Nevin Manimala

BMC Public Health. 2022 Dec 27;22(1):2439. doi: 10.1186/s12889-022-14711-7.

ABSTRACT

BACKGROUND: Population aging has led to depression becoming a serious public health problem both in China and worldwide. Marital relationships, relationships with their children, and air pollution might play an important role in the process of depressive disorders. In this study, we aimed to reveal the mechanism of the effects of these factors on depression.

METHODS: Participants were recruited from The China Health and Retirement Longitudinal Study (CHARLS) (wave 4) from July 2018 to March 2019. Depression symptoms were evaluated using the 10-item Center for Epidemiologic Studies depression scale (CESD-10). Marital relationships, relationships with their children, air quality satisfaction, and perceived health status were analyzed using Likert 5-point evaluation methods. Structural equation modeling-path (SEM) models were used to explore these variables’ mediation effects on depression symptoms.

RESULTS: Marital relationships, relationships with their children, air quality satisfaction, perceived health status, and depression symptoms were significantly associated with each other (P < 0.001). Mediation analysis showed that family relationships (standardized beta = -0.28 [-0.31, -0.26]) and quality satisfaction (standardized beta = -0.03 [-0.05, -0.01]) had negative effects on depression symptoms. The total indirect effects of family relationships and air quality satisfaction on depression symptoms were -0.06 (95% confidence interval (CI) = [-0.07, -0.05]) and -0.016 (95% CI = [-0.02, -0.01]), respectively.

CONCLUSION: Family relationships, air quality satisfaction, and perceived health status influenced depression symptoms. The effects of family relationships and air quality satisfaction on depression symptoms were significantly mediated by perceived health status. Therefore, perceived health status aspects should be considered when conducting targeted intervention toward depression symptoms among middle-aged and elderly adults.

PMID:36575446 | DOI:10.1186/s12889-022-14711-7

BMC Endocr Disord. 2022 Dec 28;22(1):332. doi: 10.1186/s12902-022-01255-5.

ABSTRACT

BACKGROUND: Socioeconomic status (SES) strongly predicts morbidity and premature mortality, especially for non-communicable diseases (NCDs). However, the effect of these factors on Metabolic Syndrome (MetS) is not clear yet. This study was conducted to assess the relationship between socioeconomic indicators and MetS.

METHODS: In this prospective cohort study, 10,009 people aged 35-70 enrolled from May 2016 to August 2018. The MetS was defined according to The Standard National Cholesterol Education Program (NCEP)-adult treatment panel III (ATP III) or NCEP-ATP III criteria. Demographics and socioeconomic data were gathered face-to-face through trained interviews. Also, lab, anthropometrics, and blood pressure measurements were assayed for participants. Logistic regression was used to estimate the association between SES and MetS, adjusted for the potential confounding factors.

RESULTS: The overall prevalence of MetS in the participants was 39.1%. The crude odds ratios were statistically significant for all the assessed variables (p < 0.05). After adjustment for age, sex, physical activity, smoking, and alcohol use as potential confounders, the results indicated significant direct independent associations between skill level (p = 0.006) and Townsend index (p = 0.002) with MetS. In contrast, no significant associations between educational level and wealth status with MetS.

CONCLUSION: The results of our study showed that SES is related to MetS. Among the four assessed SES indicators, skilled levels and Townsend score are strongly associated with MetS. We recommend considering people’s SES when interventional programs are planned and conducted on MetS in similar communities.

PMID:36575435 | DOI:10.1186/s12902-022-01255-5

Trials. 2022 Dec 28;23(1):1054. doi: 10.1186/s13063-022-06899-1.

ABSTRACT

BACKGROUND: The Minimising Young Children’s Anxiety through Schools (MY-CATS) trial is being conducted to determine whether an online evidence-based parent-guided cognitive behavioural therapy intervention in addition to usual school practice is effective and cost-effective compared with usual school practice in reducing anxiety disorders in children aged 4-7 deemed ‘at risk’ of anxiety disorders. This update article describes the detailed statistical analysis plan for the MY-CATS trial and reports a review of the underpinning sample size assumptions.

METHODS AND DESIGN: The MY-CATS study is a two-arm, definitive superiority pragmatic parallel group cluster randomised controlled trial in which schools will be randomised 1:1 to receive either the intervention (in addition to usual school practice) or the usual school practice only. This update to the (published) protocol provides a detailed description of the study methods, the statistical principles, the trial population and the planned statistical analyses, including additional analyses comprising instrumental variable regression and mediation analysis.

TRIAL REGISTRATION: ISRCTN82398107 . Prospectively registered on 14 January 2021.

