Publications by authors named "Xianchen Liu"

125 Publications

Follicular thyroid carcinoma presenting with multiple skull metastases on CT and MRI: A case report and literature review.

Radiol Case Rep 2021 Nov 26;16(11):3260-3265. Epub 2021 Aug 26.

Department of CTMR, Ningcheng County Central Hospital, Ningcheng Inner Mongolia 024200, China.

Although the incidence of thyroid carcinoma has increased in recent years, follicular thyroid carcinoma with bone metastasis as the first symptom remains rare. Here, we report a case of occult follicular thyroid carcinoma in a 65-year-old female patient admitted to hospital with cerebrovascular disease. Computed tomography findings suggested a diagnosis of meningioma; however, magnetic resonance imaging results showed multiple skull bone destruction with soft tissue masses on the left side of the skull. After surgical resection, the pathology results revealed skull metastasis of follicular thyroid carcinoma. We present this case not only because of the diagnostic challenge it posed, but also because the patient had multiple skull metastases from follicular thyroid carcinoma.
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http://dx.doi.org/10.1016/j.radcr.2021.07.054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8403711PMC
November 2021

Insomnia and other sleep-related problems during the remission period of the COVID-19 pandemic: A large-scale survey among college students in China.

Psychiatry Res 2021 10 3;304:114153. Epub 2021 Aug 3.

Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA.

This study aimed to evaluate the sleep-related problems and predictors of probable clinical insomnia among college students during the COVID-19 remission period in China. 146,102 college students from 22 colleges/universities in Guangdong province participated in this study from 1th to 15th June, 2020. Self-administered questionnaires were used to assess demographic characteristics. Sleep-related problems, depression and anxiety symptoms were measured by Youth Self-Rating Insomnia Scale, Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7, respectively. The prevalence of difficulty in initiating sleep, difficulty in maintaining sleep, early morning awakening, sleep insufficiency, unrefreshing sleep and daytime functioning impairment were 7.2%, 3.4%, 3.5%, 9.6%, 14.6%, and 7.6%, respectively. 16.9% students had varying degrees of insomnia and 6.3% were considered as displaying probable clinical insomnia. Moreover, being urban residents, having a history of physical or mental illness, and probable clinical depression or anxiety were significant risk factors of probable clinical insomnia, while college senior degree and 7-8 hours' sleep duration per day was the protective factor for probable clinical insomnia. Unrefreshing sleep was the most prominent sleep problem among college students during COVID-19 remission in China. Good sleep hygiene practices are strongly suggested to develop in the time of prolonged home isolation.
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http://dx.doi.org/10.1016/j.psychres.2021.114153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8424256PMC
October 2021

Real-World Tumor Response of Palbociclib Plus Letrozole Versus Letrozole for Metastatic Breast Cancer in US Clinical Practice.

Target Oncol 2021 Aug 2. Epub 2021 Aug 2.

The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Background: Limited information exists regarding tumor response to palbociclib plus an aromatase inhibitor (AI) versus AI alone in real-world practice.

Objective: To evaluate the real-world tumor response of palbociclib plus letrozole (PAL+LET) versus LET alone as first-line treatment for patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative metastatic breast cancer (HR+/HER2‒ MBC) in routine US clinical practice.

Patients And Methods: This retrospective analysis included HR+/HER2‒ MBC patients who initiated PAL+LET or LET as first-line treatment between February 2015 and September 2018 in the Flatiron Health Analytics database. Patients were followed until December 2018. Real-world best tumor response (rwBTR) was determined based on physicians' assessment of radiologic evidence for change in burden of disease.

Results: Of the 1383 eligible patients who initiated PAL+LET or LET as first-line therapy in the Flatiron database, 968 patients had ≥ 1 tumor response assessment (662 received PAL+LET and 306 received LET). The rwBTR rate (complete response+partial response) in the first-line setting was 59.8% in the PAL+LET group and 39.2% in the LET group (odds ratio 2.31 (95% CI 1.75‒3.04), P < 0.0001). After 1:1 propensity-score matching, the rwBTR rate was 58.6% in the PAL+LET group versus 39.1% in the LET group (odds ratio 2.21 (95% CI 1.50‒3.25), P < 0.0001).

Conclusions: This real-world analysis demonstrated that HR+/HER2‒ MBC patients were more likely to respond to PAL+LET compared to LET. These findings further showed the effectiveness of PAL+LET therapy in the real-world setting and support the combination as a standard of care for MBC.

Study Registration: Pfizer; NCT04176354; registered November 25, 2019.
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http://dx.doi.org/10.1007/s11523-021-00826-1DOI Listing
August 2021

Sleep disordered breathing symptoms are associated with depressive symptoms: A longitudinal study of Chinese adolescents.

J Affect Disord 2021 10 27;293:492-501. Epub 2021 Jul 27.

Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University & Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China. Electronic address:

Background: Little is known about the prospective association between sleep disordered breathing (SDB) and depressive symptoms in Chinese adolescents. This study examined the independent predictive role of SDB symptoms in depressive symptoms in a large sample of adolescents.

Methods: A total of 11831 adolescents who participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort and 7072 adolescents who were resurveyed 1 year later were included for the analyses. Adolescents completed a self-administered questionnaire about demographics, mental health, sleep problems, and family environment. SDB symptoms were assessed by 3 items about loud snoring, breathing pauses, and snorting/gasping. The Chinese Youth Self-Report anxious/depressed subscale was used to assess depressive symptoms.

Results: In the cross-sectional analyses, 11.8% adolescents had depressive symptoms, and elevated frequency of SDB symptoms were significantly associated with depressive symptoms. In the longitudinal study, 4.5% of adolescents had persistent depressive symptoms, the incidence rate of depressive symptoms at 1-year follow-up was 6.5%, and elevated frequency of any SDB symptoms (often: OR=2.23, 95%CI:1.50-3.32) at baseline was significantly associated with incident depressive symptoms after adjusting for potential confounders. The associations between SDB symptoms and depressive symptoms were similar for boys and girls.

Limitation: SDB symptoms and depressive symptoms were measured by self-report.

Conclusion: SDB symptoms are an independent and significant predictor of depressive symptoms in adolescents. Further research is needed to understand the biological mechanisms between SDB and mood dysregulation in adolescents.
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http://dx.doi.org/10.1016/j.jad.2021.05.079DOI Listing
October 2021

Associations of frequent pain symptoms with excessive daytime sleepiness in adolescents: a longitudinal study.

J Clin Sleep Med 2021 Jun 22. Epub 2021 Jun 22.

Department of Epidemiology, School of Public Health, Shandong University, Jinan, China.

Study Objectives: Pain symptoms, sleep disturbance, and daytime sleepiness are common in adolescents. This study examined the cross-sectional and prospective associations between pain symptoms and excessive daytime sleepiness (EDS) in a large sample of adolescents.

Methods: Participants were 7,072 adolescents (mean age = 14.6 years) in a follow-up study of behavior and health in Shandong, China. A self-administered structured questionnaire was used to assess pain symptoms (headache, stomachache, and other general pain), body weight and height, sleep, anxiety/depression, substance use, and family environment in November-December in 2015 and one year later. The Chinese adolescent daytime sleepiness scale (CADSS) was used to measure daytime sleepiness.

