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Effect of the interaction between atrial fibrillation and rt-PA dose on the prognosis of acute ischaemic stroke with intravenous thrombolysis.

Postgrad Med J 2022 Jun 24. Epub 2022 Jun 24.

Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China

Background: The association between atrial fibrillation (AF) and the prognosis of acute ischaemic stroke (AIS) remains controversial; whether the recombinant tissue plasminogen activator dose influences this association remains poorly understood.

Methods: Patients who had an AIS were enrolled from eight stroke centres in China. According to the recombinant tissue plasminogen activator dose, patients treated with intravenous recombinant tissue plasminogen activator within 4. Read More

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Accounting for concurrent antihyperglycemic medication changes in dietary and physical activity interventions: A focused literature review.

Diab Vasc Dis Res 2022 May-Jun;19(3):14791641221111252

Department of Community Health Sciences, Cumming School of Medicine, 70401University of Calgary, Calgary, AB, Canada.

Aims: To summarize methods used to account for antihyperglycemic medication changes in randomized controlled trials evaluating the effect of dietary and physical activity interventions on glycemia among adults with diabetes.

Methods: Using studies included in two recently published systematic reviews of randomized controlled trials examining the glycemic effects of dietary and physical activity interventions, we evaluated how each study accounted for antihyperglycemic medication changes. Data were analyzed using summary statistics, stratified by the type of intervention studied, and each was assigned a score from 0 to 6 reflecting the strength of medication controls employed. Read More

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Associations between Homelessness and Alzheimer's Disease and Related Dementia: A Systematic Review.

J Appl Gerontol 2022 Jun 24:7334648221109747. Epub 2022 Jun 24.

Program in Occupational Therapy, 12275Washington University in St. Louis, St. Louis, MO, USA.

The homeless population in the United States is rapidly aging, with a parallel increase in Alzheimer's disease and related dementia (ADRD). During an evolving pandemic that jeopardizes employment and housing, assessing the relationship between ADRD and homelessness is critical since the latter is potentially intervenable. The objective of this study is to review the literature and determine whether there is an association between homelessness and dementia risk. Read More

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Point-of-care lung ultrasonography for early identification of mild COVID-19: a prospective cohort of outpatients in a Swiss screening center.

BMJ Open 2022 Jun 24;12(6):e060181. Epub 2022 Jun 24.

Infectious Diseases Service, University Hospital of Lausanne, Lausanne, Switzerland.

Objectives: Early identification of SARS-CoV-2 infection is important to guide quarantine and reduce transmission. This study evaluates the diagnostic performance of lung ultrasound (LUS), an affordable, consumable-free point-of-care tool, for COVID-19 screening.

Design, Setting And Participants: This prospective observational cohort included adults presenting with cough and/or dyspnoea at a SARS-CoV-2 screening centre of Lausanne University Hospital between 31 March and 8 May 2020. Read More

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Thrombolysis, time-to-treatment and in-hospital outcomes among young adults with ischaemic stroke in China: findings from a nationwide registry study in China.

BMJ Open 2022 Jun 24;12(6):e055055. Epub 2022 Jun 24.

China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

Background And Purpose: We aimed to determine whether young adults (<50 years) with acute ischaemic stroke (AIS) are more likely to receive intravenous tissue plasminogen activator (IV tPA) and have shorter time to treatment than older patients with stroke.

Methods: We analysed data from the Chinese Stroke Center Alliance registry for patients with AIS hospitalised between August 2015 and July 2019. Patients were classified into two groups according to age: young adults (<50 years of age) and older adults (≥50 years of age). Read More

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Initiation of Inhaled Nitric Oxide by an Air Transport Team in Adult Coronavirus Disease 2019 Respiratory Failure.

Air Med J 2022 Jul-Aug;41(4):406-410. Epub 2022 Mar 10.

BerbeeWalsh University of Wisconsin Department of Emergency Medicine, Madison, WI; University of Wisconsin MedFlight, BerbeeWalsh Department of Emergency Medicine, Madison, WI.

