Publications by authors named "Yehuan Sun"

82 Publications

Association of child maltreatment and bullying victimization among chinese adolescents: The mediating role of family function, resilience, and anxiety.

J Affect Disord 2021 Nov 22;299:12-21. Epub 2021 Nov 22.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China. Electronic address:

Background: Among adolescents, child maltreatment is linked to being bullied at school. Nevertheless, little is known about the mediating mechanisms underlying this association. Therefore, our research aimed to explore and evaluate the potential mediators of the relationship between child maltreatment and bullying victimization among Chinese adolescents.

Methods: From October to December 2020, a population-based cross-sectional survey was conducted among 6247 adolescents (3401 males, 2846 females) in Anhui Province, China. The subjects of the survey were elementary and middle school students from grades 4 to 9. The data were collected through self-report questionnaires. Pearson correlation and linear regression were used to examine the relationships among child maltreatment, bullying victimization, family function, resilience, and anxiety. Structural equation modeling (SEM) was employed to conduct mediation analyses.

Results: The results indicated that child maltreatment positively predicted the later bullying victimization of adolescents. Resilience and anxiety were each shown to separately mediate this relationship. Moreover, the sequential mediating effects of family function, resilience, and anxiety also mediated the predictive effect of child maltreatment on bullying victimization.

Conclusions: Resilience and anxiety were both shown to be important independent mediators for the relationship between child maltreatment and bullying victimization. Furthermore, the combined mediating effects of family function, resilience, and anxiety were also of great significance. These findings provide additional evidence that family and individual factors are critical to understanding bullying victimization. Effective prevention and intervention strategies for school bullying should target family and individual vulnerabilities in adolescents.
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http://dx.doi.org/10.1016/j.jad.2021.11.053DOI Listing
November 2021

Radiofrequency ablation versus stereotactic body radiotherapy for hepatocellular carcinoma: a meta-analysis.

Future Oncol 2021 Oct 19;17(30):4027-4040. Epub 2021 Jul 19.

Department of Epidemiology & Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China.

The present meta-analysis was performed to evaluate the efficacy of radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) in hepatocellular carcinoma (HCC) patients. A systematic literature search was conducted of online databases prior to February 21, 2021. Eleven articles involving 8429 patients were included. The pooled hazard ratio for overall survival (OS) of RFA versus SBRT was 0.79 (p < 0.001). Statistically significant differences were found in the 1-, 2-, 3-, 4- and 5-year pooled OS and freedom from local progression (FFLP) rates between the two groups, favoring the RFA arms. However, the pooled local control (LC) rates were higher in the SBRT arm. RFA provided better OS and FFLP for treating HCC, while SBRT achieved superior LC. CRD42020207877.
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http://dx.doi.org/10.2217/fon-2021-0263DOI Listing
October 2021

Temperature and risk of infectious diarrhea: a systematic review and meta-analysis.

Environ Sci Pollut Res Int 2021 Jul 15. Epub 2021 Jul 15.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.

Infectious diarrhea (ID) is an intestinal infectious disease including cholera, typhoid and paratyphoid fever, bacterial and amebic dysentery, and other infectious diarrhea. There are many studies that have explored the relationship between ambient temperature and the spread of infectious diarrhea, but the results are inconsistent. It is necessary to systematically evaluate the impact of temperature on the incidence of ID. This study was based on the PRISMA statement to report this systematic review. We conducted literature searches from CNKI, VIP databases, CBM, PubMed, Web of Science, Cochrane Library, and other databases. The number registered in PROSPERO is CRD42021225472. After searching a total of 4915 articles in the database and references, 27 studies were included. The number of people involved exceeded 7.07 million. The overall result demonstrated when the temperature rises, the risk of infectious diarrhea increases significantly (RR=1.42, 95%CI: 1.07-1.88, RR=1.08, 95%CI: 1.03-1.14). Subgroup analysis found the effect of temperature on the bacillary dysentery group (RR=1.85, 95%CI: 1.48-2.30) and unclassified diarrhea groups (RR=1.18, 95%CI: 0.59-2.34). The result of the single-day effect subgroup analysis was similar to the result of the cumulative effect. And the sensitivity analysis proved that the results were robust. This systematic review and meta-analysis support that temperature will increase the risk of ID, which is helpful for ID prediction and early warning in the future.
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http://dx.doi.org/10.1007/s11356-021-15395-zDOI Listing
July 2021

Clinical efficacy of low-dose emetine for patients with COVID-19: a real-world study.

J BioX Res 2021 Jun 3;4(2):53-59. Epub 2020 Dec 3.

Anhui Feidong County People's Hospital.

Objective: Emetine, an isoquinoline alkaloid that is enriched at high concentrations in the lung, has shown potent in vitro activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this study was to better understand the effectiveness of low-dose emetine for patients with coronavirus disease 2019 (COVID-19).

Methods: In this real-world study, 63 patients with mild or common COVID-19 were recruited from Wuhan Fangcang Shelter Hospital and five COVID-19-designated hospitals in Anhui Province, China from February to March 2020. Thirty-nine patients from Wuhan Fangcang Shelter Hospital were assigned to a pragmatic randomized controlled clinical trial, and 24 patients from the 5 COVID-19-designated hospitals in Anhui Province underwent a real-world study. The medication course of emetine was less than 10 days. The main symptoms and adverse reactions of all patients were observed and recorded. The primary outcome measure was the time required for a negative SARS-CoV-2 RNA result or the negative result rate on day 10. Secondary outcomes included axillary temperature, transcutaneous oxygen saturation, and respiratory frequency recovery. The study was approved by the Ethics Committee of The First Affiliated Hospital of Anhui Medical University on February 20, 2019 (approval No. PJ2020-03-19) and was registered with the Chinese Clinical Trial Registry on February 20, 2019 (registration number: ChiCTR2000030022).

Results: The oxygen saturation values were higher in the treatment group than in the control group on the first day after enrollment for patients treated at Fangcang Shelter Hospital. The axillary body temperature, respiratory rate, and oxygen saturation among patients in Fangcang Shelter Hospital were related to the time effect but not to the intervention measures. The respiratory rate and oxygen saturation of patients in the Anhui designated hospitals were related to the intervention measures but not to the time effect. The axillary body temperature of patients in Anhui designated hospitals was related to the time effect but not to the intervention measures.

