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AIM: This study aims to identify the key risk factors that lead to subtypes of physical frailty assessed by walking speed and grip strength among community-dwelling Japanese individuals, stratified by the presence of musculoskeletal diseases (MSDs) and age group. METHODS: We included 302 participants aged 70 or 80 years who did not exhibit subtypes of physical frailty at baseline through the Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians (SONIC) study. Our study was a longitudinal study. The outcome was the incidence of subtypes of physical frailty after 3 years. Subtypes of physical frailty were defined as a weak grip strength or slow walking speed, or both, based on the Japanese version of the Cardiovascular Health Study Index. The risk factors for subtypes of physical frailty incidence were examined by age group and MSD, using multivariate logistic regressions. RESULTS: Of the 302 participants, 110 (36.4%) had MSD. Those with MSD were significantly more likely to have subtypes of physical frailty after 3 years compared with those without MSD. Among all participants, older age was a risk factor of subtypes of physical frailty (P

BACKGROUND: Different job strain formulations based on the Job Demand-Control model have been developed. This study evaluated longitudinal associations between job strain and psychological distress and whether associations were influenced by six formulations of job strain, including quadrant (original and simplified), subtraction, quotient, logarithm quotient, and quartile based on quotient, in randomly selected Japanese workers. METHODS: Data were from waves I and II of the Survey of Midlife in Japan (MIDJA), with a 4-year follow-up period. The study sample consisted of 412 participants working at baseline and had complete data on variables of interest. Associations between job strain at baseline and psychological distress at follow-up were assessed via multivariable linear regression, and results were expressed as β coefficients and 95% confidence intervals including R2 and Akaike information criterion (AIC) evaluation. RESULTS: Crude models revealed that job strain formulations explained 6.93-10.30% of variance. The AIC ranged from 1475.87 to 1489.12. After accounting for sociodemographic and behavioral factors and psychological distress at baseline, fully-adjusted models indicated significant associations between all job strain formulations at baseline and psychological distress at follow-up: original quadrant (β: 1.16, 95% CI: 0.12, 2.21), simplified quadrant (β: 1.01, 95% CI: 0.18, 1.85), subtraction (β: 0.39, 95% CI: 0.09, 0.70), quotient (β: 0.37, 95% CI: 0.08, 0.67), logarithm quotient (β: 0.42, 95% CI: 0.12, 0.72), and quartile based on quotient (β: 1.22, 95% CI: 0.36, 2.08). CONCLUSION: Six job strain formulations showed robust predictive power regarding psychological distress over 4 years among Japanese workers.

BACKGROUND: Food insecurity and metabolic diseases both disproportionately affect Hispanic children. Cross-sectional studies have linked food insecurity with adverse cardiometabolic markers, including elevated plasma triglycerides and glucose concentrations. However, the association between changes in food insecurity and changes in cardiometabolic markers in children remains to be explored. Furthermore, few studies have assessed the impact of school-based nutrition interventions on household food insecurity. OBJECTIVE: The objectives of this study are to assess the effect of the TX Sprouts intervention on household food insecurity and to examine the association between changes in household food insecurity and changes in cardiometabolic markers over 1 academic year. METHODS: This secondary analysis used data from TX Sprouts, a cluster-randomized school-based gardening, cooking, and nutrition trial. The study enrolled 3rd-5th-grade students from 16 schools that served primarily (>50%) Hispanic families with low income in Austin, TX. Participants (n = 619) provided household food insecurity data and fasting lipid panels at both baseline and postintervention, ∼9 mo following. RESULTS: There was no intervention effect on household food insecurity. Independent of the intervention, a 1-point increase in food insecurity, indicative of becoming more food insecure, was associated with a 2.61 mg/dL increase in triglycerides (P = 0.001; 95% CI: 1.04, 4.19) at follow-up. Children who were food insecure at baseline and became food secure at follow-up had a mean 5.05 mg/dL decrease in triglycerides compared with a 7.50 mg/dL increase in triglycerides in children who remained food insecure throughout (95% CI: -23.40, -1.71, P = 0.023). There were no other associations between changes in food insecurity and cardiometabolic markers. CONCLUSION: Although the intervention did not improve food insecurity, reductions in food insecurity over 9 mo were associated with improved cardiometabolic markers in high-risk children, emphasizing the need for interventions targeting food insecurity. The study is registered at clinicaltrials.gov under NCT02668744 (https://classic. CLINICALTRIALS: gov/ct2/show/NCT02668744).

Background: The COVID-19 pandemic's "Great Online Transition" significantly impacted teachers. Existing research on Emergency Remote Teaching (ERT) lacks longitudinal designs and consideration of subject-specific contexts. This study, using the Stressor-Strain-Outcome framework, investigates psychological needs thwarting (PNT) during ERT on teachers' well-being and online teaching intentions, considering subject of instruction as a potential factor. Methods: Data were collected from 1,369 Chinese primary and middle school teachers of Chinese literature, mathematics, and English as a Foreign Language (EFL) at two time points: two weeks after ERT implementation (Time 1, mid-November 2021) and two months later, after returning to face-to-face teaching (Time 2, mid-January 2022). PNT, emotional exhaustion, psychological distress, and intention towards online teaching were evaluated. Results: Among the types of PNT, competence thwarting emerged as the strongest predictor of emotional exhaustion, which was, in turn, associated with reduced online teaching intention and increased psychological distress. EFL teachers showed stronger associations between PNT, emotional exhaustion, and adverse outcomes, indicating higher susceptibility to strain during ERT. Conclusion: Subject of instruction, particularly for EFL teachers, significantly influences the relationship between PNT and teacher outcomes during ERT. Our findings underscore the need for subject-specific support strategies in online teaching environments. [ABSTRACT FROM AUTHOR]

This study examined the modifying effects of surgery status on the association between the Standard Deviation of NN Intervals (SDNN) of the heart rate variability and the post-traumatic stress disorder (PTSD) development. Participants with physical injury were recruited from a trauma center and followed for two years. Baseline assessment included SDNN and surgery status. Socio-demographic and clinical covariates were collected. PTSD was diagnosed at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5. Logistic regression analyses were performed. Among 538 participants, 58 (10.8%) developed PTSD during the study, with prevalence rates of 8.4% at 3 months, 6.5% at 6 months, 4.7% at 12 months, and 2.5% at 24 months. A significant modifying effect was found that lower SDNN were significantly associated with PTSD in non-surgical patients but not in surgical patients, with significant interaction terms. This pattern was observed from 3 to 12 months but not at 24 months. Surgery-dependent associations between SDNN and PTSD development were observed, highlighting the need for tailored PTSD prevention strategies considering SDNN and surgery status. [ABSTRACT FROM AUTHOR]

