Serial mediation effect of physical activity and sleep quality between dietary behaviour and depression symptoms: A nationwide cross-sectional survey.

Background: Substantial studies have revealed the potential mechanisms underlying the link between dietary behaviour and depression symptoms. This study investigated the relationship between depression symptoms and dietary behaviour, physical activity, and sleep quality in a nationwide sample of Chinese residents. Methods: A total of 18 819 Chinese Residents completed the dietary behaviour, patient health questionnaire, international physical activity questionnaire, and Pittsburgh sleep quality index. We used the Hayes' serial mediation model to investigate the correlation between the variables. Results: Among the participants, 85.5% were aged between 18 and 59, 41.2% were male, and 73.8% were urban residents. There is a negative correlation between dietary behaviour and physical activity (r = -0.038, P < 0.001), while there is a positive correlation with depression symptoms (r = 0.238, P < 0.001) and sleep quality (r = 0.115, P < 0.001). Additionally, depression shows a positive correlation with physical activity (r = 0.024, P < 0.001) and sleep quality (r = 0.298, P < 0.001), while there is a negative correlation between physical activity and sleep quality (r = -0.035, P < 0.001). Dietary behaviour was found to be connected with depression symptoms via three mediation pathways: (1) physical activity (B = -0.003, 95% confidence interval (CI) = -0.016, -0.007), (2) sleep quality (B = 0.034, 95% CI = 0.126, 0.164), and (3) physical activity and sleep quality (B = 0.001, 95% CI = 0.001, 0.003). Conclusions: These findings highlight the significance of psychological and physical factors in exploring the mechanisms through which dietary behaviour is related to depression symptoms. Overall, this study showed the important role of lifestyle factors in depression symptoms, suggesting that appropriate dietary behaviours, appropriate physical activity, and good sleep quality are necessary for the avoidance or improvement of depression symptoms.

Preoperative Systemic Inflammation Score Predicts the Prognosis of Patients with Upper Tract Urothelial Carcinoma Undergoing Radical Nephroureterectomy.

Background: To investigate the prognostic significance of systemic inflammation score (SIS) in upper tract urothelial carcinoma (UTUC) in patients undergoing radical nephroureterectomy (RNU). Methods: A total of 313 UTUC patients who underwent RNU at West China Hospital from May 2014 to June 2019 were retrospectively analyzed. The predictive value of SIS for relevant endpoints, including overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS), was assessed by Kaplan-Meier curves and the Cox proportional hazards model. Results: According to inclusion and exclusion criteria, 218 UTUC patients were ultimately included in this cohort study. Statistical analysis shows that increased SIS was significantly associated with higher TNM stage (p = 0.017), lower BMI (p = 0.037), absence of hemoglobin (p < 0.001), and pathologic necrosis (p = 0.007). Kaplan-Meier survival curves clearly visually stratified survival for the three outcomes. After adjusting for tumor grade, the multivariate Cox proportional hazards model results showed that SIS was an independent risk factor for poor OS and CSS (HR = 1.89, 95% CI: 1.11-3.21, p = 0.0183, HR = 1.89, 95% CI: 1.07-3.33, p = 0.0285) in the advanced group. Conclusions: SIS was an independent risk factor for OS and CSS after RNU in patients with high-grade UTUC. It may be a novel and conducive tool for preoperative risk stratification and guiding individualized therapy for high-risk UTUC patients.

The impact of intimate partner violence on depressive symptoms among college students: A moderated mediation model of the big five personality traits and perceived social support.