Results: Of the sample, 19.8% and 23.2% had moderate or severe EDS at baseline and at 1-year follow-up, respectively. The prevalence and 1-year incidence rates of EDS significantly increased with the frequencies of pain symptoms. Frequent pain was significantly associated with increased risk of EDS at baseline (OR=2.01, 95% CI=1.56-2.59), incident EDS (OR=1.41, 95% CI=1.03-1.93), and persistent EDS (OR=2.17, 95% CI=1.52-3.09) while adjusting for adolescent and family covariates, including anxiety/depression, nocturnal sleep duration, insomnia symptoms, frequent snoring, body mass index, and hypnotic use. Similar associations were observed across headache, stomachache, and other pain.

Conclusions: Frequent pain is significantly and independently associated with increased risk of EDS. Our findings suggest that assessing and treating pain symptoms is important to improve healthy sleep and reduce risk of EDS in adolescents. Further research is needed to understand the underlying psychological and neurobiological mechanisms between pain and daytime sleepiness in adolescents.
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http://dx.doi.org/10.5664/jcsm.9444DOI Listing
June 2021

Associations of frequent pain symptoms with excessive daytime sleepiness in adolescents: a longitudinal study.

J Clin Sleep Med 2021 Jun 22. Epub 2021 Jun 22.

Department of Epidemiology, School of Public Health, Shandong University, Jinan, China.

Study Objectives: Pain symptoms, sleep disturbance, and daytime sleepiness are common in adolescents. This study examined the cross-sectional and prospective associations between pain symptoms and excessive daytime sleepiness (EDS) in a large sample of adolescents.

Methods: Participants were 7,072 adolescents (mean age = 14.6 years) in a follow-up study of behavior and health in Shandong, China. A self-administered structured questionnaire was used to assess pain symptoms (headache, stomachache, and other general pain), body weight and height, sleep, anxiety/depression, substance use, and family environment in November-December in 2015 and one year later. The Chinese adolescent daytime sleepiness scale (CADSS) was used to measure daytime sleepiness.

Results: Of the sample, 19.8% and 23.2% had moderate or severe EDS at baseline and at 1-year follow-up, respectively. The prevalence and 1-year incidence rates of EDS significantly increased with the frequencies of pain symptoms. Frequent pain was significantly associated with increased risk of EDS at baseline (OR=2.01, 95% CI=1.56-2.59), incident EDS (OR=1.41, 95% CI=1.03-1.93), and persistent EDS (OR=2.17, 95% CI=1.52-3.09) while adjusting for adolescent and family covariates, including anxiety/depression, nocturnal sleep duration, insomnia symptoms, frequent snoring, body mass index, and hypnotic use. Similar associations were observed across headache, stomachache, and other pain.

Conclusions: Frequent pain is significantly and independently associated with increased risk of EDS. Our findings suggest that assessing and treating pain symptoms is important to improve healthy sleep and reduce risk of EDS in adolescents. Further research is needed to understand the underlying psychological and neurobiological mechanisms between pain and daytime sleepiness in adolescents.
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http://dx.doi.org/10.5664/jcsm.9444DOI Listing
June 2021

Shift work disorder and related influential factors among shift workers in China.

Sleep Med 2021 05 13;81:451-456. Epub 2021 Mar 13.

Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA.

Background: Shift work may cause insomnia and sleepiness in individuals. The present study aimed to exam shift work disorder (SWD), and to investigate their associations with individual characteristics.

Methods: A total of 1833 shift workers were assessed using the Pittsburg Sleep Quality Index, Epworth Sleepiness Scale (ESS), Composite Scale of Morningness (CSM), Circadian Type Inventory (CTI), Center for Epidemiologic Studies-Depression Scale (CES-D), Beck Anxiety Inventory (BAI) and other self-compiled socio-demographic questionnaires.

Results: In the current sample, 17.1% shift workers have experienced insomnia symptoms, 20.9% were tested for daytime sleepiness, and 19.9% were categorized as having SWD. Logistics regressions revealed that history of mental disorders (OR = 2.04, 95% CI = 1.30-3.21), chronic physical illness (OR = 1.53, 95% CI = 1.17-1.99), CES-D scores (OR = 1.03, 95% CI = 1.02-1.05), BAI scores (OR = 1.04, 95% CI = 1.03-1.06), languid/vigorous tendencies (OR = 1.06, 95% CI = 1.03-1.10) were positively associated with the onset of SWD, while morningness (OR = 0.97, 95% CI = 0.94-0.99) decreased the odds of SWD onset.

Conclusions: These findings suggested that attention should be drawn to individuals with mental and chronic diseases in when scheduling work shifts. While SWD and its associates should be considered when providing psychological services to shift workers.
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http://dx.doi.org/10.1016/j.sleep.2021.03.008DOI Listing
May 2021

Is returning to school during the COVID-19 pandemic stressful? A study on immediate mental health status of Chinese college students.

J Affect Disord 2021 05 19;287:261-267. Epub 2021 Mar 19.

Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA.

Background: As the COVID-19 pandemic has posed substantial impacts on individual's daily routine and psychological state. For the first time at great scale, Chinese college students had their educational activities moved online in spring 2020. Due to this unexpected isolation and unconventional learning method, their mental health following returning to school is worth investigating.

Methods: Between June 1 and June 15, 2020, a total of 8,921 returning college students' mental health status were assessed using instruments designed for psychiatric disorders, namely the 9-Item Patient Heath Questionnaire (PHQ-9), 7-Item Generalized Anxiety Disorder Scale (GAD-7), 6-Item Impact of Event Scale (IES-6), Youth Self Rating Insomnia Scale (YSIS), and self-developed questionnaire.

Results: Our results showed that 8.7%, 4.2%, 10.5%, and 6.1% of the participants experienced depression, anxiety, acute stress, and insomnia, respectively, with a total of 19.8% reporting having at least one psychiatric symptom following their return to school. Sophomore and Senior year, and presence of previous psychiatric conditions contribute to the increased occurrence of psychiatric issues. The level of impact by COVID-19 on one's daily functioning is also positively associated with poor mental health.

Conclusions: Our findings suggested no significant increase in the prevalence of psychiatric symptoms, following the first batch of students' return to school. These findings aim to complement the current understanding of the psychiatric impact of COVID-19 on students and assist school principals to plan their return-to-school approaches in a mental-health sensitive way.
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http://dx.doi.org/10.1016/j.jad.2021.03.035DOI Listing
May 2021

Comparative effectiveness of first-line palbociclib plus letrozole versus letrozole alone for HR+/HER2- metastatic breast cancer in US real-world clinical practice.

Breast Cancer Res 2021 03 24;23(1):37. Epub 2021 Mar 24.

David Geffen School of Medicine at University of California Los Angeles, 2825 Santa Monica Blvd, Suite 200, Santa Monica, CA, 90404, USA.

Background: Findings from randomized clinical trials may have limited generalizability to patients treated in routine clinical practice. This study examined the effectiveness of first-line palbociclib plus letrozole versus letrozole alone on survival outcomes in patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor-negative (HER2-) metastatic breast cancer (MBC) treated in routine clinical practice in the USA.

Patients And Methods: This was a retrospective observational analysis of electronic health records within the Flatiron Health Analytic Database. A total of 1430 patients with ≥ 3 months of follow-up received palbociclib plus letrozole or letrozole alone in the first-line setting between February 3, 2015, and February 28, 2019. Stabilized inverse probability treatment weighting (sIPTW) was used to balance baseline demographic and clinical characteristics. Real-world progression-free survival (rwPFS) and overall survival (OS) were analyzed.

