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Abstract Background Longitudinal evidence is lacking on the interplay between lifestyle behaviors and depressive symptoms, especially in the context of the COVID-19 pandemic. This study investigated the changes in physical activity and recreational screen time during the pandemic, along with their reciprocal associations with depressive symptoms among children and adolescents. Methods The public health emergency due to the pandemic started in January 2023 and lasted for two months in Shanghai, China. A three-wave longitudinal study was conducted among 1,666 children and adolescents (6–18 years) in January, March, and July 2023. Moderate-to-vigorous intensity physical activity (MVPA), recreational screen time, and depressive symptoms were measured using self-reported questionnaires. Random-intercept cross-lagged panel models were constructed to examine the bidirectional associations between physical activity and recreational screen time with depressive symptoms. Results Children and adolescents experienced a significant decrease in MVPA and a substantial increase in recreational screen time during the pandemic, which failed to return to pre-pandemic levels post-pandemic. Pre-pandemic MVPA was negatively associated with subsequent depressive symptoms (β = -0.147). Conversely, pre-pandemic depressive symptoms were positively associated with subsequent recreational screen time (β = 0.085), which in turn predicted heightened post-pandemic depressive symptoms (β = 0.076). When stratified by age, significant associations were found in adolescents but not children. Conclusions Sustained unhealthy changes in physical activity and recreational screen time were observed during the COVID-19 pandemic among children and adolescents. This study elucidates a potential reciprocal relationship between lifestyle behaviors and mental well-being. Effective interventions are emphasized to counter the negative impacts of insufficient physical activity and excessive screen use on the mental health of children and adolescents.

IntroductionPhysical and mental health problems among pilots affect their working state and impact flight safety. Although pilots’ physical and mental health problems have become increasingly prominent, their health has not been taken seriously. This study aimed to clarify challenges and support needs related to psychological and physical health among pilots to inform development of a more scientific and comprehensive physical and mental health system for civil aviation pilots.MethodsThis qualitative study recruited pilots from nine civil aviation companies. Focus group interviews via an online conference platform were conducted in August 2022. Colaizzi analysis was used to derive themes from the data and explore pilots’ experiences, challenges, and support needs.ResultsThe main sub-themes capturing pilots’ psychological and physical health challenges were: (1) imbalance between family life and work; (2) pressure from assessment and physical examination eligibility requirements; (3) pressure from worries about being infected with COVID-19; (4) nutrition deficiency during working hours; (5) changes in eating habits because of the COVID-19 pandemic; (6) sleep deprivation; (7) occupational diseases; (8) lack of support from the company in coping with stress; (9) pilots’ yearly examination standards; (10) support with sports equipment; (11) respecting planned rest time; and (12) isolation periods.DiscussionThe interviewed pilots experienced major psychological pressure from various sources, and their physical health condition was concerning. We offer several suggestions that could be addressed to improve pilots’ physical and mental health. However, more research is needed to compare standard health measures for pilots around the world in order to improve their physical and mental health and contribute to overall aviation safety.

IntroductionCaregivers of children with autism spectrum disorder (ASD) were reported poor quality of life (QOL). Formal social support might improve the QOL of caregivers, however, limited research to date has focused on this association in China and formal social support for this group is conspicuously lacking. The study was aim to understand the QOL in male and female caregivers with ASD children in China and to explore the relationship between QOL and formal social support for caregivers with children with ASD through a large-scale nationwide survey.MethodsAn online questionnaire was used to conduct a cross-sectional study with a sample of 6,120 caregivers of children with ASD. Relationship between Quality of Life and several potential predictors is measured and analyzed. Quality of life were measured by Medical Study Short-Form Health Survey version 2 (Chinese version). Multivariate logistic regression analysis was used to analyze the factors affecting caregivers' QOL.ResultsThe results revealed that the QOL of caregivers of autistic children in China was poor especially male caregivers. Social support was a positive predictor. More importantly, formal social support from rehabilitation institutions can improve caregivers' physical QOL. Caregivers' satisfaction with the rehabilitation institutions affecting their physical and mental QOL.ConclusionThe formal social support provided by rehabilitation institutions plays a positive role in improving the quality of life of caregivers.

