Publications by authors named "Wanxin Wang"

36 Publications

Childhood maltreatment predicts subsequent anxiety symptoms among Chinese adolescents: the role of the tendency of coping styles.

Transl Psychiatry 2021 Jun 2;11(1):340. Epub 2021 Jun 2.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 510080, Guangzhou, People's Republic of China.

Childhood maltreatment may have an influence on anxiety symptoms and coping styles. This longitudinal study aimed to estimate the prospective associations between different types of childhood maltreatment and anxiety symptoms among Chinese adolescents, with a particular focus on investigating whether these associations vary by the tendency of coping styles. Data were from the Longitudinal Study of Adolescents' Mental and Behavioral Well-being Research. The baseline sample included 1957 participants (response rate: 99.03%) and followed up at 1-year later (n = 1836, retention rate: 93.8%). Anxiety symptoms, childhood maltreatment, the tendency of coping styles, morning cortisol level, depressive symptoms, self-esteem, and other demographics were measured. Overall, the mean age of the baseline students was 13.6 (SD: 1.5) years. The final results showed that childhood emotional abuse (unstandardized β-estimate = 0.13, 95% CI = 0.07-0.18), physical abuse (unstandardized β-estimate = 0.08, 95% CI = 0.01-0.16), and sexual abuse (unstandardized β-estimate = 0.17, 95% CI = 0.04-0.29) were positively associated with anxiety symptoms at follow-up after adjusting for significant covariates at baseline. Additionally, the stratified analyses demonstrated that only among students with negative coping styles, childhood emotional abuse, physical abuse, and sexual abuse were associated with subsequent anxiety symptoms; the differences between the positive and negative coping style strata were significant (P < 0.05). Childhood maltreatment appears to be a predictor of anxiety symptoms among adolescents, and the tendency of coping styles may have a moderating role in these longitudinal associations. The efforts to prevent anxiety symptoms are recommended to be focused on adolescents with the experience of childhood maltreatment and negative coping styles.
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http://dx.doi.org/10.1038/s41398-021-01463-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8172629PMC
June 2021

Understanding the human endometrium in the 21st century.

Am J Obstet Gynecol 2021 May 19. Epub 2021 May 19.

Igenomix Foundation, INCLIVA Health Research Institute, Valencia, Spain; Department of Obstetrics and Gynecology, University of California, San Francisco, CA; Department of Obstetrics and Gynecology, University of Valencia, Valencia, Spain; Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Electronic address:

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http://dx.doi.org/10.1016/j.ajog.2021.04.224DOI Listing
May 2021

The associations between sleep situations and mental health among Chinese adolescents: A longitudinal study.

Sleep Med 2021 Jun 13;82:71-77. Epub 2021 Mar 13.

Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.

Objective: Few studies are conducted to explore the longitudinal relationships between sleep situations and mental health among adolecents. This study aimed to explore the sleep situations (ie, sleep habits and sleep problems) among Chinese adolescents and the longitudinal associations between sleep situations and mental disorder symptoms (ie, depressive and anxiety symptoms).

Methods: This longitudinal study included 1957 high school students from ten schools in Guangzhou in January 2019, with 1836 students contributing valid data at a one-year follow-up (retention rate: 93.9%). Data of depressive and anxiety symptoms, sleep habits, and sleep problems were collected using a self-reported questionnaire.

Results: The current study found that over half of the adolescents did not reach the recommended 8-h sleep-time on weekdays (63.3%). Short sleep duration, especially on weekdays, was significantly associated with subsequent depressive (AOR = 0.86, 95%CI: 0.80-0.92) and anxiety symptoms (AOR = 0.86, 95%CI: 0.77-0.96). In addition, longer weekday-weekend catch-up sleep and more sleep problems were risk factors of depressive and anxiety symptoms.

Conclusions: The health effects of insufficient sleep and suboptimal sleep quality on adolescents should not be neglected. Our longitudinal research showed that adolescents would demonstrate severer depressive and anxiety symptoms if lacking of a healthy sleeping practice. A regular sleep schedule and close attention to adolescents' mental disorders are highly recommended.
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http://dx.doi.org/10.1016/j.sleep.2021.03.009DOI Listing
June 2021

The relationship between childhood emotional abuse and depressive symptoms among Chinese college students: The multiple mediating effects of emotional and behavioral problems.

J Affect Disord 2021 Jun 31;288:129-135. Epub 2021 Mar 31.

Department of Psychiatry, University of Toronto, Toronto, ON, Canada.

Background: This study aims to explore the mediational effects of emotional and behavioral problems on the association between childhood emotional abuse and depressive symptoms among college students.

Methods: Data were drawn from 60 universities from 10 provinces in China (n=30,374). Information about childhood maltreatment, depressive symptoms, emotional and behavioral problems were gathered through the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Center for Epidemiologic Studies Depression Scale (CES-D) and the Strengths and Difficulties Questionnaire (SDQ), respectively. Univariable and multivariable logistic regression models and mediating models were used.

Results: After controlling for demographic factors, childhood emotional abuse was the strongest risk factor for depressive symptoms (adjusted odds ratio (aOR)=2.54, 95%CI=2.27-2.85). The relationship between childhood emotional abuse and depressive symptoms was partially mediated by emotional and behavioral problems with 68.7% total indirect effect. Among the 5 identified subtypes of emotional and behavioral problems, the mediating effects of emotional problems (57.3%) and hyperactivity (28.6%) were higher than peer problems (7.8%) and prosocial behavior (3.6%). Conduct problems did not show a significant mediating effect (p>0.05).

Limitations: The cross-sectional design is limited to make inferences about causality.

Conclusions: Childhood emotional abuse was strongly associated with depressive symptoms in college students. Of the five identified subtypes of emotional and behavioral problems, four subtypes mediated the relationship between childhood emotional abuse and depressive symptoms, including emotional problems, hyperactivity, peer problems and prosocial behavior.
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http://dx.doi.org/10.1016/j.jad.2021.03.074DOI Listing
June 2021

Associations of emotional and behavioral problems with Internet use among Chinese young adults: the role of academic performance.

J Affect Disord 2021 05 23;287:214-221. Epub 2021 Mar 23.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. Electronic address:

Background: To investigate the independent association between different types of emotional and behavioral problems and Internet use (i.e., Internet use time and problematic Internet use [PIU]) among Chinese young adults, and to test whether these associations vary by academic performance.

