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Background: Frequency of imaging markers (FIM) has been identified as an independent predictor of hematoma expansion in patients with intracerebral hemorrhage (ICH), but its impact on clinical outcome of ICH is yet to be determined. The aim of the present study was to investigate this association., Methods: This study was a secondary analysis of our prior research. The data for this study were derived from six retrospective cohorts of ICH from January 2018 to August 2022. All consecutive study participants were examined within 6 h of stroke onset on neuroimaging. FIM was defined as the ratio of the number of imaging markers on noncontrast head tomography (i.e., hypodensities, blend sign, and island sign) to onset-to-neuroimaging time. The primary poor outcome was defined as a modified Rankin Scale score of 3-6 at 3 months., Results: A total of 1253 patients with ICH were included for final analysis. Among those with available follow-up results, 713 (56.90%) exhibited a poor neurologic outcome at 3 months. In a univariate analysis, FIM was associated with poor prognosis (odds ratio 4.36; 95% confidence interval 3.31-5.74; p < 0.001). After adjustment for age, Glasgow Coma Scale score, systolic blood pressure, hematoma volume, and intraventricular hemorrhage, FIM was still an independent predictor of worse prognosis (odds ratio 3.26; 95% confidence interval 2.37-4.48; p < 0.001). Based on receiver operating characteristic curve analysis, a cutoff value of 0.28 for FIM was associated with 0.69 sensitivity, 0.66 specificity, 0.73 positive predictive value, 0.62 negative predictive value, and 0.71 area under the curve for the diagnosis of poor outcome., Conclusions: The metric of FIM is associated with 3-month poor outcome after ICH. The novel indicator that helps identify patients who are likely within the 6-h time window at risk for worse outcome would be a valuable addition to the clinical management of ICH., (© 2024. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.)

Objectives: To explore the 2-year physical activity trajectory of Chinese college students and further examine the longitudinal relationship between physical activity trajectory and depressive symptoms. Furthermore, our study aimed to clarify the potential role of clock genes deoxyribonucleic acid (DNA) methylation in the association between physical activity and depressive symptoms., Method: From April 2019 to May 2021, College Student Behavior and Health Cohort Study was conducted among 1,179 students from two universities in Anhui and Jiangxi provinces. Latent Class Growth Model was applied to simulate and group physical activity in a total of five surveys. The PROCESS macro for SPSS was used to analyze the moderating effects of clock genes DNA methylation on the association between physical activity and depressive symptoms., Results: Two physical activity trajectories were identified: "continued high level" and "gradual low level." Multinomial logistic regression analysis showed that the "gradual low level" of physical activity trajectory was independently associated with moderate-to-severe depressive symptoms. Furthermore, DNA methylation of the PER2 and CRY1 genes had negatively moderating effects between physical activity and depressive symptoms, and there was sex-specific effect for CRY1 gene., Conclusions: Our findings suggests that long-term low physical activity was connected to more severe depressive symptoms among college students, and clock genes DNA methylation may play a negative moderating role, attenuating the positive effect of high intensity physical activity levels on depressive symptoms. In this regard, intervention programs regarding depressive symptoms among Chinese college students should consider multiple approaches such as increasing the duration and intensity of physical activity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: To investigate the rates of problematic mobile phone use (PMPU) and chronotypes in young adults, and examine the associations of PMPU with chronotypes, as well as its gender differences. Furthermore, we explored the moderating role of PER3 gene DNA methylation on the associations., Methods: From April to May 2019, a total of 1,179 young adults were selected from 2 universities in Anhui and Jiangxi provinces. The Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU) and reduced Morningness-Eveningness Questionnaire (rMEQ) were adopted to investigate PMPU and chronotypes in young adults, respectively. Moreover, 744 blood samples were collected to measure PER3 gene DNA methylation. Multivariate logistic regression models were established to analyze the associations between PMPU and chronotypes. Moderating analysis was used to determine whether PER3 gene DNA methylation moderated the relationships between PMPU and chronotypes., Results: The prevalence of PMPU, morning chronotypes (M-types), neutral chronotypes (N-types), and evening chronotypes (E-types) of young adults were 24.6%, 18.4%, 71.1%, and 10.5%, respectively. Multivariate logistic regression results indicated that PMPU was positively correlated with E-types (OR = 3.53, 95%CI: 2.08-6.00), and the association was observed only in females after stratified by gender (OR = 5.36, 95%CI: 2.70-10.67). Furthermore, PER3 gene DNA methylation has a negative moderating role between PMPU and chronotypes and has a sex-based difference., Conclusions: This study can provide valuable information for the prevention and control of circadian rhythm disturbance among young adults from the perspective of epidemiology and biological etiology.

Introduction: Frequency of imaging markers (FIM) has been described as a novel predictor for hematoma expansion after intracerebral hemorrhage (ICH). A revised definition of hematoma expansion that incorporates intraventricular hemorrhage (IVH) growth, that is, revised hematoma expansion (RHE), has also been proposed. Nevertheless, the associations between FIM and IVH growth or RHE remains unexplored. The objective of this study was to assess the influence and performance of the FIM on two types., Materials and Methods: Patient selection and variables were based on our published protocol. FIM was defined as the ratio of the number of imaging markers to the onset-to-neuroimaging time. The association between FIM and two definitions was tested by multivariate analysis. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the FIM on two definitions were also evaluated., Results: There were 303 (20.36%) and 583 (39.18%) subjects in the IVH growth and RHE, respectively. Multivariate analysis demonstrated that FIM was associated with both IVH growth and RHE (odds ratio [OR] = 1.96, 95% confidence interval [CI] = 1.60-2.39; OR = 15.01, 95% CI = 10.51-21.43, respectively). The optimal cutoff points for FIM to predict IVH growth and RHE were 0.63 and 0.62, with AUC, sensitivity, specificity, PPV, and NPV of 0.66, 0.50, 0.78, 0.36, and 0.86 versus 0.80, 0.60, 0.93, 0.84, and 0.78, respectively., Discussion and Conclusion: FIM was not only a predictor of IVH growth, but also of RHE. These findings may have important clinical implications for decision-making based on risk stratification of patients with ICH., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Human sulfotransferase 1As (hSULT1As) play a crucial role in the metabolic clearance and detoxification of a diverse range of endogenous and exogenous substances, as well as in the bioactivation of some procarcinogens and promutagens. Pharmacological inhibiting hSULT1As activities may enhance the in vivo effects of most hSULT1As drug substrates and offer protective strategies against the hSULT1As-mediated bioactivation of procarcinogens. To date, a fluorescence-based high-throughput assay for the efficient screening of hSULT1As inhibitors has not yet been reported. In this work, a fluorogenic substrate ( HN-241 ) for hSULT1As was developed through scaffold-seeking and structure-guided molecular optimization. Under physiological conditions, HN-241 could be readily sulfated by hSULT1As to form HN-241 sulfate , which emitted brightly fluorescent signals around 450 nm. HN-241 was then used for establishing a novel fluorescence-based microplate assay, which strongly facilitated the high-throughput screening of hSULT1As inhibitors. Following the screening of an in-house natural product library, several polyphenolic compounds were identified with anti-hSULT1As activity, while pectolinarigenin and hinokiflavone were identified as potent inhibitors against three hSULT1A isozymes. Collectively, a novel fluorescence-based microplate assay was developed for the high-throughput screening and characterization of hSULT1As inhibitors, which offered an efficient and facile approach for identifying potent hSULT1As inhibitors from compound libraries.

Most studies have shown a link between chronotypes and mental health and have identified evening chronotypes (E-types) as a potential risk for depressive symptoms. However, the mechanisms behind this association remain unknown. Abnormal expression of the PER1 gene was not only associated with circadian rhythm disturbance, but also closely related to mental illness. Therefore, this study aimed to examine the association of chronotype with depressive symptoms, and further explore the moderating effects of the PER1 gene DNA methylation on chronotypes and depressive symptoms in Chinese university students. In a stratified cluster sampling design, chronotype and depressive symptoms were assessed in 1 042 university students from 2 universities in a two-year prospective survey from April 2019 to October 2020. The survey was conducted once every 6 months, corresponding to the time points in April 2019 (T0), October 2019 (T1), April 2020 (T2), and October 2020 (T3). At T0, the Morning and Evening Questionnaire 5 (MEQ-5) was adopted to assess chronotype. At T0-T3, the Patient Health Questionnaire 9 (PHQ-9) was adopted to investigate depressive symptoms. Meanwhile, at T0, participants were subjected to a health check-up trip in the hospital, and blood samples were taken from the students to measure the PER1 gene DNA methylation levels. Binary logistic regression was used to analyze the association of chronotypes with depressive symptoms. The depression/total depression group was coded as 1, while the remaining participants was defined as one group, and was coded as 0. The PROCESS plug-in of SPSS software was used to analyze the moderating effects of PER1 gene DNA methylation on the association of chronotype with depressive symptoms. After adjusting for covariates, the results indicated that T0 E-types were positively correlated with T0-T3 depression/total depression in female university students. Furthermore, the PER1 gene DNA methylation has negative moderating effects between T0 chronotype and T3 depressive symptoms and has a sex difference. This study can provide more favorable scientific value for the prevention and control of depression in university students.

