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Aim: This study aims to examine the relationship between older adults' health literacy and their psychological well‐being and the role of worry about future unmet needs for medical care in mediating this relationship. Methods: We adopted a sample of 965 older Chinese people aged 60+ (49.74% female) from the 2021 Chinese General Social Survey. A series of structural equation models (SEMs) were performed. Health literacy was measured by three items regarding older people's ability to understand medical professionals, ask them questions, and read medical instructions. A single‐item question was adopted to measure participants' worry about unmet needs for future medical care. Psychological well‐being was measured by three items regarding emotional problems and depressed or anxious mood in the past 4 weeks. Results: Worry about future unmet needs for medical care mediates the relationship between lack of health literacy and Chinese older people's psychological well‐being. The indirect effect accounts for 22.3% of the total effect. The SEM model has a satisfactory model fit (goodness of fit index = 1.000, comparative fit index = 0.999, Tucker‐Lewis index = 0.997, root mean square error of approximation = 0.009, standardized root mean square residual = 0.023, chi‐square test = 50.96, P = 0.321). Conclusions: The findings of this study underscore the importance of improving communication quality between healthcare providers and older adults. Clinical interventions that promote health literacy and address worries about unmet needs for medical services may benefit older adults. Geriatr Gerontol Int 2024; 24: 202–207. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of the aryl hydrocarbon receptor (AHR)/regulatory T cell (Treg)/T‐helper 17 (Th17) cell pathway on the pathogenesis of migraine. Background: Migraine is a disabling neurovascular disease that imposes an enormous burden on both individuals and society. The pathophysiological mechanisms of migraine remain controversial. Recent studies have suggested that immune dysfunction may be involved in the pathogenesis of migraine. The AHR, a receptor expressed on most immune cells, has been implicated in the occurrence of many autoimmune diseases; however, whether it is involved in the pathogenesis of migraine is unclear. Methods: A chronic migraine rat model was established through repeated intraperitoneal injection of nitroglycerin (NTG). The mechanical and thermal pain thresholds were assessed using von Frey filaments and radiant heat. Next, the protein expression levels of AHR in the trigeminal nucleus caudalis (TNC) region of chronic migraine (CM)‐like rats were quantified and the changes in Treg/Th17‐related transcription factors and inflammatory factors in the TNC were explored. To determine the role of AHR in CM, we examined the effects of the AHR agonist 2‐(1′‐indole‐3′‐carbonyl)‐thiazole‐4‐carboxylic acid methyl ester (ITE), and AHR antagonist CH‐223191 on pain behavior, c‐Fos, calcitonin gene‐related peptide (CGRP), AHR, and Treg/Th17‐related factor expression in CM‐like rats. Results: Repeated administration of NTG significantly enhanced nociceptive hypersensitivity and increased expression of c‐Fos and CGRP in rats, while AHR was significantly decreased in the TNC. In addition, the expression of the transcription factor forkhead box protein P3 and the signal transducer and activator of transcription 5 decreased significantly. In contrast, the expression of the transcription factor retinoic acid receptor‐related orphan receptor γ t and signal transducer and activator of transcription 3 were significantly increased. Moreover, the mRNA level of transforming growth factor beta‐1 was decreased, while that of interleukin (IL)‐10 and IL‐22 was increased in the TNC. The AHR agonist ITE alleviated migraine‐like pain behaviors in rats, activated the AHR signaling pathway, and improved the imbalance of Treg/Th17‐related transcription factors and inflammatory factors. Conversely, the AHR antagonist CH‐223191 did not alleviate migraine‐like pain behaviors in rats; and even exacerbated them. Conclusions: The AHR participates in the development of CM by regulating Treg/Th17‐related homeostasis. Therefore, treatments targeting the AHR/Treg/Th17 signaling pathway could be new effective interventions for CM treatment. [ABSTRACT FROM AUTHOR]