BACKGROUND: Previous study has identified a connection between intimate partner violence (IPV) and depressive symptoms. However, the underlying mechanisms of this connection have not yet been well understood. The aim of this study was to investigate the roles of big five personality traits and perceived social support on the association between IPV and depressive symptoms among Chinese college students. METHODS: A cross-sectional questionnaire survey was conducted among college students in 23 provinces, 5 autonomous regions, and 4 municipalities in China from June to August 2022. Intimate Partner Violence Questionnaire was used to measure the frequency of exposure to IPV. The big five personality traits were measured by 10-item Big Five Inventory, Perceptive Social Support Scale-3 items was used to estimate the degree of perceived social support and the data on depressive symptoms were collected by Patient Health Questionnaire-9 items. We used data from the "Psychology and Behavior Investigation of Chinese Residents in 2022", which includes 6686 valid questionnaires of college students. The PROCESS macro developed by Hayes was utilized to perform moderated mediation analysis. RESULTS: Among college students, IPV had a significant direct impact on depressive symptoms. Extroversion, agreeableness, conscientiousness and neuroticism mediated the association between IPV and depressive symptoms (ß = -0.08, P < 0.001; ß = -0.08, P < 0.001; ß = -0.14, P < 0.001; ß = 0.20, P < 0.001). Perceived social support significantly moderated the mediating role of the big five personality traits between IPV and depressive symptoms. Furthermore, perceived social support moderated the direct relationship between IPV and depressive symptoms (ß = 0.34, P < 0.001), as well as the indirect path of extroversion, agreeableness, neuroticism and the first half of the mediating role of conscientiousness. Moreover, perceived social support was one of the preventive factors that could effectively mitigate the harmful effects of IPV, neuroticism and depressive symptoms. LIMITATIONS: As this was a cross-sectional study, we were unable to investigate causal relationships between variables. The prevalence of IPV and depressive symptoms were self-reported by the college students, and there may be reporting bias. Additionally, this study only explored the influence and mechanism from the integrated dimension of IPV and PSSS, due to spatial constraints. CONCLUSIONS: The findings contribute to the existing understanding by clarifying the fundamental mechanisms linking IPV and depressive symptoms. These results may serve as a valuable reference for the Chinese government to improve mental health among college students.

Utilization trend of prebiopsy multiparametric magnetic resonance imaging and its impact on prostate cancer detection: Real-world insights from a high-volume center in southwest China.

BACKGROUND: Data on the utilization and effects of prebiopsy prostate multiparametric magnetic resonance imaging (mpMRI) to support its routine use in real-world setting are still scarce. OBJECTIVE: To evaluate the change of clinical practice of prebiopsy mpMRI over time, and assess its diagnostic accuracy. DESIGN, SETTING, AND PARTICIPANTS: We retrospectively analyzed data from 6168 patients who underwent primary prostate biopsy (PBx) between January 2011 and December 2021 and had prostate-specific antigen (PSA) values ranging from 3 to 100 ng/mL. INTERVENTION: Prebiopsy MRI at the time of PBx. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We performed general linear regression and to elucidate trends in the annual use of prebiopsy mpMRI and conducted multivariable logistic regression to evaluate the potential benefits of incorporating prebiopsy mpMRI for prostate cancer (PCa) detection. RESULTS AND LIMITATIONS: The utilization of prebiopsy mpMRI significantly increased from 9.2% in 2011 to 75.0% in 2021 (p < 0.001). In addition, prebiopsy mpMRI significantly reduced negative PBx by 8.6% while improving the detection of clinically significant PCa (csPCa) by 7.0%. Regression analysis showed that the utilization of prebiopsy mpMRI was significantly associated with a 48% (95% confidence interval [CI]: 1.19-1.84) and 36% (95% CI: 1.12-1.66) increased PCa detection rate in the PSA 3-10 ng/mL and 10-20 ng/mL groups, respectively; and a 34% increased csPCa detection rate in the PSA 10-20 ng/mL group (95% CI: 1.09-1.64). The retrospective design and the single center cohort constituted the limitations of this study. CONCLUSIONS: Our study demonstrated a notable rise in the utilization of prebiopsy mpMRI in the past decade. The adoption of this imaging technique was significantly associated with an increased probability of detecting prostate cancer. PATIENT SUMMARY: From 2011 to 2021, we demonstrated a steady increase in the utilization of prebiopsy mpMRI among biopsy-naïve men. We also confirmed the positive impact of prebiopsy mpMRI utilization on the detection of prostate cancer.

Evolution of HIV/AIDS Prevention and Control Policies in China: A Grounded Theory Approach.