Results: After sIPTW adjustment, median follow-up was 24.2 months (interquartile range [IQR], 14.2-34.9) in the palbociclib group and 23.3 months (IQR, 12.7-34.3) in those taking letrozole alone. Palbociclib combination treatment was associated with significantly longer median rwPFS compared to letrozole alone (20.0 vs 11.9 months; hazard ratio [HR], 0.58; 95% CI, 0.49-0.69; P < 0.0001). Median OS was not reached in the palbociclib group and was 43.1 months with letrozole alone (HR, 0.66; 95% CI, 0.53-0.82; P = 0.0002). The 2-year OS rate was 78.3% in the palbociclib group and 68.0% with letrozole alone. A propensity score matching analysis showed similar results.

Conclusions: In this "real-world" population of patients with HR+/HER2- MBC, palbociclib in combination with endocrine therapy was associated with improved survival outcomes compared with patients treated with letrozole alone in the first-line setting.

Trial Registration: Clinicaltrials.gov; NCT04176354.
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http://dx.doi.org/10.1186/s13058-021-01409-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7989035PMC
March 2021

Comparative effectiveness of first-line palbociclib plus letrozole versus letrozole alone for HR+/HER2- metastatic breast cancer in US real-world clinical practice.

Breast Cancer Res 2021 03 24;23(1):37. Epub 2021 Mar 24.

David Geffen School of Medicine at University of California Los Angeles, 2825 Santa Monica Blvd, Suite 200, Santa Monica, CA, 90404, USA.

Background: Findings from randomized clinical trials may have limited generalizability to patients treated in routine clinical practice. This study examined the effectiveness of first-line palbociclib plus letrozole versus letrozole alone on survival outcomes in patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor-negative (HER2-) metastatic breast cancer (MBC) treated in routine clinical practice in the USA.

Patients And Methods: This was a retrospective observational analysis of electronic health records within the Flatiron Health Analytic Database. A total of 1430 patients with ≥ 3 months of follow-up received palbociclib plus letrozole or letrozole alone in the first-line setting between February 3, 2015, and February 28, 2019. Stabilized inverse probability treatment weighting (sIPTW) was used to balance baseline demographic and clinical characteristics. Real-world progression-free survival (rwPFS) and overall survival (OS) were analyzed.

Results: After sIPTW adjustment, median follow-up was 24.2 months (interquartile range [IQR], 14.2-34.9) in the palbociclib group and 23.3 months (IQR, 12.7-34.3) in those taking letrozole alone. Palbociclib combination treatment was associated with significantly longer median rwPFS compared to letrozole alone (20.0 vs 11.9 months; hazard ratio [HR], 0.58; 95% CI, 0.49-0.69; P < 0.0001). Median OS was not reached in the palbociclib group and was 43.1 months with letrozole alone (HR, 0.66; 95% CI, 0.53-0.82; P = 0.0002). The 2-year OS rate was 78.3% in the palbociclib group and 68.0% with letrozole alone. A propensity score matching analysis showed similar results.

Conclusions: In this "real-world" population of patients with HR+/HER2- MBC, palbociclib in combination with endocrine therapy was associated with improved survival outcomes compared with patients treated with letrozole alone in the first-line setting.

Trial Registration: Clinicaltrials.gov; NCT04176354.
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http://dx.doi.org/10.1186/s13058-021-01409-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7989035PMC
March 2021

Psychometric properties of the Chinese version of nightmare distress questionnaire (NDQ-CV) in adolescents.

Sleep Med 2021 03 5;79:94-100. Epub 2021 Jan 5.

Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, P.R. China.

Background: The Nightmare Distress Questionnaire (NDQ) is the most common scale used to measure nightmare distress for its satisfactory psychometric properties. This study assessed the psychometric properties of the Chinese version of NDQ (NDQ-CV) in a large sample of adolescents.

Methods: The NDQ-CV consists of 14 items (12 original NDQ items, 1 modified NDQ item and 1 new item) to assess waking distress associated with nightmares. Each item is rated on a 5-point scale from 1 = Never to 5 = Always. Subjects used for psychometric assessment of the NDQ-CV were 11,831 participants of the Shandong Adolescent Behavior and Health Cohort in China. Participants completed the NDQ-CV and a structured questionnaire to assess nightmare frequency, sleep, anxiety/depression, and academic performance.

Results: The NDQ-CV score ranged from 14 to 70 (M = 22.5, SD = 8.7). Internal consistency reliability coefficient was 0.90. Both exploratory and confirmatory factor analyses yielded 2 dominant factors defined as nightmare general distress (10 items) and daytime reality perception (4 items). The NDQ-CV score was significantly correlated with short nocturnal sleep duration, anxiety/depression, insomnia, daytime sleepiness, and poor academic performance. Furthermore, NDQ-CV significantly predicted depressive symptoms 1 year later.

Study Limitations: All data were self-reported.

Conclusions: The NDQ-CV appears to be a simple, reliable, and valid scale for assessing nightmare distresses in Chinese adolescents. Further studies are warranted to test the reliability and validity of the NDQ-CV with adult samples.
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http://dx.doi.org/10.1016/j.sleep.2021.01.001DOI Listing
March 2021

MiR-216b regulates the tumorigenesis of gastric cancer by targeting PXN.

Pathol Res Pract 2021 Feb 28;218:153325. Epub 2020 Dec 28.

Departmentof General Surgery, Affiliated Hospital 2 of Nantong University, No.6 haierxiang North Road, 226000, Nantong, Jiangsu, China. Electronic address:

Background: Accumulating evidence has demonstrated that microRNAs (miRNAs) are associated with tumorigenesis. miR-216b can play a vital role in the genesis and development of gastric cancer (GC), and its molecular mechanisms require further elucidation.

Methods: The biological effects of miR-216b in GC cells were investigated by MTT, transwell assays, and cell cycle. Western blot and luciferase assay were performed to demonstrate the direct binding of miR-216b on PXN 3'UTR. Furthermore, MTT, colony formation assays, transwell assays, and flow cytometry analysis, as well as xenograft mice model, were used to measure the effects of miR-216b-PXN on GC cell proliferation, migration, and invasion indicated by in vitro and in vivo.

Results: Our results showed that miR-216b acted as a tumor suppressor in GC progression. miR-216b overexpression suppressed GC cell proliferation, migration, and invasion in vitro. Luciferase reporter assays identified paxillin (PXN) as a novel target gene of miR-216b. PXN overexpression could partially rescue miR-216b-induced the inhibitory effects in GC cells. Besides, overexpression of miR-216b contributed to the activation of PI3K/AKT signaling via partly regulating PXN in GC cells.

Conclusions: The above results showed that miR-216b could offer a novel therapeutic avenue by targeting PXN in GC.
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http://dx.doi.org/10.1016/j.prp.2020.153325DOI Listing
February 2021

MiR-216b regulates the tumorigenesis of gastric cancer by targeting PXN.

Pathol Res Pract 2021 Feb 28;218:153325. Epub 2020 Dec 28.