Background: The cardiometabolic index (CMI) has emerged as a novel marker for evaluating the distribution and dysfunction of visceral adipose tissue, yet its correlation with numerous diseases, particularly new-onset chronic conditions, remains underexplored. Therefore, we aim to explore the association of cardiometabolic index (CMI) and new-onset chronic diseases. Methods: The analysis utilized data from the China Health and Retirement Longitudinal Study, with a baseline in 2011 and follow-ups biennially until 2020. Fourteen new-onset chronic diseases were diagnosed based on self-report, and separate cohorts were created for each disease. CMI was calculated as triglycerides/ high-density lipoprotein cholesterol multiplied by the waist-to-height ratio. Cox proportional hazards models were used to assess the association between CMI and new-onset chronic diseases, while restricted cubic spline (RCS) models were employed to explore potential nonlinear effects. Additional and sensitivity analyses included Kaplan-Meier survival curves, subgroup analyses, multiple imputations, and exclude outcome events at the first follow-up. Results: Higher levels of CMI were associated with an increased risk of new-onset hypertension (HR=1.05, 95% CI=1.04-1.06, P<0.001), diabetes (HR=1.08, 95% CI=1.06-1.09, P<0.001), dyslipidemia (HR=1.07, 95% CI=1.06-1.09, P<0.001), liver disease (HR=1.05, 95% CI=1.03-1.07, P<0.003), and stroke (HR=1.04, 95% CI=1.02- 1.06, P<0.001), although the association with stroke was not significant after adjusting for confounders (HR=1.02, 95% CI=1.00-1.05, P=0.054). Participants in the highest quartile of CMI had a significantly higher risk of these diseases compared to those in the lowest quartile. RCS analyses showed a significant nonlinear relationship between CMI and the risk of these diseases above. Conclusions: CMI showed a significant positive association with the risk of new- onset chronic diseases such as hypertension, diabetes, dyslipidemia, and liver disease. Future applications of CMI hold promise as an effective marker for early identification of chronic disease risk. [ABSTRACT FROM AUTHOR]

Purpose: The longitudinal association between changes in depressive symptoms (improvement/worsening) and arthritis is unclear. Methods: Study data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) 2011–2018. The 10-item Center for Epidemiological Studies Depression Scale (CES-D-10) was used to examine participant depressive symptoms and data on self-reported history of arthritis were collected. Depressive symptoms improving is defined as depression at baseline and no depression at follow-up. Similarly, depressive symptoms worsening is defined as no depression at baseline and depression at follow-up. Cox proportional hazards models were used to evaluate the effects of improvement or deterioration in depressive symptoms on arthritis. Participants with missing data on depression and arthritis, having arthritis in 2011 CHARLS and lost to follow-up was excluded. Results: A total of 8556 participants free of arthritis were included from 2011 to 2018. After adjustment for confounders, depressive symptoms were associated with a 54% increased risk of developing arthritis. Each 1-point increase in CES-D-10 score was associated with a 4% higher risk of arthritis. Participants with depressive symptoms at baseline but improved symptoms (without depressive symptoms) at follow-up had a 25% lower rate of arthritis, and a 1-point reduction in CES-D-10 score during 8 years of follow-up was associated with a 5% lower risk of developing arthritis. Participants with no depressive symptoms at baseline but depression at follow-up had a 66% higher rate of arthritis, and a 1-point increase in CES-D-10 score during 8 years of follow-up was associated with a 5% higher risk of arthritis. Conclusions: Improvement in depressive symptoms was associated with lower risk of arthritis and worsening of depression was associated with higher risk of arthritis. These findings suggest that the relationship between depression and arthritis is complex. [ABSTRACT FROM AUTHOR]

The association between knee osteoarthritis (OA) and miRNAs has been widely reported. However, the utility of miRNAs as predictors of knee osteoarthritis (KOA) progression in longitudinal studies has not been reported. We aimed to identify circulating miRNAs (c-miRNAs) associated with KOA progression in the general population and to examine their potential use as predictors of KOA progression. In 2012 and 2018, 66 participants (128 knees) took part in a resident health check-up in the Yakumo study. If the KL classification progressed two or more levels, the patient was classified as having progressive OA. Quantitative real-time polymerase chain reaction was used to screen 21 c-miRNAs. The expression levels of those c-miRNAs were compared between the progressive OA group and non-progressive OA group using student-t-test. Logistic analysis was performed in c-miRNAs less than p < 0.10 in univariate analysis. The progressive OA group consisted of 78 knees. The results of the comparison between the progressive OA group and the non-progressive OA group showed that six c-miRNAs as follows; let7d (p = 0.030), c-miRNA-122 (p < 0.001), 150 (p = 0.070), 199 (p = 0.078), 21 (p = 0.016) and 320 (p = 0.093) were extracted as factors related to the progression of knee OA. In addition, logistic regression analysis identified c-miRNA-122 as an independent factor involved in the progression of knee osteoarthritis (odds ratio: 1.510, 95% confidence interval: 1.060–2.140, p = 0.023). The ROC curve showed by c-miRNA-122 for the progression of OA risk had an area under the curve of 0.702 (95% CI: 0.609–0.795). The threshold of c-miRNA-122 was −4.609. The expression level of c-miRNA-122 was associated with the risk of KOA progression in community dwelling Japanese people. [ABSTRACT FROM AUTHOR]

Background: Few studies have longitudinally assessed the determinants of depressive symptoms among persons 80 years and older. The aim of this study was to estimate the determinants of depressive symptoms among persons 80 years and older based on 4-wave national longitudinal data from Thailand. Methods: Data from the Health, Aging, and Retirement in Thailand study from 2015, 2017, 2020 and 2022 were utilized. The sample was restricted to community-dwelling persons 80 years and older (analytic sample: n = 2763 observations). For the pooled sample, average age was 85.0 years (range 80–117 years). Established measurements were used to assess depressive symptoms. Linear fixed effects regression was applied to assess the time-variant determinants and outcomes. Results: Regressions found that higher functional disability and an increase in the number of chronic conditions worsened depressive symptoms. More favourable self-rated physical health, and higher exercise frequency improved depressive symptoms. In addition, among women higher subjective economic status decreased depressive symptoms. Conclusions: This longitudinal study enhances our understanding of the determinants of depressive symptoms among persons 80 years and older. Strategies to delay or decrease functional disability, chronic conditions, increase physical activity, and improve subjective economic status may help in reducing depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Greenspace is an important modifiable environmental factor that is associated with health and well-being. Although previous research has shown that exposure to greenspace is beneficial for cardiovascular diseases, studies have rarely focused on early subclinical health outcomes such as electrocardiogram (ECG) abnormality. Methods: We developed a longitudinal study using data from the China National Stroke Screening Survey (2013–2019). Monthly exposure to greenspace was assessed by the Normalized Difference Vegetation Index (NDVI) values. ECG abnormality was diagnosed by physicians based on the results of the 12-lead electrocardiogram. We used fixed-effects logistic regression with participant-specific intercepts to estimate the association between exposure to greenspace and ECG abnormalities. Results: A total of 132,108 visits from 61,029 participants with ≥ 2 ECG measurements were included. At baseline, the lag-1 month average NDVI value was 0.29 (SD = 0.15). In the fully adjusted model, per 0.1-unit increment in lag-1 month average NDVI value was associated with a 3.0% (95% CI -1.6 ∼ 7.4%) decreased risk of ECG abnormality. In urban areas, the decreased risk associated with per 0.1-unit increment in NDVI was 14.81% (95% CI 9.38 ∼ 19.92%). Conclusion: Our study found that higher exposure to greenspace was associated with a decreased risk of ECG abnormality, especially in urban areas. Our findings suggested that monthly exposure to greenspace might be beneficial to cardiovascular health, and greenspace provision and maintenance could be considered an important public health intervention in urban planning. [ABSTRACT FROM AUTHOR]

The usage of smart glasses in goods logistics and order picking has mainly been studied through cross-sectional experimental studies. Our longitudinal field study investigated the effects of smart glasses on the eyesight of 43 employees at two German companies. We combined ophthalmological examinations and questionnaire surveys at two points in time, six months apart. The vision of the employees was examined before and after each work shift. Mixed effects logistic regression was conducted to determine the associations between smart glasses use and effects on visual acuity. In the baseline examination, differences in eyesight before and after shifts were small and not statistically significant. However, some individuals experienced deteriorations, especially in visual acuity at near distances (n = 7 for the right eye, n = 6 for the left). Participants over 40 years of age had 16.1 times higher odds of deterioration compared to those under 40 years (95% CI: 2.7–95.9, p = 0.002). The most commonly reported eye strains were eye fatigue (n = 32), rubbing (n = 25), and burning (n = 24). If smart glasses are to be implemented in logistics companies, it is recommended to offer employees eye tests with an industrial physician in advance. [ABSTRACT FROM AUTHOR]