Objective: This study aims to provide a theoretical foundation for the development and practical application of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) prevention and control policy systems in China by scrutinizing, analyzing, and synthesizing the evolution of Chinese policies in this domain. Methods: Utilizing grounded theory, we employed NVivo12 software to perform text content analysis, mining, and coding classification, along with visualization techniques, on policy texts sourced from Chinese government platforms, including the official website of China's State Council. We considered four analytical dimensions - time, subject, type, and object. Results: The National Health Commission and the State Council emerged as the primary entities engaged in policymaking for HIV/AIDS in China. We identified four distinct stages in the evolution of these policies, culminating in a novel 'sun-shaped' HIV/AIDS prevention and control policy network model with an emphasis on 'knowledge, attitude, and practice' at its nucleus, which aligns with national conditions and societal progress. Furthermore, the focal groups of these policies have been dynamically refined and updated over time. Conclusions: Our findings introduce a 'sun-shaped' HIV/AIDS prevention and control policy network model specific to China. We observed a conceptual policy shift towards prioritizing overall human health rather than confining the focus to disease treatment. Additionally, in light of China's growing elderly population, the imperative to address HIV/AIDS prevention and control among older adults is an issue that warrants increased attention.

The Prognostic Value of Preoperative Naples Prognostic Score in Upper Tract Urothelial Carcinoma Patients after Radical Nephroureterectomy.

This study aims to determine the prognostic value of preoperative Naples prognostic score (NPS) on survival outcomes in upper tract urothelial carcinoma (UTUC) patients after radical nephroureterectomy (RNU). We conducted a retrospective study about UTUC patients at West China Hospital from January 2015 to June 2019. The X-Tile program was used to identify the optimal cutoff value of NPS. Overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) were the endpoints of interest. Kaplan-Meier curves were used to estimate survival and Cox proportional hazard model was used for risk assessment. A total of 237 UTUC patients after RNU were identified and the threshold of NPS was determined to be 2. Preoperative high-NPS was associated with inferior OS (p = 0.004), CSS (p = 0.002) and PFS (p = 0.008), especially in locally advanced UTUC patients. Preoperative NPS was an independent predictor for OS (HR: 1.78; 95% CI: 1.08, 2.93), CSS (HR: 1.87; 95% CI: 1.11, 3.14) and PFS (HR: 1.60; 95% CI: 1.02, 2.50). The addition of NPS into the predictive model consisting of predictors from multivariate Cox regression resulted in better prediction performance. Preoperative NPS was a novel and reliable predictor for survival in UTUC patients after RNU, and should be further explored.

Survival impact of variant histology in patients with upper tract urothelial carcinoma after radical nephroureterectomy.

OBJECTIVE: To investigate the prognostic impact of variant histology (VH) on survival outcomes in upper tract urothelial carcinoma (UTUC) patients after radical nephroureterectomy (RNU). MATERIALS AND METHODS: Data from 635 UTUC patients who underwent RNU at our institution from May 2003 to June 2019 were retrospectively acquired and analyzed. After propensity score matching (PSM), we investigated the impact of VH on overall survival (OS) and cancer-specific survival (CSS) by using cumulative incidence plots with the log-rank test, Cox regression models, and competing risk regression models. RESULTS: Overall, 121 (19.1%) patients were diagnosed with VH, including 68 (10.7%) with squamous cell differentiation (SCD) and 28 (4.4%) with adenocarcinoma differentiation (AD). After PSM, the presence of VH was significantly associated with worse OS (HR 1.70, 95% CI 1.25-2.32) and CSS (HR 1.64, 95% CI 1.17-2.31) only in locally advanced UTUC patients (pT>2). In the subgroup analysis, SCD revealed inferior outcomes (OS: HR 1.81, 95% CI 1.28-2.57; CSS: HR 1.73, 95% CI 1.18-2.54) compared with pure urothelial carcinoma (pUC), whereas AD conferred comparable outcomes. In addition, compared with pUC patients, SCD patients with extensive squamous components had significantly decreased OS (HR 4.17, 95% CI 1.84-9.44) and CSS (HR 1.10, 95% CI 0.61-1.99), whereas those with regional squamous components had similar survival outcomes. CONCLUSION: For UTUC patients after RNU, the presence of VH is associated with aggressive clinicopathological features and inferior survival outcomes. However, the survival outcomes of localized UTUC patients (pT≤2) with VH, and patients with the AD or regional SCD subtype are comparable to those of patients with pUC.

Development and validation of a multimorbidity risk prediction nomogram among Chinese middle-aged and older adults: a retrospective cohort study.