Departmentof General Surgery, Affiliated Hospital 2 of Nantong University, No.6 haierxiang North Road, 226000, Nantong, Jiangsu, China. Electronic address:

Background: Accumulating evidence has demonstrated that microRNAs (miRNAs) are associated with tumorigenesis. miR-216b can play a vital role in the genesis and development of gastric cancer (GC), and its molecular mechanisms require further elucidation.

Methods: The biological effects of miR-216b in GC cells were investigated by MTT, transwell assays, and cell cycle. Western blot and luciferase assay were performed to demonstrate the direct binding of miR-216b on PXN 3'UTR. Furthermore, MTT, colony formation assays, transwell assays, and flow cytometry analysis, as well as xenograft mice model, were used to measure the effects of miR-216b-PXN on GC cell proliferation, migration, and invasion indicated by in vitro and in vivo.

Results: Our results showed that miR-216b acted as a tumor suppressor in GC progression. miR-216b overexpression suppressed GC cell proliferation, migration, and invasion in vitro. Luciferase reporter assays identified paxillin (PXN) as a novel target gene of miR-216b. PXN overexpression could partially rescue miR-216b-induced the inhibitory effects in GC cells. Besides, overexpression of miR-216b contributed to the activation of PI3K/AKT signaling via partly regulating PXN in GC cells.

Conclusions: The above results showed that miR-216b could offer a novel therapeutic avenue by targeting PXN in GC.
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http://dx.doi.org/10.1016/j.prp.2020.153325DOI Listing
February 2021

Mental Health Among College Students During the COVID-19 Pandemic in China: A 2-Wave Longitudinal Survey.

J Affect Disord 2021 02 24;281:597-604. Epub 2020 Nov 24.

Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA.

Background: Growing evidence supports a clear association between COVID-19 pandemic and mental health. However, little is known about the longitudinal course of psychopathology in young adults at different stages of the pandemic.

Methods: This large-scale, longitudinal, population-based survey was conducted among college students in China. The rates of three mental health problems (acute stress, anxiety, and depressive symptoms), and their change patterns at two phases of the pandemic (early vs under-control) were measured. Predictors of changes in mental health symptoms were examined utilizing multivariate regression.

Results: Among the 164,101 college students who participated in the first wave survey (T1=during onset of outbreak), 68,685 (41.9%) completed a follow-up survey (T2=during remission). In the follow-up survey, the prevalence of probable acute stress (T1: 34.6%; T2: 16.4%) decreased, while the rates of depressive (T1: 21.6%; T2: 26.3%) and anxiety symptoms (T1: 11.4%; T2: 14.7%) increased. Senior students, with suspected or conformed cases in their community and COVID-19 related worries (all AORs > 1.20, ps < 0.001) were found to have a higher risk of developing mental health problems in at least one wave. Less physical exercise, low perceived social support, and a dysfunctional family were found to negatively impact psychological symptoms.

Conclusions: Acute stress, anxiety, and depressive symptoms have been prevalent among college students during the COVID-19 epidemic, and showed a significant increase after the initial stage of the outbreak. Some college students, especially those with the risk factors noted above, exhibited persistent or delayed symptoms.
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http://dx.doi.org/10.1016/j.jad.2020.11.109DOI Listing
February 2021

Gut Microbiota Changes and Their Relationship with Inflammation in Patients with Acute and Chronic Insomnia.

Nat Sci Sleep 2020 5;12:895-905. Epub 2020 Nov 5.

Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA.

Purpose: The major purpose of this study was to detect the changes in gut microbiota composition and inflammatory cytokines production associated with acute and chronic insomnia. This study also evaluated the relationship between gut microbiota changes and increased inflammatory cytokines in insomnia patients.

Patients And Methods: Outpatients with acute and chronic insomnia (aged 26-55 years; n=20 and 38, respectively) and age/gender-matched healthy controls (n=38) were recruited from a southern China region. Participants' gut microbiome, plasma cytokines, and self-reported sleep quality and psychopathological symptoms were measured.

Results: The gut microbiomes of insomnia patients compared with healthy controls were characterized by lower microbial richness and diversity, depletion of anaerobes, and short-chain fatty acid (SCFA)-producing bacteria, and an expansion of potential pathobionts. and were signature bacteria for distinguishing acute insomnia patients from healthy controls, while and were signature bacteria for distinguishing chronic insomnia patients from healthy controls. Acute/chronic insomnia-related signature bacteria also showed correlations with these patients' self-reported sleep quality and plasma IL-1β.

Conclusion: These findings suggest that insomnia symptomology, gut microbiota, and inflammation may be interrelated in complex ways. Gut microbiota may serve as an important indicator for auxiliary diagnosis of insomnia and provide possible new therapeutic targets in the field of sleep disorders.
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http://dx.doi.org/10.2147/NSS.S271927DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652227PMC
November 2020

Oncologist and Patient Preferences for Attributes of CDK4/6 Inhibitor Regimens for the Treatment of Advanced/Metastatic HR Positive/HER2 Negative Breast Cancer: Discrete Choice Experiment and Best-Worst Scaling.

Patient Prefer Adherence 2020 5;14:2201-2214. Epub 2020 Nov 5.

Kantar, Health Division, Horsham, PA, USA.

Purpose: To understand and compare preferences for dosing- and toxicity-related attributes associated with selective cyclin-dependent 4/6 kinase inhibitors regimens among US oncologists and patients.

Materials And Methods: Oncologists and patients with mBC participated in an internet-based survey that included a discrete choice experiment (DCE) and a best-worst scaling (BWS) exercise. For the DCE, participants chose between two hypothetical treatment profiles, each with seven attributes: risk of dose reduction due to adverse events (AEs), risk of diarrhea, risk of abdominal pain, need for electrocardiogram (ECG) monitoring to assess heart function, risk of Grade 3/4 neutropenia, dosing regimen, and dosing schedule. The BWS exercise assessed the relative prioritization of a larger set of 16 attributes. Hierarchical Bayesian models were used to estimate preference weights for each attribute level.

Results: Oncologists (N=209) and patients (N=304) rated risks of diarrhea (25% each) and Grade 3/4 neutropenia (20% and 24%, respectively) as the most important attributes for treatment choice. The risks of diarrhea and Grade 3/4 neutropenia were 1.8 to 2.3 times (oncologists: 25% and 20%, respectively vs 11%) and 2.4 to 2.5 times (patients: 25% and 24%, respectively vs 10%) higher in relative importance than the risk of dose reduction due to AEs. Oncologists placed greater importance on the risk of dose reduction due to AEs and the need for ECG monitoring, whereas patients placed greater importance on the risk of Grade 3/4 neutropenia (all, p<0.05). The BWS exercise results were largely consistent with those from the DCE.

Conclusion: The risks of diarrhea and Grade 3/4 neutropenia were key drivers of both oncologist and patient preferences. Overall, the palbociclib + aromatase inhibitor (AI) profile was most preferred, due to its association with a lower risk of diarrhea and no ECG monitoring, compared with abemaciclib + AI and ribociclib + AI profiles, respectively.
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http://dx.doi.org/10.2147/PPA.S254934DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652230PMC
November 2020

New insights into unusual droplets: from mediating the wettability to manipulating the locomotion modes.

Chem Commun (Camb) 2020 Nov;56(94):14757-14788

Ministry of Education Key Laboratory for the Green Preparation and Application of Functional Materials, School of Materials Science & Engineering and Hubei Key Laboratory of Polymer Materials, Hubei University, Wuhan 430062, People's Republic of China. and State Key Laboratory of Solid Lubrication, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou 730000, People's Republic of China.