Purpose: The main aim of this study is to analyze the relationship between body composition indices and metabolic unhealthy phenotypes in young and middle-aged obese patients and to assess their joint predictive ability., Patients and Methods: A cross-sectional study method was used to select 207 patients who were proposed to undergo weight loss surgery for morbid obesity from March to November 2022. Total adipose tissue (TAT), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), liver fat content (LFC), cross-sectional area (CSA muscle ), and intermuscular adipose tissue (CSA IMAT ) of paraspinal muscles were measured using quantitative computed tomography. Participants were categorized into two groups: metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). The receiver operating characteristic curve comprised body composition variables that correlated with MUO, and the area under the curve (AUC) was calculated to compare their prediction capacity for MUO., Results: There were 71 patients with MHO (34.3%) and 136 patients with MUO (65.7%). The VAT, VAT/TAT ratio, LFC, and CSA muscle was higher in MUO patients than in MHO (all P < 0.001), and SAT was lower than in MHO ( P = 0.008). And all of these metrics were correlated with MUO (all P < 0.05). Inclusion of these body composition metrics in the ROC analysis showed that the AUC values for SAT, VAT, VAT/TAT ratio, LFC and CSA muscle were 0.615, 0.663, 0.727, 0.694, 0.671, respectively, and the combination of the VAT/TAT ratio and the LFC had the ability to predict MUO best (AUC=0.746, P = 0.025)., Conclusion: The combined use of VAT/TAT ratio and LFC is superior to the use of these two metrics alone in terms of their ability to predict the MUO, providing a more accurate approach to the management and prevention of obesity-related metabolic risk., Competing Interests: The authors have no relevant financial or non-financial interests to disclose for this work., (© 2024 Zhan et al.)

Background: Hematoma expansion (HE) is common in patients with intracerebral hemorrhage (ICH) and associated with a worse outcome. Imaging makers and shorter time from symptom onset are both associated with HE, but prognostic scores based on these parameters individually have not been satisfactory. We hypothesized that a score including both imaging markers of expansion, and time of onset, would improve prediction., Methods: Patients with supratentorial ICH within 6 h after onset were consecutively recruited from six centers between January 2018 and August 2022. Three markers were used: hypodensities, the blend sign, and the island sign. We first defined frequency of imaging markers (FIM) as the relationship between the number of imaging markers and onset-to-CT time (OCT). The time-adjusted FIM was defined as the ratio of the number of imaging markers to the onset-to-initial imaging time. Multivariate analysis was performed to determine the relationship between FIM and HE. Receiver operating curve analysis was used to identify potential threshold values of FIM that optimally predict HE. In addition, the sensitivity, specificity, positive and negative predictive values (PPVs and NPVs), and the area under the curve (AUC) of the optimal cut-off in predicting HE were calculated., Results: In total, 1488 patients were eligible for inclusion, of whom 418 had incident HE. Multivariate analysis showed that age, male sex, baseline Glasgow Coma Scale score, presence of intraventricular hemorrhage, and FIM were independent predictors of HE (odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.97-0.99; OR = 1.73, 95% CI = 1.28-2.35; OR = 0.87, 95% CI = 0.83-0.92; OR = 0.42, 95% CI = 0.28-0.62; OR = 7.82, 95% CI = 5.86-10.42, respectively). The optimal cut-off point for FIM in predicting HE was 0.63, with sensitivity, specificity, PPV, NPV, and AUC values of 0.69, 0.89, 0.71, 0.88, and 0.83, respectively., Conclusion: The FIM adjusted for time since symptom onset is a significant predictor of HE. Its use may allow improved prediction of those patients with ICH who develop HE, and the score may be clinically applicable in the management of patients with ICH., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: This study aimed to determine the predictive performance of non-contrast CT (NCCT) signs for hemorrhagic growth after intracerebral hemorrhage (ICH) when stratified by onset-to-imaging time (OIT)., Materials and Methods: 1488 supratentorial ICH within 6 h of onset were consecutively recruited from six centers between January 2018 and August 2022. NCCT signs were classified according to density (hypodensities, swirl sign, black hole sign, blend sign, fluid level, and heterogeneous density) and shape (island sign, satellite sign, and irregular shape) features. Multivariable logistic regression was used to evaluate the association between NCCT signs and three types of hemorrhagic growth: hematoma expansion (HE), intraventricular hemorrhage growth (IVHG), and revised HE (RHE). The performance of the NCCT signs was evaluated using the positive predictive value (PPV) stratified by OIT., Results: Multivariable analysis showed that hypodensities were an independent predictor of HE (adjusted odds ratio [95% confidence interval] of 7.99 [4.87-13.40]), IVHG (3.64 [2.15-6.24]), and RHE (7.90 [4.93-12.90]). Similarly, OIT (for a 1-h increase) was an independent inverse predictor of HE (0.59 [0.52-0.66]), IVHG (0.72 [0.64-0.81]), and RHE (0.61 [0.54-0.67]). Blend and island signs were independently associated with HE and RHE (10.60 [7.36-15.30] and 10.10 [7.10-14.60], respectively, for the blend sign and 2.75 [1.64-4.67] and 2.62 [1.60-4.30], respectively, for the island sign). Hypodensities demonstrated low PPVs of 0.41 (110/269) or lower for IVHG when stratified by OIT. When OIT was ≤ 2 h, the PPVs of hypodensities, blend sign, and island sign for RHE were 0.80 (215/269), 0.90 (142/157), and 0.83 (103/124), respectively., Conclusion: Hypodensities, blend sign, and island sign were the best NCCT predictors of RHE when OIT was ≤ 2 h. NCCT signs may assist in earlier recognition of the risk of hemorrhagic growth and guide early intervention to prevent neurological deterioration resulting from hemorrhagic growth., Competing Interests: The authors have no potential conflicts of interest to disclose., (Copyright © 2024 The Korean Society of Radiology.)

Objectives: To analyse quantitative lung densitometry and clinical baseline data of individuals with idiopathic inflammatory myopathy (IIM) and identify risk factors capable of predicting the progression of interstitial lung disease (ILD)., Methods: We utilised quantitative lung densitometry and clinical baseline data as explanatory variables. Univariate and multivariate Cox regression analyses were employed to pinpoint effective risk factors for predicting ILD progression in IIM patients., Results: The findings from the Cox univariate regression analysis indicate that elevated carcinoembryonic antigen levels (HR=1.036, 95% CI 1.004-1.069) are connected to an elevated risk of ILD progression in patients with IIM (P=0.027), while PO2 (HR=0.980, 95% CI 0.962-0.997) , forced vital capacity (HR=0.551, 95% CI 0.320-0.946) are protective factors for ILD progression in patients with IIM (p=0.025, p=0.031, respectively), anti-EJ positivity (HR=0.399, 95% CI 0.175-0.912) and anti-Ro52 positivity (HR=0.437, 95% CI 0.199-0.960) are risk factors for ILD progression in patients with IIM (p=0.029, p=0.039, respectively). Furthermore, the results of Cox multivariate regression analysis reveal that high attenuation areas (HAA) (>465.745 cm3) (HR=5.007, 95% CI 1.773-14.144) and anti-melanoma differentiation-associated gene 5 (Anti-MDA5) positivity (HR=0.127, 95% CI 0.041-0.396) are autonomous prognostic risk factors for ILD progression in individuals with IIM (p=0.002, p<0.001, respectively)., Conclusions: Among IIM patients, those who are anti-MDA5-positive, and exhibit HAA (>465.745cm3) are more likely to experience ILD progression.

Background: People with multiple health risk behaviors (HRBs) are at higher risk for psychological problems, and vice versa. However, the mechanisms underlying this association remain unknown., Method: We collected questionnaire and blood sample data from 2 universities in Anhui and Jiangxi Provinces. Demographic information, HRBs and blood samples were collected at baseline. Depression/anxiety symptoms were collected using questionnaires at follow-up. Latent class analysis was used to explore clustered HRBs pattern, and logistic regression analysis was used to examine the association between clustered HRBs quantity, pattern and anxiety-depression symptoms comorbidity. The Mplus software was used to analyze the moderating effects of inflammatory cytokines., Results: Compared to the HRB low-risk group, the substance dependence group (OR: 1.89, 95%CI: 1.11-3.21) and sedentary group (OR: 2.98, 95%CI: 1.48-6.02) had a higher risk of anxiety-depression comorbid symptoms. Compared to participants with no clustered HRBs, participants with 2 HRBs (OR: 2.16 95%CI: 1.17-4.00) and >3 HRBs (OR: 3.55, 95%CI: 1.68-7.48) were more likely to suffer from comorbid symptoms of anxiety and depression. Moreover, IL-6, IL-1β, IL-10 had negative moderating effects between clustered HRBs pattern and comorbid symptoms of anxiety and depression., Limitations: Recall bias may exist for anxiety / depression symptoms, and cannot exclude unmeasured confounders or the effect of residual confounding., Conclusions: This study finds clustered HRBs have a significant impact on mental health among young adults, and inflammatory cytokine evidence supports a negative moderating effect on the relationship. Interventions that decrease clustered HRBs may support mental health development in adolescence., Competing Interests: Declaration of competing interest All authors declare no biomedical financial interests or potential conflicts of interest., (Copyright © 2023. Published by Elsevier B.V.)