OBJECTIVES: The aim of this study is to establish a self-simple-to-use nomogram to predict the risk of multimorbidity among middle-aged and older adults. DESIGN: A retrospective cohort study. PARTICIPANTS: We used data from the Chinese Longitudinal Healthy Longevity Survey, including 7735 samples. MAIN OUTCOME MEASURES: Samples' demographic characteristics, modifiable lifestyles and depression were collected. Cox proportional hazard models and nomogram model were used to estimate the risk factors of multimorbidity. RESULTS: A total of 3576 (46.2%) participants have multimorbidity. The result showed that age, female (HR 0.80, 95% CI 0.72 to 0.89), chronic disease (HR 2.59, 95% CI 2.38 to 2.82), sleep time (HR 0.78, 95% CI 0.72 to 0.85), regular physical activity (HR 0.88, 95% CI 0.81 to 0.95), drinking (HR 1.27 95% CI 1.16 to 1.39), smoking (HR 1.40, 95% CI 1.26 to 1.53), body mass index (HR 1.04, 95% CI 1.03 to 1.05) and depression (HR 1.02, 95% CI 1.01 to 1.03) were associated with multimorbidity. The C-index of nomogram models for derivation and validation sets were 0.70 (95% CI 0.69 to 0.71, p=0.006) and 0.71 (95% CI 0.70 to 0.73, p=0.008), respectively. CONCLUSIONS: We have crafted a user-friendly nomogram model for predicting multimorbidity risk among middle-aged and older adults. This model integrates readily available and routinely assessed risk factors, enabling the early identification of high-risk individuals and offering tailored preventive and intervention strategies.

Transperineal magnetic resonance imaging targeted biopsy versus transrectal route in the detection of prostate cancer: a systematic review and meta-analysis.

PURPOSE: Magnetic resonance imaging (MRI) has deeply altered the prostate biopsy strategy to detect prostate cancer. However, it is still debatable whether the detection rate differs between transrectal (TR) and transperineal (TP) MRI-targeted biopsy (MRI-TB). To compare the effectiveness of these two methods for detecting both overall prostate cancer (PCa) and clinically significant PCa (csPCa), We performed a review and meta-analysis. METHODS: Until January 2023, we conducted a thorough search of Cochrane, Embase, Ovid, and PubMed. In total, 1482 references were identified, and 15 records were finally included. For PCa and csPCa discovered by TP and TR MRI-TB, we combined the relative sensitivity (RR) with 95% confidence intervals (CI). The RR between the TP and TR routes was established. RESULTS: Our study included 8826 patients in total and revealed that TP MRI-TB detected more PCa (RR 1.25 [95% CI 1.12, 1.39], p < 0.0001). In patients who underwent TP MRI-TB and TR MRI-TB at the same time or separately, TP MRI-TB had a greater detection rate of csPCa in per-patient analysis (one cohort (RR 1.33 [95% CI 1.09, 1.63], p = 0.005); two cohorts (RR 1.37 [95% CI 1.16, 1.61], p = 0.0002)). However, the detection rate of csPCa between the TP route and the TR route was comparable in per-lesion analysis (RR 0.91 [95% CI 0.76, 1.08], p = 0.28). Additionally, in the prostate's anterior region, we found that TP MRI-TB detected more csPCa (per-lesion (RR 1.52 [95% CI 1.04, 2.23], p = 0.03); per-patient (RR 2.55 [95% CI 1.56, 4.16], p = 0.0002)). CONCLUSION: According to this comprehensive study, TP MRI-TB is more effective than TR MRI-TB at detecting PCa and csPCa. Significant results persisted for detecting csPCa located in the anterior zone. The results need to be taken carefully notwithstanding the heterogeneity among the included studies.

An artificial intelligence method for predicting postoperative urinary incontinence based on multiple anatomic parameters of MRI.

Background: Deep learning methods are increasingly applied in the medical field; however, their lack of interpretability remains a challenge. Captum is a tool that can be used to interpret neural network models by computing feature importance weights. Although Captum is an interpretable model, it is rarely used to study medical problems, and there is a scarcity of data regarding MRI anatomical measurements for patients with prostate cancer after undergoing Robotic-Assisted Radical Prostatectomy (RARP). Consequently, predictive models for continence that use multiple types of anatomical MRI measurements are limited. Methods: We explored the energy efficiency of deep learning models for predicting continence by analyzing MRI measurements. We analyzed and compared various statistical models and provided reference examples for the clinical application of interpretable deep-learning models. Patients who underwent RARP at our institution between July 2019 and December 2020 were included in this study. A series of clinical MRI anatomical measurements from these patients was used to discover continence features, and their impact on continence was primarily evaluated using a series of statistical methods and computational models. Results: Age and six other anatomical measurements were identified as the top seven features of continence by the proposed model UINet7 with an accuracy of 0.97, and the first four of these features were also found by primary statistical analysis. Conclusions: This study fills the gaps in the in-depth investigation of continence features after RARP due to the limitations of clinical data and applicable models. We provide a pioneering example of the application of deep-learning models to clinical problems. The interpretability analysis of deep learning models has the potential for clinical applications.