Conclusion: Our preliminary study shows that low-dose emetine combined with basic conventional antiviral drugs improves clinical symptoms in patients with mild and common COVID-19 without apparent adverse effects, suggesting that moderately increased doses of emetine may have good potential for treatment and prevention of COVID-19.
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http://dx.doi.org/10.1097/JBR.0000000000000076DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8237841PMC
June 2021

Effects of ambient temperature and fall-related injuries in Ma'anshan, Anhui Province, China: a distributed lag nonlinear analysis.

Environ Sci Pollut Res Int 2021 Nov 9;28(41):58092-58103. Epub 2021 Jun 9.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.

Despite the significant economic cost of falls and injuries to individuals and communities, little is known about the impact of meteorological factors on the incidence of fall-related injuries (FRIs). Therefore, a time-series study was conducted to explore the effects of meteorological factors on FRIs in Ma'anshan City, East China. Injury data from 2011 to 2017 were collected from the National Injury Monitoring Station in Ma'anshan City. A distributed lag nonlinear model was used in this study to evaluate the correlation between ambient temperature and fall injuries. The results showed a significant exposure-response relationship between temperature and FRIs in Ma'anshan City. The high temperatures increased the risk of FRIs (RR = 1.110; 95% CI, 1.005-1.225; lag 0). The lag effect appeared at lag 10 (RR = 1.032; 95% CI, 1.003-1.063), and then gradually remained stable after lag 25 (RR = 1.077; 95% CI, 1.045-1.110). The effect of ambient temperature varied with age and gender. The lag effect of high temperature appeared in the male group after lag 15 (RR = 1.042; 95% CI, 1.006-1.079). In contrast, the effect of the female group appeared for the first time at lag 0 (RR = 1.187; 95% CI, 1.042-1.352). And the ≥ 60 years subgroup seemed to be more sensitive in low temperature (RR = 1.017; 95% CI, 1.004-1.031; lag 0; RR = 1.003; 95% CI, 1.000-1.007; lag 25). The cumulative result is similar to the single-day effect. From the results, this study would help the establishment of fall-related injury prediction and provide evidence for the formulation and implementation of preventive strategies and measures in the future.
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http://dx.doi.org/10.1007/s11356-021-14663-2DOI Listing
November 2021

The importance of social distancing policy.

J Public Health (Oxf) 2021 06;43(2):e269

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China.

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http://dx.doi.org/10.1093/pubmed/fdaa219DOI Listing
June 2021

The impact of prenatal stressful life events on adverse birth outcomes: A systematic review and meta-analysis.

J Affect Disord 2021 05 31;287:406-416. Epub 2021 Mar 31.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China; Centre for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, China. Electronic address:

Background: Stressful life events as important stressors have gradually been recognized as the potential etiology that may lead to adverse birth outcomes such as preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA). However, researches on this topic have shown relatively inconsistent results. This systematic review and meta-analysis was performed to synthesize available data on the association between prenatal stressful life events and increased risks of PTB, LBW, and SGA.

Methods: Electronic databases were searched from their inception until September 2020. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated to assess the association between prenatal stressful life events and PTB, LBW, and SGA using random effects models. In addition, subgroup analyses, cumulative meta-analyses, sensitivity analyses, and publication bias diagnosis were conducted. STATA 14.0 was applied for statistical analyses.

Results: Totally 31 cohort studies involving 5,665,998 pregnant women were included. Prenatal stressful life events were associated with a 20% higher risk of PTB (RR = 1.20, 95%CI = 1.10-1.32), a 23% increased risk for LBW (RR = 1.23, 95%CI = 1.10-1.39), and a 14% higher risk of SGA (RR = 1.14, 95%CI = 1.08-1.20). Sensitivity analysis indicated the results were stable.

Conclusions: Findings indicated that pregnant women experiencing prenatal stressful life events were at increased risk of PTB, LBW, and SGA. This information provided additional supports that pregnant women experiencing prenatal stressful life events would benefit from receiving assessment and management in prenatal care services.
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http://dx.doi.org/10.1016/j.jad.2021.03.083DOI Listing
May 2021

Aspirin Use and Risk of Breast Cancer: A Meta-analysis of Observational Studies from 1989 to 2019.

Clin Breast Cancer 2021 Dec 17;21(6):552-565. Epub 2021 Feb 17.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Anhui, China; Center for Evidence-Based Practice, Anhui Medical University, Anhui, China. Electronic address:

Background: Some evidence shows that aspirin can reduce the morbidity and mortality of different cancers, including breast cancer. Aspirin has become a new focus of cancer prevention and treatment research at present, however, clinical studies found conflicting conclusions of its anticancer characteristics.

Materials And Methods: A systematic literature search was performed in 8 electronic databases. The pooled relative risk (RR) with 95% confidence interval (CI) was calculated using the random effects model to estimate the effect of aspirin on breast cancer.

Results: Forty-two published articles with 99,769 patients were identified. The meta-analysis showed a significant decrease in breast cancer risk with aspirin use (RR, 0.92; 95% CI, 0.89-0.96; I = 72%). Aspirin use decreased the risk of hormone receptor-positive tumors (estrogen receptor [ER]-positive RR, 0.89; 95% CI, 0.82-0.97; I=54%; progesterone receptor [PR]-positive RR, 0.86; 95% CI, 0.78-0.95; I=32%; ER- and PR-positive RR, 0.92; 95% CI, 0.85-1.00; I=45%) and reduced the risk of breast cancer in postmenopausal women (RR, 0.92; 95% CI, 0.86-0.98; I=59%). Further analysis showed that for the in situ breast cancer, regular-dose and more than 3 years use of aspirin were associated with the reduced risk of breast cancer.

Conclusion: This meta-analysis suggested that aspirin may reduce the overall risk of breast cancer, reduce the risk of breast cancer in postmenopausal women, hormone receptor-positive tumors, and in situ breast cancer. Larger, multicenter clinical studies are needed to find the optimal dose range, frequency, and duration of the aspirin use to explore the best benefit-risk ratio.
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http://dx.doi.org/10.1016/j.clbc.2021.02.005DOI Listing
December 2021

Health-related quality of life of COVID-19 patients after discharge: A multicenter follow-up study.

J Clin Nurs 2021 Jun 17;30(11-12):1742-1750. Epub 2021 Mar 17.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.