PMID:36575433 | DOI:10.1186/s13063-022-06899-1

J Phys Chem B. 2022 Dec 27. doi: 10.1021/acs.jpcb.2c06641. Online ahead of print.

ABSTRACT

Assemblies of proteins and charged macromolecules (polyelectrolytes) find important applications as pharmaceutical formulations, biocatalysts, and cell-contacting substrates. A key question is how the polymer component influences the structure and function of the protein. The present paper addresses the influence of charged polymers on the thermal stability of two model beta-hairpin-forming peptides through an all-atom, replica exchange molecular dynamics simulation. The (negatively charged) peptides consist of the terminal 16 amino acids of the B1 domain of Protein G (GB1) and a variant with three of the GB1 residues substituted with tryptophan (Tryptophan Zipper 4, or TZ4). A (cationic) lysine polymer is seen to thermally stabilize TZ4 and destabilize GB1, while a (also cationic) chitosan polymer slightly stabilizes GB1 but has essentially no effect on TZ4. Free energy profiles reveal folded and unfolded conformations to be separated by kinetic barriers generally acting in the direction of the thermodynamically favored state. Through application of an Ising-like statistical mechanical model, a mechanism is proposed based on competition between (indirect) entropic stabilization of folded versus unfolded states and (direct) competition for hydrogen-bonding and hydrophobic interactions. These findings have important implications to the design of polyelectrolyte-based materials for biomedical and biotechnological applications.

PMID:36574611 | DOI:10.1021/acs.jpcb.2c06641

J Dent. 2022 Nov 26:104381. doi: 10.1016/j.jdent.2022.104381. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate a method for in situ reference acquisition of implant positions in complete edentulous maxillae using an industrial scanner. To assess in vivo trueness of full-arch implant-supported fixed dentures (IFD) and dental models based on conventional impressions.

METHODS: In five subjects, scan-bodies were mounted to six maxillary implants and scanned three times using an industrial scanner (REF). Original impression-based models used to manufacture existing IFDs, (MOD1), and models fabricated from new polyether impressions, (MOD2), were scanned three times with a laboratory scanner. Scan-bodies were aligned and exported with analogue positions corresponding to implant positions. Implant analogues were mounted onto existing IFDs and scanned three times (BRIDGE). CAD files of scan-bodies with inter-aligned CAD-analogues were geometry-aligned to REF. CAD-analogues were aligned to exported files of MOD1 and MOD2, and to BRIDGE. Resulting six CAD-analogues were Globally Aligned using a consistent geometry-based alignment. Deviations were computed after a Reference Point System Alignment at the implant/prosthetic platform for Cartesian axes and a linear Resultant.

RESULTS: REF precision was 9.3 ± 1 µm. In vivo trueness for Resultant was MOD1: 36±16 µm, MOD2: 28±7 µm and BRIDGE: 70±23 µm, where MOD1 and MOD2 were statistically significantly different from BRIDGE. In vitro manufacturing trueness of Resultant when MOD1 acted reference for BRIDGE was: 69 ± 22.

CONCLUSIONS: This method can be applied for assessing in vivo trueness. CAD/CAM processed IFD showed deviations twice that of impression-based models, however, errors from impressions and subsequent model scans were not additive to the entire workflow.

PMID:36574597 | DOI:10.1016/j.jdent.2022.104381

Joint Bone Spine. 2022 Nov 26:105501. doi: 10.1016/j.jbspin.2022.105501. Online ahead of print.

ABSTRACT

OBJECTIVES: Polyarticular juvenile idiopathic arthritis (pJIA) is a subset of juvenile idiopathic arthritis (JIA), divided into two subtypes according to the presence of rheumatoid factor : pJIA without rheumatoid factor (pJIA RF-) and pJIA with positive rheumatoid factor (pJIA RF+), this latter is characterised with more structural damage. Anti-citrullinated peptide antibodies (ACPA) are often associated with RF. The respective performance of ACPA versus RF in structural outcome in pJIA, and in particular in adulthood pJIA remains unknown. Therefore, the aim of this study was to determine whether ACPA could be of value to assess structural damage in pJIA persisting in adulthood.

METHODS: Patients with pJIA and available data for ACPA, RF and X-ray were included retrospectively. Structural damage was assessed by two independent blinded investigators using Sharp Van Der Heijde scores.