Background: While dehydration is associated with pediatric renal impairment, the regulation of hydration status can be affected by sleep. However, the interaction of hydration and sleep on kidney health remains unclear. Methods: We conducted a cohort study among 1914 healthy primary school children from October 2018 to November 2019 in Beijing, China. Four-wave urinary β2-microglobulin and microalbumin excretion were assayed to assess transient renal tubular and glomerular impairment, and specific gravity was measured to determine hydration status with contemporaneous assessment of sleep duration, other anthropometric, and lifestyle covariates. We used generalized linear mixed-effects models to assess longitudinal associations of sleep duration and hydration status with renal impairment. Results: We observed 1378 children with optimal sleep (9–<11 h/d, 72.0%), 472 with short sleep (<9 h/d), and 64 with long sleep (≥11 h/d, 3.3%). Over half (55.4%) of events determined across 6968 person-visits were transient dehydration, 19.4% were tubular, and 4.9% were glomerular impairment events. Taking optimal sleep + euhydration as the reference, the results of generalized linear mixed-effects models showed that children with long sleep + dehydration (odds ratio [OR]: 3.87 for tubular impairment [tubules] and 3.47 for glomerular impairment [glomerulus]), long sleep + euhydration (OR: 2.43 for tubules), optimal sleep + dehydration (OR: 2.35 for tubules and 3.00 for glomerulus), short sleep + dehydration (OR: 2.07 for tubules and 2.69 for glomerulus), or short sleep + euhydration (OR: 1.29 for tubules) were more likely to present transient renal impairment, adjusting for sex, age, body mass index z-score, systolic blood pressure z-score, screen time, physical activity, and Mediterranean diet adherence. Conclusions: Dehydration and suboptimal sleep aggravate transient renal impairment in children, suggesting its role in maintaining pediatric kidney health. [ABSTRACT FROM AUTHOR]

Background: Edentulism is considered the ultimate sign of oral health disease burden. It is a common and frequent clinical disease, mostly seen in the elderly, which has been reported to be closely associated with many diseases. While physical activity is known to benefit many chronic diseases, the relationship between the volume of physical activity and edentulism remains unclear. Materials and methods: The CHARLS provided the data for this study. A total of 6,480 participants were enrolled in this study, of whom 46.02% were male and 53.98% were female. The edentulism was defined according to self-report and physical activity volume can be represented by metabolic equivalents. Multiple logistic regression, smooth curve fitting, threshold effects analysis, and Cox regression models were used to explore the relationship between physical activity volume and edentulism. Results: In the fully adjusted model, physically active participants had a 24% lower risk of edentulism compared to those who were physically inactive. Then, we subdivided participants with adequate physical activity into four levels: 600 ≤ PAV < 1200; 1200 ≤ PAV < 1800; 1800 ≤ PAV < 3000; and PAV ≥ 3000. We found that the risk of developing edentulism was lowest and statistically significant at the level of 1,800-3,000 MET-minutes/week physical activity volume (OR = 0.41; 95% CI, 0.24–0.69, p < 0.001). A U-shaped relationship between physical activity volume and edentulism with an inflection point of 2514 (MET-minutes/week) was observed. The results of the longitudinal study also confirm the benefits of physical activity volume with edentulism, participants with adequate physical activity volume had a 21% lower risk of developing edentulism than participants with inadequate physical activity volume (HR = 0.79; 95% CI, 0.67–0.94, p = 0.008). Conclusions: This study reveals a U-shaped relationship between physical activity volume and edentulism. Physical activity reduces the risk of developing edentulism in middle-aged and older populations, but it is important to control the appropriate volume of physical activity. [ABSTRACT FROM AUTHOR]

Background: Very few studies to date investigated the prospective association of changes in exposure to the food environment with cardiovascular disease (CVD) risk. We aim to explore if time-varying exposure to the food environment was associated with hospitalization and mortality due to total and specific types of CVD in The Netherlands. Methods: In this prospective cohort study, 4,641,435 Dutch adults aged 35 + years who did not change residence in 2002–2018 were identified through registry data. Exposure to the food environment was defined as time-varying Food Environment Healthiness Index (FEHI) scores (range: − 5 to 5) and time-varying kernel density of specific food retailers (e.g., fast food outlets, supermarkets) around the home location between 2004 and 2018. The main outcome measures were hospitalization and mortality due to overall CVD, stroke, HF, and CHD occurring between 2004 and 2020, based on hospital and death registries. Results: In Cox regression models, each unit increase in the FEHI was associated with a lower hospitalization and mortality of CVD (hospitalization hazard ratio (HRh) = 0.90 (0.89 to 0.91), mortality hazard ratio (HRm) = 0.85 (0.82 to 0.89)), CHD (HRh = 0.88 (0.85 to 0.91), HRm = 0.80 (0.75 to 0.86)), stroke (HRh = 0.89 (0.84 to 0.93)), HRm = 0.89 (0.82 to 0.98)), and HF (HRh = 0.90 (0.84–0.96), HRm = 0.84 (0.76 to 0.92)). Increased density of local food shops, fast food outlets, supermarkets, and convenience stores and decreased density of food delivery outlets and restaurants were associated with a higher risk of CVD, CHD, stroke, and HF hospitalization and mortality. Conclusions: In this observational longitudinal study, changes in exposure to a healthier food environment over 14 years were associated with a risk reduction in CVD hospitalization and mortality, in particular in urbanized areas and for younger adults and those with higher incomes. [ABSTRACT FROM AUTHOR]

Mathematical performance, a competitive edge for children, has received ample attention from stakeholders, especially from parents. However, the association between parenting style and children's mathematics performance remains open to debate, and longitudinal studies are lacking. Therefore, this study used longitudinal data from four waves of surveys (2012, 2014, 2016, and 2018), with an initial sample of 1042 children (51.5% girls) aged 11, 13, and 15 years. Positive associations between supportive parenting style and higher mathematics scores were observed across all waves, both in unadjusted and adjusted generalized linear regression models, with all p < 0.05. Even after running five sets of sensitivity analyses (e.g., controlling counting skills in toddlerhood, imputing key covariates), the positive association remained robust. Ultimately, we found that supportive parenting style was positively associated with improved mathematical performance in adolescents measured up to six years later. This finding underscores the importance of supportive parenting in enhancing adolescents' mathematical performance and suggests that integrating supportive parenting strategies into family-based approaches may effectively improve children's mathematical achievements. [ABSTRACT FROM AUTHOR]