Social Participation: A Strategy to Manage Depression in Disabled Populations.

This study aimed to investigate whether social participation (SP) can decrease depressive symptom severity in disabled older adults. A total of 5,937 disabled participants (4877, 1970, 219, and 8 participants responding 1, 2, 3, 4 times, respectively), obtained from the China Health and Retirement Longitudinal Study, were enrolled in our analysis. Based on pooled Ordinary Least Square regressions, SP was associated with decreased depressive symptom severity, and this association was significant in recreational activities and interacting with friends. For brain-disabled respondents, the association was not significant. SP is effective in decreasing depressive symptom severity in disabled older populations. Diversified activities and targeted interventions should be applied to specified older disabled populations to prevent depression.

Correlations between depressives symptom severity and social participation (SP) among disable older adults were measured in a Chinese context.Pooled Ordinary Least Square regression were used to explore the impact of SP on depressives symptom severity in older populations with disabilities.Social participation, including recreational activities and interacting with friends, was associated with decreased depressives symptom severity in disabled middle-aged and older adults.The impact of SP on depressives symptom severity was not significant for older adults with brain disabilities.

Association Between Urinary Bisphenols and Body Composition Among American Adults: Cross-Sectional National Health and Nutrition Examination Survey Study.

BACKGROUND: Bisphenol A (BPA), bisphenol S (BPS), and bisphenol F (BPF) are widely used in various consumer products. They are environmental contaminants with estrogenic properties that have been linked to various health outcomes. Understanding their impact on body composition is crucial for identifying potential health risks and developing preventive strategies. However, most current studies have only focused on their relationship with BMI. OBJECTIVE: This study aimed to investigate the association between urinary levels of BPA, BPS, and BPF and body composition, including BMI, lean mass, and fat mass, in a large population-based sample. METHODS: We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey 2003-2016. Body composition data were assessed using dual-energy X-ray absorptiometry, which provided precise measurements of lean mass, fat mass, and other indicators. We used multivariate linear regression models to estimate the associations, adjusting for potential confounders such as age, gender, race, socioeconomic factors, and lifestyle variables. RESULTS: The results revealed significant associations between bisphenol exposure and body composition. After adjusting for covariates, BPS showed a positive association with BMI, with quartiles 3 and 4 having 0.91 (95% CI 0.34-1.48) and 1.15 (95% CI 0.55-1.74) higher BMI, respectively, compared with quartile 1 (P<.001). BPA was negatively associated with total lean mass (TLM) and appendicular lean mass, with quartiles 2, 3, and 4 having -7.85 (95% CI -11.44 to -4.25), -12.33 (95% CI -16.12 to -8.54), and -11.08 (95% CI -15.16 to -7.01) lower TLM, respectively, compared with quartile 1 (P<.001). BPS was negatively associated with TLM, with quartiles 3 (ß=-10.53, 95% CI -16.98 to -4.08) and 4 (ß=-11.14, 95% CI -17.83 to -4.45) having significantly lower TLM (P=.005). Both BPA and BPS showed a positive dose-response relationship with trunk fat (BPA: P=.002; BPS: P<.001) and total fat (BPA: P<.001; BPS: P=.01). No significant association was found between BPF and any body composition parameter. CONCLUSIONS: This large-sample study highlights the associations between urinary levels of BPA and BPS and alterations in body composition, including changes in lean mass, fat mass, and regional fat distribution. These findings underscore the importance of understanding the potential health risks associated with bisphenol exposure and emphasize the need for targeted interventions to mitigate adverse effects on body composition.

Associations between internet addiction and psychological problems among adolescents: description and possible explanations.