The ability to manipulate droplets can be utilized to develop various smart sensors or actuators, endowing them with fascinating applications for drug delivery, detection of target analytes, environmental monitoring, intelligent control, and so on. However, the stimuli-responsive superhydrophobic/superhydrophilic materials for normal water droplets cannot satisfy the requirements from some certain circumstances, i.e., liquid lenses and biosensors (detection of various additives in water/blood droplets). Stimuli-responsive wetting/dewetting behaviors of exceptional droplets are open issues and are attracting much attention from across the world. In this perspective article, the unconventional droplets are divided into three categories: ionic or surfactant additives in water droplets, oil droplets, and bubble droplets. We first introduce several classical wettability models of droplets and some methods to achieve wettability transition. The unusual droplet motion is also introduced in detail. There are four main types of locomotion modes, which are vertical rebound motion, lateral motion, self-propulsion motion, and anisotropic wettability controlled sliding behavior. The driving mechanism for the droplet motion is briefly introduced as well. Some approaches to achieve this manipulation goal, such as light irradiation, electronic, magnetic, acid-base, thermal, and mechanical ways will be taken into consideration. Finally, the current researches on unconventional droplets extending to polymer droplets and liquid metal droplets on the surface of special wettability materials are summarized and the prospect of unconventional droplet research directions in the field of on-demand transport application will be proposed.
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http://dx.doi.org/10.1039/d0cc05801gDOI Listing
November 2020

Early Childhood Co-Sleeping Predicts Behavior Problems in Preadolescence: A Prospective Cohort Study.

Behav Sleep Med 2021 Sep-Oct;19(5):563-576. Epub 2020 Sep 18.

School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Objective/background: Co-sleeping is common practice around the globe. The relationship between early childhood co-sleeping and adolescent behavior problems remains uncertain. We aim to identify whether early childhood co-sleeping can predict behavior problems in preadolescence.

Participants: A cohort of 1,656 Chinese preschool children were followed up in adolescence.

Methods: Prospective cohort study design involving two waves of data collection from the China Jintan Cohort (1,656 children aged 3-5 years). Co-sleeping history was collected at 3-5-years-old via parent-reported questionnaire at wave I data collection. Behavior problems were measured twice in childhood and preadolescence, respectively. Adolescent behavior problems were measured by integrating data from self-report, parent-report and teacher-report using the Achenbach System of Empirically Based Assessment. Predictions were assessed using the general linear model with mixed effects on the inverse probability weight propensity-matched sample.

Results: 1,656 children comprising 55.6% boys aged 4.9 ± 0.6 were initially enrolled in the first wave of data collection. In the second wave of data collection, 1,274 children were 10.99 ± 0.74 (76.9%) aged 10-13 years were retained. Early childhood co-sleeping is significantly associated with increased behavior problems in childhood (Odds Ratio [OR] 1.22-2.06, ps<0.03) and preadolescence (OR 1.40-2.27, ps<0.02). Moreover, co-sleeping history significantly predicted multiscale increase in internal (OR 1.63-2.61, ps<0.02) and external behavior problems in adolescence.

Conclusions: Early childhood co-sleeping is associated with multiple behavioral problems reported by parents, teachers, and children themselves. Early childhood co-sleeping predicts preadolescent internalizing and externalizing behavior after controlling for baseline behavior problems.
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http://dx.doi.org/10.1080/15402002.2020.1818564DOI Listing
September 2021

Early Childhood Co-Sleeping Predicts Behavior Problems in Preadolescence: A Prospective Cohort Study.

Behav Sleep Med 2021 Sep-Oct;19(5):563-576. Epub 2020 Sep 18.

School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Objective/background: Co-sleeping is common practice around the globe. The relationship between early childhood co-sleeping and adolescent behavior problems remains uncertain. We aim to identify whether early childhood co-sleeping can predict behavior problems in preadolescence.

Participants: A cohort of 1,656 Chinese preschool children were followed up in adolescence.

Methods: Prospective cohort study design involving two waves of data collection from the China Jintan Cohort (1,656 children aged 3-5 years). Co-sleeping history was collected at 3-5-years-old via parent-reported questionnaire at wave I data collection. Behavior problems were measured twice in childhood and preadolescence, respectively. Adolescent behavior problems were measured by integrating data from self-report, parent-report and teacher-report using the Achenbach System of Empirically Based Assessment. Predictions were assessed using the general linear model with mixed effects on the inverse probability weight propensity-matched sample.

Results: 1,656 children comprising 55.6% boys aged 4.9 ± 0.6 were initially enrolled in the first wave of data collection. In the second wave of data collection, 1,274 children were 10.99 ± 0.74 (76.9%) aged 10-13 years were retained. Early childhood co-sleeping is significantly associated with increased behavior problems in childhood (Odds Ratio [OR] 1.22-2.06, ps<0.03) and preadolescence (OR 1.40-2.27, ps<0.02). Moreover, co-sleeping history significantly predicted multiscale increase in internal (OR 1.63-2.61, ps<0.02) and external behavior problems in adolescence.

Conclusions: Early childhood co-sleeping is associated with multiple behavioral problems reported by parents, teachers, and children themselves. Early childhood co-sleeping predicts preadolescent internalizing and externalizing behavior after controlling for baseline behavior problems.
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http://dx.doi.org/10.1080/15402002.2020.1818564DOI Listing
September 2021

Identification of critical genes in gastric cancer to predict prognosis using bioinformatics analysis methods.

Ann Transl Med 2020 Jul;8(14):884

Department of Oncology, Affiliated Hospital of Nantong University, Nantong, China.

Background: Ranking fourth in the world in tumor incidence and second in cancer-related death worldwide, gastric cancer (GC) is one of the major malignant tumors, and has a very complicated pathogenesis. In the present study, we aimed to identify new biomarkers to predict the survival rate of GC patients.

Methods: The differentially expressed genes (DEGs) between GC tissues and normal stomach tissues were obtained by using GEO2R, and overlapped DEGs were acquired with Venn diagrams. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were conducted with R software. Then, the protein-protein interaction (PPI) of these DEGs was visualized by Cytoscape. Gene Expression Profiling Interactive Analysis (GEPIA) was used to verify the expression differences of hub genes in gastric adenocarcinoma tissues and normal tissues. Overall survival (OS) of hub genes was calculated by Kaplan-Meier plotter.

Results: There were a total of 128 consistently expressed genes in the two datasets: 85 upregulated genes were enriched in extra-cellular matrix (ECM)-receptor interaction, protein digestion and absorption, focal adhesion, gastric acid secretion, mineral absorption, systemic lupus erythematosus, amoebiasis, and PI3K-Akt signaling pathway, and 43 downregulated genes were enriched in palate development, blood coagulation, positive regulation of transcription from RNA polymerase II promoter, axonogenesis, receptor internalization, negative regulation of transcription from RNA polymerase II promoter, and in no significant signaling pathways. From the PPI network analyzed by Molecular Complex Detection (MCODE) plug-in, all 27 upregulated genes were selected. Furthermore, to analyze the OS among these genes, Kaplan-Meier analysis was conducted, and 25 genes were associated with remarkably worse survival. For validation in GEPIA, 11 of 25 genes were discovered to be highly expressed in GC tissues compared to normal OS tissues. Furthermore, in the re-analysis of the Database for Annotation, Visualization and Integrated Discovery (DAVID), three genes [G2/miotic-specific cyclin B1 (CCNB1), polo-like kinases 1 (PLK1), and pituitary tumor-transforming gene-1 (PTTG1)] were markedly enriched in the cell cycle pathway, particulary the G1-G1/S phase.