Methods: Data was drawn from the 2019 National School-based Chinese Adolescents Health Survey, and 30,581 undergraduates (mean age: 19.9 [SD: 1.6] years) completed standard questionnaires qualifiedly. Daily hours of Internet use, PIU, emotional and behavioral problems, and academic performance were measured.

Results: After adjusting for control variables and academic performance, students who reported having emotional problems (daily hours: adjusted unstandardized β estimate=0.14, 95% CI=0.12~0.15; PIU: adjusted unstandardized β estimate=1.82, 95% CI=1.77~1.89), conduct problems (daily hours: adjusted unstandardized β estimate=0.12, 95% CI=0.09~0.15; PIU: adjusted unstandardized β estimate=1.76, 95% CI=1.67~1.84), hyperactivity (daily hours: adjusted unstandardized β estimate=0.08, 95% CI=0.06~0.12; PIU: adjusted unstandardized β estimate=1.46, 95% CI=1.38~1.54), and peer problems (daily hours: adjusted unstandardized β estimate=0.03, 95% CI=0.002~0.05; PIU: adjusted unstandardized β estimate=0.53, 95% CI=0.44~0.62) were more likely to engaged in prolonged daily Internet use and PIU. In contrast, prosocial behavior was negatively associated with Internet use time and PIU. Stratified analyses showed that some of the associations in poor academic performers were stronger than in students with good and average academic performance.

Limitations: The cross-sectional design limited the ability to make causal inferences.

Conclusions: The findings suggest that the efforts to prevent abnormal Internet use should be focused on students with emotional and behavioral problems or poor academic performance.
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http://dx.doi.org/10.1016/j.jad.2021.03.050DOI Listing
May 2021

Association of FKBP5 gene variants with depression susceptibility: A comprehensive meta-analysis.

Asia Pac Psychiatry 2021 Jun 20;13(2):e12464. Epub 2021 Mar 20.

Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China.

Background: This comprehensive meta-analysis aimed to combine data from different studies and to estimate the association between FKBP5 polymorphisms and depression.

Methods: We performed a meta-analysis of observational studies. An electronic search was conducted on four databases for articles published before July 1, 2020.

Results: A total of 5125 patients with depression and 8399 controls from 16 independent studies were included in the analysis. The results showed that FKBP5 rs1360780 was associated with the risk of depression in the codominant model (CT vs. CC; OR = 1.10, 95% CI = 1.00-1.20, P = .04); rs4713916 polymorphism was associated with depression in the codominant model (AG vs. GG; OR = 1.19, 95% CI = 1.05-1.34, P = .008) and recessive model (AA vs. AG + GG; OR = 0.74, 95% CI = 0.56-0.99, P = .04); a significant association between rs3800373 and depression was found in the codominant genetic model (AC vs. AA; OR = 1.18, 95% CI = 1.05-1.34, P = .007) and dominant model (CC + AC vs. AA; OR = 1.15, 95% CI = 1.03-1.30, P = .02); there was no significant association of FKBP5 rs9470080 or rs9296158 with depression in any genetic model (P > .05). No publication bias was observed in our analysis. Moreover, sensitivity analyses demonstrated the Zobel's study significantly affected the heterogeneity for rs4713916 and rs3800373.

Conclusions: FKBP5 rs1360780 was associated with an increased risk of depression in the codominant model. We also found that rs4713916 and rs3800373 were involved in depression, rs4713916 was positively associated with depression in the codominant model and recessive model, and rs3800373 was related to an elevated risk of depression in the codominant model and dominant model.
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http://dx.doi.org/10.1111/appy.12464DOI Listing
June 2021

Association between problematic internet use and behavioral/emotional problems among Chinese adolescents: the mediating role of sleep disorders.

PeerJ 2021 22;9:e10839. Epub 2021 Feb 22.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China.

Background: Studies that focus on the relationships of problematic Internet use (PIU), sleep disorders, and behavioral/emotional problems were limited. This study aimed to explore (1) the relationship between PIU and behavioral/emotional problems among Chinese adolescents and (2) whether sleep disorders mediate the relationship between PIU and behavioral/emotional problems.

Methods: A total of 1,976 adolescents were recruited by cluster sampling from ten secondary schools in Guangzhou between January and April 2019, and 1,956 of them provided valid information (response rate: 98.9% ). Among them, 50.8% were males and the mean age was 13.6±1.5 years, ranging from 11 to 18 years. Data on behavioral/emotional problems, sleep disorders, and PIU were collected using a self-reported questionnaire. Linear regression models and mediation analyses were performed.

Results: Of the participants, 14.5% (284/1,956) reported moderate to severe PIU, and their average score for total difficulties was significantly higher than the score for average users (14.9±5.5 Vs 9.8±4.7). After adjusting for controlled variables, PIU was further proven to be positively related to elevated levels of behavioral/emotional problems (unstandardized  = 0.16,  < 0.05). In addition, sleep disorders partially mediated the forgoing associations.

Conclusions: Adolescents with problematic Internet habits were at higher risk of developing behavioral and emotional problems than their normal-use peers, and sleep disorders partially mediated the effect. Close attention and effective guidance for adolescents with PIU and behavioral/emotional problems were recommended for parents and schools.
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http://dx.doi.org/10.7717/peerj.10839DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7906038PMC
February 2021

Association between problematic internet use and behavioral/emotional problems among Chinese adolescents: the mediating role of sleep disorders.

PeerJ 2021 22;9:e10839. Epub 2021 Feb 22.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China.

Background: Studies that focus on the relationships of problematic Internet use (PIU), sleep disorders, and behavioral/emotional problems were limited. This study aimed to explore (1) the relationship between PIU and behavioral/emotional problems among Chinese adolescents and (2) whether sleep disorders mediate the relationship between PIU and behavioral/emotional problems.

Methods: A total of 1,976 adolescents were recruited by cluster sampling from ten secondary schools in Guangzhou between January and April 2019, and 1,956 of them provided valid information (response rate: 98.9% ). Among them, 50.8% were males and the mean age was 13.6±1.5 years, ranging from 11 to 18 years. Data on behavioral/emotional problems, sleep disorders, and PIU were collected using a self-reported questionnaire. Linear regression models and mediation analyses were performed.