Benzo[a]pyrene (BaP) is a common air pollutant that has been reported to cause oxidative stress and carcinogenesis. Wogonin, a flavonoid compound extracted from the roots of Scutellaria baicalensis, has been found to possess a variety of pharmacological activities, including anti-inflammatory and anti-cancer effects. The purpose of this study was to examine the ability of wogonin to alleviate the cytotoxicity induced by BaP in human airway epithelial cells and explore the corresponding mechanism. Our study found that wogonin treatment inhibited DNA damage and reactive oxygen species overproduction induced by BaP in human airway epithelial cells. In vitro enzyme assays showed that wogonin significantly inhibited the enzymatic activity of CYP1A1. In addition, wogonin decreased the basal level of CYP1A1 and inhibited the CYP1A1 overexpression induced by BaP, whereas overexpression of CYP1A1 partially reversed the effect of wogonin on BaP-induced DNA damage. Meanwhile, a CYP1A1 inhibitor and CYP1A1 knockdown also showed these same effects. Further studies showed that wogonin regulates CYP1A1 expression by inhibiting CDK7 and CDK9 activity. The use of CDK7 or CDK9 inhibitors decreased BaP-induced cytotoxicity and CYP1A1 expression. Finally, we found that the methoxy group of wogonin was crucial for its inhibitory activity. In conclusion, our data indicated that wogonin could effectively relieve BaP induced cytotoxicity, and its mechanism was related to the dual inhibition of CYP1A1 activity and expression., (© 2023 Wiley Periodicals LLC.)

Background: The association of evening chronotype with cardiometabolic disease has been well established. However, the extent to which circadian rhythm disturbances independently result in risk remains unclear. This study aimed to investigate the cross-sectional and prospective longitudinal associations between chronotype and cardiometabolic risk among Chinese young adults., Methods: From April to May 2019, a total of 1 135 young adults were selected to complete the self-administered questionnaire, and 744 fasting blood samples were collected to quantify cardiometabolic parameters. From April to May 2021, 340 fasting blood samples were collected to quantify cardiometabolic parameters. The Morning and Evening Questionnaire 5 (MEQ-5) was used to assess chronotype. The cardiometabolic (CM)-risk score was the sum of standardized Z scores based on gender for the 5 indicators: waist circumference (WC), mean arterial pressure (MAP), triglyceride (TG), homeostasis model assessment for insulin resistance (HOMA-IR), and high-density lipoprotein cholesterol (HDL-C), where the HDL-C is multiplied by-1. The generalized linear model was used to determine the cross-sectional and prospective longitudinal associations between chronotype and each cardiometabolic parameter., Results: Cross-sectional association analysis showed that lower MEQ-5 scores were correlated with higher fasting insulin (β=-1.420, 95%CI: -2.386~-0.453), higher HOMA-IR (β=-0.301, 95%CI: -0.507~-0.095), and higher CM risk score (β=-0.063, 95%CI: -0.122~-0.003), even after adjustment for covariates. Prospective longitudinal association analysis also showed that lower MEQ-5 scores were associated with 2 years later higher fasting glucose (β=-0.018, 95%CI: -0.034~-0.003), higher fasting insulin (β=-0.384, 95%CI: -0.766~-0.003), higher HOMA-IR (β=-0.089, 95%CI: -0.176~-0.002), and higher CM-risk score (β=-0.109, 95%CI: -0.214~-0.003) after adjustment for covariates., Conclusions: Evening chronotype was significantly correlated with higher CM risk among young adults. Our findings suggest that biologically and socially affected sleep timing misalignment is a contributing factor to cardiovascular disease risk., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Insomnia in adolescents is an important public health concern, as its impacts on both their current and future physical and mental health has been discussed. However, few longitudinal studies have examined insomnia and chronic inflammation at the transition from adolescence to adulthood. This study aimed to examine the predictive effects of insomnia and insomnia trajectories on inflammation in college students by using a prospective design. Using data from the College Student Behaviour and Health Cohort Study, which was conducted between April 2019 and April 2021, with an interval of 6 months. We investigated the associations between insomnia trajectories from Year 1 to Year 3 and five inflammatory biomarkers (C-reactive protein [CRP], tumour necrosis factor [TNF]-α, interleukin [IL]-6, IL-1β, IL-10) at Year 3. The association of insomnia symptoms at baseline, Wave 1 or Wave 2 with inflammatory biomarkers at Wave 4 were also assessed. A total of 312 college students (males: 51.6%) aged 16-26 years (mean [SD] 18.82 [1.22] years) were analysed. We identified two insomnia trajectory classes: increasing insomnia (n = 63 [20.2%]) and decreasing insomnia (n = 249 [79.8%]). Generalised linear model analysis revealed that insomnia symptoms at Wave 1 were associated with significantly elevated CRP and TNF-α levels at Wave 4. Increasing insomnia trajectories predicted consistently higher levels of CRP, TNF-α and IL-10. However, after adjusting for potential confounders, these associations were significantly attenuated. Overall, the findings suggest that insomnia symptoms affect chronic inflammation at the transition to adulthood. Our study needs to be replicated in larger cohorts to further explore how inflammation interacts with insomnia to increase the susceptibility to adverse health conditions., (© 2023 European Sleep Research Society.)

Introduction: Rather than focusing on the activities that the smartphone has been used for, the existing literature frequently focuses on the association between problematic use of smartphone independent of the content of use (self-reported) and depressive symptoms in youth. This study aims to explore patterns of smartphone usage and the association with depressive symptoms in nursing students., Methods: This cross-sectional study of nursing freshmen ( n = 1, 716) was conducted between October and November 2018. Participants were recruited from three Chinese public medical universities using stratified cluster sampling. Self-rated frequency of 12 different smartphone activities over the preceding week was evaluated. Depressive symptoms were assessed by using the Patient Health Questionnaire-9 (PHQ-9)., Results: Of the 1,716 students recruited, 1,424 (83.0%) were girls, and the mean [SD] age was 18.90 [1.39] years. Using principal component analysis (PCA), two typical usage patterns were indicated. The "entertainment pattern" factor included a high frequency of streaming images or videos, searching for information, chatting online, online shopping, downloading, reading online, checking social media sites, taking pictures or videos, and playing games. The "communication pattern" had a high frequency of emailing, texting, and calling. Using logistic regression models, the association between smartphone usage patterns and depressive symptoms was tested. The "communication pattern" was significantly associated with a 53% increase in the odds of moderate and above depressive symptoms (AOR = 1.529; 95% CI = 1.286-1.818; p < 0.001), controlling for a set of socio-demographic and smartphone use covariates., Discussion: This study provides insights into how the patterns of smartphone usage are associated with the severity of depressive symptoms in nursing students. It indicates that it may primarily be how we use our smartphones rather than how much we use them that poses a risk for depression., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yang, Granlund, Tao, Tao, Zou, Wu, Hong and Enskär.)

Objective: To describe the prevalence of physical activity and comorbid symptoms of anxiety and depression in college students, and to explore the correlation strength between changes in physical activity and comorbid symptoms of anxiety and depression, so as to provide a reference for promoting college students&apos; mental health., Methods: From April to May 2019, 1179 freshmen majoring in public health, nursing, chemistry and physical education were randomly sampled from one university in Hefei City, Anhui Province, and Shangrao City, Jiangxi Province, respectively. A baseline questionnaire survey was conducted. A follow-up survey was conducted in May 2021, and a total of 1046 subjects were included, including 647 female and 399 male. The International Physical Activity Questionnaire-Short Form was used to evaluate the physical activity level of college students, and the Patient Health Questionnaire and Generalized Anxiety Disorder Scale were used to evaluate the anxiety and depression symptoms of college students during follow-up. Determining the coexistence of anxiety and depression symptoms in college students as anxiety-depression comorbid symptoms., Results: In the follow-up survey, the detection rate of anxiety and depression comorbid symptoms of college students was 16.9%(n=177), and the detection rates of sufficient, decreased, increased, and insufficient physical activity changes were 72.5%(n=758), 13.8%(n=144), 9.2%(n=96), and 4.6%(n=48), respectively. The result of multiple Logistic regression model showed that, after controlling for confounding factors, compared with those with sustained high level of physical activity, i. e. , adequate physical activity, increased physical activity(OR=1.89, 95%CI 1.10-3.25), decreased physical activity(OR =2.80, 95% CI 1.72-4.57), and insufficient physical activity(OR = 3.66, 95% CI 1.85-7.23) increased the risk of anxiety-depression comorbidity symptoms of college students(P&lt;0.05). However, there was no significant increase in the risk of anxiety or depressive symptoms in those who increased, decreased, or insufficient physical activity compared with those who were sufficient physical activity(P&gt;0.05)., Conclusion: The level of physical activity and its changes are related to mental health of college students. The continuous low level of physical activity is associated with the increased risk of comorbidity of anxiety and depression in college students.