Introduction: Internet addiction (IA) is becoming a significant public health issue that requires urgent attention, especially for adolescents. Previous studies mainly focused on the risk factors of Internet addiction and drawn some conclusions. The purpose of this study is to investigate the Internet addiction status and concurrent psychological problems in adolescent groups, and explore the differences in the relationship between IA and psychological problems in adolescents from gender and grade. Methods: A cross-sectional study was conducted among students of junior and senior high school in 21 prefecture-level cities of Guangdong Province. The Young Diagnostic Questionnaire (YDQ) and the validated Chinese version of the Depression Anxiety Stress Scale-21 (DASS-21) were used to assess participants' Internet addiction and psychological status. Two-way ANOVA was used to verify the interaction between gender and Internet addiction, grade and Internet addiction on psychological problems. When the interaction was statistically significant, simple effect analysis was further carried out. Results: The prevalence of problematic Internet use (PIU), depression, anxiety, and stress symptoms among adolescents were 16.32%, 30.16%, 35.97% and 18.80% respectively. Although the prevalence of PIU among boys (17.89%) was higher than that of girls (14.86%), girls in PIU group had the highest scores of depression, anxiety and stress. Similarly, the interaction between grade and Internet addiction was also significant (p < 0.05). Although the prevalence of PIU was the highest in grade 9 (17.29%), the adverse effects of Internet addiction on psychological problems were different in different grades. Discussion: Internet addiction was prevalent among adolescents in Guangdong province, and psychological problems also cannot be ignored. Thus, this study suggests that long-term follow-ups should be included in mental health programs of adolescents to monitor the development of Internet addiction and psychological problems.

The association between sex hormones and periodontitis among American adults: A cross-sectional study.

Introduction: After adulthood, as a person grows older, the secretion of sex hormones in the body gradually decreases, and the risk of periodontitis increases. But the relationship between sex hormones and periodontitis is still controversial. Methods: We investigated the association between sex hormones and periodontitis among Americans over 30 years old. 4,877 participants containing 3,222 males and 1,655 postmenopausal females who had had periodontal examination and detailed available sex hormone levels, were included in our analysis from the 2009-2014 National Health and Nutrition Examination Surveys cycles. We applied multivariate linear regression models to estimate the connection between sex hormones and periodontitis after converting sex hormones into categorical variables through tertile. Additionally, to ensure the stability of the analysis results, we carried out a trend test, subgroup analysis, and interaction test. Results: After fully adjusting the covariates, estradiol levels were not associated with periodontitis in both males and females with a P for trend = 0.064 and 0.064, respectively. For males, we found that sex hormone-binding globulin was positively associated with periodontitis (tertile3 vs tertile1: OR=1.63, 95% CI=1.17-2.28, p = 0.004, P for trend = 0.005). Congruously, free testosterone (tertile3 vs tertile1: OR=0.60, 95% CI=0.43-0.84, p = 0.003), bioavailable testosterone (tertile3 vs tertile1: OR=0.51, 95% CI=0.36-0.71, p < 0.001), and free androgen index (tertile3 vs tertile1: OR=0.53, 95% CI=0.37-0.75, p < 0.001) was found to be negatively associated with periodontitis. Moreover, subgroup analysis of age found a closer relationship between sex hormones and periodontitis in those younger than 50 years. Conclusion: Our research suggested that males with lower bioavailable testosterone levels affected by sex hormone-binding globulin were at a higher risk of periodontitis. Meanwhile, estradiol levels were not associated with periodontitis in postmenopausal women.

DOK3 promotes proliferation and inhibits apoptosis of prostate cancer via the NF-κB signaling pathway.