Background: The longitudinal associations of sleep timing and time in bed (TIB) with dementia and cognitive decline in older adults are unclear. Methods: This population‐based cohort study used data from 1982 participants who were aged ≥60 years, free of dementia, and living in rural communities in western Shandong, China. At the baseline (2014) and follow‐up (2018) examinations, sleep parameters were assessed using standard questionnaires. Cognitive function was measured using the Mini‐Mental State Examination (MMSE). Dementia was diagnosed following the DSM‐IV criteria, and the NIA‐AA criteria for Alzheimer disease (AD). Data were analyzed using restricted cubic splines, Cox proportional‐hazards models, and general linear models. Results: During the mean follow‐up of 3.7 years, dementia was diagnosed in 97 participants (68 with AD). Restricted cubic spline curves showed J‐shaped associations of sleep duration, TIB, and rise time with dementia risk, and a reverse J‐shaped association with mid‐sleep time. When sleep parameters were categorized into tertiles, the multivariable‐adjusted hazard ratio (HR) of incident dementia was 1.69 (95%CI 1.01–2.83) for baseline sleep duration >8 hours (vs. 7–8 h), 2.17 (1.22–3.87) for bedtime before 9 p.m. (vs. 10 p.m. or later), and 2.00 (1.23–3.24) for mid‐sleep time before 1 a.m. (vs. 1–1.5 a.m.). Early bedtime and mid‐sleep time were significantly associated with incident AD (HR range: 2.25–2.51; p < 0.05). Among individuals who were free of dementia at follow‐up, baseline long TIB, early bedtime and mid‐sleep time, early and late rise time, and prolonged TIB and advanced bedtime and mid‐sleep time from baseline to follow‐up were associated with a greater decline in MMSE score (p < 0.05). These associations with cognitive decline were statistically evident mainly among men or participants who were aged 60–74 years. Conclusions: Long TIB and early sleep timing are associated with an increased risk of dementia, and the associations with greater cognitive decline are evident only among older people aged 60–74 years and men. [ABSTRACT FROM AUTHOR]

Background: Sleep disturbance is common in patients with heart failure. The aims of this study were to assess the prevalence of sleep disturbance in patients with heart failure, and to examine the serial multiple mediation effects of psychological distress and sleep hygiene practices on the relationship between symptom burden and sleep quality. Methods: We recruited eligible heart failure patients in a large, university‐affiliated hospital in Shandong Province, China, from November 2018 to June 2019. The Pittsburgh Sleep Quality Index, Heart Failure Somatic Perception Scale, Hospital Anxiety and Depression Scale, and Sleep Hygiene Practice Scale were used to assess patients' sleep quality, symptom burden, psychological distress, and sleep hygiene practices. The mediation effects were analyzed using the PROCESS tool in SPSS. Results: Two hundred and thirty seven heart failure patients were included in the final analyses. Among these patients, 189 patients (67.1%) had a sleep disturbance (Pittsburgh Sleep Quality Index score of >5). Higher symptom burden, higher level of psychological distress, and poorer sleep hygiene practices were associated with patients' poorer sleep quality. The psychological distress and sleep hygiene practices had mediation effects on the relationship between symptom burden and sleep quality in patients with heart failure. Conclusions: Patients' symptom burden could affect their sleep quality through psychological distress and sleep hygiene practices besides a direct effect. Thus, psychological distress and sleep hygiene practices should be fully considered in the development of interventions to improve patients' sleep quality, apart from alleviating patients' symptom burden. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effectiveness of a professional identity promotion strategy (PIPS) on nursing students' professional identity and resilience. Methods: This study was a quasi‐experimental study with a random cluster sample of 103 sophomore undergraduate nursing students. One hundred students answered the questionnaires at both baseline and follow‐up (51 of 53 in the intervention group and 49 of 50 in the control group). Intervention and control groups underwent 5 months PIPS and standard professional education from May 2 to September 27, respectively. Participants completed the professional identity questionnaire for nursing students (PIQNS) and Connor–Davidson resilience scale (CD‐RISC). Data were collected at baseline (T0), after the intervention (T1) and 3 months after the intervention (T2), and analyzed using the Chi‐squared test, Fisher's exact test, and repeated‐measures analysis of variance. Results: There were no significant differences between the two groups (p >.05) regarding demographic questions, professional identity, or resilience at baseline (p >.05). Significant differences were found in professional identity between groups (p <.001), measurement times (p =.026), and in the interaction between groups and measurement times (p =.018) from T0 to T2. Significant differences were found in resilience between groups (p <.001), measurement times (p =.007), and in the interaction between groups and measurement times (p =.035) from T0 to T2. Conclusions: The PIPS program improved nursing students' professional identity and resilience. Further long‐term effectiveness of the program needs to be tested with implementation through various forms of mobile technology. [ABSTRACT FROM AUTHOR]