Purpose: Smartphone use could lead to being physically inactive and a greater risk for health problems, such as inflammation. However, the associations between smartphone use, physical activity (PA), and systemic low-grade inflammation remained unclear. This study aimed to examine the potential mediating effect of PA on the association between smartphone use and inflammation., Patients and Methods: A two-year follow-up study was conducted between April 2019 and April 2021. Duration of smartphone use, smartphone dependence and PA were assessed by a self-administered questionnaire. Laboratory analysis of blood samples was performed to evaluate the levels of TNF-α, IL-6, IL-1β, and CRP as biomarkers of systemic inflammation. The correlations between smartphone use, PA, and inflammation were analyzed using Pearson correlation. Structural equation modelling was used to analyze the potential mediating effect of PA on the associations between smartphone use and inflammation., Results: A total of 210 participants were included with a mean (standard deviation) age of 18.7 (1.0) years, 82 (39%) of whom were males. Smartphone dependence was negatively associated with the total PA level (r=-0.18, P <0.01). PA mediated the associations between the duration of smartphone use and smartphone dependence with inflammatory markers. Specifically, as PA decreased, the duration of smartphone use was more negatively associated with TNF-α (ab=-0.027; 95% CI: -0.052, -0.007) and more positively correlated to IL-6 (ab=0.020; 95% CI: 0.001, 0.046) and CRP (ab=0.038; 95% CI: 0.004, 0.086); smartphone dependency was more negatively associated with TNF-α (ab=-0.139; 95% CI: -0.288, -0.017) and more positively related to CRP (ab=0.206; 95% CI: 0.020, 0.421)., Conclusion: Our study illustrates that there are no direct associations between smartphone use and systemic low-grade inflammation, however, PA level plays a weak but significant mediating effect on the associations between smartphone use and inflammation among college students., Competing Interests: The authors declared no potential conflicts of interest concerning the research, authorship, and/or publication of this article., (© 2023 Li et al.)

Objective: The purpose of this study was to investigate whether sleep pattern is associated with metabolic disorders among young adults., Methods: We measured sleep patterns using multiple sleep behaviors in an ongoing prospective cohort among college students (n = 1,151). At baseline, 729 college students provided fasting blood samples and human body morphological measurements for quantification of metabolic parameters. Then, 340 participants continued to take metabolic parameters measurements at a 2-year follow-up. Sleep patterns were defined by chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. Metabolic scores were derived for four metabolic parameters including body mass index (BMI), waist circumference (WC), fasting blood sugar (FBG), and insulin. Multivariate linear regression model was applied to analyze the association between sleep pattern types and metabolic parameters and metabolic scores., Results: In the baseline survey, we found that a total of 41 (4.1%) participants had poor sleep patterns. Then, metabolic scores were significantly higher among college students with poor sleep patterns, compared with those who with healthy sleep patterns at baseline (1.00 ± 0.96 vs. 0.78 ± 0.72, p < 0.05) and 2-year follow-up (0.34 ± 0.65 vs. 1.50 ± 1.64, p < 0.05). After covariates were adjusted, poor sleep pattern ( β = 0.22, 95% CI: 0.06~2.53, p = 0.001) was associated with elevated metabolic scores at the 2-year follow-up., Conclusions: The elevated metabolic burden observed in college students with poor sleep patterns highlights the need to identify and address sleep problems in order to minimize the long-term impact on disease vulnerability., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Zhang, Yang, Zhai, Qu, Li, Xie, Tao, Zou, Tao and Wu.)

Background: The purpose of this study was to identify different develpment trajectories of depression symptoms during college period, and prospectively investigate the associations healthy sleep patterns with trajectories of depression symptoms among college students from freshman through junior year., Methods: A total of 999 participants from the College Student Behavior and Health Cohort Study were included between April 2019 and June 2021. Healthy sleep patterns were defined by chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. Latent growth curve model was used to identify trajectories of depression symptoms. Then binary logistic regression was used to examine association of the healthy sleep patterns with these trajectories., Results: In baseline survey, we found that a total of 100 (10.0%) participants had healthy sleep patterns' score equal to 5. Then, we used 5 surveys' data to identify 2 distinct trajectories of depression symptoms during college (decreasing: 82.5%; increasing: 17.5%). The healthy sleep patterns were associated with these trajectories, the better healthy sleep patterns significantly decrease the risk of increasing trajectories of depression symptoms in males (OR: 0.72, 95%CI: 0.54 ~ 0.97, P = 0.031). Moreover, we found out that the healthy sleep patterns of college students can predict the future depressive symptoms in this study (all P < 0.001)., Conclusion: Our findings indicate that the better healthy sleep patterns may significantly decrease the risk of increasing trajectory of depression symptoms only in male college students. The results speak to a need for college student with depression symptoms to identify and address sleep problems when present, which could prevent or reduce depression detriments in later life., (© 2023. The Author(s).)

Background: Poor sleepers have a higher prevalence of mental health problems, and vice versa. However, the mechanisms underlying this association remain unknown. We aimed to examine the bidirectional association between sleep quality and mental health, and further explore the moderating effects of PER3 gene DNA methylation on the association., Methods: This prospective longitudinal study was conducted from April 2019 to May 2021, integrated questionnaire and blood sample data from 2 universities in Anhui and Jiangxi Provinces. The current study recruited 1179 young adults at baseline and conducted the follow-up survey among 1135 half a year later. The sleep quality and depressive symptoms, anxiety symptoms, and stress symptoms were assessed using a questionnaire at baseline and follow-up. Blood samples were collected at baseline, and MethyTarget™ was used to detect the PER3 gene DNA methylation level. A cross-lag model was used to examine the bidirectional association between sleep quality and mental health. The PROCESS plug-in of SPSS software was used to analyse the moderating effects of PER3 gene DNA methylation., Results: Cross-lagged analyses suggested a significant bidirectional relationship between poor sleep quality and depressive symptoms, anxiety symptoms, and stress symptoms. Sleep quality at baseline was a significant predictor of depressive symptoms (β = 0.344, P < 0.001), anxiety symptoms (β = 0.348, P < 0.001), and stress symptoms (β = 0.324, P < 0.001) half a year later. Depressive symptoms (β = 0.049, P < 0.001), anxiety symptoms (β = 0.055, P < 0.001), and stress symptoms (β = 0.063, P < 0.001) at baseline were also significant predictors of poor sleep quality half a year later. Furthermore, PER3 gene DNA methylation has negative moderating effects between sleep quality at baseline and depressive symptoms (β = -11.706, P = 0.012), anxiety symptoms (β = -10.289, P = 0.019), and stress symptoms (β = -10.799, P = 0.024) half a year later and a sex difference. Among boys, PER3 gene DNA methylation has positive moderating effects between anxiety symptoms at baseline and sleep quality (β = 3.337, P = 0.018) half a year later. However, there was no association between mental health at baseline and sleep quality half a year later among girls., Conclusion: Bidirectional relationships were identified between sleep quality and mental health among Chinese young adults during the study period. DNA methylation evidence supports a negative moderating effect of PER3 gene DNA methylation on the relationship between sleep quality at baseline and mental health half a year later and had sex differences. Among boys, PER3 gene DNA methylation had positive moderating effects between anxiety symptoms at baseline and sleep quality half a year later. These findings point to the importance of circadian clock gene DNA methylation in the relationship between sleep quality and mental health., Competing Interests: Conflict of interest The author(s) has no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Hemorrhage progression in deep intracerebral hemorrhage (ICH) involves not only the growth of parenchymal hematoma but also an increase in intraventricular hemorrhage (IVH). The search for methods that predict both the increased risk of parenchymal hematoma and IVH growth is warranted., Methods: We conducted a retrospective cohort study at multiple centers. Participants with deep ICH were enrolled from January 2018 to December 2021. Prediction models based on logistic regression analysis included clinical as well as routine radiographic and radiomics variables, separately or in combination. The performance of each model was evaluated using discrimination measures (e.g., area under the curve [AUC]). Evaluation of clinical utility was performed using decision curve analysis (DCA)., Results: Overall, 647 individuals across 4 stroke centers were included. A total of 429 (66%) patients from 3 centers were assigned to the primary cohort and 218 (34%) from another center were placed in the validation cohort. Multivariate analysis showed that the Glasgow Coma Scale score, baseline ICH volume, IVH, blend sign, and radiomics score were associated with hemorrhage progression in the primary cohort. The clinical-radiomics model (AUC = 0.852 and 0.835) improved the prediction performance of hemorrhage progression compared to the Noncontrast computed tomography signs model (AUC = 0.666 and 0.618) in both the primary and validation cohorts, with similar results in the decision curve analysis curves., Conclusions: The clinical-radiomics model outperformed the routine Noncontrast computed tomography signs model in predicting the progression of deep ICH. The clinical benefit of screening patients using this model may assist in risk stratification., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: Inflammation is closely related to poor mental and physical health, including depressive symptoms and its specific symptoms. To reveal the linear and nonlinear relationships between depressive symptoms and chronic inflammation levels, and perform further analysis of the associations between symptom-specificity of depressive symptoms and inflammation among young adults by using a prospective design., Methods: In this longitudinal study, we examined college students recruited from two universities in China, who were examined at baseline and 2-years follow-up. Depressive symptoms were measured by applying the Patient Health Questionnaire 9 (PHQ-9) at baseline. Plasma levels of four inflammatory biomarkers, including interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and C reactive protein (CRP) were assayed at baseline and 2-year follow-up. In addition to the conventional generalized linear models, as well as restricted cubic splines were innovatively used to analyze the cross-sectional and longitudinal nonlinear relationships between depressive symptoms and inflammatory biomarkers., Results: Generalized linear model analysis revealed that there were no statistical associations between depressive symptoms and any inflammatory biomarker levels. The results of the restricted cubic spline demonstrated a U-shaped nonlinear association between depressive symptoms and ΔIL-1β or ΔTNF-α (changes in baseline and 2-year follow-up), but these associations disappeared after adjusting the confounders. Symptom-specificity of depressive symptoms such as sleeping problems and suicidal ideation were associated with lower IL-1β at baseline or changes in IL-1β levels. Sleeping problems and psychomotor changes at baseline were associated with higher CRP at 2-year follow-up. Suicidal ideation at baseline was associated with changes in TNF-α levels., Conclusion: Our findings suggested that symptom-specificity of depressive symptoms was associated with inflammation during a 2-year follow-up at the transition to adulthood. Simultaneously, more research is warranted to seek the directionality of depressive symptoms and chronic inflammation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Zhai, Qu, Zhang, Li, Xie, Wu, Zou, Yang, Tao and Tao.)