Results: Of the participants, 14.5% (284/1,956) reported moderate to severe PIU, and their average score for total difficulties was significantly higher than the score for average users (14.9±5.5 Vs 9.8±4.7). After adjusting for controlled variables, PIU was further proven to be positively related to elevated levels of behavioral/emotional problems (unstandardized  = 0.16,  < 0.05). In addition, sleep disorders partially mediated the forgoing associations.

Conclusions: Adolescents with problematic Internet habits were at higher risk of developing behavioral and emotional problems than their normal-use peers, and sleep disorders partially mediated the effect. Close attention and effective guidance for adolescents with PIU and behavioral/emotional problems were recommended for parents and schools.
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http://dx.doi.org/10.7717/peerj.10839DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7906038PMC
February 2021

Associations Among Screen Time, Sleep Duration and Depressive Symptoms Among Chinese Adolescents.

J Affect Disord 2021 04 2;284:69-74. Epub 2021 Feb 2.

Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China. Electronic address:

Objectives: Relatively few studies have explored the inter-relationship between screen time (ST), sleep duration and depressive symptoms. The study herein sought to determine (1) the relationships between ST, sleep duration and depressive symptoms among Chinese adolescents; (2) whether sleep duration mediates the relationships between ST and depressive symptoms.

Methods: 1 grade students (n=1,976) from ten high schools in Guangzhou, China were invited through cluster sampling between January and April 2019. Self-reported ST with electronic devices and Internet, sleep duration, and The Center for Epidemiology Scale for Depression (CES-D) score were collected. Generalized mixed linear models and mediation analyses were conducted.

Results: There were 1,956 self-reported questionnaires received (response rate: 98.99%). Approximately 25% (471/1,929 for Internet use, 399/1,928 for electronic device) of the total sample reported ST >2 hours/day. Approximately 8.9% (169/1,894) reported a CES-D score >28. Longer ST with electronic devices (estimate=0.52, 95%CI: 0.24~0.80), Internet usage (estimate=0.82, 95%CI: 0.53~1.11) were positively associated with depressive symptoms, while less sleep (estimate=-1.85, 95%CI: -2.27~-1.43) was negatively associated with depressive symptoms. There is significant indirect effect of electronic device usage on depressive symptoms through sleep duration (indirect effect=0.08, 95%CI: 0.01~0.15).

Limitations: This study only included school students from Guangzhou. Causal relationship cannot be inferred by this cross-sectional design.

Conclusions: ST and sleep duration were significantly associated with depressive symptoms severity. The indirect effect of sleep duration suggests a possible mechanism of the association between ST and depressive symptoms. Future interventions to manage depressive symptoms should target sleep time and decrease ST among adolescents.
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http://dx.doi.org/10.1016/j.jad.2021.01.082DOI Listing
April 2021

Associations Among Screen Time, Sleep Duration and Depressive Symptoms Among Chinese Adolescents.

J Affect Disord 2021 04 2;284:69-74. Epub 2021 Feb 2.

Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China. Electronic address:

Objectives: Relatively few studies have explored the inter-relationship between screen time (ST), sleep duration and depressive symptoms. The study herein sought to determine (1) the relationships between ST, sleep duration and depressive symptoms among Chinese adolescents; (2) whether sleep duration mediates the relationships between ST and depressive symptoms.

Methods: 1 grade students (n=1,976) from ten high schools in Guangzhou, China were invited through cluster sampling between January and April 2019. Self-reported ST with electronic devices and Internet, sleep duration, and The Center for Epidemiology Scale for Depression (CES-D) score were collected. Generalized mixed linear models and mediation analyses were conducted.

Results: There were 1,956 self-reported questionnaires received (response rate: 98.99%). Approximately 25% (471/1,929 for Internet use, 399/1,928 for electronic device) of the total sample reported ST >2 hours/day. Approximately 8.9% (169/1,894) reported a CES-D score >28. Longer ST with electronic devices (estimate=0.52, 95%CI: 0.24~0.80), Internet usage (estimate=0.82, 95%CI: 0.53~1.11) were positively associated with depressive symptoms, while less sleep (estimate=-1.85, 95%CI: -2.27~-1.43) was negatively associated with depressive symptoms. There is significant indirect effect of electronic device usage on depressive symptoms through sleep duration (indirect effect=0.08, 95%CI: 0.01~0.15).

Limitations: This study only included school students from Guangzhou. Causal relationship cannot be inferred by this cross-sectional design.

Conclusions: ST and sleep duration were significantly associated with depressive symptoms severity. The indirect effect of sleep duration suggests a possible mechanism of the association between ST and depressive symptoms. Future interventions to manage depressive symptoms should target sleep time and decrease ST among adolescents.
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http://dx.doi.org/10.1016/j.jad.2021.01.082DOI Listing
April 2021

Association of sexual minority status, gender nonconformity with childhood victimization and adulthood depressive symptoms: A path analysis.

Child Abuse Negl 2021 Jan 6;111:104822. Epub 2020 Dec 6.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China. Electronic address:

Background: Sexual minority status and childhood gender nonconformity have been associated with elevated risks of childhood adversities and poorer mental health.

Objective: To explore how abuse and bullying explain the disparities in the associations of sexual minority status and childhood gender nonconformity with adulthood depressive symptoms in men.

Participants And Setting: We conducted a cross-sectional study using a self-report questionnaire among Chinese adult men (18-35 years) who were identified as heterosexual (n = 873) and sexual minority (n = 858) in Guangzhou from 2017 to 2019.

Methods: Structural equation modeling (SEM) were conducted for path analysis.

Results: The levels of exposure to childhood maltreatment were higher in sexual minorities than in straight men, and sexual minority status predicted an increased risk of depressive symptoms via childhood maltreatment (indirect effect: β = 0.026, p = 0.004). Meanwhile, childhood gender nonconformity predicted higher depressive symptoms via both family (indirect effect: β = 0.042, p < 0.001) and school (indirect effect: β = 0.028, p < 0.001) victimization, and there was a direct effect (β = 0.154, p < 0.001) of gender nonconformity on depressive symptoms.

Conclusion: Sexual minority status and gender nonconformity are indicators of men's increased risk of childhood victimization and adulthood depressive symptoms. As a result, intervention based on both family and school dimensions needs to be developed.
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http://dx.doi.org/10.1016/j.chiabu.2020.104822DOI Listing
January 2021

Association Among Maltreatment, Bullying and Mental Health, Risk Behavior and Sexual Attraction in Chinese Students.