Aims And Objectives: To determine the health-related quality of life (HRQoL) of COVID-19 patients after discharge and its predicting factors.

Background: COVID-19 has caused a worldwide pandemic and led a huge impact on the health of human and daily life. It has been demonstrated that physical and psychological conditions of hospitalised COVID-19 patients are impaired, but the studies focus on physical and psychological conditions of COVID-19 patients after discharge from hospital are rare.

Design: A multicentre follow-up study.

Methods: This was a multicentre follow-up study of COVID-19 patients who had discharged from six designated hospitals. Physical symptoms and HRQoL were surveyed at first follow-up (the third month after discharge). The latest multiple laboratory findings were collected through medical examination records. This study was performed and reported in accordance with STROBE checklist.

Results: Three hundred eleven patients (57.6%) were reported with one or more physical symptoms. The scores of HRQoL of COVID-19 patients at third month after discharge, except for the dimension of general health, were significantly lower than Chinese population norm (p < .001). Results of logistic regression showed that female (odds ratio (OR): 1.79, 95% confidence interval (CI): 1.04-3.06), older age (≥60 years) (OR: 2.44, 95% CI: 1.33-4.47) and the physical symptom after discharge (OR: 40.15, 95% CI: 9.68-166.49) were risk factors for poor physical component summary; the physical symptom after discharge (OR: 6.68, 95% CI: 4.21-10.59) was a risk factor for poor mental component summary.

Conclusions: Health-related quality of life of discharged COVID-19 patients did not come back to normal at third month after discharge and affected by age, sex and the physical symptom after discharge.

Relevance To Clinical Practice: Healthcare workers should pay more attention to the physical and psychological rehabilitation of discharged COVID-19 patients. Long-term follow-up on COVID-19 patients after discharge is needed to determine the long-term impact of COVID-19.
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http://dx.doi.org/10.1111/jocn.15733DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013595PMC
June 2021

Short-term effects of ambient temperature and road traffic accident injuries in Dalian, Northern China: A distributed lag non-linear analysis.

Accid Anal Prev 2021 Apr 26;153:106057. Epub 2021 Feb 26.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Center for Injury Control and Prevention, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China. Electronic address:

Background: Although traffic accidents cause considerable economic losses and injuries to individuals, families, and communities, little is known about the impact of meteorological factors on the incidence of traffic accident injuries (TAIs). Therefore, a time-series study was conducted to explore the effect of meteorological variables on TAIs in Dalian, Northern China.

Methods: Poisson generalized linear models (PGLM) combined with distributed lag nonlinear models (DLNM) were used to estimate the association between daily TAIs and ambient temperature in Dalian, China, 2015-2017. The injury data collected by Dalian national injury surveillance hospitals, and meteorological data were extracted and accumulated from the National Meteorological Information Center. Modified the model with variables such as pressure, humidity, precipitation, PM, SO, O, day of the week, seasonality, and time trend. In the subgroup analysis, the modification effects of gender and age were also examined.

Results: Both high temperatures (RR = 1.198, 95%CI:1.017-1.411) and low temperatures (RR = 1.017, 95%CI:1.001-1.035) increased the risk of TAIs. The cumulative lag effect would last until after the 7th day. While the 40-59 years subgroup seemed to be more vulnerable in high temperature environments, those who are more than 60 years showed higher TAIs in low temperatures for both single-day and cumulative TAI risks.

Conclusions: Identifying the association between ambient temperature and traffic injuries could provide needed scientific evidence for relevant public health actions.
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http://dx.doi.org/10.1016/j.aap.2021.106057DOI Listing
April 2021

Short-term effects of ambient temperature and road traffic accident injuries in Dalian, Northern China: A distributed lag non-linear analysis.

Accid Anal Prev 2021 Apr 26;153:106057. Epub 2021 Feb 26.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China; Center for Injury Control and Prevention, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China. Electronic address:

Background: Although traffic accidents cause considerable economic losses and injuries to individuals, families, and communities, little is known about the impact of meteorological factors on the incidence of traffic accident injuries (TAIs). Therefore, a time-series study was conducted to explore the effect of meteorological variables on TAIs in Dalian, Northern China.

Methods: Poisson generalized linear models (PGLM) combined with distributed lag nonlinear models (DLNM) were used to estimate the association between daily TAIs and ambient temperature in Dalian, China, 2015-2017. The injury data collected by Dalian national injury surveillance hospitals, and meteorological data were extracted and accumulated from the National Meteorological Information Center. Modified the model with variables such as pressure, humidity, precipitation, PM, SO, O, day of the week, seasonality, and time trend. In the subgroup analysis, the modification effects of gender and age were also examined.

Results: Both high temperatures (RR = 1.198, 95%CI:1.017-1.411) and low temperatures (RR = 1.017, 95%CI:1.001-1.035) increased the risk of TAIs. The cumulative lag effect would last until after the 7th day. While the 40-59 years subgroup seemed to be more vulnerable in high temperature environments, those who are more than 60 years showed higher TAIs in low temperatures for both single-day and cumulative TAI risks.

Conclusions: Identifying the association between ambient temperature and traffic injuries could provide needed scientific evidence for relevant public health actions.
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http://dx.doi.org/10.1016/j.aap.2021.106057DOI Listing
April 2021

Characteristics of sleep architecture in autism spectrum disorders: A meta-analysis based on polysomnographic research.

Psychiatry Res 2021 02 24;296:113677. Epub 2020 Dec 24.

Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei 230032, Anhui, PR China. Electronic address:

Eleven parameters recorded by polysomnography were used to evaluate the differences in sleep structure between individuals with autism spectrum disorders (ASDs) and typically developed individuals (TDs). Four databases (PubMed, Web of Science, Cochrane Library, and China National Knowledge Infrastructure (CNKI)) were searched for potentially relevant literature published before July 14, 2019. Data extraction was performed by two independent assessors. The Cohen's d effect sizes and their 95% confidence intervals (CIs) were calculated to assess the effectiveness with the random-effects model. The heterogeneity was estimated by Cochran's Q test. The research yielded 14 case-control studies, 11 of which were included in this meta-analysis. Synthesis of the differences in 11 sleep parameters between individuals with ASDs and TDs demonstrated the pooled effect size of Cohen'd was -0.52 (95% CI: (-0.97, -0.08)) for total sleep time (TST), -0.69 (95% CI: (-1.27, -0.11)) for sleep efficiency (SE%) and 0.93 (95% CI: (0.37, 1.48)) for stage 1 sleep (S1%), respectively. Our findings suggested that compared with TDs, individuals with ASDs tend to have a decreased TST and SE% and an increased S1%. Differences of characteristics of sleep architecture in other sleep parameters between individuals with ASDs and TDs were not found in this study.
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http://dx.doi.org/10.1016/j.psychres.2020.113677DOI Listing
February 2021

The relationship between psychological resilience and emotion regulation among preschool left-behind children in rural China.