Objectives: To describe the prevalence of depressive symptoms among Chinese college students and examine the relationship between sleep and circadian rhythm disruption (SCRD) indicators (chronotype, social jetlag, sleep duration) and depressive symptoms., Methods: From April to May 2019, the College Student Behavior and Health Cohort Study was conducted among Chinese college students from 2 universities in Anhui and Jiangxi provinces. The current study used data from the third follow-up study. Questionnaire content includes socio-demographic and lifestyle information. Social jetlag and sleep duration were calculated by answering the question about sleep time. Chronotype was assessed by the Morning and Evening Questionnaire (MEQ-5). Depressive symptoms were evaluated by the Patient Health Questionnaire 9 (PHQ-9). A Chi-square test was used to examine the proportion depressive symptoms. Multinomial logistic regression model were used to explore the associations of circadian rhythm indicators with depressive symptoms., Results: The prevalence of mild depression, moderate and above depression was 18.8 % and 6.9 %. Evening types (E-types) and short sleep duration were significantly associated with depression. Stratified analysis indicated that E-types and social jetlag≥2 h were associated with mild depression (OR = 5.67, 95 % CI: 1.83-17.51), as well as stratified analysis indicated that E-types and sleep duration<8 h were associated with mild depression (OR = 5.10, 95 % CI: 1.88-13.87)., Conclusions: The findings suggest that depressive symptoms are more severe when multiple SCRD indicators are out of whack. The intervention programs of depressive symptoms should consider the context of the multidimensional aspects of Chinese college student sleep., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Aims: This study aimed to describe the prevalence of problematic mobile phone use (PMPU) and chronotype among Chinese college students, estimate PMPU development trajectories, and further examine the effect of PMPU trajectories on chronotype., Design: In a stratified cluster sampling design, PMPU and chronotype were evaluated in 999 college students from two universities in a 2-year prospective investigation from April 2019 to April 2021, and an investigation was conducted every six months (time 1 ∼ time 5, T1 ∼ T5)., Participants: N = 999 college students (mean age at T1: 18.8 years (SD = 1.2), 37.7% male) took part in the study., Measurements: The Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU) and the Pittsburgh Sleep Quality Index (PSQI) were used to assess the PMPU and sleep quality of college students at each time point. The Morning and Evening Questionnaire (MEQ) was adopted to investigate the chronotype of college students at T5., Findings: The prevalence of PMPU at T1 ∼ T5 was 24.3%, 27.3%, 35.1%, 31.2% and 31.9%, respectively. The prevalence rates of morning types (M-types), neutral types (N-types), and evening types (E-types) were 19.1%, 70.8%, and 10.1%, respectively. Using latent growth mixture modelling, we identified three trajectories of PMPU: low-level (49.5%), moderate-level (38.6%), and high-level score trajectories (11.9%). Multivariate logistic regression analysis results showed that a trajectory with a high score was positively associated with E-types (P < 0.05). After stratification by gender, a high-level score trajectory was positively associated with E-types only among female college students (P < 0.05). There were sex differences in the association between trajectories of PMPU and chronotype., Conclusion: Long-term symptoms of PMPU may be a potential risk factor for circadian rhythm disturbance among college students, and this effect was significantly different between genders., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The Afro-Asian summer monsoon (AfroASM) sustains billions of people living in many developing countries covering West Africa and Asia, vulnerable to climate change. Future increase in AfroASM precipitation has been projected by current state-of-the-art climate models, but large inter-model spread exists. Here we show that the projection spread is related to present-day interhemispheric thermal contrast (ITC). Based on 30 models from the Coupled Model Intercomparison Project Phase 6, we find models with a larger ITC trend during 1981-2014 tend to project a greater precipitation increase. Since most models overestimate present-day ITC trends, emergent constraint indicates precipitation increase in constrained projection is reduced to 70% of the raw projection, with the largest reduction in West Africa (49%). The land area experiencing significant increases of precipitation (runoff) is 57% (66%) of the raw projection. Smaller increases of precipitation will likely reduce flooding risk, while posing a challenge to future water resources management., (© 2022. The Author(s).)

Objective: To examine the relationship between health-risk behaviors and depressive symptoms among college students, and explore the mediating role of plasma IL-10 level in the relationship between the two., Methods: Freshman students in two universities in Hefei City, Anhui Province and Shangrao City, Jiangxi Province were recruited between April and May 2019, and follow-up investigation was conducted 6 months later. Health risk behaviors were measured based on the Young Risk Behavior Surveillance System(YRBSS) questionnaire, and depressive symptoms was evaluated by using the Depression Anxiety Stress Scale(DASS-21) among college students at baseline and 6 months follow-up survey. Plasma interleukin-10(IL-10) level was measured at baseline. Univariate analysis was used to compare the correlation between health risk behaviors and depressive symptoms among college students. Binary Logistic regression analyzed the relationship between health risk behaviors, IL-10 and depressive symptoms. The mediation model was used to explore the mediating role of IL-10 levels in the association between health risk behaviors and depressive symptoms., Results: At baseline, boys reported a higher rate of depressive symptoms than that of girls(χ~2=6.33, P=0.01); higher rates of depressive symptoms were observed in students who were from a family with a low perceived economic status(χ~2=7.31, P=0.03)or in poor health(χ~2=6.71, P=0.04). Participants who reported low physical activity(χ~2=19.09, P&lt;0.01), smoking(χ~2=7.03, P&lt;0.01), and poor sleep quality(χ~2=68.78, P&lt;0.01)at baseline were more likely to experience depressive symptoms. Multiple health-risk behaviors at baseline were positively correlated with depressive symptoms among college students. After adjusting gender, self-reported family economy and self-rated health, the regression model showed that plasma IL-10 at baseline was negatively associated with the prevalence of depressive symptoms(OR=0.36, 95% CI 0.18-0.72) and the incidence of depressive symptoms after 6 months(OR=0.20, 95% CI 0.08-0.49). Structural equation model showed that health-risk behaviors was negatively correlated to IL-10 level(β=-0.13, SE=0.04), IL-10 negatively predicted depressive symptoms at follow-up(β=-0.09, SE=0.04), and IL-10 play a mediating role between health risk behavior and depressive symptoms., Conclusion: Health risk behaviors are positively correlated with depressive symptoms among college students. Plasma IL-10 level at baseline was negatively associated with the incidence of depressive symptoms after 6 months, and IL-10 level at baseline has a partial mediating effect between baseline health risk behavior clustering and depressive symptoms at follow-up.

Identifying the alert groups of mechanism-based inactivators of human cytochrome P450s (hCYPs) is very helpful for early prediction of drug toxicity and for rational drug design to avoid idiosyncratic toxicity. Here, we report that a natural compound bufalin (BF) could time-dependently inactivate hCYP3A via complex CYP-catalyzed cascade oxidative metabolism. Metabolite profiling and time-dependent inhibition assays showed that 3-keto-bufalin (3-KBF), a unique nonpolar oxidative metabolite of BF, was the key substance responsible for hCYP3A inactivation. Further investigations demonstrated that 3-KBF was further metabolized by hCYPs to generate two mono-hydroxylated metabolites, which could be readily dehydrated and then covalently bound on glutathione or hCYP3A4. Collectively, this study uncovers unique CYP-catalyzed cascade oxidative pathways of BF in which two reactive intermediates bearing a Michael acceptor are finally formed as hCYP3A inactivators. These findings expand the current knowledge of CYP inactivators and suggest that some steroids bearing the 3-keto group may trigger time-dependent CYP3A inactivation.