The prevalence of osteoporosis has drastically increased recently. It is not only the most frequent but is also a major global public health problem due to its high morbidity. There are many risk factors associated with osteoporosis were identified. However, most studies have used the traditional multiple linear regression (MLR) to explore their relationships. Recently, machine learning (Mach-L) has become a new modality for data analysis because it enables machine to learn from past data or experiences without being explicitly programmed and could capture nonlinear relationships better. These methods have the potential to outperform conventional MLR in disease prediction. In the present study, we enrolled a Chinese post-menopause cohort followed up for 4 years. The difference of T-score (δ-T score) was the dependent variable. Information such as demographic, biochemistry and life styles were the independent variables. Our goals were: (1) Compare the prediction accuracy between Mach-L and traditional MLR for δ-T score. (2) Rank the importance of risk factors (independent variables) for prediction of δ T-score. Totally, there were 1698 postmenopausal women were enrolled from MJ Health Database. Four different Mach-L methods namely, Random forest (RF), eXtreme Gradient Boosting (XGBoost), Naïve Bayes (NB), and stochastic gradient boosting (SGB), to construct predictive models for predicting δ-BMD after four years follow-up. The dataset was then randomly divided into an 80% training dataset for model building and a 20% testing dataset for model testing. A 10-fold cross-validation technique for hyperparameter tuning was used. The model with the lowest root mean square error for the validation dataset was viewed as the best model for each ML method. The averaged metrics of the RF, SGB, NB, and XGBoost models were used to compare the model performance of the benchmark MLR model that used the same training and testing dataset as the Mach-L methods. We defined that the priority demonstrated in each model ranked 1 as the most critical risk factor and 22 as the last selected risk factor. For Pearson correlation, age, education, BMI, HDL-C, and TSH were positively and plasma calcium level, and baseline T-score were negatively correlated with δ-T score. All four Mach-L methods yielded lower prediction errors than the MLR method and were all convincing Mach-L models. From our results, it could be noted that education level is the most important factor for δ-T Score, followed by DBP, smoking, SBP, UA, age, and LDL-C. All four Mach-L outperformed traditional MLR. By using Mach-L, the most important six risk factors were selected which are, from the most important to the least: DBP, SBP, UA, education level, TG and sleeping hour. δ T score was positively related to SBP, education level, UA and TG and negatively related to DBP and sleeping hour in postmenopausal Chinese women. [ABSTRACT FROM AUTHOR]

Background: Emotional disorders such as depression and anxiety disorders share substantial similarities in their etiology and treatment. In recent decades, these commonalities have been increasingly recognized in classification systems and treatment programs crossing diagnostic boundaries. Methods: To examine the prospective effects of different transdiagnostic markers on relevant treatment outcomes, we plan to track a minimum of N = 200 patients with emotional disorders during their routine course of cognitive behavioral therapy at two German outpatient clinics. We will collect a wide range of transdiagnostic markers, ranging from basic perceptual processes and self-report measures to complex behavioral and neurobiological indicators, before entering therapy. Symptoms and psychopathological processes will be recorded before entering therapy, between the 20th and 24th therapy session, and at the end of therapy. Discussion: Our results could help to identify transdiagnostic markers with high predictive power, but also provide deeper insights into which patient groups with which symptom clusters are less likely to benefit from therapy, and for what reasons. Trial Registration: The trial was preregistered at the German Clinical Trial Register (DRKS-ID: DRKS00031206; 2023–05-09). [ABSTRACT FROM AUTHOR]

Background: Mental distress among retirees and older people is a severe public health challenge, and information on new risk groups is needed. This study aims to identify subgroups of old-age retirees with varying associations between low social support and mental distress by applying model-based recursive partitioning (MOB). Methods: We used the Helsinki Health Study follow-up survey data of old-age retired former municipal sector employees of the City of Helsinki, Finland. Phase 1 data were collected in 2000–2002, when all participants were employed, Phase 2 in 2007, Phase 3 in 2012, Phase 4 in 2017, and Phase 5 in 2022 (n = 4,466, 81% women). Social support and covariates were measured at each Phase 1–5 and the outcome, mental distress (Depression Anxiety Stress Scales [DASS-21]) was measured at a single occasion, during Phase 5. The three subscales and the common factor of general distress were analysed separately. An approach rooted in computational statistics was used to investigate risk factor heterogeneity in the association of low social support and mental distress. MOB combines decision trees with regression analysis to identify subgroups with the most significant heterogeneity among risk factors. Results: Median (IQR) general distress score from DASS-21 was 5.7 (3.0, 9.0), while Social Support Questionnaire number-score (SSQN) was 1.5 (1.15, 2.05). The primary effect modifier for the association between social support and general distress was education (p < 0.001). Those with high education had a different association of low social support and general distress than those with low or medium education. Additionally, the subgroup with low and medium education had a significant effect modification for age (p = 0.01). For the association between low social support and depressive symptoms, the moderating effect of education was dependent on gender, as men with medium–high education had the weakest association, while for women with medium–high education the association was strongest. Conclusions: Our results suggest that stratification by sociodemographic variables is justifiable when investigating risk factors of mental distress in old-age retirees. The incongruent association of low social support and depressive symptoms in men with medium–high education compared to women with medium–high education is a promising target for confirmatory research. [ABSTRACT FROM AUTHOR]

Childhood maltreatment has been demonstrated to impact brain development. However, whether childhood maltreatment can influence the effects of recent stress on brain networks remains unclear. This study aimed to investigate whether childhood maltreatment moderates the longitudinal relationship between recent life stress and within- and between-network connectivity in key brain networks, including the anterior salience (ASN), central executive (CEN), default mode (DMN), and emotional regulation network (ERN). A cohort of 172 individuals from the Neuroscience in Psychiatry Network (NSPN) underwent MRI scans at two specific time points and undertook evaluations of childhood maltreatment and recent life stress. The results showed that childhood abuse moderated the association of recent life stress with the within-network connectivity of ASN and ERN but not DMN and CEN. Furthermore, recent life stress significantly interacted with childhood abuse to be associated with the between-network connectivity of ASN-DMN, ASN-CEN, ASN-ERN, DMN-ERN and CEN-ERN. Overall, among youth exposed to higher degrees of childhood abuse, greater recent life stress was longitudinally associated with increased network connectivity. Understanding these interactions can provide valuable insights for developing prevention strategies and interventions aimed at mitigating the lasting impact of childhood maltreatment on brain development and overall well-being. [ABSTRACT FROM AUTHOR]