BACKGROUND: DOK3 (Downstream of kinase 3) is involved primarily with immune cell infiltration. Recent research reported the role of DOK3 in tumor progression, with opposite effects in lung cancer and gliomas; however, its role in prostate cancer (PCa) remains elusive. This study aimed to explore the role of DOK3 in PCa and to determine the mechanisms involved. METHODS: To investigate the functions and mechanisms of DOK3 in PCa, we performed bioinformatic and biofunctional analyses. Samples from patients with PCa were collected from West China Hospital, and 46 were selected for the final correlation analysis. A lentivirus-based short hairpin ribonucleic acid (shRNA) carrier was established for silencing DOK3. A series of experiments involving the cell counting kit-8, bromodeoxyuridine, and flow cytometry assays were performed to identify cell proliferation and apoptosis. Changes in biomarkers from the nuclear factor kappa B (NF-κB) signaling pathway were detected to verify the relationship between DOK3 and the NF-κB pathway. A subcutaneous xenograft mouse model was performed to examine phenotypes after knocking down DOK3 in vivo . Rescue experiments with DOK3 knockdown and NF-κB pathway activation were designed to verify regulating effects. RESULTS: DOK3 was up-regulated in PCa cell lines and tissues. In addition, a high level of DOK3 was predictive of higher pathological stages and worse prognoses. Similar results were observed with PCa patient samples. After silencing DOK3 in PCa cell lines 22RV1 and PC3, cell proliferation was significantly inhibited while apoptosis was promoted. Gene set enrichment analysis revealed that DOK3 function was enriched in the NF-κB pathway. Mechanism experiments determined that knockdown of DOK3 suppressed activation of the NF-κB pathway, increased the expressions of B-cell lymphoma-2 like 11 (BIM) and B-cell lymphoma-2 associated X (BAX), and decreased the expression of phosphorylated-P65 and X-linked inhibitor of apoptosis (XIAP). In the rescue experiments, pharmacological activation of NF-κB by tumor necrosis factor-α (TNF-α) partially recovered cell proliferation after the knockdown of DOK3. CONCLUSION: Our findings suggest that overexpression of DOK3 promotes PCa progression by activating the NF-κB signaling pathway.

The role of anxiety and depressive symptoms in mediating the relationship between subjective sleep quality and cognitive function among older adults in China.

BACKGROUND: Deterioration of cognitive function has a significant impact on the unavoidable burden on individuals, families, and society. This study aimed to examine the serial multiple mediating effects of anxiety and depressive symptoms on the relationship between subjective sleep quality and cognitive function among older adults in China. METHODS: We selected 6442 Chinese older adults aged 65 years and older from the 2018 Chinese Longitudinal Healthy Longevity Survey. The SPSS PROCESS macro was employed to perform simple and serial multiple mediation analyses. RESULTS: Subjective sleep quality, depressive symptoms, anxiety symptoms, and cognitive function were significantly related (P < 0.01). Poor sleep quality can have a direct negative influence on cognitive function among older adults (effect = -0.110; 95 % CI = [-0.166, -0.053]), but it can also have an indirect negative impact via three pathways: the independent mediation of anxiety symptoms (effect = -0.028; 95 % CI = [-0.048, -0.011]), the independent mediation of depressive symptoms (effect = -0.014; 95 % CI = [-0.026, -0.002]), and the serial mediation of anxiety and depressive symptoms (effect = -0.009; 95 % CI = [-0.017, -0.001]). LIMITATIONS: This study used a cross-sectional design, which restricts the ability to infer causal relationships. CONCLUSIONS: The effect of subjective sleep quality on cognitive function was serially mediated by anxiety and depressive symptoms among older adults. Diverse therapies targeted at improving sleep quality in older adults may improve mood and cognitive functioning.

The prevalence and risk of developing major depression among individuals with subthreshold depression in the general population.

BACKGROUND: Subthreshold depression could be a significant precursor to and a risk factor for major depression. However, reliable estimates of the prevalence and its contribution to developing major depression under different terminologies depicting subthreshold depression have to be established. METHODS: By searching PubMed and Web of Science using predefined inclusion criteria, we included 1 129 969 individuals from 113 studies conducted. The prevalence estimates were calculated using the random effect model. The incidence risk ratio (IRR) was estimated by measuring the ratio of individuals with subthreshold depression who developed major depression compared to that of non-depressed individuals from 19 studies (88, 882 individuals). RESULTS: No significant difference in the prevalence among the different terminologies depicting subthreshold depression (Q = 1.96, p = 0.5801) was found. By pooling the prevalence estimates of subthreshold depression in 113 studies, we obtained a summary prevalence of 11.02% [95% confidence interval (CI) 9.78-12.33%]. The youth group had the highest prevalence (14.17%, 95% CI 8.82-20.55%), followed by the elderly group (12.95%, 95% CI 11.41-14.58%) and the adult group (8.92%, 95% CI 7.51-10.45%). Further analysis of 19 studies' incidence rates showed individuals with subthreshold depression had an increased risk of developing major depression (IRR = 2.95, 95% CI 2.33-3.73), and the term minor depression showed the highest IRR compared with other terms (IRR = 3.97, 95% CI 3.17-4.96). CONCLUSIONS: Depression could be a spectrum disorder, with subthreshold depression being a significant precursor to and a risk factor for major depression. Proactive management of subthreshold depression could be effective for managing the increasing prevalence of major depression.

