONS: Several constituents of YXT possess multiple regulatory effects on known therapeutic targets of AD that range from ß-amyloid to acetylcholinesterase. The demonstrated neuroprotective and neurogenic actions of YXT lend credence to its use as an alternative medicine for treating AD.

Coping strategies predict daily emotional reactivity to stress: An ecological momentary assessment study.

BACKGROUND: Emotional reactivity predicts poor health and psychopathology. Despite its theoretical importance, little research has tested whether coping predicts emotional reactivity to stressors. We analyse three studies to test this hypothesis for negative (NA) and positive affect (PA) reactivity to daily stressors. METHODS: 422 Participants (72.5 % females, Mage = 22.79 ± 5.36) came from three longitudinal, ecological momentary assessment (EMA) studies across 7-15 days (ACES N = 190; DESTRESS N = 134; SHS N = 98). Coping was measured at baseline. NA, PA, and daily stressors were assessed via EMA. Mixed effects linear models tested whether coping predicted NA and PA reactivity, defined as their slope on within- and between-person daily stressors. RESULTS: Behavioural disengagement and mental disengagement coping predicted greater within-person NA reactivity across all studies (all p < .01, all f2 = 0.01). Denial coping predicted greater within-person NA reactivity in ACES and DESTRESS (both p < .01, f2 from 0.02-0.03) and between-person in ACES and SHS (both p < .01, f2 from 0.02 to 0.03). For approach-oriented coping, only active planning coping predicted lower within-person NA reactivity and only in DESTRESS (p < .01, f2 = 0.02). Coping did not predict PA reactivity (all p > .05). LIMITATIONS: Our findings cannot be generalised to children or older adults. Emotional reactivity to daily stressors may differ from severe or traumatic stressors. Although data were longitudinal, the observational design precludes establishing causality. CONCLUSIONS: Avoidance-oriented coping strategies predicted greater NA reactivity to daily stressors with small effect sizes. Few and inconsistent results emerged for approach-oriented coping and PA reactivity. Clinically, our results suggest that reducing reliance on avoidance-oriented coping may reduce NA reactivity to daily stressors.

Provision of a personalized survivorship care plan and its impact on cancer-related health literacy among childhood cancer survivors in Hong Kong.

PURPOSE: To evaluate the short-term effectiveness of a personalized survivorship care plan (SCP) in improving cancer-related literacy among childhood cancer survivors, and to identify characteristics of survivors who demonstrated minimal gain from the intervention. METHODS: We recruited survivors diagnosed with cancer at ≤18 years old and were >2 years post treatment. The intervention included a personalized SCP and 30-minute health risk counseling. The participants' knowledge of their cancer diagnosis and potential treatment-related late effects (LEs) was assessed at baseline, immediately post intervention, and 1-3 months post intervention. Generalized estimating equation was used to test for changes in the awareness scores, with interacting terms (time*factor) added to identify differences in the score trajectory across clinically relevant subgroups. RESULTS: In total, 248 survivors completed the intervention (mean age: 19.4 [SD = 6.7] years; 54.1% male; 66.1% hematological malignancies), of whom 162 completed all assessments. There was significant increase in survivors' awareness of their cancer diagnoses (mean adjusted score: baseline 66.9, post intervention 86.3; p < .001) and potential LEs (baseline 30.9, post intervention 66.3; p < .001). The proportion of survivors who demonstrated awareness of their potential LEs increased from 9.7% to 54.3%. The interaction analysis showed that there was significantly less improvement in awareness among survivors of non-central nervous system (non-CNS) solid tumors (p = .032), lower socioeconomic status (p = .014), and parents of pediatric survivors (vs. adult survivors; p = .013). CONCLUSIONS: The provision of a personalized SCP showed preliminary effectiveness in improving survivors' understanding of their treatment-related LEs. Health counseling with SCP should be reinforced in vulnerable subgroups. Future work includes evaluating its long-term impact on lifestyle and health outcomes.

How much does sleep vary from night-to-night? A quantitative summary of intraindividual variability in sleep by age, gender, and racial/ethnic identity across eight-pooled datasets.

Habitual sleep duration and efficiency vary widely by age, gender, and racial/ethnic identity. Despite growing research on the importance of night-to-night, intraindividual variability (IIV) in sleep, few studies have examined demographic differences in sleep IIV. The present study describes typical sleep IIV overall and by demographics among healthy sleepers. Eight datasets of healthy sleepers (N = 2,404; 26,121 total days of sleep data) were synthesised to examine age, gender, and racial/ethnic identity differences in sleep IIV measured via diaries, actigraphy, and electroencephalography (EEG). Sleep IIV estimates included the intraindividual standard deviation (iSD), root mean square of successive differences (RMSSD), coefficient of variation (CV), and a validated Bayesian Variability Model (BVM). There was substantial IIV in sleep across measurement types (diary, actigraphy, EEG) for both sleep duration (iSD: 85.80 [diary], 77.41 [actigraphy], 67.04 [EEG] minutes; RMSSD: 118.91, 108.89, 91.93 minutes; CV: 19.19%, 19.11%, 18.57%; BVM: 60.60, 58.20, 48.60 minutes) and sleep efficiency (iSD: 5.18% [diary], 5.22% [actigraphy], 6.46% [EEG]; RMSSD: 7.01%, 7.08%, 8.44%; CV: 5.80%, 6.27%, 8.14%; BVM: 3.40%, 3.58%, 4.16%). Younger adults had more diary and actigraphy sleep duration IIV. Gender differences were inconsistent. White and non-Hispanic/Latinx adults had less IIV in sleep duration and efficiency compared to racial/ethnic minority groups. Even among healthy sleepers, sleep varies widely from night-to-night. Like mean sleep, there also may be disparities in IIV in sleep by demographic characteristics. Study results help characterise normative values of sleep IIV in healthy sleepers.