Dating violence can manifest itself in different ways, with important consequences for both members of the couple. Due to the normalization of certain behaviour and the perceived quality of the relationship, it may be difficult to identify this violent dynamic in its early stages, allowing it to escalate and lead to severe levels of violent behaviour. This study aims to analyse violent profiles using latent class analysis (LCA) and explore the role of relationship quality variables as risk factors for those profiles. A two-stage longitudinal design was used with a sample of 2849 Spanish adolescents between 12 and 18 years old. The LCA produced five different groups: those not involved in violence; those involved in mild forms of violence (with two sub-groups: those involved in psychological–sexual violence and in psychological–physical violence); and those involved in the most severe forms of violence, with a co-occurrence of psychological–physical–sexual violence (with two sub-groups, according to the higher of lower frequency of involvement). Despite the differences between boys and girls, negative-quality variables played a more important role in dating violence. Discussion of the results focuses on both the complex nature of the violence and the multi-probabilistic view of its development. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the relationships between serum cortisol levels, personality traits, and the development of Post‐Traumatic Stress Disorder (PTSD) over 2 years among individuals with physical injuries. Methods: Participants were consecutively recruited from a trauma center and followed prospectively for 2 years. At baseline, serum cortisol levels were measured, and personality traits were categorized into five dimensions (Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness), using the Big Five Inventory‐10. The diagnosis of PTSD during follow‐up (at 3, 6, 12, and 24 months post‐injury) was determined using the Clinician‐Administered PTSD Scale for DSM‐5. Binary and multinomial logistic regression analyses were conducted to examine the interactions between cortisol levels, personality traits, and PTSD development. Results: Among 923 patients analyzed, 112 (12.1%) were diagnosed with PTSD at some point during the study period, with prevalence rates decreasing from 8.8% at 3 months to 3.7% at 24 months post‐injury. Direct associations between cortisol levels or personality traits and PTSD were not observed. However, a significant interaction between lower cortisol levels and higher Neuroticism in relation to PTSD risk was identified, especially during the early follow‐up periods (3 to 6 months), but this association waned from the 12‐month follow‐up onward. Conclusion: Our findings reveal Neuroticism‐dependent associations between serum cortisol levels and PTSD development, exhibiting temporal variations. These results suggest that PTSD development may be influenced by a complex, time‐sensitive interplay of biological and psychosocial factors, underscoring the importance of considering individual differences in stress reactivity and personality in PTSD research and treatment. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate the long-term effects of intense pulsed light (IPL) therapy on patients with dry eye disease (DED) associated with meibomian gland dysfunction (MGD). Methods: A retrospective case series was performed with 110 participants undergoing IPL therapy. Assessments included the eye fitness test (EFT) to gauge subjective symptoms, along with objective measures using the Tearcheck® device (ESW Vision, Houdan, France) noninvasive first breakup time (NIFBUT), noninvasive average breakup time (NIABUT), central tear meniscus height (CTMH), thinnest tear meniscus height (TTMH), and ocular surface inflammatory risk evaluation (OSIE) assessed using the SCHWIND SIRIUS device (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany). Results: This study documented significant improvements in subjective and objective symptoms associated with DED and MGD. Subjective symptoms measured by the EFT showed an average increase of 9.74 points (range −10 to 28, standard deviation [SD] ± 7.54), indicating reduced symptoms. Objective measures of tear film stability, represented by NIABUT, increased by an average of 4.04 s (range −15.00 to 14.40, SD ± 4.91). Tear film stability evaluation (TFSE) scores decreased by 229.12 points on average (range −1775 to 528, SD ± 384.94), suggesting enhanced tear film stability. OSIE type 1 showed a reduction in inflammation, with a percentage decrease of 4.98% (range −45 to 5, SD ± 7.33). Additionally, OSIE capture time decreased by 3.25 s on average (range −27 to 22, SD ± 10.35), further indicating an improvement in ocular surface health. Conclusion: IPL therapy was shown to be a promising, noninvasive approach for improving quality of life in patients with DED by effectively managing symptoms and stabilizing tear film. The findings support the use of IPL as a sustainable treatment modality for DED associated with MGD. [ABSTRACT FROM AUTHOR]

Diabetes mellitus type 2 (T2D) is associated with accelerated biological aging and the increased risk of onset of other age-related diseases. Epigenetic changes in DNA methylation levels have been found to serve as reliable biomarkers for biological aging. This study explores the relationship between various epigenetic biomarkers of aging and diabetes risk using longitudinal data. Data from the Swedish Adoption/Twin Study of Aging (SATSA) was collected from 1984 to 2014 and included 536 individuals with at least one epigenetic measurement. The following epigenetic biomarkers of aging were employed: DNAm PAI-1, DNAmTL, DunedinPACE, PCHorvath1, PCHorvath2, PCHannum, PCPhenoAge, and PCGrimAge. Firstly, longitudinal analysis of biomarker trajectories was done. Secondly, linear correlations between the biomarkers and time to diabetes were studied within individuals developing diabetes. Thirdly, Cox proportional hazards (PH) models were used to assess the associations between these biomarkers and time of diabetes diagnosis, with adjustments for chronological age, sex, education, smoking, blood glucose, and BMI. The longitudinal trajectories of the biomarkers revealed differences between individuals with and without diabetes. Smoothened average curves for DunedinPACE and DNAm PAI-1 were higher for individuals with diabetes around the age 60–70, compared to controls. Likewise, DunedinPACE and DNAm PAI-1 were higher closer to diabetes onset. However, no significant associations were found between the epigenetic biomarkers of aging and risk of diabetes in Cox PH models. Our findings suggest the potential value of developing epigenetic biomarkers specifically tailored to T2D, should we wish to model and explore the potential for predicting the disease. [ABSTRACT FROM AUTHOR]

Background: Alterations in DNA methylation (DNAm) have been observed in patients with fatty liver, but whether they are cause or consequence remains unknown. The study aimed to investigate longitudinal association of epigenome-wide DNAm with liver fat content (LFC) in Chinese participants, and explore their temporal relationships. Methods: Data were obtained from 2 waves over a four-year time period of the Shanghai Changfeng Study (discovery, n = 407 and replication, n = 126). LFC and peripheral blood DNAm were repeatedly measured using quantitative hepatic ultrasonography and the 850 K Illumina EPIC BeadChip, respectively. Longitudinal and cross-sectional epigenome-wide association studies (EWASs) were conducted with linear mixed model and linear regression model, respectively. Meta-analysis was performed using METAL. Cross-lagged panel analysis (CLPA) was carried out to infer temporal relationships between the significant CpGs and LFC. Results: Longitudinal EWAS identified cg11024682 (SREBF1), cg06500161 (ABCG1), cg16740586 (ABCG1), cg15659943 (ABCA1) and cg00163198 (SNX19) significantly associated with LFC with P < 1e-7. Another 6 of the 22 previously reported CpGs were replicated in the present longitudinal EWAS. CLPA showed longitudinal effects of cg11024682 (SREBF1) (β = 0.14 [0.06, 0.23]), cg16740586 (ABCG1) (β = 0.17 [0.08, 0.25]), cg06500161 (ABCG1) (β = 0.12 [0.03, 0.20]), cg17901584 (DHCR24) (β = -0.10 [-0.18, -0.02]), cg00574958 (CPT1A) (β = -0.09 [-0.17, -0.01]), cg08309687 (LINC00649) (β = -0.11 [-0.19, -0.03]), and cg27243685 (ABCG1) (β = 0.09 [0.01, 0.18]) on subsequent LFC. The effects were attenuated when further adjusting for body mass index. High levels of LFC led to alterations in DNAm of cg15659943 (ABCA1) (β = 0.13 [0.04, 0.21]), cg07162647 (β = -0.11 [-0.19, -0.03]), cg06500161 (ABCG1) (β = 0.10 [0.02, 0.18]), and cg27243685 (ABCG1) (β = 0.10 [0.02, 0.18]). Conclusions: Blood DNAm at SREBF1, ABCG1, DHCR24, CPT1A, and LINC00649 may be predictors of subsequent LFC change. The effects of DNAm at SREBF1 and ABCG1 on LFC were partially influenced by obesity. The findings have potential implications in understanding disease pathogenesis and highlight the potential of DNAm for early detection or intervention of fatty liver. [ABSTRACT FROM AUTHOR]

Background: Given the established link between obesity and hyperuricemia (HUA), the research want to investigate the relationship between different obesity indices and HUA, and further analyze which obesity index can better predict HUA. Methods: The data were obtained from a longitudinal study involving middle-aged and elderly populations in Dalian, China. The research encompassed individuals who exhibited typical uric acid levels initially and tracked their progress over a three-year period. 8 obesity indices were evaluated retrospectively. Subgroup analyses were conducted to identify susceptible populations. Restricted cubic splines (RCS) were utilized to model the dose-response relationships between obesity indices and HUA. Receiver operating characteristic (ROC) curves were applied to visualize and compare the predictive value of both traditional and new obesity indices for HUA. Results: Among 4,112 individuals with normal baseline uric acid levels, 950 developed HUA. Significant associations with HUA were observed for body mass index (BMI), waist circumference (WC), body roundness index (BRI), cardiometabolic index (CMI), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI), lipid accumulation product (LAP), and abdominal volume index (AVI). Subgroup analysis indicated that all obesity indices proved more effective in assessing the onset of HUA in women without Metabolic Syndrome (MetS). Further analysis using RCS revealed non-linear dose-response relationships between LAP, CMI, VAI, and HUA in males, with similar non-linear relationships observed for all indices in females. The results from the ROC curves indicate that LAP may serve as a better predictor of HUA in males, and CVAI may serve as a better predictor in females. Conclusion: HUA is closely associated with obesity indices. Among females, CVAI emerges as the preferred predictive index for HUA. In males, LAP emerges as the preferred predictive index for HUA. [ABSTRACT FROM AUTHOR]