Conclusions: Three remarkably upregulated DEGs with poor prognosis in GC were identified and may serve as new prognostic biomarkers and targets in GC therapy.
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http://dx.doi.org/10.21037/atm-20-4427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7396774PMC
July 2020

Identification of critical genes in gastric cancer to predict prognosis using bioinformatics analysis methods.

Ann Transl Med 2020 Jul;8(14):884

Department of Oncology, Affiliated Hospital of Nantong University, Nantong, China.

Background: Ranking fourth in the world in tumor incidence and second in cancer-related death worldwide, gastric cancer (GC) is one of the major malignant tumors, and has a very complicated pathogenesis. In the present study, we aimed to identify new biomarkers to predict the survival rate of GC patients.

Methods: The differentially expressed genes (DEGs) between GC tissues and normal stomach tissues were obtained by using GEO2R, and overlapped DEGs were acquired with Venn diagrams. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were conducted with R software. Then, the protein-protein interaction (PPI) of these DEGs was visualized by Cytoscape. Gene Expression Profiling Interactive Analysis (GEPIA) was used to verify the expression differences of hub genes in gastric adenocarcinoma tissues and normal tissues. Overall survival (OS) of hub genes was calculated by Kaplan-Meier plotter.

Results: There were a total of 128 consistently expressed genes in the two datasets: 85 upregulated genes were enriched in extra-cellular matrix (ECM)-receptor interaction, protein digestion and absorption, focal adhesion, gastric acid secretion, mineral absorption, systemic lupus erythematosus, amoebiasis, and PI3K-Akt signaling pathway, and 43 downregulated genes were enriched in palate development, blood coagulation, positive regulation of transcription from RNA polymerase II promoter, axonogenesis, receptor internalization, negative regulation of transcription from RNA polymerase II promoter, and in no significant signaling pathways. From the PPI network analyzed by Molecular Complex Detection (MCODE) plug-in, all 27 upregulated genes were selected. Furthermore, to analyze the OS among these genes, Kaplan-Meier analysis was conducted, and 25 genes were associated with remarkably worse survival. For validation in GEPIA, 11 of 25 genes were discovered to be highly expressed in GC tissues compared to normal OS tissues. Furthermore, in the re-analysis of the Database for Annotation, Visualization and Integrated Discovery (DAVID), three genes [G2/miotic-specific cyclin B1 (CCNB1), polo-like kinases 1 (PLK1), and pituitary tumor-transforming gene-1 (PTTG1)] were markedly enriched in the cell cycle pathway, particulary the G1-G1/S phase.

Conclusions: Three remarkably upregulated DEGs with poor prognosis in GC were identified and may serve as new prognostic biomarkers and targets in GC therapy.
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http://dx.doi.org/10.21037/atm-20-4427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7396774PMC
July 2020

A Real-World Observational Study of Hospitalization and Health Care Costs Among Nonvalvular Atrial Fibrillation Patients Prescribed Oral Anticoagulants in the U.S. Medicare Population.

J Manag Care Spec Pharm 2020 May;26(5):639-651

Bristol Myers Squibb, Lawrenceville, New Jersey.

This article has been corrected. Please see J Manag Care Spec Pharm, 2020;26(5):682 BACKGROUND: Clinical trials have shown that direct oral anticoagulants (DOACs)-including dabigatran, rivaroxaban, apixaban, and edoxaban-are at least as effective and safe as warfarin for the risk of stroke/systemic embolism (SE) and major bleeding (MB) in patients with atrial fibrillation (AF). However, few studies have compared oral anticoagulants (OACs) among elderly patients.

Objective: To compare hospitalization risks (all-cause, stroke/SE-related, and MB-related) and associated health care costs among elderly nonvalvular AF (NVAF) patients in the Medicare population who initiated warfarin, dabigatran, rivaroxaban, or apixaban.

Methods: Patients (aged ≥ 65 years) initiating warfarin or DOACs (apixaban, rivaroxaban, and dabigatran) were selected from the Centers for Medicare & Medicaid Services database from January 1, 2013, to December 31, 2014. Patients initiating each OAC were matched 1:1 to apixaban patients using propensity score matching to balance demographic and clinical characteristics. Cox proportional hazards models were used to estimate the risk of hospitalization of each OAC versus apixaban. Generalized linear models and two-part models with bootstrapping were used to compare all-cause health care costs and stroke/SE- and MB-related medical costs between matched cohorts.

Results: Of the 264,479 eligible patients, 77,480 warfarin-apixaban, 41,580 dabigatran-apixaban, and 77,640 rivaroxaban-apixaban patients were matched. The OACs were associated with a significantly higher risk of all-cause hospitalization compared with apixaban (warfarin: HR = 1.27, 95% CI = 1.23-1.31, < 0.001; dabigatran: HR = 1.13, 95% CI = 1.08-1.18, < 0.001; and rivaroxaban: HR = 1.22, 95% CI = 1.18-1.26, < 0.001) and were associated with a significantly higher risk of hospitalization due to stroke/SE (warfarin: HR = 2.18, 95% CI = 1.80-2.64, < 0.001; dabigatran: HR = 1.45, 95% CI = 1.12-1.88, = 0.006; and rivaroxaban: HR = 1.40, 95% CI = 1.14-1.71, = 0.001). Also, the OACs were associated with significantly higher risk of hospitalization due to MB-related conditions compared with apixaban (warfarin: HR = 1.76, 95% CI = 1.59-1.95, < 0.001; dabigatran: HR = 1.44, 95% CI = 1.23-1.68, < 0.001; and rivaroxaban: HR = 1.89, 95% CI = 1.71-2.09, < 0.001). Compared with apixaban, warfarin ($3,577 vs. $3,183, < 0.001); dabigatran ($3,217 vs. $3,060, < 0.001); and rivaroxaban ($3,878 vs. $3,180, < 0.001) had significantly higher all-cause total health care costs per patient per month. Patients initiating the OACs had significantly higher MB-related medical costs compared with apixaban: warfarin ($472 vs. $269; < 0.001); dabigatran ($364 vs. $245, < 0.001); and rivaroxaban ($493 vs. $270, < 0.001). Warfarin was also associated with higher stroke/SE-related medical costs compared with apixaban ($124 vs. $62, < 0.001).

Conclusions: This real-world study showed that among elderly NVAF patients in the Medicare population, apixaban was associated with significantly lower risks of all-cause, stroke/SE-related, and MB-related hospitalizations compared with warfarin, dabigatran, and rivaroxaban. Accordingly, apixaban showed significantly lower all-cause health care costs and MB-related medical costs.