Anxiety and depression are common mental illnesses among nurses fighting coronavirus disease 2019 (COVID‐19). However, the precise factors that affect anxiety and depression in this population require further evaluation. This study aimed to explore factors associated with anxiety and depression among nurses fighting COVID‐19 in China. We used convenience sampling to recruit 282 nurses fighting COVID‐19 in three hospitals. Participants were questioned about demographic characteristics, daily working time, daily sleep duration, sleep quality, anxiety, depression, resilience, and coping styles. Linear regression analysis indicated that resilience (β = −0.217, P < 0.001), positive coping style (β = −0.281, P < 0.001), negative coping style (β = 0.395, P < 0.001), and sleep quality (β = 0.153, P = 0.010) were predictive factors for anxiety, and the model explained 44.20% (P < 0.001) of variability. Resilience (β = −0.239, P < 0.001), positive coping style (β = −0.222, P < 0.001), negative coping style (β = 0.152, P < 0.001), and sleep quality (β = 0.104, P = 0.003) were identified as explanatory factors for depression, and the model explained 34.50% (P < 0.001) of variability. The present study suggested that resilience, coping styles, and sleep quality could account for an individual's levels of anxiety and depression. [ABSTRACT FROM AUTHOR]

In spite of the potentials promised by MOOCs (massive open online courses), the adoption rate of MOOCs is still low, especially in developing countries. Research on the adoption of MOOCs in developing countries is also limited. To fill this research gap, this research aims to study the adoption of MOOCs by extending current research on innovation and technology adoption in order to promote the diffusion of MOOCs in developing countries. Here, a conceptual framework, technology–user–environment was proposed to identify influential drivers and barriers of MOOC adoption. Eight hundred and twenty‐seven individuals in a developing country, were invited to participate in a questionnaire survey. Data were analysed by hierarchical regression, and the results show that for the (a) technological characteristics, perceived usefulness has the most significant influence, followed by lack of accessibility and performance‐to‐cost value; for the (b)user factors, self‐regulation was the most significant predictor of MOOC adoption, and female learners showed higher willingness to adopt MOOCs; and for the (c) social environmental factors, tradition and social norms and lack of information about MOOCs were negatively associated with adoption of MOOCs. Implications and suggestions are discussed at the end of this paper. Lay Description: What is already known about this topic: MOOCs (massive open online courses), as educational innovations, are supposed to bridge the digital divide and promote educational equity globally.The benefits of MOOCs for learners are obvious.However, the adoption rate of MOOCs is still relatively low while the dropout rate is high, especially in developing countries.Research on the adoption of MOOCs in developing countries is still limited.What this paper adds: This research proposed a conceptual framework, namely, technology–user–environment, in order to identify influential drivers and barriers from the technological characteristics of MOOCs as well as the user and the social environmental factors.After conducting a survey among 827 learners in a developing country, it was found that perceived usefulness of MOOCs, performance‐to‐cost value, and self‐regulation are positively associated with learners' intention of adopting MOOCs, whereas lack of accessibility tradition and social norms and lack of supporting information are negatively associated with their intention of MOOC adoption.Implications for practice and/or policy: For MOOC content provider, it is necessary to enhance the usefulness of MOOCs, as perceived usefulness is ranked as the strongest predictor of MOOC adoption.Universities in developing countries should help students overcome the potential obstacles at the beginning of MOOC learning by providing instructions to learners to search for course materials and how to use MOOCs to supplement their formal learning.Governments of developing countries are encouraged to be involved and support the development and delivery as well as the usage of MOOCs. Such participation by active stakeholders in developing countries has potential to bridge the digital divide between developed and developing countries.For learners, they should be equipped with self‐regulating strategies so that they will be competent to manage challenges (e.g., distractions) while learning in MOOCs. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to evaluate the correlation between calcium‐binding protein S100A8 and S100A9 expression in non‐small cell lung cancer (NSCLC) and patients’ clinical features. Methods: Fifty‐two NSCLC patients who underwent surgery at Zhejiang Hospital from February 2014 to January 2016 were included in this study. Calcium‐binding protein S100A8 and S100A9 expression patterns in cancer and para‐cancer tissues were examined by immunohistochemistry assay. The correlation between calcium‐binding protein S100A8 and S100A9 expression patterns and NSCLC patients’ clinical characteristics, including age, gender, tumor node metastasis stage, and pathology type, were evaluated. Results: S100A8 and S100A9 were generally expressed on the cytoplasm and nucleus of NSCLC cells, mainly located in the cytoplasm, stained with brown particles, and distributed evenly. The positive expression rates of S100A8 and S100A9 in cancer tissues were 71.2% and 76.9%, respectively, which were significantly higher than in para‐cancer tissues at 11.5% and 19.2%, respectively, with statistical significance (P < 0.05). S100A8 and S100A9 positive expression was associated with tumor differentiation degree (P < 0.05) but were not correlated with age, gender, smoking history, tumor diameter, pathology type, tumor node metastasis stage, or pleural effusion (Pall > 0.05). Conclusion: S100A8 and S100A9 positive expression in cancer tissues was significantly higher than in para‐cancer tissues and was correlated with tumor differentiation, which may be a potential marker for poor prognosis. [ABSTRACT FROM AUTHOR]

Background China has the world's highest diabetes prevalence, which along with hypertension and inflammation continues to grow particularly among children. Little is known about the strength of the association of these cardiometabolic risk factors between parents and their children; thus, the potential of household-based strategies to reduce risk is unknown. Objectives The objective of the study is to examine the parent-child association for haemoglobin A1c (HbA1c), blood pressure (BP) and C-reactive protein (CRP) in a large, geographically diverse Chinese sample. Methods In 940 parent-child pairs (children aged 7-17 years) who participated in the 2009 China Health and Nutrition Survey, we measured each individual's HbA1c and CRP using fasting blood and BP. We used sex-specific random-effects linear regression to examine the parent-child association for these risk factors, accounting for within-family clustering. Results Child's HbA1c was positively associated with parental HbA1c. Beta coefficients ranged from 0.06 (95% CI 0.03-0.12) for father-daughter to 0.43 (95% CI 0.28-0.58) for mother-son pairs. We also detected a positive mother-daughter association for BP and positive father-child associations for CRP. Conclusion The statistically significant parent-child association for HbA1c, BP and CRP in Chinese families suggests that household-based interventions could be useful for confronting the high rates of diabetes, hypertension and inflammation in China. [ABSTRACT FROM AUTHOR]

Previous studies have explored the set points of the positivity ratio by grouping according to predetermined cut-off scores, resulting in inconsistent criteria and unstable results. This study intends to further explore the set points of the positivity ratio using latent profile analysis. Two samples of 716 college students and 381 adults in China completed the Questionnaire for Eudaimonic Well-Being, the Personal Growth Subscale from Ryff's Psychological Well-being Scale, the Need Satisfaction Questionnaire, and the Emotional Experience of Well-Being Questionnaire. College students were classified into four classes (2.0, 2.8, 3.7 and 5.0) with the set points of the positivity ratio, whereas adults were classified into three classes (1.9, 2.9 and 4.2) with the set points of the positivity ratio. The difference of the set points between college students and adults was nonsignificant for medium and high well-being classes, and significant with a small effect size for the higher well-being class. Future research should examine more diverse samples and combine the real experience method to further explore the set points of the positivity ratio. [ABSTRACT FROM AUTHOR]