The gut microbiota-immune-brain axis is a feedback network which influences diverse physiological processes and plays a pivotal role in overall health and wellbeing. Although research in humans and laboratory mice has shed light into the associations and mechanisms governing this communication network, evidence of such interactions in wild, especially in young animals, is lacking. We therefore investigated these interactions during early development in a population of common buzzards (Buteo buteo) and their effects on individual condition. In a longitudinal study, we used a multi-marker approach to establish potential links between the bacterial and eukaryotic gut microbiota, a panel of immune assays and feather corticosterone measurements as a proxy for long-term stress. Using Bayesian structural equation modeling, we found no support for feedback between gut microbial diversity and immune or stress parameters. However, we did find strong relationships in the feedback network. Immunity was negatively correlated with corticosterone levels, and microbial diversity was positively associated with nestling body condition. Furthermore, corticosterone levels and eukaryotic microbiota diversity decreased with age while immune activity increased. The absence of conclusive support for the microbiota-immune-brain axis in common buzzard nestlings, coupled with the evidence for stressmediated immunosuppression, suggests a dominating role of stress-dominated maturation of the immune system during early development. Confounding factors inherent to wild systems and developing animals might override associations known from adult laboratory model subjects. The positive association between microbial diversity and body condition indicates the potential health benefits of possessing a diverse and stable microbiota. [ABSTRACT FROM AUTHOR]

Objective: The quality of the relationship between persons with dementia and family carers influences health and quality-of-life outcomes. Little is known regarding those at higher risk of experiencing a decline in relationship quality, who could potentially benefit the most from interventions. We aimed to identify these risk profiles and explore the underlying factors. Methods: We applied a latent profile analysis to relationship quality data from a 1-year follow-up of 350 dyads of persons with dementia and their informal carers from the Actifcare cohort in eight European countries. Assessments included sociodemographic, clinical, functional, psychosocial and quality-of-life measures. Relationship quality was assessed with the Positive Affect Index. A discriminant analysis explored factors influencing the risk profiles. Results: There were two relationship quality profiles among persons with dementia (gradually decreasing, 74.0%; low but improving, 26%) and two among carers (steadily poor, 57.7%; consistently positive, 42.3%). The 'gradually decreasing' profile (persons with dementia) was related to their levels of dependence and unmet needs, along with carers' social distress and negative feelings, lower baseline RQ and sense of coherence. The 'steadily poor' profile (carers) was influenced by their social distress and negative feelings, lower sense of coherence and perceived social support. These two predominant profiles showed significant decreases in quality-of-life over one year. Conclusions: Specific profiles of persons with dementia and their carers are at risk of worse relationship quality trajectories. By considering modifiable related factors (e.g., carers' stress), our findings can help develop tailored, effective interventions. [ABSTRACT FROM AUTHOR]

Adequate sleep duration has recently been recognized as a major determinant of cardiovascular health by the American Heart Association. This is a significant step toward recognizing sleep as a major lifestyle factor and pillar of health, along with physical activity and nutrition. However, healthy sleep is not only a matter of duration. Other dimensions, such as timing, regularity, efficiency, satisfaction with sleep, and daytime alertness are also deemed important to consider. We have designed a systematic review protocol according to the PRISMA-P guidelines with the objective of determining which sleep dimensions are predictors of all-cause mortality and major adverse cardiovascular events (MACE; cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and unstable angina requiring hospitalization), and whether or not the use of multiple dimensions of sleep yields superior predictive value to the use of sleep duration alone in predicting the above-mentioned outcomes. We will implement a systematic search strategy in 10 databases with independentmanual screening by two reviewers. The aim is to comprehensively identify longitudinal studies which have examined the relationship between sleep duration and at least one other dimension of sleep andmortality orMACE.Meta-analysis will be performed after data extraction to address these objectives quantitatively. We anticipate that several sleep dimensions beyond sleep duration have been studied in relationship to all-cause mortality and MACE, and that a combination of multiple sleep dimensions can better predict these outcomes than sleep duration alone. Such findings would lay important groundwork to establish multidimensional sleep health as a major determinant of cardiovascular health. [ABSTRACT FROM AUTHOR]

Background: Although high-density lipoprotein cholesterol (HDL-C) exerts a significant influence on the development of metabolic dysfunction-associated fatty liver disease (MAFLD), the association of dynamic changes in HDL-C levels with the risk of MAFLD remains unclear. Thus, the aim of the current study was to explore the association between the changing trajectories of HDL-C and new-onset MAFLD. The findings of this study may provide a theoretical basis for future personalized intervention and prevention targeting MAFLD. Methods: A total of 1507 participants who met the inclusion criteria were recruited from a community-based physical examination population in Nanjing, China from 2017 to 2021. Group-based trajectory models were constructed to determine the heterogeneous HDL-C trajectories. The incidence of MAFLD in each group in 2022 was followed up, and the Cox proportional hazards regression model was applied to investigate the associations between different HDL-C trajectories and the risk of new-onset MAFLD. Results: The incidences of MAFLD in the low-stable, moderate-stable, moderate-high-stable, and high-stable groups of HDL-C trajectory were 26.5%, 13.8%, 7.2% and 2.6%, respectively. The incidence rate of MAFLD in the order of the above trajectory groups exhibited a decreasing trend (χ2 = 72.55, Ptrend<0.001). After adjusting for confounders, the risk of MAFLD onset in HDL-C low-stable group was still 5.421 times (95%CI: 1.303–22.554, P = 0.020) higher than that in the high-stable group. Subgroup analyses of the combined (moderate high-stable and high-stable groups combined), moderate-stable and low-stable groups showed that sex, age, and overweight/obesity did not affect the association between HDL-C trajectory and MAFLD risk. Conclusions: Persistently low HDL-C level is a risk factor for the onset of MAFLD. Long-term monitoring of HDL-C levels and timely intervention for those experiencing persistent declines are crucial for early prevention of MAFLD. [ABSTRACT FROM AUTHOR]