Disclosures: This study was funded by Bristol Myers Squibb and Pfizer. Amin is an employee of the University of California, Irvine, and was a paid consultant to Bristol Myers Squibb in connection with this study and the development of this manuscript. He has served as a consultant and/or speaker for Bristol Myers Squibb, Pfizer, and Boehringer Ingelheim. Keshishian and Zhang are employees of STATinMED Research, a paid consultant to Pfizer and Bristol Myers Squibb in connection with this study and the development of this manuscript. Trocio, Dina, Mardekian, and Liu are employees of Pfizer, with ownership of stocks in Pfizer. Le, Rosenblatt, Nadkarni, and Vo are employees of Bristol Myers Squibb. Rosenblatt and Vo have ownership of stocks in Bristol Myers Squibb. Baser has no conflicts to disclose.
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http://dx.doi.org/10.18553/jmcp.2020.26.5.639DOI Listing
May 2020

Identifying the hub gene in gastric cancer by bioinformatics analysis and in vitro experiments.

Cell Cycle 2020 06 15;19(11):1326-1337. Epub 2020 Apr 15.

Department of Radiation Oncology, Affiliated Hospital of Nantong University , Nantong, Jiangsu, China.

Gastric cancer (GC) is one of the main causes of the high death rate in the world. But the molecular mechanisms of GC carcinogenesis remain little known. This study aimed to identify novel promising biomarkers of GC and reveal its potential molecular mechanisms by integrating bioinformatics analysis. We screened the overlapped differentially expressed genes (DEGs) of TCGA and several GEO datasets. Among these DEGs, we used protein-protein interactions network analysis to recognize the hub genes. Moreover, functional enrichment analysis including GO and KEGG pathway analysis and gene set enrichment analysis (GSEA) were performed to study the role of DEGs and potential underlying mechanisms of GC. Based on integrated bioinformatics analysis, SERPINH1, COL1A2, COL8A1, COL4A1, COL5A1, COL12A1, and COL1A1 were screened as candidate diagnostic marker genes. In addition, SERPINH1 was identified as a core gene in the regulation of GC development. Furthermore, we confirmed that SERPINH1 could promote the proliferation, migration, and cell cycle of GC cells. Our present study demonstrated that SERPINH1 was a core therapeutic biomarker in the regulation of candidate genes involved in GC progression.
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http://dx.doi.org/10.1080/15384101.2020.1749789DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7469508PMC
June 2020

Prolonged Mobile Phone Use Is Associated with Poor Academic Performance in Adolescents.

Cyberpsychol Behav Soc Netw 2020 May 19;23(5):303-311. Epub 2020 Mar 19.

Shandong University School of Public Health, Jinan, China.

Prolonged mobile phone use (MPU) is prevalent in adolescents. This study examined the associations between prolonged MPU and academic performance in Chinese adolescents. Participants were 11,831 adolescents who participated in the Shandong Adolescent Behavior and Health Cohort in 2015. We used a self-administered questionnaire to collect data on demographics, weekday and weekend MPU, sleep duration, insomnia, depression, and academic performance. We obtained a subsample's year-end achievement test scores for Chinese, Mathematics, and English, 3 months after baseline survey ( = 856). Results showed that with prolonged MPU from ≥1 hour/day on weekdays and ≥2 hours/day on weekends, the prevalence of self-reported poor academic performance significantly increased, and the achievement test scores significantly decreased. After controlling for adolescent and family covariates, students who used mobile phone ≥2 hours/day on weekdays (OR = 2.12, 95% CI = 1.82-2.47) and ≥5 hours/day on weekends (OR = 1.50, 95% CI = 1.31-1.72) were significantly more likely to report poor overall academic performance and scored significantly lower on Mathematics and English compared with those who used mobile phone <1 hour/day on weekdays and <2 hours/day on weekends, respectively. The mediating effects of reduced sleep duration, insomnia, and depression on the association between prolonged MPU and academic performance was small. In conclusion, prolonged MPU is associated with poor academic performance as measured by self-reports and subject tests in Chinese adolescents. Our findings suggest that adolescents should be advised to limit the time of MPU to minimize its harmful effects on sleep, mental health, and academic performance.
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http://dx.doi.org/10.1089/cyber.2019.0591DOI Listing
May 2020

Trajectories of maternal symptoms of posttraumatic stress disorder predict long-term mental health of children following the Wenchuan earthquake in China: A 10-year follow-up study.

J Affect Disord 2020 04 22;266:201-206. Epub 2020 Jan 22.

Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.

Background: Maternal psychopathology can be an important factor associated with psychological adjustment of children. However, there is limited research on long-term impacts of maternal posttraumatic stress disorder (PTSD) on children's mental health. This study examined how PTSD trajectories of women exposed to the 2008 Wenchuan earthquake in China predicted their children's mental health symptoms 10 years after the earthquake.

Methods: 410 dyads of mothers and their adolescent children who exposed to the Wenchuan earthquake were investigated at 12 and 18 months post-earthquake. While the mothers completed measures of earthquake exposure and PTSD symptoms, the children completed measures of earthquake exposure, PTSD, depression and anxiety symptoms. In the 10-year follow up, 257 out of the 410 children completed measures of PTSD, depression and anxiety symptoms. Data were analyzed using linear regression.

Results: Four trajectories of maternal PTSD symptoms were identified: (a) chronic (9.5%); (b) resilient (66.3%); (c) delayed (7.6%); and (d) recovery (16.6%); More importantly, the findings demonstrated that children whose mothers experienced chronic PTSD reported higher level of PTSD and anxiety symptoms 10 years after the earthquake.

Limitations: Only two waves of maternal PTSD were collected, self-reported tools other than clinical reviews were used to collect data, and a significant proportion of participants did not respond at the 10-year follow-up.

Conclusions: This study identified maternal PTSD trajectories following the Wenchuan earthquake. Chronic PTSD symptoms in mothers were associated with increased risk of children's PTSD and anxiety 10 years after the earthquake.
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http://dx.doi.org/10.1016/j.jad.2020.01.084DOI Listing
April 2020

Depressive symptoms are associated with short and long sleep duration: A longitudinal study of Chinese adolescents.

J Affect Disord 2020 02 27;263:267-273. Epub 2019 Nov 27.

Department of Epidemiology, Shandong University School of Public Health, Jinan, China; School of Psychology, South China Normal University, Shipai, Guangzhou, China; Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA. Electronic address:

Aims: Sleep loss and irregular sleep patterns in adolescents are major public health concerns in the modern society. This study aimed to explore the associations between short and long sleep duration and depressive symptoms among Chinese adolescents.

Methods: A total of 7311 adolescents who participated in the baseline survey and were followed up 1 year or 2 years later were included in the analyses. Participants completed a self-administered questionnaire at baseline and follow-up surveys. The Center for Epidemiologic Studies Depression (CES-D) scale was used to assess depressive symptoms. Generalized estimating equation (GEE) and restrictive cubic spline models were used to estimate the association between sleep duration and depressive symptoms.

Results: After adjusting for adolescent and family covariates, sleep duration <8 h and >=9 h on weekdays and sleep duration <8 h and >=12 h on weekends were significantly associated with depressive symptoms compared with sleep 8 h. Weekend-weekday sleep difference >=3 h or <-1 h (ie. sleeping >1 h on weekdays than weekends) was also associated with depressive symptoms. There were U-shaped relationships between sleep duration on weekdays, weekends, or weekday-weekend sleep difference and depressive symptoms.

Limitations: Sleep duration and depression were measured by self-report.

Conclusions: Our findings highlight the risk of short and long sleep duration, and weekday-weekend sleep imbalance for depression in adolescents.
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http://dx.doi.org/10.1016/j.jad.2019.11.113DOI Listing
February 2020

Associations between sleep problems and ADHD symptoms among adolescents: findings from the Shandong Adolescent Behavior and Health Cohort (SABHC).