Background Being small for gestational age ( SGA), a foetal growth abnormality, has a long-lasting impact on childhood health. Its aetiology and underlying mechanisms are not well understood. Underlying epigenetic changes of imprinted genes have emerged as a potential pathological pathway because they may be associated with growth, including SGA. As a common methyl donor, folic acid ( FA) is essential for DNA methylation, synthesis and repair, and FA supplementation is widely recommended for women planning pregnancy. The present study aimed to investigate the inter-relationships among methylation levels of two imprinted genes [ H19 differentially methylated regions ( DMRs) and MEST DMRs], maternal FA supplementation and SGA. Methods We conducted a case-control study. Umbilical cord blood was taken from 39 SGA infants and 49 controls whose birth weights are appropriate for gestational age ( AGA). DNA methylation levels of H19 and MEST DMRs were determined by an analysis of mass array quantitative methylation. Results Statistically significantly higher methylation levels were observed at sites 7.8, 9 and 17.18 of H19 ( P = 0.030, 0.016 and 0.050, respectively) in the SGA infants compared to the AGA group. In addition, the association was stronger in male births where the mothers took FA around conception at six H19 sites ( P = 0.004, 0.005, 0.048, 0.002, 0.021 and 0.005, respectively). Conclusions Methylation levels at H19 DMRs were higher in SGA infants compared to AGA controls. It appears that the association may be influenced by maternal peri-conception FA supplementation and also be sex-specific. [ABSTRACT FROM AUTHOR]

Aim To assess the associations of oral hygiene and periodontal health with chronic obstructive pulmonary disease ( COPD) exacerbations. Material and Methods In total, 392 COPD patients were divided into frequent and infrequent exacerbation (≥2 times and <2 times in last 12 months) groups. Their lung function and periodontal status were examined. Information on oral hygiene behaviours was obtained by interview. Results In the univariate analysis, fewer remaining teeth, high plaque index ( PLI) scores, low tooth brushing times, and low regular supra-gingival scaling were significantly associated with COPD exacerbations (all p-values <0.05). After adjustment for age, gender, body mass index, COPD severity and dyspnoea severity, the associations with fewer remaining teeth ( p = 0.02), high PLI scores ( p = 0.02) and low tooth brushing times ( p = 0.008) remained statistically significant. When stratified by smoking, fewer remaining teeth ( OR = 2.05, 95% CI: 1.04-4.02) and low tooth brushing times ( OR = 4.90, 95% CI: 1.26-19.1) among past smokers and high PLI scores ( OR = 3.43, 95% CI: 1.19-9.94) among never smokers were significantly associated with COPD exacerbations. Conclusions Fewer remaining teeth, high PLI scores, and low tooth brushing times are significant correlates of COPD exacerbations, indicating that improving periodontal health and oral hygiene may be a potentially preventive strategy against COPD exacerbations. [ABSTRACT FROM AUTHOR]