Acad Pediatr 2020 Dec 3. Epub 2020 Dec 3.

Department of Medical Statistics and Epidemiology (M Zhao, W Wang, R Wu, L Guo, C Lu), School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China. Electronic address:

Objective: To identify the association between sexual attraction, childhood maltreatment and bullying victimization, and mental and behavioral health problems among Chinese adolescents.

Methods: A cross-sectional study among Chinese high school students by multistage stratified cluster sampling was conducted using a self-reported questionnaire. Participants who were same- or both-sex attracted were identified as sexual minorities, and those who were opposite-sex attracted were identified as heterosexuals. Childhood maltreatment was assessed as physical, emotional, and sexual abuse, and bullying was assessed as traditional and cyberbullying. Psychological distress was assessed as depressive and anxiety symptoms, and self-destructive behavior was assessed as suicidal behavior and nonsuicidal self-injury. Logistic regression and path analysis were conducted to analyze the data.

Results: There were 1360 sexual minority and 15,020 heterosexual respondents. Sexual minority status was associated with increased risk of maltreatment (adjusted odds ratio [AOR] range: 1.25-2.46) and bullying (AOR range: 1.38-1.77) victimization, and a series of health problems (AOR range: 1.85-3.69). Furthermore, childhood maltreatment could partially explain the association of sexual minority status with psychological distress (indirect effect: β = 0.026 for boys; β = 0.086 for girls) and self-destructive behavior (β = 0.056 for boys; β = 0.125 for girls), and bullying could partially explain the association between sexual minority status and psychological distress (β = 0.040 for boys; β = 0.031 for girls).

Conclusions: Sexual minority adolescents were more likely than heterosexuals to experience different forms of childhood victimization, which may put them at higher risk for mental and behavioral health problems. Interventions based on both family and school are essential.
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http://dx.doi.org/10.1016/j.acap.2020.11.024DOI Listing
December 2020

Prevalence of refractive error, visual impairment and access to eyecare for the homeless in Wales, United Kingdom.

Eye (Lond) 2020 Nov 24. Epub 2020 Nov 24.

University Hospital Wales, School of Optometry & Vision Sciences, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK.

Background/aims: To investigate visual impairment and disability, refractive error, and barriers to eye care in the homeless in Cardiff, United Kingdom.

Methods: Prospective cross-sectional study carried out on participants in homeless shelters in Cardiff. We collected participants socio-demographic profile, ocular history and access to eyecare services. Quantitative data included near and distance visual acuity and a non-cycloplegic refraction.

Results: A total of 100 participants were studied in this study. Prevalence of myopia was 19% and hyperopia 17%. Mean SE (Spherical Equivalent) for myopia -2.42D (95% CI: -1.65 to -3.19 D), for hyperopia this was +2.22D (95% CI: + 1.66 to +2.79). The prevalence of astigmatism was 36% (mean: 1.67 D, 95% CI: -0.88 to 0.94, n = 100). The number of participants with visual acuity (VA) worse than 6/12 was 11% in comparison to 0.89% and 1.1% in the general Cardiff and Welsh population respectively (p < 0.05). Additionally, 1% of the homeless subjects were registerable as blind (visual acuity worse than 3/60 in the better eye). Barriers to eyecare services were high, with 50% not seen by an optometrist within the last 5 years.

Conclusions: These findings indicate a significant disparity in ocular health, visual acuity and refractive error amongst the homeless in comparison with the general population.
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http://dx.doi.org/10.1038/s41433-020-01271-6DOI Listing
November 2020

Prevalence of refractive error, visual impairment and access to eyecare for the homeless in Wales, United Kingdom.

Eye (Lond) 2020 Nov 24. Epub 2020 Nov 24.

University Hospital Wales, School of Optometry & Vision Sciences, Maindy Road, Cathays, Cardiff, CF24 4HQ, UK.

Background/aims: To investigate visual impairment and disability, refractive error, and barriers to eye care in the homeless in Cardiff, United Kingdom.

Methods: Prospective cross-sectional study carried out on participants in homeless shelters in Cardiff. We collected participants socio-demographic profile, ocular history and access to eyecare services. Quantitative data included near and distance visual acuity and a non-cycloplegic refraction.

Results: A total of 100 participants were studied in this study. Prevalence of myopia was 19% and hyperopia 17%. Mean SE (Spherical Equivalent) for myopia -2.42D (95% CI: -1.65 to -3.19 D), for hyperopia this was +2.22D (95% CI: + 1.66 to +2.79). The prevalence of astigmatism was 36% (mean: 1.67 D, 95% CI: -0.88 to 0.94, n = 100). The number of participants with visual acuity (VA) worse than 6/12 was 11% in comparison to 0.89% and 1.1% in the general Cardiff and Welsh population respectively (p < 0.05). Additionally, 1% of the homeless subjects were registerable as blind (visual acuity worse than 3/60 in the better eye). Barriers to eyecare services were high, with 50% not seen by an optometrist within the last 5 years.

Conclusions: These findings indicate a significant disparity in ocular health, visual acuity and refractive error amongst the homeless in comparison with the general population.
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http://dx.doi.org/10.1038/s41433-020-01271-6DOI Listing
November 2020

Single-cell transcriptomic atlas of the human endometrium during the menstrual cycle.

Nat Med 2020 10 14;26(10):1644-1653. Epub 2020 Sep 14.

Department of Bioengineering, Stanford University, Stanford, CA, USA.

In a human menstrual cycle the endometrium undergoes remodeling, shedding and regeneration, all of which are driven by substantial gene expression changes in the underlying cellular hierarchy. Despite its importance in human fertility and regenerative biology, our understanding of this unique type of tissue homeostasis remains rudimentary. We characterized the transcriptomic transformation of human endometrium at single-cell resolution across the menstrual cycle, resolving cellular heterogeneity in multiple dimensions. We profiled the behavior of seven endometrial cell types, including a previously uncharacterized ciliated cell type, during four major phases of endometrial transformation, and found characteristic signatures for each cell type and phase. We discovered that the human window of implantation opens with an abrupt and discontinuous transcriptomic activation in the epithelia, accompanied with a widespread decidualization feature in the stromal fibroblasts. Our study provides a high-resolution molecular and cellular characterization of human endometrial transformation across the menstrual cycle, providing insights into this essential physiological process.
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http://dx.doi.org/10.1038/s41591-020-1040-zDOI Listing
October 2020

Single-cell transcriptomic atlas of the human endometrium during the menstrual cycle.