ObjectiveThis longitudinal study aimed to examine the association of intrinsic motivation, parental physical activity, and parental support with physical activity maintenance and increase among children and adolescents.MethodsA sample of 2,424 children and adolescents in Shanghai, China participated in the two-wave survey before and during the COVID-19 pandemic. The questionnaire measured children and adolescents’ physical activity and intrinsic motivation, as well as their parental physical activity and support (concern for their child and co-activity with their child). Multivariable logistic regressions were performed by groups to examine the associations between these factors and physical activity change.ResultsMost children and adolescents exhibited a decline in physical activity participation during the pandemic, as indicated by a mere 15.0 and 8.0% of individuals maintaining and increasing their pre-pandemic levels, respectively. Among the initially active participants, perceived self-choice [OR = 1.341 (95%CI: 1.173–1.533)] and parental concern [OR = 1.922 (95%CI: 1.204–3.068)] predicted maintained physical activity. Increased physical activity was predicted by perceived enjoyment [OR = 1.193 (95%CI: 1.046–1.362)] and parental co-activity (OR = 1.995 [95%CI: 1.095–3.633]).ConclusionThis study provides longitudinal evidence that intrinsic motivation and parental support can have a positive impact when physical activity levels change significantly. Effective interventions targeting multilevel factors are needed to maintain or increase children and adolescents’ physical activity.

In addition to the light curve and energy spectrum, polarization is also important for inferring the physical properties of the gamma-ray burst (GRB). Rotation of the polarization angle (PA) with time will cause depolarization of the time-integrated polarization degree. However, it has rarely been studied before. Here, we use a magnetic reconnection model with a large-scale ordered aligned magnetic field in the emitting region to study the influence of the parameters on the PA rotations in the GRB prompt phase. We find that the half-opening angle of the jet θ _j , the observational angle θ _V , and the bulk Lorentz factor Γ all have significant impacts on the PA rotations. The PA rotations are affected by the product value of θ _j Γ _0 (Γ _0 is the normalization factor of Γ with ${\rm{\Gamma }}{(r)={{\rm{\Gamma }}}_{0}(r/{r}_{0})}^{s}$ ), but are roughly independent of the concrete values of both θ _j and Γ _0 . For the typical parameters, the changes of the PA within T _90 (△PA) would be within (12°, 66°) for slight off-axis observations, where T _90 is the duration of the burst with the accumulated flux density ranging from 5% to 95%. The q range for △PA > 10° becomes smaller with the increase of the product value of θ _j Γ _0 . The most significant PA rotation with △PA ∼ 90° will happen when θ _j Γ _0 > 50 and 1.0 < q ≤ 1.2.

The observed abrupt twice-90° rotations of the polarization angle (PA) in the prompt phase of gamma-ray bursts (GRBs) are difficult to understand within the current one-emitting-shell models. Here, we apply a model with multiple emitting shells to solve this new challenging problem. Two configurations of large-scale ordered magnetic fields in the shells are considered: toroidal and aligned. Together with the light curves and the spectral peak energy evolutions, the twice-90° PA rotations in GRB 170114A and GRB 160821A could be well interpreted with the multishell aligned magnetic field configuration (MFC). Our numerical calculations also show that the multiple shells with the toroidal MFC could not explain the observed twice-90° PA rotations. An aligned MFC in the GRB outflow usually indicates the preference of a magnetar central engine, while a toroidal field configuration is typically related to a central black hole. Therefore, the magnetar central engines for the two GRBs are favored.

The time-integrated polarization degree (PD) in the prompt optical band of a gamma-ray burst (GRB) was predicted to be less than 20%, while the time-resolved one can reach as high as 75% in the photosphere model. Polarizations in the optical band during the GRB prompt phase have not previously been studied in the framework of the magnetic reconnection model. Here, a three-segment power law of the energy spectrum is used to reconstruct the Stokes parameters of the magnetic reconnection model. Multiwavelength light curves and polarization curves from the optical band to MeV gamma rays in the GRB prompt phase are studied. We found that, depending mainly on the jet dynamics, there is a long-lasting high-PD phase in all calculated energy bands for the typical parameter sets. The time-resolved PD could be as high as 50%, while the time-integrated one is roughly 17% in the optical band. The time-resolved PD in X-rays can reach 60% and the time-integrated one is around 30%–40%. The evolution of polarization angle (PA) is random in both optical and gamma-ray bands for the photosphere model, while it is roughly constant in the synchrotron models. Therefore, future time-resolved PA observations in the prompt optical or gamma-ray band could distinguish between the photosphere and synchrotron models.