Fibroblast activation protein alpha (FAP-α, EC3.4.2. B28), a type II transmembrane proteolytic enzyme for the serine protease peptidase family. It is underexpressed in normal tissues but increased significantly in disease states, especially in neoplasm, which is a potential biomarker to turmor diagnosis. The inhibition of FAP-α activity will retard tumor formation, which is expected to be a promising tumor therapeutic target. At present, although the FAP-α expression detection methods has diversification, a superlative detection means is necessary for the clinical diagnosis. This review covers the discovery and the latest advances in FAP-α, as well as the future research prospects. The tissue distribution, structural characteristics, small-molecule ligands and structure-activity relationship of major inhibitors of FAP-α were summarized in this review. Furthermore, a variety of detection methods including traditional detection methods and emerging probes detection were classified and compared, and the design strategy and kinetic parameters of these FAP-α probe substrates were summarized. In addition, these comprehensive information provides a series of practical and reliable assays for the optimal design principles of FAP-α probes, promoting the application of FAP-α as a disease marker in diagnosis, and a drug target in drug design., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Despite the evidence of an association between problematic mobile phone use (PMPU) and psychological symptoms, a few studies explore whether physical activity (PA) could moderate the effect of PMPU on psychological symptoms and its neural substrates. The aim of this study was to examine the association between PMPU and psychological symptoms in late adolescents, along with the potential moderating effect of PA and neural basis by brain gray matter volume (GMV)., Methods: A total of 251 college students reported on their PMPU, PA, and psychological symptoms and subsequently underwent structural magnetic resonance imaging to explore the neural basis of their PA characteristics. A multiple regression model was performed to detect brain GMV associated with PA by the voxel-based morphometry (VBM) method. Moderating analysis was conducted using PROCESS macro in the SPSS software., Results: Behavioral results showed that PMPU was correlated to depression, anxiety, and stress, and PA has significantly moderated the association between PMPU with depression, anxiety, and stress. The VBM analysis showed that PA was correlated to GMV of the right fusiform gyrus (FFG), left precuneus (PCUN), left insula (INS), and left triangular part of inferior frontal gyrus (IFGtriang). Moreover, GMV of the left INS moderated the relationship between PMPU and depression., Conclusion: This study has shed light on the neural perspective of PA that moderates the relationship between PMPU and depressive symptom., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zou, Wu, Tao, Yang, Zhang, Hong, Xie, Li, Zheng and Tao.)

Background: Physical activity (PA) deficiency, outdoor time reduction during college have been associated with higher cumulative physiological burden as measured by allostatic load (AL). Therefore, the present research sought to analyze the independent and interaction effects of PA and outdoor time on AL in college students., Methods: A cross-sectional survey was conducted in two universities from April to May 2019. Self-assessment questionnaire and International Physical Activity Questionnaire Short Version (IPAQ-SF) were used in the investigation, AL level was assessed according to the results of biochemical examination, blood pressure and human body morphological measurements. Binary Logistic Analysis was used to analyze the relationships between PA, outdoor time and AL., Results: The prevalence of low PA, low outdoor time and high AL were 16.3%, 71.1% and 47.6%, respectively. Low PA (OR=1.83, 95%CI: 1.20~2.78) and low outdoor time (OR=1.90, 95%CI: 1.35~2.67) are independently associated with high AL (P<0.05, for each). Interaction analysis indicated that low PA and low outdoor time were interactively associated with high AL (OR=2.93, 95%CI: 1.73~4.94, P<0.05)., Conclusions: There were the significant independent and interaction effects between PA and outdoor time on AL. In the future, college students' physical education can be arranged reasonably to reduce the health risks., (© 2022. The Author(s).)

Background and Aim: Problematic mobile phone use (PMPU) is prevalent and increases the risk for a variety of health problems. However, few studies have explored the neural mechanisms that might render adolescents more or less vulnerable. Here, we aimed to identify whether PMPU is associated with depressive symptoms and whether this relationship is moderated by intrinsic functional connectivity (iFC) which is associated with PMPU., Methods: In this longitudinal study, we included 238 students (mean age = 19.05, SD = 0.81) that came from a university in Hefei, China. They all finished MRI scans at baseline and completed questionnaires both at baseline and 1 year later. A self-rating questionnaire for adolescent problematic mobile phone use and depression anxiety stress scale-21 were used to assess PMPU and depressive symptoms. We first assessed the relationship between PMPU and depressive symptoms using an autoregressive cross-lagged model. Then, we detected the brain regions that were associated with PMPU. Moreover, the neuroimaging results were extracted to explore whether the iFC of these brain regions moderated the relationship between PMPU and depression., Results: Consistent with our hypotheses, PMPU was positively associated with depressive symptoms, and the relationship between PMPU and depressive symptoms was moderated by iFC of the left parahippocampal gyrus-right middle temporal gyrus both at baseline and after 1 year (β = 0.554, P = 0.003; β = 0.463, P = 0.016, respectively)., Conclusions: These results advance the understanding of PMPU and suggest that iFC of the left parahippocampal gyrus-right middle temporal gyrus may be a neurobiological contributor to its relationship with depressive symptoms.

Background : Nowadays, magnetic resonance imaging (MRI) is routinely applied in clinical diagnosis. However, using one contrast agent (CA) to simultaneously enhance the T 1 and T 2 MR contrast at low and high magnetic fields respectively has not been reported. Methods : Herein, we investigated the MR property of a γ-glutamyl transpeptidase (GGT)-instructed, intracellular formed gadolinium nanoparticle (DOTA-Gd-CBT-NP) at low and high magnetic fields. Results : Experimental results showed that DOTA-Gd-CBT-NP possesses a low r 2 /r 1 ratio 0.91 which enables it to enhance T 1 MR imaging of liver tumor at 1.0 T, and a high r 2 /r 1 ratio 11.8 which renders the nanoparticle to largely enhance T 2 MR imaging of liver tumor at 9.4 T. Conclusion: We expect that our GGT-responsive Gd-nanoparticle could be applied for simultaneous T 1 and T 2 MRI diagnosis of early liver cancer in clinic at respective low and high magnetic fields when the 9.4 T MR machine is clinically available in the future., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Purpose: Sleep insufficiency and circadian rhythm disturbances in college students have become prominent. Current findings show that sleep insufficiency is closely related to inflammation. Studies on the correlation between chronotype and inflammatory factors are still lacking. Therefore, this research intended to examine the relationships between sleep duration, chronotype and inflammatory cytokines in young adults, and to estimate the correlation between chronotype and inflammatory cytokines stratified by sleep duration., Patients and Methods: We conducted a cross-sectional study in April and May 2019. Participants were recruited from two colleges located in central China. The Pittsburgh Sleep Quality Index (PSQI) and the Morning and Evening Questionnaire-5 (MEQ-5) were administered to assess sleep duration and chronotype. Sleep duration less than 7 hours was defined as insufficient sleep. Fasting venous blood was collected to measure plasma levels of inflammatory markers including IL-1β, IL-6, TNF-α and IL-10., Results: A total of 723 participants were included in this study, with a mean age of 18.68 years (standard deviation=0.99). After adjusting for confounding factors, the results of generalized linear model showed that sleep insufficiency was positively correlated with IL-1β, TNF-α and IL-10; and evening-types (E-types) were positively associated with the levels of IL-1β and IL-6 ( p <0.05). Compared to the control group (sleep sufficiency and M-types), there were positive interaction effects of sleep insufficiency and neutral-types (N-types) on the levels of IL-1β, IL-6, TNF-α and IL-10 ( p <0.05). The hierarchical regression model showed that N-types and E-types were positively correlated to the levels of IL-1β, IL-6, TNF-α and IL-10 among college students with sleep insufficiency ( p <0.05)., Conclusion: The levels of inflammatory markers were higher among college students with sleep insufficiency and E-types. N-types and E-types were positively correlated with IL-1β, IL-6, TNF-α and IL-10 among college students with sleep insufficiency., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© 2021 Zhai et al.)

This study aimed to investigate the brain grey matter volume (GMV) related to problematic mobile phone use (PMPU), and whether these regions of GMV play a potential moderating role in the relationship between PMPU and depressive symptoms. We recruited 266 students who underwent magnetic resonance imaging (MRI) scanning. PMPU and depressive symptoms were assessed by a self-rating questionnaire for adolescent PMPU and patient health questionnaire-9, respectively. A multiple regression model was performed to detect GMV and white matter (WM) integrity associated with PMPU by voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) methods, and the moderating analysis was conducted by PROCESS using SPSS software. VBM analysis found an inverse correlation between the GMV of the anterior cingulate gyrus (ACC) and right fusiform gyrus (FFG) with PMPU (PFDR < 0.05), and TBSS analysis revealed that fractional anisotropy (FA) in the body of the corpus callosum was negatively correlated with PMPU. The correlation between PMPU and depressive symptoms was moderated by the GMV of the ACC. These results suggest that the GMV of the ACC and right FFG, as well as FA in the body of the corpus callosum, was related to PMPU, and we further found that increased GMV of the ACC could reduce the relationship between PMPU and depressive symptoms in college students., (© The Author(s) 2021. Published by Oxford University Press.)