RESULTS: 56 pJIA adult patients were included : 62% (35/56) had pJIA RF+ and 38% (21/56) pJIA RF-. ACPA positivity in pJIA was significantly associated with presence of RF (96% vs 26%, p<0.001 ). RF positivity was significantly associated with higher Sharp van Der Heijde erosion and total scores (respectively p< 0.01 and p< 0.05 ). There were higher Sharp Van Der Heijde erosion, joint space narrowing and total scores in the pJIA ACPA+ subgroup than in the pJIA ACPA- subgroup, although there was no statistical significance. However, when adjusted on disease duration, pJIA ACPA+ patients had significantly higher erosion and total scores than pJIA ACPA- patients (p<0.05), and pJIA ACPA+ patients required more bDMARDs than pJIA ACPA- patients (p<0.05). Moreover, pJIA patients with high Sharp van Der Heijde joint space narrowing and total scores had significantly higher ACPA levels (p<0.01). A correlation was identified between ACPA levels and Sharp van Der Heijde total score ( r=0.54, p<0.05). In the pJIA RF+ subgroup the presence of ACPA was associated with additional structural damage compared to no ACPA: sharp Van Der Heijde erosion, joint space narrowing and total scores were higher in the pJIA RF+ ACPA+ subgroup than in the pJIA RF+ ACPA- subgroup although these results did not reach significance.

CONCLUSION: Our results suggest that pJIA RF+ ACPA+ adult patients may have a more severe articular phenotype than pJIA RF+ ACPA- patients. ACPA could bring an additional value to RF for pJIA patients regarding structural damage. Altogether our results show that RF and ACPA are associated with structural damage measured by Sharp Van Der Heijde score in pJIA persisting in adulthood.

PMID:36574572 | DOI:10.1016/j.jbspin.2022.105501

Ann Vasc Surg. 2022 Nov 26:S0890-5096(22)00729-4. doi: 10.1016/j.avsg.2022.10.008. Online ahead of print.

ABSTRACT

OBJECTIVES: Thoracic Endovascular Aortic Repair (TEVAR) is a minimally invasive surgery for repairing thoracic aneurysms and dissections. This study aims to compare postoperative outcomes of TEVAR performed under general versus locoregional anesthesia.

MATERIAL AND METHODS: Utilizing the 2008-2019 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database, patients older than the age of 18 years who received TEVAR, were identified using the following current procedural terminology codes: 33880, 33881, 33883, 33884, or 33886. Patients who underwent concomitant procedures, those with both thoraco-abdominal and abdominal aortic pathologies, and trauma cases were excluded. Standard descriptive statistics, in addition to χ², Fisher’s exact, and Mann-Whitney U tests were used to compare patient baseline characteristics and postoperative outcomes between general and locoregional anesthesia groups, as appropriate. Univariable and multivariable logistic regression analyses were performed to assess independent predictors of hospital length of stay (LOS) greater than 7 days.

RESULTS: Of the 1,028 patients included in the study, 86.5% received general anesthesia, and 13.5% received locoregional anesthesia, such as local anesthesia with monitored anesthesia care or regional anesthesia. No significant differences were found between patients receiving locoregional vs general anesthesia in mortality (3.6% vs 7.9%, respectively, p=0.071) and morbidity (18.7% and 24.8%, respectively, p=0.121) within 30 days post-TEVAR, including any wound, pulmonary, thromboembolic, renal, septic, and cardiac arrest complications. Patients who received general anesthesia had significantly higher median LOS compared to those who received locoregional anesthesia [5 days (IQR: 3-10) vs 4 days (IQR: 2-7), p=0.002], with 34.3% of the general anesthesia group having a LOS greater than 7 days compared to 21.6% of locoregional anesthesia group, p=0.003. On multivariable logistic regression analysis, general anesthesia was found to be an independent predictor of prolonged LOS greater than 7 days (OR: 1.72, 95% CI: 1.05-2.81, p=0.031).

CONCLUSION: Locoregional anesthesia results in significantly lower postoperative hospital LOS with similar postoperative mortality and morbidity compared to general anesthesia in patients undergoing TEVAR.

PMID:36574571 | DOI:10.1016/j.avsg.2022.10.008

J Gerontol A Biol Sci Med Sci. 2022 Dec 27:glac256. doi: 10.1093/gerona/glac256. Online ahead of print.

ABSTRACT

BACKGROUND: This study was performed to derive and validate a prognostic prediction model for individualized estimation of mortality risk among the frail oldest old (aged 80 years or older).

METHODS: This analysis was based on the prospective open cohort study from the Chinese Longevity and Health Longitudinal Survey. A total of 14118 frail oldest old were included from the 2002 wave to 2014 waves; the study outcome was all-cause mortality. Available predictors included frailty, demographics, and social factors. Cox models were used to estimate the coefficients of the predictors and least absolute shrinkage and selection operator (LASSO) was used for selecting predictors. Model performance was measured by discrimination and calibration with internal validation by bootstrapping. We also developed a nomogram to visualize and predict the three-year mortality risk based on the obtained prognostic prediction model.