Sleep 2020 06;43(6)

School of Public Health, Shandong University, Jinan, China.

Study Objectives: Sleep problems and symptoms of attention-deficit hyperactivity disorder (ADHD) in adolescence are common. Little is known about the prospective the prospective associations between sleep and subsequent ADHD symptoms in adolescents. This study examined the prospective associations between sleep problems and subsequent ADHD symptoms in a large sample of adolescents.

Methods: Participants included 7072 adolescents from the Shandong Adolescent Behavior and Health Cohort (SABHC) study in Shandong, China. Participants were initially assessed in November-December of 2015 and were reassessed 1-year later in 2016. Sleep duration, sleep problems, and psychosocial information were collected using a structured questionnaire. ADHD symptoms were measured by the Achenbach Child Behavior Checklist-Youth Self-Report.

Results: At baseline, 7.6% participants had clinically relevant ADHD symptoms, which were highly comorbid with sleep problems including insomnia symptoms, poor sleep quality, symptoms of restless legs syndrome (RLS), frequent snoring, and short sleep duration. Of the 6531 participants without clinically relevant ADHD symptoms at baseline, 4.5% reported clinically relevant ADHD symptoms at 1-year follow-up. After adolescent and family covariates were adjusted for, insomnia (OR = 2.09, 95% CI = 1.45-3.02), RLS (OR = 1.47, 95% CI = 1.02-2.11), and frequent snoring (OR = 2.30, 95% CI = 1.36-3.90) were all significantly associated with subsequent ADHD symptoms.

Conclusion: ADHD symptoms and sleep problems are highly comorbid. Insomnia, RLS and frequent snoring appear to be significant predictors of subsequent ADHD symptoms. Our study highlights the importance of assessing and managing sleep problems for prevention and clinical treatment of ADHD symptoms in adolescence.
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http://dx.doi.org/10.1093/sleep/zsz294DOI Listing
June 2020

Analysis of lncRNA-mRNA networks after MEK1/2 inhibition based on WGCNA in pancreatic ductal adenocarcinoma.

J Cell Physiol 2020 04 3;235(4):3657-3668. Epub 2019 Oct 3.

Department of Radiotherapy, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.

Pancreatic ductal adenocarcinoma (PDA) responds poorly to treatment. Efforts have been exerted to prolong the survival time of PDA, but the 5-year survival rates remain disappointing. Understanding the molecular mechanisms of PDA development is significant. MEK/ERK pathway signaling has been proven to be important in PDA. lncRNA-mRNA networks have become a vital part of molecular mechanisms in the MEK/ERK pathway. Herein, weighted gene coexpression network analysis was used to investigate the coexpressed lncRNA-mRNA networks in the MEK/ERK pathway based on GSE45765. Differently expressed long noncoding RNA (lncRNA) and messenger RNA (mRNA) were found and 10 modules were identified based on coexpression profiles. Gene ontology and Kyoto Encyclopedia of Genes and Genomes were then performed to analyze the coexpressed lncRNA and mRNA in different modules. PDA cells and tissues were used to validate the analysis results. Finally, we found that NONHSAT185150.1 and B4GALT6 were negatively correlated with MEK1/2. By analyzing GSE45765, the genome-wide profiles of lncRNA-mRNA network after MEK1/2 was established, which might aid the development of drug-targeting MEK1/2 and the investigation of diagnostic markers.
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http://dx.doi.org/10.1002/jcp.29255DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6972678PMC
April 2020

Prolonged mobile phone use is associated with depressive symptoms in Chinese adolescents.

J Affect Disord 2019 12 12;259:128-134. Epub 2019 Aug 12.

Shandong University School of Public Health, Jinan, China; South China Normal University School of Psychology, Guangzhou, China; Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA. Electronic address:

Background: Prolonged screen time has negative impacts on health and well-being. This study examined the association between the duration of mobile phone use (DMPU) and depressive symptoms in a large sample of Chinese adolescents.

Methods: 11,831 adolescent students participated in the baseline Shandong Adolescent Behavior and Health Cohort (SABHC) survey in Shandong, China in 2015. A self-administered questionnaire was used to measure DMPU on weekdays and the weekend, sleep, mental health, and family environment. The Center for Epidemiologic Studies Depression Scale (CES-D) and Youth Self-Report (YSR) depression scales were used to assess depressive symptoms.

Results: The mean age of participants was 15.0 (SD = 1.5) and 51% were male. The prevalence of depressive symptoms increased with prolonged DMPU. After adjusting for adolescent and family covariates, DMPU ≥ 2 h/day on weekdays (OR = 1.78, 95%CI = 1.48-2.15) and ≥ 5 h/day on the weekend (OR = 1.67, 95%CI = 1.41-1.98) was associated with increased risk of depressive symptoms as assessed by CES-D. The DMPU-depression association was found to be partially mediated by short sleep duration or insomnia. Similar associations were observed for depression as assessed by YSR.

Study Limitation: This is a cross-sectional survey. Mobile phone use and depressive symptoms were measured by self-report.

Conclusions: Prolonged mobile phone use of ≥ 2 h on weekdays and ≥ 5 h on the weekend is associated with an increased risk of depressive symptoms. The association appears to be partially mediated by sleep disturbances.
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http://dx.doi.org/10.1016/j.jad.2019.08.017DOI Listing
December 2019

Bidirectional associations between insomnia, posttraumatic stress disorder, and depressive symptoms among adolescent earthquake survivors: a longitudinal multiwave cohort study.

Sleep 2019 10;42(11)

School of Psychology, South China Normal University, Guangzhou, Guangdong, People's Republic of China.

Study Objectives: To assess insomnia symptoms in adolescents with probable posttraumatic stress disorder (PTSD) and to determine whether there are longitudinal and reciprocal associations between insomnia, PTSD, and depressive symptoms.

Methods: Participants were 1,492 adolescent survivors who had been exposed to the 2008 Wenchuan earthquake in China. Insomnia, PTSD, and depressive symptoms were measured at 12 months (T1, n = 1407), 18 months (T2, n = 1335), and 24 months (T3, n = 1361) postearthquake by self-report questionnaires. Generalized estimating equation (GEE) models were used to examine the cross-sectional and longitudinal associations of insomnia with PTSD and depression.

Results: Insomnia, PTSD, and depressive symptoms were common among adolescent survivors. Among participants with probable PTSD, approximately 47% (48.5%, T1; 48.1%, T2; and 44.2%, T3) reported difficulty falling asleep or difficulty maintaining sleep. Cross-sectional analyses showed that insomnia co-occurred with PTSD (odds ratio [OR] = 2.04) and depressive symptoms (OR = 2.10). Longitudinal analyses revealed that probable PTSD (OR = 1.50) and depression (OR = 1.42) predicted the incidence of insomnia; in turn, insomnia predicted the incidence of depression (OR = 1.65) over time. Furthermore, PTSD predicted (OR = 3.11) and was predicted (OR = 3.25) by depressive symptoms.

Conclusions: There is a bidirectional relationship between insomnia, PTSD, and depressive symptoms. This suggests that insomnia, PTSD, and depression are intertwined over time.
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http://dx.doi.org/10.1093/sleep/zsz162DOI Listing
October 2019
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