Aim: A new subset of CD4+ T cells, Th17, has been recently discovered independent from Th1/Th2 paradigm. The aim of this study was to investigate the effects of nonsurgical periodontal therapy on the expression of Th17/Th1/Th2 cytokines and transcription factors, and Th17 cell vibration in Chinese chronic periodontitis patients. Materials and methods: The levels of Th17/Th1/Th2 cytokines (IL-17, IL-21/IFN-γ/ IL-4) in gingival crevicular fluid from 30 chronic periodontitis patients before and after treatment were determined by ELISA. The expression of transcription factors (RORC, T-bet and GATA-3) in peripheral blood was measured by real-time PCR, and the levels of Th17 cells in CD41 T cells were determined by flow cytometry. Results: After treatment, the levels of IL-17 and IL-21were down-regulated (P<0.05), and IL-4 was increased (P<0.05), but there were no differences in the level of IFN-γ (P<0.05). Correspondingly, the expression of RORC was decreased 1.99-fold (P<0.05), and GATA-3 was increased 1.76-fold (P<0.05). However, there were no differences in the level of T-bet (P>0.05). Moreover, the quantity of Th17 cells in peripheral blood was decreased (P<0.05), especially IL-17+IFN-γ+ subgroup. Conclusions: These results suggest that Th17 cells play a destructive role in the immune balance of periodontitis, and the effect of Th1 cells is not significant, while Th2 cells have a protective effect. [ABSTRACT FROM AUTHOR]

Li F, Liu X, Zhang L, Shen L, Chen J. Bonding efficiency of contemporary adhesives to the dentinoenamel junction zone. Eur J Oral Sci 2011; 119: 232-240. © 2011 Eur J Oral Sci The aim of this study was to investigate the bonding of dental adhesives to the dentinoenamel junction (DEJ) zone. Bonding of four adhesives [two etch-and-rinse adhesives (ERAs) and two self-etching adhesives (SEAs)] to enamel, dentin, and the DEJ zone was evaluated using a micro-shear test. Based on the measured bond strengths of dentin/enamel and on the area percentages of dentin in the DEJ zone, predicted bond strengths for the DEJ zone were calculated and compared with those measured. The DEJ zone was analyzed, using scanning electron microscopy, after conditioning, resin infiltration, and debonding. Regardless of the adhesive, bond strengths were significantly influenced by substrates, exhibiting the following order of bond strength (strongest to weakest): dentin > DEJ zone > enamel. The predicted values of the DEJ zone for the ERA groups were significantly higher than the measured values. Analysis of the ERA specimens using scanning electron microscopy showed distinct etching textures of enamel and dentin, which outlined the DEJ and increased the adhesive thickness at the enamel side of the DEJ. Those characteristics could not be detected in the SEA groups. The DEJ zone displayed bond properties that were stronger than enamel but weaker than dentin and therefore may be considered as transitional bond properties. Enamel/dentin within the DEJ zone might bond more weakly to ERAs than its counterpart of the bulk tissue. The presence of the DEJ in the bond area might compromise the bonding efficiency of ERAs. [ABSTRACT FROM AUTHOR]

Oral Diseases (2011) , 270-276 Coronary heart disease (CHD) and chronic periodontitis (CP) both are multifactorial chronic diseases and related to inflammation. Interleukin-6 (IL-6) plays an important role in the pathogenesis of inflammatory diseases. The purpose of the study was to investigate the association among IL-6 gene polymorphisms, CP and CHD susceptibility in a Chinese population. The investigation was conducted as a case-control study involving 505 individuals: 113 patients with CHD and CP, 84 patients with CHD, 178 patients with CP and 130 control individuals. The polymorphisms of IL-6 gene were analyzed by polymerase chain reaction-restriction fragment length polymorphism. Relationships between the distributions of the genotypes and risk factors were also assessed. Mutations at the loci -174 G/C, -597 G/A of IL-6 were rare in a Chinese population. No significant difference for IL-6-572C/G polymorphism was detected among moderate CP group, severe CP group and control ( P = 0.312 and 0.481), significant differences were found between CHD groups and non-CHD groups ( P ≤ 0.001). After adjustment for CHD risk factors, the G allele resulted in an increased risk (OR = 1.676-1.856), the GG/CG genotype was nearly two times higher risk compared to CC genotype (OR = 2.010-2.136). IL-6-572C/G polymorphism did not correlate with CP susceptibility, but might be a potential risk factor for CHD in a Chinese population. [ABSTRACT FROM AUTHOR]