Nat Med 2020 10 14;26(10):1644-1653. Epub 2020 Sep 14.

Department of Bioengineering, Stanford University, Stanford, CA, USA.

In a human menstrual cycle the endometrium undergoes remodeling, shedding and regeneration, all of which are driven by substantial gene expression changes in the underlying cellular hierarchy. Despite its importance in human fertility and regenerative biology, our understanding of this unique type of tissue homeostasis remains rudimentary. We characterized the transcriptomic transformation of human endometrium at single-cell resolution across the menstrual cycle, resolving cellular heterogeneity in multiple dimensions. We profiled the behavior of seven endometrial cell types, including a previously uncharacterized ciliated cell type, during four major phases of endometrial transformation, and found characteristic signatures for each cell type and phase. We discovered that the human window of implantation opens with an abrupt and discontinuous transcriptomic activation in the epithelia, accompanied with a widespread decidualization feature in the stromal fibroblasts. Our study provides a high-resolution molecular and cellular characterization of human endometrial transformation across the menstrual cycle, providing insights into this essential physiological process.
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http://dx.doi.org/10.1038/s41591-020-1040-zDOI Listing
October 2020

Gender differences in the associations between types of childhood maltreatment and sleep disturbance among Chinese adolescents.

J Affect Disord 2020 03 22;265:595-602. Epub 2019 Nov 22.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, China. Electronic address:

Background: To explore the association between different types of childhood maltreatment and sleep disturbance among Chinese adolescents, with a particular focus on gender differences.

Methods: A cross-sectional study was conducted in 7 randomly selected provinces of China via the 2015 School-Based Chinese Adolescents Health Survey. Questionnaires from 153,547 students were completed and were eligible for this study. The Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI) and Childhood Trauma Questionnaire-Short Form (CTQ-SF) were used to assess sleep disturbance and childhood maltreatment, respectively.

Results: The prevalence of sleep disturbance among adolescents in China was 21.6%. A significantly increased risk of sleep disturbance was associated with physical abuse (aOR=1.22, 95% CI=1.21-1.24), emotional abuse (aOR=1.15, 95% CI=1.14-1.15), sexual abuse (aOR=1.16, 95% CI=1.15-1.18), physical neglect (aOR=1.04, 95% CI=1.03-1.05), and emotional neglect (aOR=1.03, 95% CI=1.02-1.03). A significant dose-response relationship was found between cumulative childhood maltreatment experiences and sleep disturbance. The interaction terms (between physical abuse/emotional abuse/sexual abuse/physical neglect/emotional neglect/number of childhood traumas and gender) were significantly associated with sleep disturbance. Further stratification analyses by gender showed that girls who reported experiencing one or more of these five types of childhood maltreatment had a higher risk of sleep disturbance than boys.

Limitations: The study only included school students, and the cross-sectional design limited our ability to make causal inferences.

Conclusions: The study findings suggest that childhood maltreatment increases the risk of sleep disturbance in adolescents. Furthermore, exposure to single and multiple types of childhood maltreatment predicts lower sleep quality in girls.
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http://dx.doi.org/10.1016/j.jad.2019.11.099DOI Listing
March 2020

Patterns of Bullying Victimization and Associations with Mental Health Problems in Chinese Adolescents: A Latent Class Analysis.

Int J Environ Res Public Health 2020 01 27;17(3). Epub 2020 Jan 27.

Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.

Bullying victimization in school students is a serious public health concern and has been linked to a wide range of mental health problems. The current study aims to examine patterns of involvement in different types of bullying victimization among Chinese adolescents and evaluate the associations between bullying victimization and mental health problems. Cross-sectional data from 20,722 middle school students from Guangdong Province were sampled using a multistage, stratified cluster-randomized sampling method. Latent class analysis (LCA) was performed on seven items representing bullying victimization. Levels of mental health outcomes were compared across each latent class. Four latent classes were identified for boys: the high victimization class (0.6%), the moderate victimization class (2.8%), the verbal victimization class (12.4%), and the low victimization class (84.2%). For girls, three latent classes were identified: the high victimization class (0.7%), the moderate victimization class (5.6%), and the low victimization class (93.7%). Characteristics of the item probabilities were different between boys and girls. For both genders, a graded relationship was found between bullying victimization class membership and mental health outcomes. These findings underline the complexity of bullying victimization patterns among Chinese adolescents. Students with higher involvement in bullying victimization have more severe mental health problems.
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http://dx.doi.org/10.3390/ijerph17030779DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7037478PMC
January 2020

Effects of Elevated Root-Zone CO on Root Morphology and Nitrogen Metabolism Revealed by Physiological and Transcriptome Analysis in Oriental Melon Seedling Roots.

Int J Mol Sci 2020 Jan 25;21(3). Epub 2020 Jan 25.

College of Horticulture, Shenyang Agricultural University, Shenyang 110866, China.

Rhizosphere CO is vital for crop growth, development, and productivity. However, the mechanisms of plants' responses to root-zone CO are unclear. Oriental melons are sensitive to root-zone gas, often encountering high root-zone CO during cultivation. We investigated root growth and nitrogen metabolism in oriental melons under T1 (0.5%) and T2 (1.0%) root-zone CO concentrations using physiology and comparative transcriptome analysis. T1 and T2 increased root vigor and the nitrogen content in the short term. With increased treatment time and CO concentration, root inhibition increased, characterized by decreased root absorption, incomplete root cell structure, accelerated starch accumulation and hydrolysis, and cell aging. We identified 1280 and 1042 differentially expressed genes from T1 and T2, respectively, compared with 0.037% CO-grown plants. Among them, 683 co-expressed genes are involved in stress resistance and nitrogen metabolism (enhanced phenylpropanoid biosynthesis, hormone signal transduction, glutathione metabolism, and starch and sucrose metabolism). Nitrogen metabolism gene expression, enzyme activity, and nitrogen content analyses showed that short-term elevated root-zone CO mainly regulated plant nitrogen metabolism post-transcriptionally, and directly inhibited it transcriptionally in the long term. These findings provided a basis for further investigation of nitrogen regulation by candidate genes in oriental melons under elevated root-zone CO.
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http://dx.doi.org/10.3390/ijms21030803DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7037942PMC
January 2020

Effects of Elevated Root-Zone CO on Root Morphology and Nitrogen Metabolism Revealed by Physiological and Transcriptome Analysis in Oriental Melon Seedling Roots.