Psychol Health Med 2021 06 18;26(5):595-606. Epub 2020 Nov 18.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.

To evaluate the relationship between resilience and emotion regulation among preschool left-behind children (LBC) in rural China. A total of 620 preschool LBC were enrolled from rural areas in Anhui province, China. Multivariate logistic regression was used to evaluate the associations between resilience and variables. The results showed that 20.2% of LBC had higher resilience. Emotion regulation was correlated with resilience among preschool LBC. Children with higher cognitive reconstruction (adjusted OR (AOR) = 0.349,95%CI:0.249-0.489), passive dealing (AOR = 0.577, 95%CI:0.411-0.810), alternative action (AOR = 0.369, 95%CI:0.267-0.510) and self-comforting (AOR = 0.441, 95%CI:0.315-0.619) would have lower risk of low resilience. Our findings suggest that strengthening emotion regulation could promote psychological resilience and prevent adverse developments in LBC.
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http://dx.doi.org/10.1080/13548506.2020.1849748DOI Listing
June 2021

Association of food hypersensitivity in children with the risk of autism spectrum disorder: a meta-analysis.

Eur J Pediatr 2021 Apr 4;180(4):999-1008. Epub 2020 Nov 4.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.

This meta-analysis was performed to clarify the association between food hypersensitivity in children and autism spectrum disorder (ASD) in detail. Relevant studies published in 8 databases before March 2020 were retrieved and screened according to established inclusion criteria. The odds ratio (OR) with the 95% confidence interval (CI) was pooled to estimate the effect. Subgroup analyses were performed in terms of publication year, study design, location, sample size, definition of food hypersensitivity, definition of ASD, and study quality score. Furthermore, we stratified studies by participant sex and age to perform a more detailed analysis. This meta-analysis included 12 published articles with 434,809 subjects. A significant association was observed between food hypersensitivity and the risk of ASD (OR = 2.792, 95% CI: 2.081-3.746). The risk of ASD among girls and subjects younger than 12 with food hypersensitivity may be greater than that among boys and those older than 12. The results of sensitivity analysis and publication bias analysis show that the association is relatively stable.Conclusion: Our results showed a positive association between food hypersensitivity and autism spectrum disorder, and girls and subjects younger than 12 may be more sensitive to this association. The role of food hypersensitivity in the onset of ASD deserves more attention. What is Known: • Food hypersensitivity is a term used to describe food allergies and food intolerance. • ASD is a group of neurodevelopmental disorders that are characterized by deficits in social interaction, repetitive or stereotypic behavior, and verbal communication disorder. • The prevalence rates of ASD and food hypersensitivity in the developed world are increasing. What is New: • In this work, we reviewed and analyzed the available data and studies and found a positive association between food hypersensitivity and ASD. • Girls and children younger than 12 may be more sensitive to have ASD than boys and children older than 12.
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http://dx.doi.org/10.1007/s00431-020-03826-xDOI Listing
April 2021

Association of food hypersensitivity in children with the risk of autism spectrum disorder: a meta-analysis.

Eur J Pediatr 2021 Apr 4;180(4):999-1008. Epub 2020 Nov 4.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.

This meta-analysis was performed to clarify the association between food hypersensitivity in children and autism spectrum disorder (ASD) in detail. Relevant studies published in 8 databases before March 2020 were retrieved and screened according to established inclusion criteria. The odds ratio (OR) with the 95% confidence interval (CI) was pooled to estimate the effect. Subgroup analyses were performed in terms of publication year, study design, location, sample size, definition of food hypersensitivity, definition of ASD, and study quality score. Furthermore, we stratified studies by participant sex and age to perform a more detailed analysis. This meta-analysis included 12 published articles with 434,809 subjects. A significant association was observed between food hypersensitivity and the risk of ASD (OR = 2.792, 95% CI: 2.081-3.746). The risk of ASD among girls and subjects younger than 12 with food hypersensitivity may be greater than that among boys and those older than 12. The results of sensitivity analysis and publication bias analysis show that the association is relatively stable.Conclusion: Our results showed a positive association between food hypersensitivity and autism spectrum disorder, and girls and subjects younger than 12 may be more sensitive to this association. The role of food hypersensitivity in the onset of ASD deserves more attention. What is Known: • Food hypersensitivity is a term used to describe food allergies and food intolerance. • ASD is a group of neurodevelopmental disorders that are characterized by deficits in social interaction, repetitive or stereotypic behavior, and verbal communication disorder. • The prevalence rates of ASD and food hypersensitivity in the developed world are increasing. What is New: • In this work, we reviewed and analyzed the available data and studies and found a positive association between food hypersensitivity and ASD. • Girls and children younger than 12 may be more sensitive to have ASD than boys and children older than 12.
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http://dx.doi.org/10.1007/s00431-020-03826-xDOI Listing
April 2021

A Novel Indicator of Children's Lipid Accumulation Product Associated with Impaired Fasting Glucose in Chinese Children and Adolescents.

Diabetes Metab Syndr Obes 2020 14;13:1653-1660. Epub 2020 May 14.

Department of Child and Adolescent Health, School of Public Health, Bengbu Medical College, Bengbu, People's Republic of China.

Background: Diabetes is one of the most prevalent noncommunicable diseases worldwide. Children's lipid accumulation product (CLAP) is a novel indicator to show children's lipid accumulation and is effectively associated with metabolic syndrome among children and adolescents. The aim of the present study was to explore an association between CLAP and impaired fasting glucose (IFG) in Chinese children and adolescents.