RESULTS: During the 16-years follow-up, 10410 (76.42%) deaths were identified. The final model comprises the following factors: frailty, age, sex, race, birthplace, education, occupation, marital status, residence, economic condition, number of children, and the question “who do you ask for help first when in trouble”. The model has valid predictive ability as measured and validated by Harrell’s C statistic (0.602) and calibration plots.

CONCLUSIONS: This study provides a basic prognostic prediction model to quantify absolute mortality risk for the frail oldest old. Future studies are needed, firstly, to update, adjust, and perform external validation of the present model by using phenotypic frailty, and secondly, to add biomarkers, environmental, and psychological factors to the prediction model.

PMID:36574506 | DOI:10.1093/gerona/glac256

Hum Factors. 2022 Dec 27:187208221145264. doi: 10.1177/00187208221145264. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the effect of gender transfer in virtual reality on implicit gender bias.

BACKGROUND: Gender bias is a type of discrimination based on gender, which can lead to increased self-doubt and decreased self-esteem. Sexual harassment is a hostile form of gender bias that can cause anxiety, depression, and significant mental health issues. Virtual reality (VR) has been employed to help make people become aware of their biases and change their attitudes regarding gender, race, and age.

METHODS: Forty participants were embodied in avatars of different genders and experienced sexual harassment scenarios in VR. A gender Implicit Association Test (IAT) was administered before and after the experience.

RESULTS: There was a statistically significant main effect of participant gender (F (1,36) = 10.67, p = .002, partial η² = .23) on ΔIAT, where males and females reported a decrease (M = -.12, SD = .24) and an increase (M = .10, SD = .25) in IAT scores, respectively. A statistically significant two-way interaction between gender transfer and participant gender was revealed (F (1,36) = 6.32, p = .02, partial η² = .15). There was a significant simple effect of gender transfer for male participants (F (1,36) = 8.70, p = .006, partial η² = .19).

CONCLUSIONS: Implicit gender bias can be modified, at least temporarily, through embodiment in VR. Gender transfer through embodiment while encountering different sexual harassment scenarios helped reduce implicit gender bias. There was a tendency for individuals to increase bias for the gender of the avatar in which they embodied.

APPLICATIONS: The current research provided promising evidence that a virtual environment system may be used as a potential training tool to improve implicit gender bias.

PMID:36574504 | DOI:10.1177/00187208221145264

Nicotine Tob Res. 2022 Dec 27:ntac294. doi: 10.1093/ntr/ntac294. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the percentage and correlates of giving and receiving cigarettes as gifts among adult non-smokers in China.

METHODS: We analyzed non-smokers (N=1,813) aged ≥18 years using data from the International Tobacco Control China Wave 5 Survey. Descriptive statistics summarized the characteristics of those who gave and received cigarettes as gifts. Multivariable logistic regression models were used to identify factors associated with the two behaviors.

RESULTS: Among non-smokers, 9.9% reported giving cigarettes as gifts to family or friends in the last 6 months. Higher level of knowledge about smoking harms was associated with lower adjusted odds of gifting cigarettes. Non-smokers aged 25-39, with middle income, positive attitude toward cigarette gifts, exposure to anti-smoking information and smoking promotion, and those who reported receiving cigarettes as gifts from family or friends were more likely to give cigarettes as gifts. 6.6% of non-smokers reported receiving cigarettes as gifts in the last 6 months. High education, neutral or positive attitude toward cigarette gifts, exposure to anti-smoking information, exposure to smoking promotion, and having smoking friends were associated with receiving cigarettes as gifts.

CONCLUSIONS: It is concerning that Chinese cultural norms that support cigarette gifting have extended to giving non-smokers cigarettes as gifts. Effective anti-smoking messages are needed. Changing the norms around cigarette gifting and increasing knowledge about smoking harms should help reduce cigarette gifting among non-smokers.

IMPLICATIONS: Easy access to cigarettes received as gifts, along with the wide acceptance of smoking in China, places Chinese non-smokers in a risky position. More educational campaigns targeting non-smokers to proactively prevent them from smoking are called for.The ineffectiveness of existing anti-smoking information highlights the need for more effective anti-smoking messages.That attitude toward cigarette gifts is the strongest predictor of giving cigarettes as gifts suggests a need for interventions to reverse the positive attitude about cigarette gifting in order to decrease the popularity of this activity.

PMID:36574502 | DOI:10.1093/ntr/ntac294