The coronavirus disease 2019 (COVID-19) pandemic has caused a significant increase in the volume of critical care flight transports between outlying referral hospitals and tertiary care facilities. Because of the tropism of severe acute respiratory syndrome coronavirus 2, flight crews are often asked to transport mechanically ventilated patients in refractory hypoxemic respiratory failure. The authors present a case series of 5 patients with COVID-19 acute respiratory distress syndrome (ARDS) who were initiated on inhaled nitric oxide (iNO) by the transport team before rotor wing transport and survived the journey in stable or improved condition upon arrival. Read More

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Rare cause of diffuse alveolar haemorrhage and subconjunctival haemorrhage rescued by extracorporeal membrane oxygenation and rituximab.

BMJ Case Rep 2022 Jun 24;15(6). Epub 2022 Jun 24.

Department of Rheumatology, Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.

A previously healthy man in his 20s presented with acute respiratory distress syndrome and subconjunctival haemorrhage. Imaging was indicative of pervasive pulmonary haemorrhage. There was no evidence of renal involvement. Read More

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UK National Screening Committee's approach to reviewing evidence on artificial intelligence in breast cancer screening.

Lancet Digit Health 2022 Jul;4(7):e558-e565

Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.

Artificial intelligence (AI) could have the potential to accurately classify mammograms according to the presence or absence of radiological signs of breast cancer, replacing or supplementing human readers (radiologists). The UK National Screening Committee's assessments of the use of AI systems to examine screening mammograms continues to focus on maximising benefits and minimising harms to women screened, when deciding whether to recommend the implementation of AI into the Breast Screening Programme in the UK. Maintaining or improving programme specificity is important to minimise anxiety from false positive results. Read More

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Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study.


Lancet Digit Health 2022 Jul;4(7):e520-e531

Background: Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

Methods: We did a systematic review and international external validation cohort study. Read More

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Does essential tremor increase the risk of dementia? No.

Alex Rajput

Int Rev Neurobiol 2022 31;163:233-253. Epub 2022 Mar 31.

Division of Neurology, Saskatchewan Movement Disorders Program, University of Saskatchewan/Saskatchewan Health Authority, Saskatoon, SK, Canada. Electronic address:

Essential tremor (ET) is the most common neurological cause of tremor affecting adult humans affecting about 6% of those over age 65 years. In the United States, dementia has a prevalence of 15% in those age 68 and older. Overlap of the two conditions is therefore not surprising. Read More

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Recent information on test utilization and intraindividual change in anti-glutamic acid decarboxylase antibody in Korea: a retrospective study.

BMJ Open Diabetes Res Care 2022 Jun;10(3)

Green Cross Laboratories, Yongin-si, Republic of Korea

Introduction: This study aimed to evaluate the test utilization and intraindividual changes of anti-glutamic acid decarboxylase antibody (GADA), a biomarker for autoimmune diabetes in Korean adults.

Research Design And Methods: We retrospectively investigated longitudinally measured GADA test results to assess test utilization and intraindividual changes through a laboratory information system.

Results: During the 3-year study period, 11 668 GADA tests were performed in 11 184 Korean adults. Read More

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A Hemagglutinin 1 Carrying Plant-Based Virus-like Particle Vaccine Generates an Efficacious Cellular Response by Exploiting IL-1 Signaling in Both Adult and Aged Mice.

Immunohorizons 2022 Jun 24;6(6):384-397. Epub 2022 Jun 24.

Department of Microbiology & Immunology, McGill University, Montreal, Quebec, Canada;

Inactivated influenza vaccines have struggled to provide consistent protection in older individuals. Circumventing immune senescence, an aging of the immune response characterized by weak humoral responses to vaccines, and unchecked inflammation during infection require novel immunization strategies. Plant-based virus-like particles (VLPs) bearing recombinant hemagglutinin proteins have been shown to provide protection in older animals in preclinical challenge studies, despite eliciting relatively low or absent humoral responses. Read More

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Level and Duration of IgG and Neutralizing Antibodies to SARS-CoV-2 in Children with Symptomatic or Asymptomatic SARS-CoV-2 Infection.

Immunohorizons 2022 Jun 24;6(6):408-415. Epub 2022 Jun 24.

Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University, Indianapolis, IN; and

There are conflicting data about level and duration of Abs to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children after symptomatic or asymptomatic infection. In this human population, we enrolled adults and children in a prospective 6-mo study in the following categories: 1) symptomatic, SARS-CoV-2 PCR (SP; children, = 8; adults, = 16), 2) symptomatic, PCR, or untested (children, = 27), 3) asymptomatic exposed (children, = 13), and 4) asymptomatic, no known exposure (children, = 19). Neutralizing Abs (nAbs) and IgG Abs to SARS-CoV-2 Ags and spike protein variants were measured by multiplex serological assay. Read More

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Long-Term Outcomes of Ross Procedure versus Mechanical Aortic Valve Replacement: Meta-Analysis of Reconstructed Time-To-Event Data.

Trends Cardiovasc Med 2022 Jun 21. Epub 2022 Jun 21.

Department of Cardiothoracic Surgery, Lankenau Heart Institute, Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania, USA; Department of Cardiothoracic Surgery Research, Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, USA.

In the era of lifetime management of aortic valve disease, the Ross procedure emerged as an alternative to prosthetic heart valves for young adults; however, more long-term data are warranted. We performed a meta-analysis of reconstructed time-to-event data to compare long-term outcomes between the Ross procedure and mechanical aortic valve replacement (mAVR) in young adults. PubMed/MEDLINE, EMBASE and GoogleScholar were searched for studies comparing Ross procedure with mAVR that reported mortality/survival rates and/or reoperation rates accompanied by at least one Kaplan-Meier curve for any of the outcomes. Read More

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Association between Trajectories of End-tidal Carbon Dioxide and Return of Spontaneous Circulation among Emergency Department Patients with Out-of-hospital Cardiac Arrest.

Resuscitation 2022 Jun 21. Epub 2022 Jun 21.

Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

Background: We aimed to identify distinct trajectories of end-tidal carbon dioxide (EtCO) during cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest (OHCA) and to investigate the association between EtCO trajectories and OHCA outcomes.

Methods: This was a secondary analysis of a prospectively collected database on adult patients with OHCA who had been resuscitated in the emergency department of a tertiary medical center between 2015 and 2020. The primary outcome was the return of spontaneous circulation (ROSC). Read More

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Characteristics of statewide prescription drug monitoring programs and potentially inappropriate opioid prescribing to patients with non-cancer chronic pain: A machine learning application.

Prev Med 2022 Jun 21:107116. Epub 2022 Jun 21.

Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas, Houston, TX, United States of America.

Unnecessary/unsafe opioid prescribing has become a major public health concern in the U.S. Statewide prescription drug monitoring programs (PDMPs) with varying characteristics have been implemented to improve safe prescribing practice. Read More

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Does artistic activity help kids avoid obesity? Emergent considerations in the ecology of childhood BMI.

Prev Med 2022 Jun 21:107120. Epub 2022 Jun 21.

Department of Educational Foundations, Organizations, and Policy, University of Pittsburgh, PA, USA.

Although the positive relationship between arts engagement and mental health is well documented, arts participation may be an emergent factor in the ecology of childhood obesity. Prior research hypothesized several potential health benefits of arts participation including healthy diet and lifestyles, but the available evidence is mainly limited to cross-sectional covariate-adjustment models for the adult population. We employed a newly released panel of the Early Childhood Longitudinal Study kindergarten cohort (ECLS-K: 2011), which is a nationally representative sample of American children who entered kindergarten in 2010-2011 (n = 15,820). Read More

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Dosing of Rifaximin Soluble Solid Dispersion Tablets in Adults With Cirrhosis: 2 Randomized, Placebo-Controlled Trials.

Clin Gastroenterol Hepatol 2022 Jun 21. Epub 2022 Jun 21.

Medical University of South Carolina, Charleston, South Carolina.

Background & Aims: Cirrhosis-related complications are a major burden. Rifaximin soluble solid dispersion (SSD) tablets (immediate-release [IR]; sustained extended-release [SER]) were designed to increase rifaximin water solubility. These analyses evaluate dosing for prevention of cirrhosis complication-related hospitalizations/mortality and overt hepatic encephalopathy (OHE) treatment. Read More

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Time of day differences in appetite and gut hormone responses to meal and stress challenges in adults with normal-weight and obesity.

Physiol Behav 2022 Jun 21:113890. Epub 2022 Jun 21.

Mt Sinai St. Luke's Hospital, Icahn School of Medicine at Mt Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA; Department of Psychiatry, Icahn School of Medicine at Mt Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA; Department of Psychology, Touro College and University System, 320 W 31st St, New York, NY 10001, USA.