Methods: A total of 683 children and adolescents aged 8-15 years were recruited using the stratified cluster sampling method in this cross-sectional study and were measured for body height, weight, waist circumference (WC), abdominal skinfold thickness (AST), triglycerides (TG), fasting plasma glucose, dietary behaviors and physical activities. A logistic regression model and receiver operating characteristic (ROC) curve were used to compare the effects of CLAP for predicting IFG.

Results: The prevalence of IFG in children and adolescents was 13.8%: 16.9% in boys and 10.1% in girls (<0.05). The CLAP, height, weight, WC, AST, waist-to-height ratio (WHtR), and TG among boys with IFG were significantly higher than those among boys without IFG (<0.05). The area under the ROC curve of CLAP for predicting IFG (0.637 (0.562-0.712)) was higher than those of WC, WHtR, AST, and TG. The cutoff point of CLAP was the optimal value to predict IFG among boys, and the OR (95% CI) was 2.48 (1.40-4.42) and area under the ROC curve was 0.595 (0.513-0.676).

Conclusion: The CLAP was a novel indicator associated with IFG in Chinese boys, and it performed better than WC, WHtR, AST and TG.
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http://dx.doi.org/10.2147/DMSO.S238224DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234967PMC
May 2020

Independent and combined effects of triglyceride-glucose index on prehypertension risk: a cross-sectional survey in China.

J Hum Hypertens 2021 03 10;35(3):207-214. Epub 2020 Mar 10.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.

Triglyceride-glucose (TyG) index is considered a simple and feasible indicator of insulin resistance (IR). This study aims to delve into the association and interaction of TyG index on the risk of prehypertension in Chinese adults. A community based cross-sectional survey conducted in Chinese population. Eligible participants were recruited, and questionnaire survey, anthropometric tests, and blood samples collection were performed. TyG index was obtained as ln [fasting TG(mg/dl) × FPG(mg/dl)/2]. Logistic regression model and the area under the receiver-operating characteristics (ROC) curves (AUC) were analyzed. Interaction analysis was conducted by calculating relative excess risk for interaction (RERI), attributable proportion for interaction (AP) as well as synergy index (SI). A total of 3115 recruited participants (1307 males and 1808 females) were aged 60.82 years on average. The prevalence of prehypertension reached 36.4% on the whole, 37.6% in male and 35.5% in female, respectively. The results of multivariable logistic regression model suggested that the adjusted OR for prehypertension was upregulated across TyG index quartiles, up to 2.06 (95% CI:1.53-2.77) for quartiles 4 versus quartiles 1. Furthermore, TyG index outperformed FPG (Z = 2.15, p = 0.032) and TG (Z = 6.10, p < 0.001) in discriminating prehypertension risk. Besides, TyG index with abdominal obesity (RERI:1.53, 95% CI:0.39-2.67; AP: 0.37, 95% CI: 0.16-0.59; SI:1.96, 95% CI:1.15-3.34) displayed a noticeable interaction on risk of prehypertension. Our study indicated that a higher TyG index rose the risk of prehypertension independently and synergistically with abdominal obesity in Chinese adults. Furthermore, it exhibited a higher predictability compared with conventional indices.
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http://dx.doi.org/10.1038/s41371-020-0321-9DOI Listing
March 2021

Epidemiology of fatal crashes in an underdeveloped city for the decade 2008-2017.

Int J Inj Contr Saf Promot 2020 Jun 9;27(2):253-260. Epub 2020 Mar 9.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.

The road traffic accident is an important public health issue affecting social development and public safety. The purpose of this study is to describe the situation of traffic accidents, and to explore the relationship between fatal traffic accidents and risk factors in Suzhou city of Anhui province in China. The accident data was obtained from the Traffic Police Detachment of the Suzhou Public Security Bureau. Other vehicle, population and road information are derived from Suzhou Statistical Yearbook. Descriptive analysis was used to summarize road traffic accident participants' characteristics. The binary logistic regression model was used to analyze the factors that affected fatal traffic accident. There are 7,795 cases involved 18,774 road traffic participants. By logistic regression, we found that in Suzhou, makes traffic accidents more likely to be the most fatal traffic accidents (adjusted OR = 5.33, 95%CI: 2.60-10.93). and might also increase the probability of fatal traffic accidents. These findings would help transportation authorities identify dangerous driving behaviors and take the necessary measures to improve road safety in undeveloped areas.
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http://dx.doi.org/10.1080/17457300.2020.1737140DOI Listing
June 2020

The association between hypertension and colorectal cancer: a meta-analysis of observational studies.

Eur J Cancer Prev 2021 01;30(1):84-96

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.

The relationship between hypertension and risk of colorectal cancer (CRC) is unclear. This meta-analysis aims to explore the association between them. Six databases were searched for studies published before August 2019. The pooled relative risk (RR) and 95% confidence intervals (CIs) were calculated to estimate the association between the hypertension and CRC risk. A total of 2841 potentially relevant articles were obtained, and 25 studies with a pooled 1.95 million participants were finally included in the meta-analysis. These results suggested a positive association between hypertension and risk of CRC with a pooled RR of 1.15 (95% CI: 1.08, 1.23). Male patients with hypertension had a 13% (95% CI: 1.06, 1.20) increased risk of CRC. The risk of colon cancer and rectal cancer in male patients was 1.17 (95% CI: 1.01, 1.36) and 1.35 (95% CI: 1.04, 1.74), respectively, while no association between hypertension and the risk of CRC in females was elucidated. This meta-analysis demonstrated that a positive association between hypertension and CRC exists, with male patients having a higher risk of developing CRC than female patients.
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http://dx.doi.org/10.1097/CEJ.0000000000000578DOI Listing
January 2021

Low-dose CT screening can reduce cancer mortality: A meta-analysis.

Rev Assoc Med Bras (1992) 2019 Dec;65(12):1508-1514

. Department of Epidemiology and Health Statistics, Anhui Medical University, Hefei 230032, China.

Objective: Lung cancer is the leading cause of cancer-related death. To reduce lung cancer mortality and detect lung cancer in early stages, low dose CT screening is required. A meta-analysis was conducted to verify whether screening could reduce lung cancer mortality and to determine the optimal screening program.

Methods: We searched PubMed, Web of Science, Cochrane library, ScienceDirect, and relevant Chinese databases. Randomized controlled trial studies with participants that were smokers older than 49 years (smoking >15 years or quit smoking 10 or 15 years ago) were included.