Int J Mol Sci 2020 Jan 25;21(3). Epub 2020 Jan 25.

College of Horticulture, Shenyang Agricultural University, Shenyang 110866, China.

Rhizosphere CO is vital for crop growth, development, and productivity. However, the mechanisms of plants' responses to root-zone CO are unclear. Oriental melons are sensitive to root-zone gas, often encountering high root-zone CO during cultivation. We investigated root growth and nitrogen metabolism in oriental melons under T1 (0.5%) and T2 (1.0%) root-zone CO concentrations using physiology and comparative transcriptome analysis. T1 and T2 increased root vigor and the nitrogen content in the short term. With increased treatment time and CO concentration, root inhibition increased, characterized by decreased root absorption, incomplete root cell structure, accelerated starch accumulation and hydrolysis, and cell aging. We identified 1280 and 1042 differentially expressed genes from T1 and T2, respectively, compared with 0.037% CO-grown plants. Among them, 683 co-expressed genes are involved in stress resistance and nitrogen metabolism (enhanced phenylpropanoid biosynthesis, hormone signal transduction, glutathione metabolism, and starch and sucrose metabolism). Nitrogen metabolism gene expression, enzyme activity, and nitrogen content analyses showed that short-term elevated root-zone CO mainly regulated plant nitrogen metabolism post-transcriptionally, and directly inhibited it transcriptionally in the long term. These findings provided a basis for further investigation of nitrogen regulation by candidate genes in oriental melons under elevated root-zone CO.
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http://dx.doi.org/10.3390/ijms21030803DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7037942PMC
January 2020

Association between habitual weekday sleep duration and depressive symptoms among Chinese adolescents:The role of mode of birth delivery.

J Affect Disord 2020 03 14;265:583-589. Epub 2019 Nov 14.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, China. Electronic address:

Background: Depressive symptoms among adolescents are common. This study aimed to assess, among Chinese adolescents, the associations of habitual weekday sleep duration with depressive symptoms and whether these associations varied with the mode of birth delivery.

Methods: Data were from the 2015 School-based Chinese Adolescents Health Survey, and 150,053 students' questionnaires were qualified for analysis. Multi-level logistic regression models were performed.

Results: A weekday sleep duration of ≤5 h/night was associated with depressive symptoms (adjusted odds ratio [aOR]=2.98, 95% CI=2.75-3.24), and adolescents who reported a weekday sleep duration of 5-7 h/night (aOR=1.69, 95% CI=1.60-1.79) and >9 h/night (aOR=1.28, 95% CI=1.11-1.45) were also at a higher risk of depressive symptoms. Stratification analyses showed that in both adolescents delivered by vaginal birth and cesarean section (CS), a weekday sleep duration of ≤5 h/night, 5-7 h/night, and >9 h/night were associated with the increased risk of depressive symptoms in the adjusted models, and the magnitudes of the aORs in adolescents delivered by CS were slightly higher than those in adolescents delivered by vaginal birth.

Limitations: The cross-sectional study design and self-reported sleep duration and depressive symptoms.

Conclusion: This study demonstrates a significant U-shaped association between weekday sleep duration and depressive symptoms among Chinese adolescents. In both adolescents delivered by vaginal birth and CS, those who reported having abnormal sleep duration were at a high risk of depressive symptoms. Based on the findings of this study, we suggest sleep duration and mode of delivery should be a matter of concern for public health authorities.
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http://dx.doi.org/10.1016/j.jad.2019.11.095DOI Listing
March 2020

Association between habitual weekday sleep duration and depressive symptoms among Chinese adolescents:The role of mode of birth delivery.

J Affect Disord 2020 03 14;265:583-589. Epub 2019 Nov 14.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, China. Electronic address:

Background: Depressive symptoms among adolescents are common. This study aimed to assess, among Chinese adolescents, the associations of habitual weekday sleep duration with depressive symptoms and whether these associations varied with the mode of birth delivery.

Methods: Data were from the 2015 School-based Chinese Adolescents Health Survey, and 150,053 students' questionnaires were qualified for analysis. Multi-level logistic regression models were performed.

Results: A weekday sleep duration of ≤5 h/night was associated with depressive symptoms (adjusted odds ratio [aOR]=2.98, 95% CI=2.75-3.24), and adolescents who reported a weekday sleep duration of 5-7 h/night (aOR=1.69, 95% CI=1.60-1.79) and >9 h/night (aOR=1.28, 95% CI=1.11-1.45) were also at a higher risk of depressive symptoms. Stratification analyses showed that in both adolescents delivered by vaginal birth and cesarean section (CS), a weekday sleep duration of ≤5 h/night, 5-7 h/night, and >9 h/night were associated with the increased risk of depressive symptoms in the adjusted models, and the magnitudes of the aORs in adolescents delivered by CS were slightly higher than those in adolescents delivered by vaginal birth.

Limitations: The cross-sectional study design and self-reported sleep duration and depressive symptoms.

Conclusion: This study demonstrates a significant U-shaped association between weekday sleep duration and depressive symptoms among Chinese adolescents. In both adolescents delivered by vaginal birth and CS, those who reported having abnormal sleep duration were at a high risk of depressive symptoms. Based on the findings of this study, we suggest sleep duration and mode of delivery should be a matter of concern for public health authorities.
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http://dx.doi.org/10.1016/j.jad.2019.11.095DOI Listing
March 2020

Association between habitual weekday sleep duration and depressive symptoms among Chinese adolescents:The role of mode of birth delivery.

J Affect Disord 2020 03 14;265:583-589. Epub 2019 Nov 14.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou, 510080, China. Electronic address:

Background: Depressive symptoms among adolescents are common. This study aimed to assess, among Chinese adolescents, the associations of habitual weekday sleep duration with depressive symptoms and whether these associations varied with the mode of birth delivery.

Methods: Data were from the 2015 School-based Chinese Adolescents Health Survey, and 150,053 students' questionnaires were qualified for analysis. Multi-level logistic regression models were performed.