Background: In the past, there has been a clear conclusion regarding the sole impact of serum neurofilament light chain (sNfL) levels or type 2 diabetes mellitus (DM) on the risk of death. However, the combined effect of sNfL levels and type 2 DM on all-cause and cardiovascular mortality is still uncertain. Methods: This study was a prospective cohort study based on data from the National Health and Nutrition Examination Survey (NHANES). The sNfL levels were measured through immunological methods using blood samples collected during the survey. The diagnosis of diabetes was based on rigorous criteria, and participants' mortality data were followed up until December 31, 2019. Firstly, we separately examined the effects of sNfL and type 2 DM on all-cause and cardiovascular mortality, and finally studied the comprehensive impact of the combination of sNfL and type 2 DM on the risk of mortality. Cumulative Kaplan-Meier curves, multivariate logistic regression and sensitivity analysis were incorporated throughout the entire study. Results: Participants in the highest quartile of sNfL were observed. Multivariable COX regression model showed that increased sNfL levels and type 2 DM were respectively associated with an increased risk of all-cause and cardiovascular mortality. Furthermore, elevated sNfL levels were significantly associated with an increased risk of all-cause mortality and cardiovascular mortality after adjustment for confounding factors. When considering both elevated sNfL levels and type 2 DM, individuals had a significantly increased risk of mortality. Sensitivity analysis confirmed the robustness of the findings. Conclusions: These results suggest that elevated levels of sNfL and type 2 DM are associated with an increased risk of all-cause and cardiovascular mortality, and that participants with increased sNfL levels associated with type 2 DM have higher all-cause mortality and cardiovascular mortality. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a significant global health concern, with a growing prevalence in Japan. Individuals with normal body mass index who are metabolically unhealthy exhibit an elevated risk of diabetes onset. Investigating the relationship between Metabolically Unhealthy Normal-weight (MUNW) status and the risk of diabetes in non-diabetic individual is vital for implementing early preventive strategies. Methods: Using data from the NAGALA cohort, This study categorized 8,194 Japanese adults based on the score of metabolic syndrome (MetS) components they possessed. Cox proportional hazards regression models and multivariate logistic regression were used to assess the relationship between MUNW and the risk of developing diabetes, with analyses stratified by age and sex. Results: During an average follow-up of 7.19 years, 123 participants (1.5%) were diagnosed with diabetes. Among the participants, 766 (9.35%) were classified as MUNW, and 157 (1.92%) as having MetS. Compared to those with no MetS components, individuals with 1, 2, and ≥3 MetS components had progressively higher adjusted hazard ratios (HRs) for developing diabetes, at 4.56, 8.79, and 25.16, respectively. Further stratified analysis revealed that men aged ≤40 years had the highest risk of developing diabetes. For men, the adjusted HRs for having 1, 2, and ≥3 MetS components were 5.61, 7.80, and 28.59, respectively, and for participants aged ≤40 years, the HRs were 12.31, 25.57, and 129.82, respectively. Conclusion: The prevalence of MUNW in non-diabetic individuals in Japan is 9.35%. The score of MetS components was positively correlated with the risk of diabetes. Early intervention and lifestyle modifications are crucial, especially for MUNW individuals and notably young Japanese men aged ≤40 years, for the prevention and management of diabetes. [ABSTRACT FROM AUTHOR]

Background: Intracranial artery stenosis (ICAS) and cerebral small vessel disease (CSVD) are associated with a heavy socioeconomic burden; however, their longitudinal changes remain controversial. Methods: We conducted a longitudinal analysis on 756 participants of Shunyi Cohort who underwent both baseline and follow-up brain magnetic resonance imaging (MRI) and MR angiography in order to investigate the risk factors for ICAS and CSVD progression in community population. Incident ICAS was defined as new stenosis occurring in at least one artery or increased severity of the original artery stenosis. CSVD markers included lacunes, cerebral microbleeds (CMB), and white matter hyperintensities (WMH). Results: After 5.58 ± 0.49 years of follow-up, 8.5% of the 756 participants (53.7 ± 8.0 years old, 65.1% women) had incident ICAS. Body mass index (BMI) (OR = 1.09, 95% CI = 1.01–1.17, p = 0.035) and diabetes mellitus (OR = 2.67, 95% CI = 1.44–4.93, p = 0.002) were independent risk factors for incident ICAS. Hypertension was an independent risk factor for incident lacunes (OR = 2.12, 95% CI = 1.20–3.77, p = 0.010) and CMB (OR = 2.32, 95% CI = 1.22–4.41, p = 0.011), while WMH progression was primarily affected by BMI (β = 0.108, SE = 0.006, p = 0.002). A higher LDL cholesterol level was found to independently protect against WMH progression (β = −0.076, SE = 0.027, p = 0.019). Conclusions: Modifiable risk factor profiles exhibit different in patients with ICAS and CSVD progression. Controlling BMI and diabetes mellitus may help to prevent incident ICAS, and antihypertensive therapy may conduce to mitigate lacunes and CMB progression. LDL cholesterol may play an inverse role in large arteries and small vessels. [ABSTRACT FROM AUTHOR]

Purpose: This longitudinal study aimed to investigate the causal relationship between physical exercise and emotional states among university students, focusing on the mediating role of sense of coherence. Method: A total of 1,215 university students (aged 18-25 years) were recruited and completed questionnaires assessing physical activity (International Physical Activity Questionnaire-Short Form), emotional states (Positive and Negative Affect Schedule), and sense of coherence (Sense of Coherence Scale-13) at three time points over a three-month period. Preliminary analyses included independent samples t-tests, chi-square tests, and Pearson correlations. Cross-lagged panel mediation analysis was conducted using Mplus 8.3, with bootstrapping employed to test indirect effects. Results: Results indicated that sense of coherence significantly predicted positive affect (β = 0.259-0.369, p < 0.001). Positive affect, in turn, predicted physical exercise (β = 0.083-0.182, p < 0.05), while negative affect also influenced physical exercise (β = -0.096-0.203, p < 0.05). Physical exercise indirectly influenced positive affect through sense of coherence (β = 0.037, p = 0.045), and positive affect indirectly influenced physical exercise through sense of coherence (β = 0.029, p = 0.028). Other indirect effects involving physical exercise, sense of coherence, and negative affect were non-significant. Conclusion: This study underscores the importance of sense of coherence in promoting emotional well-being among university students and in the reciprocal relationship between physical exercise and positive emotional states. Findings suggest that interventions targeting sense of coherence may enhance the emotional benefits of physical exercise. Future research should explore other potential mediators and moderators of the relationship between physical exercise and emotions and examine the effectiveness of sense of coherence-based interventions on well-being in this population. [ABSTRACT FROM AUTHOR]

Background: Isolated rapid eye movement sleep behavior disorder (iRBD) serves as a prodromal phase of Parkinson's disease (PD) and dementia with Lewy bodies (DLB). Blunted tachycardia (BT) during postural changes indicates neurogenic orthostatic hypotension, a marker of autonomic dysfunction. We aimed to investigate whether BT is associated with cardiac sympathetic neurogenic denervation. Additionally, we conducted a preliminary short-term follow-up to examine the potential prognostic significance of BT regarding phenoconversion and mortality. Methods: Forty-three patients with iRBD at Shiga University of Medical Science Hospital underwent active standing tests to identify BT, defined by a specific ratio of decrease in systolic blood pressure to inadequate increase in heart rate after standing, and orthostatic hypotension. 123I-metaiodobenzylguanidine myocardial scintigraphy (123I-MIBG) and dopamine transporter single-photon emission computed tomography (DAT-SPECT) were performed. Participants were followed up for 3.4 ± 2.4 years for phenoconversion and 4.0 ± 2.3 years for mortality assessment, and the risk of events was analyzed using log-rank tests. Results: Among the 43 participants (mean age, 72.3 ± 7.9 years; 8 female), 17 met the BT criteria. We found no significant comorbidity-related differences in hypertension or diabetes between the BT(+) and BT(-) groups. Orthostatic hypotension was more prevalent in the BT(+) group than in the BT(-) group (47.1% vs 7.7%, p = 0.003). BT(+) patients were older with a lower early and delayed MIBG uptake; however, no significant differences were observed in DAT accumulation. Phenoconversion was observed in seven (41.2%) BT(+) and seven (26.9%) BT(-) patients. Three deaths were recorded in the BT(+) group (17.6%) and three in the BT(-) group (11.5%). No significant differences were observed in the risk of phenoconversion or mortality between the groups. Conclusions: We have identified the possibility that BT reflects cardiac sympathetic neurogenic denervation in patients with iRBD. Future research is needed to elucidate the potential prognostic value of BT. [ABSTRACT FROM AUTHOR]