Results: Nine RCT studies met the criteria. LDCT screening could find more lung cancer cases (RR=1.58, 95%CI=1.25-1.99, P<0.001) and more stage I lung cancers (RR=3.45, 95%CI=2.08-5.72, P<0.001) compared to chest-X ray or the no screening group. This indicated a statistically significant reduction in lung-cancer-specific mortality (RR=0.84, 95%CI=0.75-0.95, P=0.004), but without a statistically reduction in mortality due to all causes (RR=1.26, 95%CI=0.89-1.78, P=0.193). Annually, LDCT screening was sensitive in finding more lung cancers.

Conclusions: Low-dose CT screening is effective in finding more lung cancer cases and decreasing the deaths from lung cancer. Annual low-dose CT screening may be better than a biennial screening to detect more early-stage lung cancer cases.
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http://dx.doi.org/10.1590/1806-9282.65.12.1508DOI Listing
December 2019

The efficacy of statins in the treatment of Alzheimer's disease: a meta-analysis of randomized controlled trial.

Neurol Sci 2020 Jun 13;41(6):1391-1404. Epub 2020 Jan 13.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.

Objective: Alzheimer's disease (AD) is a common type of dementia, which has caused heavy global economic and health burden, and the using of statins to treat AD has caused widely debated. The purpose of this meta-analysis is to explore the effect of statins in the treatment of Alzheimer's disease.

Methods: Studies were retrieved by searching PubMed, Embase, Cochrane library, OvisdSP, Web of Science, Chinese Nation Knowledge Infrastructure (CNKI) and Chinese Biomedical Database (CBM) databases before March 31, 2019. We extracted the Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognitive (ADAS-Cog), Neuropsychiatric Inventory (NPI), Activities of Daily Living (ADL) scale score, and other information. The pooled Weighted Mean Difference (WMD) and their 95% confidence intervals (95% CI) were calculated with random effect model or fixed random effect model.

Results: A total of nine randomized controlled trials were included that contained 1489 patients; of them, 742 patients in the statins group, 747 patients in the control group. There were nine studies used the MMSE scale, five studies used the ADAS-Cog scale, four studies used the NPI scale, and six studies used the ADL scale. Meta-analysis of the nine studies that reported the MMSE scale scores indicated that there is no significant effect of statins as compared with control group (the pooled WMD = 1.09, 95% CI, - 0.00, 2.18, p = 0.05, I = 87.9%). Meta-analysis of the five studies that reported the ADAS-Cog scale scores also indicated that there is no significant effect of statins as compared with control group (the pooled WMD = - 0.16, 95% CI, - 2.67, 2.36, p = 0.90, I = 80.1%). Meta-analysis of the four studies that reported the NPI scale scores indicated that treatment with statins could slow the rise in the NPI scale scores (the pooled WMD = - 1.16, 95% CI, - 1.88, - 0.44, p = 0.002, I = 45.4%). Meta-analysis of the six studies that reported the ADL scale scores indicated that treatment with statins could improve patients' daily living ability (the pooled WMD = - 4.06, 95% CI, - 6.88, - 1.24, p = 0.005, I = 86.7%). Results of subgroup analysis indicated that the use of statins in the short term (≤ 12 months) associated with the change of the MMSE scale scores (the pooled WMD = 1.78, 95% CI, 0.53, 3.04, p = 0.005, I = 79.6%). Sensitivity analysis and publication bias test were both negative, and the results were relatively reliable and stable.

Conclusion: Statins used in AD patients had beneficial effects on the scores of MMSE scale in the short term (≤ 12 months), and statins could slow the deterioration of neuropsychiatric status and significantly improve activities of daily living ability in AD patients, but statins did not show an advantage in the change of the ADAS-Cog scale scores.
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http://dx.doi.org/10.1007/s10072-020-04243-6DOI Listing
June 2020

Low dose of emetine as potential anti-SARS-CoV-2 virus therapy: preclinical in vitro inhibition and in vivo pharmacokinetic evidences.

Mol Biomed 2020 30;1(1):14. Epub 2020 Nov 30.

Key Laboratory for Medical and Health of the 13th Five-Year Plan, Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui 230601 P. R. China.

The global pandemic of COVID-19 has attracted extensive drug searching interets for the new coronavirus SARS-CoV-2. Although currently several of clinically used "old" drugs have been repurposed to this new disease for the urgent clinical investigation, there is still great demand for more effective therapies for the anti-infections. Here we report the discovery that an "old" drug Emetine could potently inhibit SARS-CoV-2 virus replication and displayed virus entry blocking effect in Vero cells at low dose. In addition, Emetine could significantly reduce the lipopolysaccharide (LPS) induced interleukin-6 (IL-6) protein level and moderately reduce the tumor necrosis factor (TNF-α) protein level in the M1 polarized THP-1 macrophages. In vivo animal pharmacokinetics (PK) study revealed that Emetine was enriched in the lung tissue and had a long retention time (over 12 h). With 1 mg/kg single oral dose, the effective concentration of Emetine in lung was up to 1.8 μM (mice) and 1.6 μM (rats) at 12 h, which is over 200-fold higher than the EC of the drug. The potent in vitro antiviral replication efficacy and the high enrichment in target tissue, combining with the well documented safety profiles in human indicate that low dose of Emetine might be a potentially effective anti-SARS-CoV-2 infection therapy.

Supplementary Information: The online version contains supplementary material available at 10.1186/s43556-020-00018-9.
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http://dx.doi.org/10.1186/s43556-020-00018-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700809PMC
November 2020

Effect of apparent temperature on daily emergency admissions for mental and behavioral disorders in Yancheng, China: a time-series study.

Environ Health 2019 11 20;18(1):98. Epub 2019 Nov 20.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China.

Background: Very few studies have focused on the relationship between ambient apparent temperature (AT) and admission of mental and behaviour disorders (MDs). Therefore, a time-series study was conducted in Yancheng, China, to explore the effects of AT on the daily emergency admissions of patients with MDs over the period of 2014-17.

Methods: A quasi-Poisson generalized linear model (GLM) combined with a distributed lag non-linear model (DLNM) was adopted to explore the associations after adjusting for time trend, day of the week, humidity, sunshine duration, rainfall, holidays and air pollutants. In the subgroup analysis, the modification effects of age and sex were also examined.