Results: A weekday sleep duration of ≤5 h/night was associated with depressive symptoms (adjusted odds ratio [aOR]=2.98, 95% CI=2.75-3.24), and adolescents who reported a weekday sleep duration of 5-7 h/night (aOR=1.69, 95% CI=1.60-1.79) and >9 h/night (aOR=1.28, 95% CI=1.11-1.45) were also at a higher risk of depressive symptoms. Stratification analyses showed that in both adolescents delivered by vaginal birth and cesarean section (CS), a weekday sleep duration of ≤5 h/night, 5-7 h/night, and >9 h/night were associated with the increased risk of depressive symptoms in the adjusted models, and the magnitudes of the aORs in adolescents delivered by CS were slightly higher than those in adolescents delivered by vaginal birth.

Limitations: The cross-sectional study design and self-reported sleep duration and depressive symptoms.

Conclusion: This study demonstrates a significant U-shaped association between weekday sleep duration and depressive symptoms among Chinese adolescents. In both adolescents delivered by vaginal birth and CS, those who reported having abnormal sleep duration were at a high risk of depressive symptoms. Based on the findings of this study, we suggest sleep duration and mode of delivery should be a matter of concern for public health authorities.
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http://dx.doi.org/10.1016/j.jad.2019.11.095DOI Listing
March 2020

Cross-sectional study on influence of the family environment on the lifetime non-medical use of prescription drugs among Chinese adolescents in Guangdong: an analysis of sex differences.

BMJ Open 2019 07 4;9(7):e026758. Epub 2019 Jul 4.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.

Objectives: This study aimed to assess if adolescents had used any prescription drugs non-medically, to explore the associations between the family environment and non-medical use of prescription drugs (NMUPD) and to investigate whether there are any sex differences in the aforementioned associations.

Design: A population-based cross-sectional study.

Setting: A secondary analysis of the cross-sectional data collected from high school students in Guangdong who were sampled using a multistage, stratified-cluster, random-sampling method in the 2015 School-based Chinese Adolescents Health Survey.

Participants: A total of 21 774 students aged 12-20 years.

Data Analysis: Multilevel logistic regression models were used to explore the univariable and multivariable relationship between family environment and NMUPD among adolescents. Adjusted ORs and corresponding 95% CI were calculated.

Outcome Measures: Questions regarding to adolescent' NMUPD (including sedative, opioid and stimulant) were surveyed in the study.

Results: A total of 6.3% students reported lifetime NMUPD in this study. The most commonly used drugs were opioids (3.9%), followed by sedatives (3.2%) and stimulants (2.5%). Multilevel analyses indicated that living arrangements, family economic status, parental relationships, parental education levels, monthly pocket money, parental drinking and drug problems were significantly correlated to the NMUPD among all students. Among boys, living arrangements, family economic status, maternal education levels, monthly pocket money, parental drinking and drug problems were significantly related to different types of NMUPD. The same factors were related to girls' NMUPD, except for maternal education levels. Parental relationships and paternal education levels were also associated with girls' NMUPD.

Conclusion: The family environment exerts an important influence on adolescents' NMUPD. Interventions targeted at families are highly recommended considering the negative effects of NMUPD. In addition, the child's sex might be taken into consideration when developing and implementing preventive strategies.
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http://dx.doi.org/10.1136/bmjopen-2018-026758DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615848PMC
July 2019

Trends in Health-Risk Behaviors among Chinese Adolescents.

Int J Environ Res Public Health 2019 05 29;16(11). Epub 2019 May 29.

Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.

Adolescent health-risk behaviors can have long lasting negative effects throughout an individual's life, and cause a major economic and social burden to society. This study aimed to estimate the prevalence of the health-risk behaviors among Chinese adolescents and to test the trends in health-risk behaviors without and with adjusting for sociodemographic characteristics. Data were drawn from the School-based Chinese Adolescents Health Survey, which is an ongoing school-based study about the health-risk behaviors among Chinese adolescents (7th to 12th grade). During the first wave through the third wave, the prevalence of lifetime, past 12-month, and past 30-day use of opioid decreased by 4.19%, 0.63%, and 0.56%, respectively. Moreover, the prevalence of lifetime, past 12-month, and past 30-day sedative use decreased by 3.03%, 0.65%, and 0.35%, respectively. During the three waves, most trends in the prevalence of health-risk behaviors were downward, with a few exceptions: The prevalence of lifetime smoking, drinking, methamphetamine use, and sleep disturbance increased by 7.15%, 13.08%, 0.48%, and 9.06%, respectively. The prevalence of lifetime 3,4-methylene dioxy methamphetamine use (from 0.49% to 0.48%), lifetime mephedrone use (from 0.30% to 0.24%), or suicide attempts (from 2.41% to 2.46%) remained stable.
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http://dx.doi.org/10.3390/ijerph16111902DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603688PMC
May 2019

Association between weekday sleep duration and nonmedical use of prescription drug among adolescents: the role of academic performance.

Eur Child Adolesc Psychiatry 2019 Sep 18;28(9):1265-1275. Epub 2019 Feb 18.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China.

Nonmedical use of prescription drug (NMUPD) among adolescents has increased substantially over the last 2 decades, and evidence suggests that sleep duration may impact upon drug use and academic performance. This study aimed to estimate the prevalence of sleep duration, NMUPD, and academic performance among Chinese adolescents, to test the independent associations of sleep duration with NMUPD, and to investigate whether these associations vary by academic performance. Data were from the 2015 School-based Chinese Adolescents Health Survey using a multi-stage, stratified-cluster, random-sampling method to collect information from 162,601 high school students [mean age (SD) =15.2 (1.9) years; 47.4% were male] from 42 cities in China. The weighted prevalence of sleeping ≤ 5 h/weekday was 1.1% (95% CI, 1.0-1.1%), and the weighted prevalence of sleeping > 9 h/weekday was 7.6% (95% CI 7.4-7.7%). After adjusting for significant covariates and academic performance, the results showed that compared with those with 7-9 h/weekday sleep duration, students reporting ≤5 h/weekday were more likely to misuse opioids (AOR = 2.12, 95% CI 1.73-2.59), sedatives (AOR = 2.00, 95% CI 1.65-2.42), and any prescription drug use (AOR = 1.89, 95% CI 1.60-2.23); students with>9 h/weekday sleep duration were also at a higher risk of opioids use, sedative use, and any prescription drug misuse; the U-shaped association of sleep duration with NMUPD was found. Moreover, there exist significant associations between weekday sleep duration and NMUPD among Chinese adolescents, and academic performance plays a moderating role in the aforementioned associations. The efforts to prevent NMUPD should be focused on adolescents who report abnormal sleep duration or poor academic performance.
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http://dx.doi.org/10.1007/s00787-019-01294-9DOI Listing
September 2019

Association between weekday sleep duration and nonmedical use of prescription drug among adolescents: the role of academic performance.