Statins are a group of hydroxymethylglutaryl coenzyme A reductase inhibitors that are used in the treatment of cardiovascular diseases. However, statins have been found to be cytotoxic, and many unexpected side effects have been reported in clinical applications. The susceptibilities of different cell lines toward statins are diverse, and the mechanisms of cytotoxicity remain unknown. Therefore, the present study aimed to investigate differences in the susceptibility to and mechanisms of statin-induced cytotoxicity in two cell lines, HT-29 and A549, using a high content screening-based multiparametric toxicity assay panel. We found that the two cell types exhibited differing susceptibilities to the cytotoxic effects of the different statins. Additionally, the cytotoxicity was inconsistent between different statins in the two cell lines. Four statins with strong cytotoxicity decreased the viability of HT-29 cells via the mitochondrial pathway, as evidenced by decreased mitochondrial membrane potential, and elevated mitochondrial mass, calcium release and cell apoptosis, and reactive oxygen species. In contrast, these four statins only induced a decrease in the mitochondrial membrane potential in A549 cells. The above results provide an objective reason for future evaluations of cytotoxic differences in cell types and the underlying mechanisms of cytotoxicity in different statins, and provide a good scientific basis for further research on countermeasures against statin-induced cell injuries., (© 2021 Wiley Periodicals LLC.)

Objective: To describe the prevalence of chronotype and depressive symptoms among Chinese college students and to examine the association between chronotype and depressive symptoms. Methods: From April to May 2019, a cross-sectional survey was conducted among 1,179 Chinese college students from 2 universities in Anhui and Jiangxi provinces. A total of 1,135 valid questionnaires were collected, the valid response rate was 98.6%. The questionnaire investigated age, gender, major, height, weight, only child status, living place, self-reported family economy, and self-reported study burden. The chronotype was assessed by the Morning and Evening Questionnaire (MEQ). Depressive symptoms and sleep quality were evaluated by the Patient Health Questionnaire 9 (PHQ-9) and the Pittsburgh Sleep Quality Index (PSQI), respectively. A Chi-square test was used to examine the proportion of depressive symptoms among Chinese college students with different demographic characteristics. The generalized linear model was used to analyze the relationships between chronotype and depressive symptoms. Results: The proportion of morning types (M-types), neutral types (N-types), and evening types (E-types) of college students were 18.4, 71.1, and 10.5%, respectively. The proportion of mild depression, moderate depression, and moderate to severe depression of participants were 32.4, 6.0, and 4.2%, respectively. Compared to the M-types, after controlled for age, gender, major, sleep quality, self-reported study burden, father's education level, and self-reported family economy, depressive symptoms were positively correlated with E-types ( OR = 2.36, 95% CI: 1.49-3.73). Conclusions: There was a significant association between chronotype and depressive symptoms among Chinese college students. Further longitudinal studies were needed to clarify the causal relationship between chronotype and depressive symptoms., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2020 Li, Xie, Tao, Yang, Xu, Zou, Tao and Wu.)

Background: Previous research has found a relationship between problematic mobile phone use (PMPU) and suicidality. However, few studies have examined the interaction effects between low physical activity (PA) and PMPU on suicidality among college students. This study aimed to examine the interactions of PA and PMPU and their impact on suicidality in a school-based sample among Chinese college students., Methods: Analysis is based on date from two university in China, which recruited 4787 participants. Binomial logistic regression models were used to explore the associations of PA, PMPU with suicidal ideation and suicide attempt, as well as the interaction of PA and PMPU with suicidality., Results: The prevalence of suicide attempt and suicidal ideation were 3.5 and 7.2%, respectively. Low PA was significantly associated with suicide attempt (OR = 3.48, 95%CI: 2.52-4.81) and suicidal ideation (OR = 1.90, 95%CI: 1.46-2.46). PMPU was significantly associated with suicide attempt (OR = 3.65, 95%CI: 2.66-5.01) and suicidal ideation (OR = 2.83, 95%CI: 2.25-3.54). Interaction analysis indicated that low PA and PMPU were interactively associated with suicide attempt (OR = 9.51, 95%CI: 6.15-14.73, P < 0.001), RERI = 4.85(1.20-8.50), AP = 0.51(0.29-0.73), SI = 2.32(1.34-4.04). There was no additive interaction effects between PA and PMPU on suicidal ideation., Conclusions: The findings reveals that the intervention programs of suicide attempt should consider the students PA levels and PMPU.

Today, tumor therapy and its therapeutic efficiency evaluation are conducted separately, and current imaging techniques cannot evaluate tumor-therapeutic effects in real time. Therefore, it is of great importance to develop highly efficient theranostic strategies which are able to evaluate their tumor-therapeutic effects in real time. In this work, by rational design of a small molecular near-infrared probe Cys(StBu)-Asp-Glu-Val-Asp-Lys(Cypate)-CBT ( Cy-CBT ) and using a CBT-Cys click condensation reaction, we facilely prepare an intelligent nanoparticle Cy-CBT-NP which is able to evaluate its photothermal therapy (PTT) efficiency on tumors by fluorescence "Turn-On". Fluorescence of Cy-CBT-NP is quenched and photothermal responsive. Upon caspase 3 (Casp3) cleavage of its DEVD substrates, Cy-CBT-NP disassembles to turn the fluorescence "On", which in turn evaluates the PTT efficiency of the nanoparticle on cells and tumors in real time. We envision that our smart strategy could be applied for PTT and real-time evaluation of the therapeutic efficiency of solid tumors in the near future.

Previous studies have shown the associations between phthalates exposure and psychological behavior problems in children and adolescents, but such associations have not been fully elucidated in university students, especially among Chinese university students. This study aims to examine the association between urinary phthalates metabolites concentration and emotional symptoms in Chinese university students. A school-based cross-sectional survey was carried out among 990 university students aged 17-24 years from two universities in Anhui and Jiangxi provinces of China. Concentration of six phthalate metabolites in urine was determined by high-performance liquid chromatography-tandem mass spectrometry and the emotional symptoms were assessed by the 21-item Depression, Anxiety, and Stress Scale. The detection rate of six phthalate metabolites in urine ranged from 79.6% to 99.7%. The median concentration of six phthalate metabolites ranged from 2.90 to 119.64 ng/mL. The positive rates of depressive symptoms, anxiety symptoms, and stress were 17.4%, 24.8%, and 9.5%, respectively. After adjusting for the confounding variables, mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) was found to be associated with depressive symptoms (β = 8.84, P = 0.017), anxiety symptoms (β = 8.46, P = 0.015), and stress symptoms (β = 9.95, P = 0.012) in males; whereas, monobutyl phthalate (MBP) was found to be associated with depressive symptoms (β = 1.86, P = 0.002), anxiety symptoms (β = 1.81, P = 0.005), and stress symptoms (β = 1.48, P = 0.047) in females. Our study demonstrates that Chinese university students are widely exposed to phthalates; and high- and low-molecular weight phthalates are associated with emotional symptoms in males and females, respectively., Competing Interests: Declaration of competing interest All authors declare no conflict of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Cognitive impairment has received attention as an important problem in patients with end-stage renal disease, although end-stage renal disease patients with secondary hyperparathyroidism have not been studied., Purpose: To assess the pattern of brain volume changes in end-stage renal disease patients with secondary hyperparathyroidism by using voxel-based morphometry and correlating these measures with clinical markers and the Montreal Cognitive Assessment scores., Material and Methods: Fifty end-stage renal disease patients with no anatomical abnormalities in conventional MRI (25 patients with secondary hyperparathyroidism, 14 men, mean age 42.20 ± 7.53 years; 25 patients without secondary hyperparathyroidism, 15 men, mean age 41.96 ± 6.17 years) were selected in this study. All patients underwent laboratory tests, neuropsychological tests, and MRI. Voxel-based morphometry analysis was performed to detect regional gray matter volume differences between the two groups. The relationships between abnormal gray matter volume and clinical markers and Montreal Cognitive Assessment scores were investigated., Results: Voxel-based morphometry revealed increased gray matter volume in end-stage renal disease patients with secondary hyperparathyroidism in the bilateral caudate and bilateral thalamus compared with non- secondary hyperparathyroidism end-stage renal disease patients ( P  < 0.05, FWE corrected). Regarding the laboratory and neuropsychological tests, we found significant correlations between volume in these brain regions and intact parathyroid hormone levels and negative correlations with the Montreal Cognitive Assessment scores. There were no significant associations between brain volume changes and other clinical data (disease duration, urea, creatinine, and uric acid levels)., Conclusion: Our results showed significantly increased gray matter volume in end-stage renal disease patients with secondary hyperparathyroidism, which was associated with intact parathyroid hormone levels and cognitive impairment. Serum intact parathyroid hormone levels may be a risk factor for cognitive impairment in end-stage renal disease patients with secondary hyperparathyroidism.