Results: Overall, 8438 cases of MDs emergency admissions were identified. With the apparent temperature with the minimum number of admissions (- 3.4 °C) serving as a reference, a positive correlation emerged between high AT and daily emergency admissions of patients with MDs in Yancheng, China, with the lagged effect of 1 to 5 days. The subgroup analysis demonstrated a positive relationship between AT and MDs emergency admissions among males and individuals younger than 45 years old, with no lagged effect.

Conclusions: The results will provide important scientific evidence for mental health policy-makers and practitioners for possible intervention, especially among the vulnerable populations.
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http://dx.doi.org/10.1186/s12940-019-0543-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880413PMC
November 2019

Proton pump inhibitors use and dementia risk: a meta-analysis of cohort studies.

Eur J Clin Pharmacol 2020 Feb 21;76(2):139-147. Epub 2019 Nov 21.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.

Purpose: The aim of this study was to explore the relationship between proton pump inhibitors use and the risk of dementia.

Methods: A comprehensive literature search was conducted in English and Chinese databases from origination to December 2018. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with a random-effects model. Subgroup analyses and sensitivity analyses were also conducted. Cochran's Q test and the I statistic were used to evaluate the heterogeneity. Publication bias was assessed by Begg's test and Egger's test.

Results: Six studies were included, which contained a total of 166,146 participants. The overall result demonstrated a significant increase in dementia risk with proton pump inhibitors use (HR = 1.29, 95% CI = 1.12-1.49). In subgroup analyses, a significant association was detected between proton pump inhibitors use and the risk of dementia in Europe (HR = 1.46, 95% CI = 1.23-1.73) and among participants aged ≥ 65 years (HR = 1.39, 95% CI = 1.17-1.65). For the factor follow-up time ≥ 5 years, the pooled HR was 1.28 (95% CI = 1.12-1.46), demonstrating a 1.28-fold increase in the risk of dementia among proton pump inhibitors users. In the case of regional impact, participants from Europe showed an overall pooled HR estimate of 1.46 (95% CI = 1.23-1.73). There was no evidence of publication bias.

Conclusions: The overall result of this meta-analysis supports the hypothesis that proton pump inhibitors increase the risk of dementia. Furthermore, high-quality cohort studies are needed to confirm these findings.
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http://dx.doi.org/10.1007/s00228-019-02753-7DOI Listing
February 2020

The association between orthostatic hypotension and cognition and stroke: a meta-analysis of prospective cohort studies.

Blood Press 2020 02 13;29(1):3-12. Epub 2019 Nov 13.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.

Many studies have indicated that orthostatic hypotension (OH) may be a risk factor for dementia and stroke, but the results have been inconsistent. To further ascertain the links between OH and cognition or stroke, a meta-analysis was performed. The Chinese Biomedical Database, PubMed, Web of Science, and the Cochrane Library database were searched (up to March 2019) to identify prospective cohort studies that examined the associations between OH and the risks of stroke and dementia among adult populations. Subgroup analyses and meta-regression analyses were conducted to identify sources of heterogeneity. We also performed Begg's test and Egger's test to assess publication bias. A total of 3490 articles were identified, and 18 prospective observational cohort studies were ultimately included. Among these studies, eight prospective studies were about stroke, nine studies were about cognition and one study reported data about both stroke and dementia. Meta-analysis revealed an association between OH and worse cognition (hazard ratio (HR): 1.18, 95% confidence interval (CI): 1.03-1.35, I = 69.5%). For dementia, the pooled HR was 1.30, with 95% CI: 1.14-1.48, I = 31.0%. In addition, we found that OH was associated with a higher risk of stroke (HR: 1.36, 95% CI = 1.17-1.57, I = 67.3%). No publication bias was detected. This meta-analysis provides evidence that OH was associated with worse cognition. OH accounted for a 30% increase in the risk of dementia and a 36% increase in the risk of stroke.
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http://dx.doi.org/10.1080/08037051.2019.1689808DOI Listing
February 2020

Is periodontitis a risk indicator for gastrointestinal cancers? A meta-analysis of cohort studies.

J Clin Periodontol 2020 02 25;47(2):134-147. Epub 2019 Nov 25.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.

Objective: To evaluate the association between periodontitis and the incidence and mortality of gastrointestinal cancer.

Method: A comprehensive literature search was conducted to identify all relevant studies published prior to April 2019 according to the established inclusion criteria. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with a random-effects model.

Results: We identified 10 studies with 26 estimates of the relationship between periodontitis and gastrointestinal cancer. The HR for the incidence of gastrointestinal cancer in periodontitis was 1.23 (95% CI: 1.10-1.37). Subgroup analyses showed that periodontitis was associated with an increased risk of gastrointestinal cancers in prospective cohort studies and high-quality studies, North American individuals, and individuals 18 years or older, as well as when the dental status was self-reported and when the study was adjusted for smoking. A meta-analysis of nine reports demonstrated that periodontitis was associated with increased mortality from gastrointestinal cancer (HR = 1.59, 95% CI: 1.16-2.16). Additionally, periodontitis was associated with mortality from pancreatic cancer (HR = 2.20, 95% CI: 1.44-3.37); thus, periodontitis may be a risk factor for pancreatic cancer.

Conclusion: Our meta-analysis demonstrated that periodontitis may be a risk factor for gastrointestinal cancers. Additional prospective cohort studies are warranted to confirm these findings.
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http://dx.doi.org/10.1111/jcpe.13217DOI Listing
February 2020

Dynamics and predictors of resilience in Chinese rural children: a follow-up study.

Psychol Health Med 2020 08 17;25(7):855-866. Epub 2019 Oct 17.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University , Hefei, Anhui, China.