Eur Child Adolesc Psychiatry 2019 Sep 18;28(9):1265-1275. Epub 2019 Feb 18.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, People's Republic of China.

Nonmedical use of prescription drug (NMUPD) among adolescents has increased substantially over the last 2 decades, and evidence suggests that sleep duration may impact upon drug use and academic performance. This study aimed to estimate the prevalence of sleep duration, NMUPD, and academic performance among Chinese adolescents, to test the independent associations of sleep duration with NMUPD, and to investigate whether these associations vary by academic performance. Data were from the 2015 School-based Chinese Adolescents Health Survey using a multi-stage, stratified-cluster, random-sampling method to collect information from 162,601 high school students [mean age (SD) =15.2 (1.9) years; 47.4% were male] from 42 cities in China. The weighted prevalence of sleeping ≤ 5 h/weekday was 1.1% (95% CI, 1.0-1.1%), and the weighted prevalence of sleeping > 9 h/weekday was 7.6% (95% CI 7.4-7.7%). After adjusting for significant covariates and academic performance, the results showed that compared with those with 7-9 h/weekday sleep duration, students reporting ≤5 h/weekday were more likely to misuse opioids (AOR = 2.12, 95% CI 1.73-2.59), sedatives (AOR = 2.00, 95% CI 1.65-2.42), and any prescription drug use (AOR = 1.89, 95% CI 1.60-2.23); students with>9 h/weekday sleep duration were also at a higher risk of opioids use, sedative use, and any prescription drug misuse; the U-shaped association of sleep duration with NMUPD was found. Moreover, there exist significant associations between weekday sleep duration and NMUPD among Chinese adolescents, and academic performance plays a moderating role in the aforementioned associations. The efforts to prevent NMUPD should be focused on adolescents who report abnormal sleep duration or poor academic performance.
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http://dx.doi.org/10.1007/s00787-019-01294-9DOI Listing
September 2019

Association between Problematic Internet Use and Sleep Disturbance among Adolescents: The Role of the Child's Sex.

Int J Environ Res Public Health 2018 11 28;15(12). Epub 2018 Nov 28.

Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.

Use of the Internet has become an integral part of daily life. Adolescents are especially at a higher risk of developing problematic Internet use (PIU). Although one of the most well-known comorbid conditions of PIU is sleep disturbance, little is known about the sex disparity in this association. This school-based survey in students of grades 7⁻9 was conducted to estimate the prevalence of PIU and sleep disturbance among Chinese adolescents, to test the association between PIU and sleep disturbance, and to investigate the role of the child's sex in this association. A two-stage stratified cluster sampling method was used to recruit participants, and two-level logistic regression models were fitted. The mean Internet addiction test score was 37.2 (SD: 13.2), and 15.5% (736) met the criteria for PIU. After adjusting for control variables, problematic Internet users were at a higher risk of sleep disturbance (adjusted odds ratio = 2.41, 95% confidence interval (CI) = 2.07⁻3.19). Sex-stratified analyses also demonstrated that association was greater in girls than boys. In this respect, paying more attention to the sleep patterns of adolescents who report excessive Internet use is recommended, and this early identification may be of practical importance for schools, parents, and adolescents themselves.
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http://dx.doi.org/10.3390/ijerph15122682DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313705PMC
November 2018

Association between childhood maltreatment and non-medical prescription opioid use among Chinese senior high school students: The moderating role of gender.

J Affect Disord 2018 08 10;235:421-427. Epub 2018 Apr 10.

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China. Electronic address:

Background: Non-medical prescription opioid use (NMPOU) and childhood maltreatment are currently serious problems among adolescents worldwide, and childhood maltreatment may be associated with the increased rates of NMPOU. This study examined the specific associations between particular types of childhood maltreatment and lifetime NMPOU and assessed whether gender has a moderating effect on these associations.

Methods: A 3-stage, stratified cluster, randomized sampling method was used to collect data from 11,194 high school students in Chongqing.

Result: The prevalence of the lifetime NMPOU among senior high school students in Chongqing was 7.7%. Physical abuse (AOR = 1.11, 95% CI = 1.07-1.14), emotional abuse (AOR = 1.05, 95% CI = 1.03-1.08), sexual abuse (AOR = 1.04, 95% CI = 1.01-1.07), physical neglect (AOR = 1.06, 95% CI = 1.04-1.09), and emotional neglect (AOR = 1.03, 95% CI = 1.02-1.04) were all positively associated with lifetime NMPOU. The moderating effects of gender on emotional abuse (P = 0.004) and sexual abuse (P = 0.019) were statistically significant in the adjusted model of lifetime NMPOU. According to the stratification analyses in which the male and female students were analyzed separately, female students who previously experienced emotional/sexual abuse had a higher prevalence of lifetime NMPOU.

Limitations: The study sample only contained school students and cross-sectional design limited our ability to make causal inferences.

Conclusion: Childhood maltreatment was positively associated with lifetime NMPOU, and gender had a moderating effect on the associations between childhood maltreatment and lifetime NMPOU. Early identification of and intervention for childhood maltreatment victims, particularly female victims, may help reduce the lifetime risk of NMPOU.
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http://dx.doi.org/10.1016/j.jad.2018.04.070DOI Listing
August 2018

iterClust: a statistical framework for iterative clustering analysis.

Bioinformatics 2018 08;34(16):2865-2866

Department of Systems Biology, Columbia University, New York, NY, USA.

Motivation: In a scenario where populations A, B1 and B2 (subpopulations of B) exist, pronounced differences between A and B may mask subtle differences between B1 and B2.

Results: Here we present iterClust, an iterative clustering framework, which can separate more pronounced differences (e.g. A and B) in starting iterations, followed by relatively subtle differences (e.g. B1 and B2), providing a comprehensive clustering trajectory.

Availability And Implementation: iterClust is implemented as a Bioconductor R package.

Supplementary Information: Supplementary data are available at Bioinformatics online.
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http://dx.doi.org/10.1093/bioinformatics/bty176DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6084607PMC
August 2018