In traditional Chinese medicine herbs (TCM), including Radix Salviae Miltiorrhizae (Danshen), Radix Puerariae Lobatae (Gegen), Radix Angelicae Sinensis (Danggui), and Rhizoma Chuanxiong (Chuanxiong) are widely used for the prevention and treatment of cardiovascular diseases and also often co-administered with Western drugs as a part of integrative medicine practice. Carboxylesterase 1 (CES1) plays a pivotal role in the metabolisms of pro-drugs. Since ( S )-2-(2-(6-dimethylamino)-benzothiazole)-4,5-dihydro-thiazole-4-carboxylate (NLMe) has recently been identified by us as a selective CES1 bioluminescent sensor, we developed a rapid method using this substrate for the direct measurement of CES1 activity in rats. This bioluminescence assay was applied to determine CES1 activity in rat tissues after a two-week oral administration of each of the four herbs noted above. The results demonstrated the presence of CES1 enzyme in rat blood and all tested tissues with much higher enzyme activity in the blood, liver, kidney and heart than that in the small intestine, spleen, lung, pancreas, brain and stomach. In addition, the four herbs showed tissue-specific effects on rat CES1 expression. Based on the CES1 biodistribution and its changes after treatment in rats, the possibility that Danshen, Gegen and Danggui might alter CES1 activities in human blood and kidney should be considered. In summary, a selective and sensitive bioluminescence assay was developed to rapidly evaluate CES1 activity and the effects of orally administered TCMs in rats., Competing Interests: The authors declare that there are no conflicts of interest., (© 2020 Xi'an Jiaotong University. Production and hosting by Elsevier B.V.)

Doxophylline (DOXO) and theophylline are widely used as bronchodilators for treating asthma and chronic obstructive pulmonary disease, and DOXO has a better safety profile than theophylline. How DOXO's metabolism and disposition affect its antiasthmatic efficacy and safety remains to be explored. In this study, the metabolites of DOXO were characterized. A total of nine metabolites of DOXO were identified in vitro using liver microsomes from human and four other animal species. Among them, six metabolites were reported for the first time. The top three metabolites were theophylline acetaldehyde (M1), theophylline-7-acetic acid (M2), and etophylline (M4). A comparative analysis of DOXO metabolism in human using liver microsomes, S9 fraction, and plasma samples demonstrated the following: 1) The metabolism of DOXO began with a cytochrome P450 (P450)-mediated, rate-limiting step at the C ring and produced M1, the most abundant metabolite in human liver microsomes. However, in human plasma, the M1 production was rather low. 2) M1 was further converted to M2 and M4, the end products of DOXO metabolism in vivo, by non-P450 dismutase in the cytosol. This dismutation process also relied on the ratio of NADP + /NADPH in the cell. These findings for the first time elucidated the metabolic sites and routes of DOXO metabolism in human. SIGNIFICANCE STATEMENT: We systematically characterized doxophylline metabolism using in vitro and in vivo assays. Our findings evolved the understandings of metabolic sites and pathways for methylxanthine derivatives with the aldehyde functional group., (Copyright © 2020 by The American Society for Pharmacology and Experimental Therapeutics.)

Objectives: Neuroimaging studies of acute lymphoblastic leukemia (ALL) during chemotherapy treatment have shown alterations in structure, function, and connectivity in several brain regions, suggesting neurobiological impairment that might influence the large-scale brain network. This study aimed to detect the alterations in the topological organization of structural covariance networks of ALL patients., Methods: This study included 28 ALL patients undergoing chemotherapy and 20 matched healthy controls. We calculated the gray matter volume of 90 brain regions based on an automated anatomical labeling template and applied graph theoretical analysis to compare the topological parameters of the gray matter structural networks between the two groups., Results: The results demonstrated that both the ALL and healthy control groups exhibited a small-world topology across the range of densities. Compared to healthy controls, ALL patients had less highly interactive nodes and a reduced degree/betweenness in temporal regions, which may contribute to impaired memory and executive functions in these patients., Conclusion: These results reveal that ALL patients undergoing chemotherapy treatment may have decreased regional connectivity and reduced efficiency of their structural covariance network. This is the first report of anomalous large-scale gray matter structural networks in ALL patients undergoing chemotherapy treatment and provides new insights regarding the neurobiological mechanisms underlying the chemo-brain network., (Copyright © 2019 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Postpartum depression is a disabling mental disorder commonly seen in parturients under trial of labor after cesarean, which causes serious harm to the parturients. The etiology is unclear. We hypothesized that epidural labor analgesia can reduce the incidence rate of postpartum depression. Enrolled multiparas were divided into the epidural labor analgesia group ( n  = 263) or nonanalgesia group ( n  = 160) according to their own request. Edinburgh Postnatal Depression Scale was used to assess their mental status at 48 hours and 42 days after delivery. Relative perinatal variables were collected and further analyzed using univariate analysis and multivariate logistic regression analysis to assess the relation of epidural analgesia with the occurrence of postpartum depression under trial of labor after cesarean. The Edinburgh Postnatal Depression Scale score 48 hours ≥ 10 in the no epidural analgesia group was 26.42% while the epidural analgesia group was 8.49% (OR, 0.209; 95% CI, 0.096-0.429; P < 0.001). The Edinburgh Postnatal Depression Scale score 42 day ≥ 10 in the no epidural analgesia group was 25.16% while the epidural analgesia group was 6.59% (OR, 0.235; 95% CI, 0.113-0.469; P < 0.001). The incidence of postpartum depression was significantly lower in the epidural labor analgesia group at 48 hours and 42 days. There was also a significant relation between the Edinburgh Postnatal Depression Scale scores at 48 hours and 42 days after delivery. Epidural analgesia, discomfort within 42 days, and self-rating anxiety scale are independent predictors of postpartum depression for trial of labor after cesarean in 42 days. Epidural labor analgesia is associated with a decreased risk of postpartum depression. Further study with a large sample size and more centers is needed to evaluate the impact of epidural analgesia on the occurrence of postpartum depression. Chinese Clinical Trial Register, ChiCTR-ONC-17010654., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this article., (Copyright © 2020 Jing Sun et al.)

Background: The trial of labor after cesarean section (TOLAC) is a relatively new technique in mainland of China, and epidural analgesia is one of the risk factors for uterine rupture. This study aimed to evaluate the effect of epidural analgesia on primary labor outcome [success rate of vaginal birth after cesarean (VBAC)], parturient complications and neonatal outcomes after TOLAC in Chinese multiparas based on a strictly uniform TOLAC indication, management and epidural protocol., Methods: A total of 423 multiparas undergoing TOLAC were enrolled in this study from January 2017 to February 2018. Multiparas were divided into two groups according to whether they received epidural analgesia (study group, N = 263) or not (control group, N = 160) during labor. Maternal delivery outcomes and neonatal characteristics were recorded and evaluated using univariate analysis, multivariable logistic regression and propensity score matching (PSM)., Results: The success rate of VBAC was remarkably higher (85.55% vs. 69.38%, p < 0.01) in study group. Epidural analgesia significantly shortened initiating lactation period and declined Visual Analogue Score (VAS). It also showed more superiority in neonatal umbilical arterial blood pH value. After matching by PSM, multivariable logistic regression revealed that the correction of confounding factors including epidural analgesia, cervical Bishop score at admission and spontaneous onset of labor were still shown as promotion probability in study group (OR = 4.480, 1.360, and 10.188, respectively; 95%CI = 2.025-10.660, 1.113-1.673, and 2.875-48.418, respectively; p < 0.001, p = 0.003, and p < 0.001, respectively)., Conclusions: Epidural analgesia could reduce labor pain, and no increased risk of postpartum bleeding or uterine rupture, as well as adverse effects in newborns were observed. The labor duration of multiparas was increased, but within acceptable range. In summary, epidural analgesia may be safe for both mother and neonate in the three studied hospitals., Trial Registration: Chineses Clinical Trial Register, ChiCTR-ONC-17010654. Registered February 16th, 2017.

Background and Aim: Problematic mobile phone use (PMPU) and depression are great public health concerns among adolescents. The aim of this study was to determine the association between PMPU and symptoms of depression, as well as the mediating role of sleep quality. Methods: A total of 4,624 college students participated in this study. The Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU), Pittsburgh Sleep Quality Index (PSQI), and Patient Health Questionnaire-9 (PHQ-9) were administered to assess PMPU, sleep quality, and symptoms of depression. Mediation analysis was conducted using PROCESS macro in the SPSS software. Results: Of the participants, 27.5% were classified as PMPU, 44.9% exhibited symptoms of depression, and 15.6% reported sleep problems. Compared with those without PMPU, those with PMPU exhibited higher rates of sleep problems and depressive symptoms. The mediation analysis further revealed partial mediation effects of sleep quality on the association between PMPU and depression. Conclusions: This study demonstrated that PMPU was associated with mental health in college students, and sleep quality played a mediating role in this relationship. Our findings highlight the critical role of early intervention for depression with a focus on those with PMPU and, more specifically, on those with sleep problems., (Copyright © 2019 Zou, Wu, Tao, Xu, Xie, Yang and Tao.)

A traceless-activation strategy for the synthesis of 4-arylchroman-2-ones via a Rh(III)-catalyzed C-H activation of 2-arylpyridines and subsequent conjugated/decarboxylative addition to coumarin-3-carboxylic acids has been reported. The carboxyl group at C3 position of coumarin proved to be crucial to realize the reaction, which is spontaneously removed after the reaction by the release of CO 2 . The reaction displayed good substrate tolerance and gave various 4-arylchroman-2-ones in up to 90% yield.