Abstract Background We examined the prospective associations of changes in lifestyle behaviors before/during the COVID-19 pandemic, namely physical activity and screen time, with mental health. Furthermore, the impacts of physical activity and screen time on mental health during the pandemic were examined cross-sectionally. Methods A two-wave longitudinal study was conducted among 2423 children and adolescents in Shanghai, China. Lifestyle behavior variables (physical activity and screen time) and psychological variables (depressive symptoms, anxiety, and stress) were measured using a self-reported questionnaire in January and March 2020. A series of multivariable logistic regressions were performed to examine the associations between changes in lifestyle behaviors in two waves and psychological problems. The combined associations of physical activity and screen time with psychological problems were also explored using the second wave data. Results Compared to students with persistently short screen time before and during the COVID-19 pandemic, those with prolonged screen time (OR = 1·36 for depression, OR = 1·48 for anxiety) and those with persistently long screen time (OR = 1·70 for depression, OR = 2·13 for anxiety) reported a higher risk of psychological symptoms. The association between changes in physical activity and psychological symptoms was not statistically significant after adjustment for demographic factors, socioeconomic status, and screen time. During the COVID-19 pandemic, engaging in longer screen time (OR = 1·44 for depression, OR = 1·55 for anxiety) was associated with worsened psychological conditions, while engaging in increased physical activity (OR = 0·58 for depression, OR = 0·66 for anxiety) was associated with better psychological conditions. Conclusions Our study suggests that promoting physical activity and limiting leisure screen time during the COVID-19 pandemic are important to prevent and mitigate psychological problems in children and adolescents. Therefore, effective interventions targeting lifestyle behaviors are needed to protect children and adolescents’ physical and mental health.

Cardiovascular diseases (CVDs) and neurological diseases are widespread diseases with substantial rates of morbidity and mortality around the world. For the past few years, the preventive effects of Chinese herbal medicine on CVDs and neurological diseases have attracted a great deal of attention. Icariin (ICA), the main constituent of Epimedii Herba, is a flavonoid. It has been shown to provide neuroprotection, anti-tumor, anti-osteoporosis, and cardiovascular protection. The endothelial protection, anti-inflammatory, hypolipidemic, antioxidative stress, and anti-apoptosis properties of ICA can help stop the progression of CVDs and neurological diseases. Therefore, our review summarized the known mechanisms and related studies of ICA in the prevention and treatment of cardio-cerebrovascular diseases (CCVDs), to better understand its therapeutic potential.

In addition to the light curve and energy spectrum, polarization is also important for inferring the physical properties of the gamma-ray burst (GRB). Rotation of the polarization angle (PA) with time will cause depolarization of the time-integrated polarization degree. However, it has rarely been studied before. Here, we use a magnetic reconnection model with a large-scale ordered aligned magnetic field in the emitting region to study the influence of the parameters on the PA rotations in the GRB prompt phase. We find that the half-opening angle of the jet θ j , the observational angle θ V , and the bulk Lorentz factor Γ all have significant impacts on the PA rotations. The PA rotations are affected by the product value of θ j Γ0 (Γ0 is the normalization factor of Γ with Γ (r) = Γ 0 (r / r 0) s ), but are roughly independent of the concrete values of both θ j and Γ0. For the typical parameters, the changes of the PA within T 90 (△PA) would be within (12°, 66°) for slight off-axis observations, where T 90 is the duration of the burst with the accumulated flux density ranging from 5% to 95%. The q range for △PA > 10° becomes smaller with the increase of the product value of θ j Γ0. The most significant PA rotation with △PA ∼ 90° will happen when θ j Γ0 > 50 and 1.0 < q ≤ 1.2. [ABSTRACT FROM AUTHOR]

IntroductionModified Linggui Zhugan Decoction (MLZD) is a Traditional Chinese Medicine prescription developed from Linggui Zhugan Decoction (LZD) that has been used for the clinical treatment of ischemic cardiovascular diseases. However, the cardioprotective mechanism of MLZD against post-myocardial infarction (MI) ventricular remodeling remains unclear.MethodsWe explored the effects of MLZD on ventricular remodeling and their underlying mechanisms, respectively, in SD rats with MI models and in H9c2 cardiomyocytes with oxygen-glucose deprivation (OGD) models. The cardiac structure and function of rats were measured by echocardiography, HE staining, and Masson staining. Apoptosis, inflammation, mitochondrial structure and function, and sirtuin 3 (SIRT3) expression were additionally examined.ResultsMLZD treatment significantly ameliorated cardiac structure and function, and thus reversed ventricular remodeling, compared with the control. Further research showed that MLZD ameliorated mitochondrial structural disruption, protected against mitochondrial dynamics disorder, restored impaired mitochondrial function, inhibited inflammation, and thus inhibited apoptosis. Moreover, the decreased expression level of SIRT3 was enhanced after MLZD treatment. The protective effects of MLZD on SIRT3 and mitochondria, nevertheless, were blocked by 3-TYP, a selective inhibitor of SIRT3.DiscussionThese findings together revealed that MLZD could improve the ventricular remodeling of MI rats by ameliorating mitochondrial damage and its associated apoptosis, which might exert protective effects by targeting SIRT3.