Background: . Lifestyle factors like time of eating and stress exposure may impact physiology to promote excess weight gain. To understand behavioral and physiological mechanisms underlying these potential effects, we compared appetite and gut hormone responses to a series of meal and stress challenges beginning in the morning and the afternoon, in adults with normal-weight and obesity. Read More

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Clinical Outcomes Following Implementation of a Formalized "Flashes and Floaters" Emergency Department Triage Protocol.

Am J Ophthalmol 2022 Jun 21. Epub 2022 Jun 21.

Mayo Clinic Department of Ophthalmology, 200 First Street SW, Rochester, MN 55905. Electronic address:

Purpose: To report outcomes of patients presenting to the emergency department (ED) with new-onset visual flashes and/or floaters following implementation of a formalized triage protocol allowing eligible patients to be discharged for prompt outpatient ophthalmic examination.

Design: Retrospective consecutive case series.

Methods: Patient characteristics, protocol eligibility, and clinical outcomes were recorded for adult patients triaged within a formal "flashes and floaters" protocol at a single academic emergency department. Read More

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Intrathecal and oral baclofen use in adults with spinal cord injury (SCI): a systematic review of efficacy in spasticity reduction and functional improvement, dosing and adverse events.

Arch Phys Med Rehabil 2022 Jun 21. Epub 2022 Jun 21.

Department of Neurological Surgery, University of Louisville, Louisville, KY, USA; Kentucky Spinal Cord Injury Research Center, Louisville, KY, USA. Electronic address:

Objective: To examine the efficacy, dosing, and safety profiles of intrathecal and oral baclofen in treating spasticity after spinal cord injury (SCI).

Data Sources: PubMed and Cochrane Databases were searched between 1970-2018 with keywords baclofen, spinal cord injury and efficacy.

Study Selection: The database search yielded 588 sources and 10 additional relevant publications. Read More

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Comparison of surgical techniques for recurrent pterygium.

Can J Ophthalmol 2022 Jun 21. Epub 2022 Jun 21.

Department of Ophthalmology, Boston University School of Medicine, Boston, Mass. Electronic address:

Objective: Although conjunctival autograft (CAU) and amniotic membrane grafting (AMG) with mitomycin-C (MMC) are most effective for the treatment of primary pterygium, the optimal surgical treatment of recurrent pterygium is not well established. We thus aimed to examine recurrence rates after recurrent pterygium excision surgery performed with CAU or AMG with or without MMC.

Methods: We performed a retrospective review of adult patients who underwent recurrent pterygium excision surgery at Boston Medical Center between January 1999 and July 2019. Read More

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An Audit To Estimate The Quality Of Practices Followed During Bedside Blood Transfusion In A Tertiary Care Hospital and Role of Continuous Medical Education In It.

Transfus Clin Biol 2022 Jun 21. Epub 2022 Jun 21.

Department of Medical Administration, Sarvodaya Hospital & Research Centre, Faridabad, Delhi NCR, India. Electronic address:

Blood transfusion is an integral component of the health Service system and it becomes imperative that its benefits, risks as well as prospective and viable alternatives of this common medical intervention are explained explicitly to the patients. Appropriate compliance to bedside blood transfusion practices can also help in avoiding adverse transfusion outcomes. At the same time, it is also crucial to document a patient's valid consent based on their decision after evaluation of the risk to benefit ratio. Read More

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Di-(2-ethylhexyl) phthalate increases plasma glucose and induces lipid metabolic disorders via FoxO1 in adult mice.

Sci Total Environ 2022 Jun 21:156815. Epub 2022 Jun 21.

School of Life Science and Technology, Harbin Institute of Technology, Harbin 150001, China; State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin 150006, China. Electronic address:

Di-(2-ethylhexyl) phthalate (DEHP), an endocrine-disrupting chemical (EDC) commonly used as a plasticizer, is responsible for widespread environmental pollution. Epidemiological and experimental data implicate DEHP and its metabolite mono(2-ethylhexyl) phthalate (MEHP) in the occurrence and development of metabolic syndrome. However, the specific effects and potential mechanisms of action of DEHP on glucose and lipid metabolism in adults are currently unclear. Read More

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Pre-visit concerns: What caregivers hope to address at a specialty clinic for down syndrome.