Combining clinical parameters and multiparametric magnetic resonance imaging to stratify biopsy-naïve men for an optimum diagnostic strategy with prostate-specific antigen 4 ng ml-1 to 10 ng ml-1.

We attempted to perform risk categories based on the free/total prostate-specific antigen ratio (%fPSA), prostate-specific antigen (PSA) density (PSAD, in ng ml-2), and multiparametric magnetic resonance imaging (mpMRI) step by step, with the goal of determining the best clinical diagnostic strategy to avoid unnecessary tests and prostate biopsy (PBx) in biopsy-naïve men with PSA levels ranging from 4 ng ml-1 to 10 ng ml-1. We included 439 patients who had mpMRI and PBx between August 2018 and July 2021 (West China Hospital, Chengdu, China). To detect clinically significant prostate cancer (csPCa) on PBx, receiver-operating characteristic (ROC) curves and their respective area under the curve were calculated. Based on %fPSA, PSAD, and Prostate Imaging-Reporting and Data System (PI-RADS) scores, the negative predictive value (NPV) and positive predictive value (PPV) were calculated sequentially. The optimal %fPSA threshold was determined to be 0.16, and the optimal PSAD threshold was 0.12 for %fPSA ≥0.16 and 0.23 for %fPSA <0.16, respectively. When PSAD <0.12 was combined with patients with %fPSA ≥0.16, the NPV of csPCa increased from 0.832 (95% confidence interval [CI]: 0.766-0.887) to 0.931 (95% CI: 0.833-0.981); the detection rate of csPCa was similar when further stratified by PI-RADS scores (P = 0.552). Combining %fPSA <0.16 with PSAD ≥0.23 ng ml-2 predicted significantly more csPCa patients than those with PSAD <0.23 ng ml-2 (58.4% vs 26.7%, P < 0.001). Using PI-RADS scores 4 and 5, the PPV was 0.739 (95% CI: 0.634-0.827) when further stratified by mpMRI results. In biopsy-naïve patients with PSA level of 4-10 ng ml-1, stratification of %fPSA and PSAD combined with PI-RADS scores may be useful in the decision-making process prior to undergoing PBx.

Effects of physical activity and use of digital devices on visual acuity in children and adolescents during the COVID-19 pandemic: A cross-sectional study.

Purpose: To determine the association between poor visual acuity, the use of digital devices and physical activity (PA) during the COVID-19 pandemic. Methods: A total of 327,646 Chinese children and adolescents were included in the analysis using a cluster random sampling method; this is a case-control study, of those 144,708 children and adolescents with poor visual acuity were included in the case group, while 182,938 who did not have poor visual acuity were included in the control group. A logistic regression model was used to assess the contribution of PA and the use of digital devices to poor visual acuity. Results: A total of 144,708 children and adolescents experienced poor visual acuity during the COVID-19 pandemic; 54.8% were male, and 55.2% live in rural areas. Compared to controls, children and adolescents with poor visual acuity exhibited more time for the use of digital devices (4.51 ± 2.44 vs. 3.79 ± 2.34 for cases and controls, respectively; P < 0.001) and PA (3.07 ± 0.92 vs. 2.85 ± 1.00 for cases and controls, respectively; P < 0.001). During the COVID-19 pandemic, risk factors related to poor visual acuity among children and adolescents included the use of digital devices (OR 1.135; 95% CI 1.132-1.139), and PA (OR 1.269; 95%CI 1.259-1.278). The results of interaction analysis show that for children and adolescents aged 12 to 17, the positive association between the use of digital devices and poor visual acuity decreased. The interaction effect between PA and digital devices is 0.987. Conclusions: Children and adolescents were at risk of poor visual acuity during the COVID-19 pandemic. Extended use of the digital devices increased the risk of poor visual acuity, especially for children aged 6-11 years. But the risk of poor visual acuity among children and adolescents decreases as the time spent on PA increases.