The present study attempted to investigate dynamics and predictors of resilience amongst Chinese children using prospective data. Totally 816 children completed the resilience measurement at baseline and one-year follow-up. Multivariate logistic regression was used to examine associations between high resilience and predictor variables. Mean resilience scores increased during the one-year follow-up ( = -2.35, = 0.019). Although the proportions of high and low resilience were relatively stable, whereas 28% of children had inconsistent resilience level during the follow-up. Multivariable logistic regression analysis showed that participants' parents having secondary school (adjusted OR (aOR) = 1.67, 95%CI = 1.14-2.44) or higher (aOR = 2.53, 95%CI = 1.51-4.24) education level, and high quality of life (aOR = 1.81, 95%CI = 1.20-2.73) were positively associated with high resilience, whereas moderate family function obstacles (aOR = 0.47, 95%CI = 0.34-0.67), abuse experience (aOR = 0.68, 95%CI = 0.50-0.92), and significant depression symptoms (aOR = 0.47, 95%CI = 0.28-0.77) were negatively associated with high resilience. Results highlight that resilience levels were not merely static trait and improved over one year among Chinese children. Findings would deepen understanding of resilience change and provide potential targets of resilience-focused intervention in children.
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http://dx.doi.org/10.1080/13548506.2019.1679848DOI Listing
August 2020

The relationship between childhood abuse and depression in a sample of Chinese people who use methamphetamine.

Int J Clin Health Psychol 2019 Sep 7;19(3):181-188. Epub 2019 Jul 7.

Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China.

Background/objective: Previous studies have shown that childhood abuse is associated with symptoms of depression. This study aims to examine the prevalence of childhood abuse or neglect and its correlation with depression among a sample of Chinese people who use methamphetamine.

Method: People who use methamphetamine (MA) ( = 1,173) were recruited from government-operated drug rehabilitation centres in Anhui province, China. Participants were assessed using the short form of Childhood Trauma Questionnaire and the Beck Depression Inventory-II for childhood abuse or neglect and depression symptoms.

Results: A total of 44.6% of people who use MA reported moderate/severe childhood abuse or neglect, and 56.9% of this sample were diagnosed with depression. Emotional abuse, sexual abuse, emotional neglect and physical neglect were revealed to increase the risk of depression. Multivariable regression analyses showed that depression scores were significantly predicted by gender, duration of drug use, sexual abuse and emotional neglect (model  = .08,  .001). The interaction between emotional neglect and duration of drug use on the depression was statistically significant.

Conclusions: These analyses indicate that sexual abuse and emotional neglect increase the severity of depression in individuals who use MA in drug rehabilitation centres of China.
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http://dx.doi.org/10.1016/j.ijchp.2019.06.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732768PMC
September 2019

Association of famine exposure with the risk of type 2 diabetes: A meta-analysis.

Clin Nutr 2020 06 10;39(6):1717-1723. Epub 2019 Aug 10.

Department of Epidemiology and Health Statistics, School of Public Health, No. 81 Meishan Road, Hefei, 230032 Anhui, China; Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui, China. Electronic address:

Purpose: The association between famine exposure and type 2 diabetes (T2DM) remains controversial. A meta-analysis was performed to clarify the relation of famine exposure to T2DM risk in detail.

Methods: A systematic literature search was performed in PubMed, Cochrane library, Web of Science, China National Knowledge Infrastructure (CNKI), Sinomed (CBM), Wanfang Data Knowledge Service Platform and China Science and Technology Journal VIP Database. The articles were limited to be available in English or Chinese before 10 April 2019. The pooled relative risk (RR) with 95% confidence interval (CI) was used to estimate the effect of famine exposure on T2DM. The I square value (I) was used to assess heterogeneity, and the random effects model (REM) was adopted as the pooling method.

Results: This meta-analysis included 24 published articles with 1,660,385 subjects. A significant association of famine exposure with increased risk of T2DM was observed (RR = 1.433, 95% CI: 1.101-1.865). The pooled RRs were different in terms of publication year, location, study design, sample size, famine duration and definition of diabetes (criteria). Longer the famine exposure experienced, greater the effect of famine exposure on T2DM would be. Compared to WHO criteria, studies of which diabetes diagnosed by ADA criteria and other criteria might more likely to find this association. Compared to moderate famine exposure, the pooled RR in severe famine was statistically significant. Furthermore, the pooled RR adjusted for the most confounders in females was 1.517 (95% CI: 1.018-2.261). In terms of period of famine exposure, compared to adult exposure, people who exposure famine in fetal, childhood, and adolescent were likely to be diabetes.

Conclusion: Famine exposure may increase the risk of T2DM. The risk may vary with famine duration, definition of diabetes, gender and period of famine exposure.
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http://dx.doi.org/10.1016/j.clnu.2019.08.002DOI Listing
June 2020

Meteorological variables and the risk of fractures: A systematic review and meta-analysis.

Sci Total Environ 2019 Oct 20;685:1030-1041. Epub 2019 Jun 20.

School of Public Health, the University of Adelaide, Adelaide, SA 5005, Australia. Electronic address:

Purpose: The association between meteorological variables and risk of fractures has attracted increasing attentions but remain controversial. Therefore, our main aim is to clarify the association, and also to identify possible susceptible groups.

Methods: Relevant literature was obtained through standard MeSH literature searching seven electronic databases. Because some studies expressed the association as the rate of incidence (IRR) of fractures associated with each 1 °C rise in temperature and 1% increase in relative humidity (RH), some expressed as IRR of fractures for the day with specific climatic variable versus control days, and also the association was expressed as correlations coefficients (COR) in some studies, separated meta-analyses were undertaken, with one based on IRR and another based on COR.

Results: A total of 24 studies were included. Results showed that each 1 °C increase was significantly associated with a 3.0% decrease in fracture risk (IRR = 0.970, 95%CI: 0.952-0.988). The day with freezing rain and snow were associated with increased risk for both the lower extremity fracture (freezing rain: IRR = 1.174, 95%CI: 1.022-1.348; snow: IRR = 1.245, 95%CI: 1.050-1.477) and the upper extremity fracture (freezing rain: IRR = 1.376, 95%CI: 1.192-1.588; snow: IRR = 1.548, 95%CI: 1.361-1.761). No significant association was detected between RH, dew, frost, fog, storm and high wind, and fracture. The COR meta-analysis showed that mean temperature (moderately), maximum temperature (moderately), rainfall (weakly) and sunlight duration (weakly) were correlated with fracture occurrence.

Conclusion: The incidence of fractures was increased in lower temperature, the day with freezing rain, and snow. Other meteorological factors may have some effects on the incidence of fracture. The association maybe stronger for males, lower extremity fracture, and people living in Asia, subtropical zone, low-latitude, and northern hemisphere. Further studies are needed.
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http://dx.doi.org/10.1016/j.scitotenv.2019.06.281DOI Listing
October 2019
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