Abstract Background Although approximately 50% of Chinese with type 2 diabetes mellitus (T2DM) patients have vitamin D deficiency, studies regarding vitamin D supplementation on insulin resistance (IR) have mainly focused on non-Asians. Endurance exercise training (ET) enhances insulin-mediated glucose metabolism, which plays a critical role in T2DM prevention and control. However, the combined effects of vitamin D supplementation and ET on IR in T2DM patients are unclear. The objectives of this study is to investigate the synergistic effect of vitamin D supplementation combined with exercise training intervention on IR in T2DM patients. Methods and analysis We propose a 3-month randomized controlled trial among 60 T2DM patients aged 40–65, newly diagnosed with T2DM ≤ 1 year, and with stable HbA1c level (≤ 8.0%) in the past 3 months. The participants will be randomly allocated to the vitamin D group, vitamin D combined with exercise training group, exercise training group, and control group (CG) using a computer-generated random number sequence. At baseline, participants will undergo a medical review, anthropometric measurements, dual X-ray absorptiometry, a 75-g oral glucose tolerance test (OGTT), ankle-brachial index measurements, and physical fitness measurements and will complete related lifestyle questionnaires. Fasting blood lipid and glucose levels were also measured. In a 3-month intervention period, vitamin D intervention group will receive a dose of 1000 IU daily; exercise group will perform a 1-h endurance exercise 3 times per week (maximal heart rate, 60–80%), and the control group will receive apparently identical tablets. Additionally, all participants will be advised to maintain their normal diet and physical activities during the intervention. All measurements will be repeated at 3-month follow-up after the intervention with the primary outcome measure expressed as a change from baseline in insulin sensitivity and secretion. Secondary outcome measures will compare the changes in anthropometry, ankle-brachial index, and physical fitness factors (e.g., peak oxygen uptake, hand grip strength). Data will be managed and analyzed using the Statistical Package for the Social Sciences. Discussion This is the first study to conduct a randomized trial to clearly determine the independent and combined effects of vitamin D supplementation and endurance exercise trial on IR in Chinese T2DM patients as measured by OGTT. The findings from the proposed study will not only provide new evidences that vitamin D supplementation plays an important role in IR management but also develop a simple and efficient method to improve IR-associated metabolic diseases for T2DM patients. Trial registration Chinese Clinical Trial Registry ChiCTR1800015383 , Registered on 28 March 2018

BackgroundConcerning the changes in the prevalence of neurodevelopmental disorders (NDDs), we estimate the prevalence of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), intellectual disorder (ID), and learning disability (LD) among US children and adolescents aged 3–17 years in 2019 and 2020.MethodsThe study includes 14,983 US children and adolescents aged 3–17 years in 2019 and 2020 from the National Health Interview Survey (NHIS). Parents were interviewed about whether their children ever and/or currently had NDDs diagnosed. Prevalence estimates of NDDs were calculated with a survey-based weighting scheme. Logistic regression models were used to estimate the associations between NDDs prevalence and subgroups.ResultsThe weighted prevalence of ADHD, ASD, ID, and LD was 8.5% (95% CI: 7.9–9.2%), 2.9% (95% CI: 2.6–3.4%), 1.4% (95% CI: 1.2–1.7%), and 6.4% (95% CI: 5.8–7.0%), respectively. A higher prevalence of ADHD, ASD, ID, and LD was observed in boys, those who ever had anxiety or depression symptoms, those with lower family income, those living in a rented house, ever been bullied, and ever lived with anyone mentally ill.ConclusionThe study found the prevalence of ADHD, ASD, ID, and LD was different by demographics, comorbidity/mental problems, household/parental characteristics, and stressful life events.