Eur J Med Genet 2022 Jun 21:104550. Epub 2022 Jun 21.

Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, USA. Electronic address:

Purpose: Individuals with Down syndrome have an increased prevalence of various medical conditions across the lifespan; multidisciplinary Down syndrome specialty clinics can address these needs. However, the caregiver-perceived purpose of bringing their loved one to a Down syndrome specialty clinic has not been investigated.

Methods: Retrospective review of electronic intake forms, completed prior to visits at MGH's Down Syndrome Program, was completed. Read More

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Baseline Hemodynamic Impairment and Revascularization Outcome in Newly Diagnosed Adult Moyamoya Disease determined by Pseudo-continuous Arterial Spin Labeling.

World Neurosurg 2022 Jun 21. Epub 2022 Jun 21.

Nanjing Comprehensive Stroke Center, Affiliated Nanjing Brain Hospital, Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, PR China. Electronic address:

Objective: The study aimed to investigate the hemodynamic features and independent predictors of neoangiogenesis after revascularization in MMD by pseudo-continuous arterial spin labeling magnetic resonance imaging (pCASL MRI).

Methods: 39 MMD patients were categorized into infarction group, hemorrhagic group and atypical group. All patients underwent combined bypass surgery and pCASL imaging with post-labeling delays (PLD) of 1525ms and 2525ms. Read More

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Outcomes of combined revascularization surgery for moyamoya disease without preoperative cerebral angiography.

World Neurosurg 2022 Jun 21. Epub 2022 Jun 21.

Department of Neurosurgery,Hokkaido University Graduate School of Medicine,Sapporo,Japan.

Objective: Cerebral angiography is the gold standard for diagnosing moyamoya disease (MMD), whereas magnetic resonance (MR) imaging/angiography is becoming more popular in the field of cerebrovascular disease due to its low invasiveness. Although there are concerns about using only MR imaging/angiography for preoperative analysis of MMD, considering the underestimation of pre-existing transdural collateral circulations and dangerous collaterals related to the risk of hemorrhage, we retrospectively reviewed our 10-year experience of MRI-first diagnosis and analyzed the perioperative outcomes.

Methods: We analyzed 160 consecutive direct/indirect combined revascularization procedures for MMD preoperatively assessed using MR imaging/angiography alone. Read More

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The independent and interactive effects of phthalates exposure and hypertension on the indicators of early renal injury in US adults: Evidence from NHANES 2001-2004.

Environ Res 2022 Jun 21:113733. Epub 2022 Jun 21.

School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200032, China. Electronic address:

The association between phthalates and early renal injury is largely unknown in adults. We aim to explore the associations of phthalates and hypertension with early renal injury, and the interactive effects of phthalate and hypertension on the early renal injury. This study enrolled 3283 U. Read More

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Ecotoxicological effects of the UV-filter 4-MBC on sperms and adults of the mussel Mytilus galloprovincialis.

Environ Res 2022 Jun 21:113739. Epub 2022 Jun 21.

Interuniversity Consortium of Marine Biology and Applied Ecology "G. Bacci", 57128, Livorno, Italy; Department of Veterinary Sciences, University of Pisa, 56122, San Piero a Grado, PI, Italy. Electronic address:

Present in an increasing number of products, UV-filters are continuously discharged into aquatic environments. Despite potential risks for inhabiting organisms are recognized, the effects of UV-filter 4-methylbenzylidenecamphor (4-MBC) on marine invertebrates are poorly investigated. By combining in vitro/in vivo exposures through a multi-biomarker approach on sperms and adults, the present study evaluated how 4-MBC affect the mussel species Mytilus galloprovincialis, providing ecologically relevant information on organisms' responses. Read More

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Relative deprivation, depression and quality of life among adults in Shandong Province, China: A conditional process analysis based on social support.

J Affect Disord 2022 Jun 21. Epub 2022 Jun 21.

Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; National Health Commission (NHC) Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China.

Background: Relative deprivation has been confirmed as one of the pathways underlying the link between income inequality and health. However, the mechanism between relative deprivation and health was still unclear. This study aimed to test the mediating role of depression and the moderating role of social support in the association between relative deprivation and quality of life. Read More

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