Cardiovascular diseases (CVDs) have been on the rise around the globe in the past few decades despite the existing guidelines for prevention and treatment. Short-chain fatty acids (SCFAs) are the main metabolites of certain colonic anaerobic bacterial fermentation in the gastrointestinal tract and have been found to be the key metabolites in the host of CVDs. Accumulating evidence suggest that the end-products of SCFAs (including acetate, propionate, and butyrate) interact with CVDs through maintaining intestinal integrity, anti-inflammation, modulating glucolipid metabolism, blood pressure, and activating gut-brain axis. Recent advances suggest a promising way to prevent and treat CVDs by controlling SCFAs. Hence, this review tends to summarize the functional roles carried out by SCFAs that are reported in CVDs studies. This review also highlights several novel therapeutic interventions for SCFAs to prevent and treat CVDs.

OBJECTIVES Proper blood lipid levels are essential for survival in older adults, but inconsistent relationships have been reported between blood lipids and all-cause mortality in the elderly. METHODS This retrospective longitudinal study analyzed data from 1,067 Chinese older adults enrolled in the Chinese Longitudinal Healthy Longevity Survey collected in 2008 and followed up until death or December 31, 2018. The outcome was all-cause mortality. Multivariate Cox regression analyses were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) with stratification by age (60-80, 80-100, or ≥100 years) for further analysis. The survival probability according to lipid profile quartiles was calculated using Kaplan-Meier curves and the log-rank test. RESULTS The participants’ mean age was 84.84 years, and 57.0% were female. In total, 578 individuals died, and 277 were lost to follow-up. The mean total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were higher among those who died than among those who survived. Participants in the second HDL-C quartile and the highest LDL-C and triglyceride (TG) quartiles had 28% higher, 23% lower, and 49% lower risks of all-cause mortality, respectively. After further adjustment, the associations remained except for HDL-C, and additional associations were observed between all-cause mortality and the third TC and LDL-C quartiles and the second TG quartile (HR, 1.44; 95% CI, 1.01 to 2.06; HR, 0.68; 95% CI, 0.49 to 0.94; HR, 0.79; 95% CI, 0.62 to 0.99, respectively). CONCLUSIONS Older adults should maintain an LDL-C level of 1.91-2.47 mmol/L and a TG level of no less than 1.66 mmol/L.

Glutamate-mediated excitotoxicity is an important mechanism leading to post ischemic stroke damage. After acute stroke, the sudden reduction in cerebral blood flow is most initially followed by ion transport protein dysfunction and disruption of ion homeostasis, which in turn leads to impaired glutamate release, reuptake, and excessive N-methyl-D-aspartate receptor (NMDAR) activation, promoting neuronal death. Despite extensive evidence from preclinical studies suggesting that excessive NMDAR stimulation during ischemic stroke is a central step in post-stroke damage, NMDAR blockers have failed to translate into clinical stroke treatment. Current treatment options for stroke are very limited, and there is therefore a great need to develop new targets for neuroprotective therapeutic agents in ischemic stroke to extend the therapeutic time window. In this review, we highlight recent findings on glutamate release, reuptake mechanisms, NMDAR and its downstream cellular signaling pathways in post-ischemic stroke damage, and review the pathological changes in each link to help develop viable new therapeutic targets. We then also summarize potential neuroprotective drugs and therapeutic approaches for these new targets in the treatment of ischemic stroke.

Aims: Pathological left ventricular (LV) remodeling induced by multiple causes often triggers fatal cardiac dysfunction, heart failure (HF), and even cardiac death. This study is aimed to investigate whether qiliqiangxin (QL) could improve LV remodeling and protect against HF via modulating gut microbiota and inhibiting nod-like receptor pyrin domain 3 (NLRP3) inflammasome activation.Methods: Rats were respectively treated with QL (100 mg/kg/day) or valsartan (1.6 mg/kg/day) by oral gavage after transverse aortic constriction or sham surgery for 13 weeks. Cardiac functions and myocardial fibrosis were assessed. In addition, gut microbial composition was assessed by 16S rDNA sequencing. Furthermore, rats’ hearts were harvested for histopathological and molecular analyses including immunohistochemistry, immunofluorescence, terminal-deoxynucleotidyl transferase-mediated 2’-deoxyuridine 5’-triphosphated nick end labeling, and Western blot.Key findings: QL treatment preserved cardiac functions including LV ejection fractions and fractional shortening and markedly improved the LV remodeling. Moreover, HF was related to the gut microbial community reorganization like a reduction in Lactobacillus, while QL reversed it. Additionally, the protein expression levels like IL-1β, TNF-α, NF-κB, and NLRP3 were decreased in the QL treatment group compared to the model one.Conclusion: QL ameliorates ventricular remodeling to some extent in rats with HF by modulating the gut microbiota and NLRP3 inflammasome, which indicates the potential therapeutic effects of QL on those who suffer from HF.