Background: Myxomatous mitral valve degeneration (MMVD) is a prevalent canine heart condition often accompanied by pulmonary hypertension (PH). Echocardiography is a valuable diagnostic tool for MMVD, but its accessibility is limited in small veterinary clinics. Aim: This study aimed to identify clinical parameters and biochemistry and cardiac biomarkers as prognostic indicators for cardiac mortality in MMVD dogs with and without PH. Animals: Ninety-nine MMVD dogs and nineteen normal dogs. Methods: In a five-year longitudinal study, data including clinical and laboratory measurements as well as echocardiographic parameters were collected every 6 months. Dogs were monitored until death or loss to follow-up, and the cause of death was determined when possible. Statistical analysis was performed to identify factors that predicted death. Results: Alterations in body condition score, total protein, fractional shortening percentage, and mean corpuscular volume were predictive of impending cardiac mortality. High blood urea nitrogen-to-creatinine ratio, heart rate, and low hemoglobin levels were associated with an increased risk of death. N-terminal pro-B-type natriuretic peptide was also a significant predictor of cardiac-related mortality, with higher levels indicating increased risk. Moreover, MMVD dogs with PH had a significantly lower survival rate than those with MMVD without PH. However, no significant difference in survival was observed between MMVD stage C and D with PH and MMVD stage C and D without PH groups. Conclusion: These findings provide valuable insights into the monitoring of MMVD progression in dogs using clinical parameters and biomarkers, especially when echocardiography cannot be performed. [ABSTRACT FROM AUTHOR]

Purpose: Growth mindset and self-control, both recognized as pivotal qualities with significant impacts on personal success, possess respective robust predictive power for academic achievement and broader life outcomes. However, the bidirectional relationship between them remains largely unexplored. This study aims to investigate whether growth mindset, conceptualized as the belief that abilities can be developed through effort and support, prospectively predicts the development of self-control over time. Additionally, it endeavors to explore whether self-control, a crucial positive psychological trait, exerts an influence on the fostering of growth mindset. In summary, our research focuses on elucidating the bidirectional relationship between growth mindset and self-control among Chinese primary school students. Participants and Methods: The current research recruited a sample of 428 primary school students, aged 9– 12, from China (214 females, mean age = 9.64 ± 1.21) to participate in a longitudinal study. Participants underwent two follow-up assessments of growth mindset and self-control over a six-month period. Results: The correlation analysis revealed significant associations between growth mindset at T1 and self-control at T2, as well as between self-control at T1 and growth mindset at T2(r = 0.23 to 0.25, ps < 0.01). Cross-lagged analysis found that growth mindset at T1 positively predicted self-control at T2 (β = 0.11, p = 0.04), while self-control at T1 did not significantly predict growth mindset at T2. Conclusion: The results suggest that growth mindset exerts a direct impact on self-control among primary school students. This finding extends the scope of research concerning growth mindset and provides important theoretical inspiration and practical guidance for educators, parents and counselling professionals in assisting students to enhance self-control. [ABSTRACT FROM AUTHOR]

The reactivity effect of metacognitive judgments on first-order task performance has received increased research attention. Previous studies showed that soliciting retrospective confidence ratings (CRs) reactively enhances task performance itself, such as performance in decision making and reasoning tasks, especially for those with high self-confidence. It remains unknown whether CRs can improve students' academic assessment performance in real educational settings. The current study recruited 795 fourth-grade elementary school children to explore if making CRs reactively affects students' academic assessment performance in two main subjects (i.e., Chinese Language and Mathematics). The data were collected across six waves with half-year intervals. From Wave 2, children either provided (CR group) or did not provide CRs (no-CR group) when completing standardized academic assessments. The results showed Bayesian evidence supporting the claim that making CRs does not influence children's academic assessment performance (both the average performance across waves 2–6 and the performance in each wave) in both subjects. Furthermore, children's self-confidence did not moderate the reactive influence of CRs. The results from multilevel regression analyses re-confirmed the above conclusions. Possible explanations for the absence of the reactivity effect of CRs on children's academic assessment performance are discussed. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine the relationship between stress perception and achievement goals among rural college students in China. Using a two-wave random intercept cross-lagged model, this study analyzed data from a longitudinal survey conducted at 15 public universities in Beijing. First, there was a significant decline in stress levels among Chinese rural students from their junior to senior years. Second, the achievement goal orientations of these students remained relatively stable during the period. Third, while no significant association was found between approach goals and stress perception, a clear positive reciprocal relationship emerged between avoidance goals and stress perception. These results suggest that educators should focus on alleviating the stress experienced by rural college students through academic, employment, and interpersonal support to break the vicious cycle of stress perception and avoidance goal orientation. Future research should further explore the influence of diverse group characteristics and emotional states on these outcomes. [ABSTRACT FROM AUTHOR]

Multiparty alliances (MPAs) are increasingly used to deliver large utilities infrastructure projects on‐time, on‐budget, and to specified quality. In theory, MPAs should help buyers to coordinate suppliers, enable concurrent scheduling, and create process innovations. On the other hand, these governance structures are inherently less stable than dyadic relationships due to their additional complexity and greater opportunities for free riding. We conduct a multi‐source, longitudinal study, investigating how a buyer actively manages the dynamics between competition and cooperation during the formation of an MPA consisting of a lead organization and directional relationships between all partners. We contribute to MPA and coopetition literature by exploring cooperation and competition dynamics that are associated with the MPA structure that would largely be absent in dyads, and unpack the process by which a buyer orchestrates these dynamics by sequentially introducing new initiatives that seek to balance coopetition. MPAs have been recommended by governments and industry bodies as one solution for time and cost overruns in the utilities infrastructure sector, our study also provides guidance to buyers on the management of the alliance during the critical formation stage of the relationship lifecycle. [ABSTRACT FROM AUTHOR]

Background and Aims: In the neurobiological theory of attention, the orienting network mainly supports the temperamental regulatory function in infancy, with soothing methods such as visual attention distraction influencing its development. The attention distraction method chosen for soothing is thought to be influenced by maternal sensitivity, which has been found to decrease with poor maternal mental health. We hypothesize that the degree of maternal distress may affect the choice of attention distraction soothing method. Further, individual differences in being soothed by attention distraction will be associated with the temperamental regulation function in infancy/toddlerhood. Method: Structural equation modeling (SEM) was conducted on longitudinal data at 6 and 24 months on a sample (N = 1892) drawn from the sub‐cohort of the Japan Environment and Children's Study (JECS). Temperament was examined through the short Infant Behavior Questionnaire‐Revised (Japanese version) and the Early Childhood Behavior Questionnaire (Japanese version). Distress in caregivers was measured through the Kessler Psychological Distress Scale (Japanese version) at prenatal and 1‐year‐postnatal stages. Individual differences in using visual distraction soothing methods were also measured using tailor‐made items. Results: Postnatal maternal distress at 12 months was negatively related to the tendency to use visual attention distraction as a soothing method (β = −0.06, p = 0.006) at 24 months. When we applied the subscale of the temperamental regulatory factor in SEM, the more the mothers chose the distraction method for soothing, i.e., the more the toddlers experienced it, the higher their attention shifting scores (β = 0.07, p = 0.002). Conclusion: The findings support the view that caregivers' choice of method for distracting offspring's attention from distress may be associated with the development of self‐regulation during infancy and toddlerhood. Keynotes: In the neurobiological temperament model, the orienting attention network mainly supports the regulatory function in infancy, with soothing methods, including visual attention distraction, influencing its development.In the sub‐cohort of the Japan Environment and Children's Study, the relationship between maternal distress and mothers' choice of distraction as a soothing method and between the degree of being soothed by distraction and infants/toddlers' regulatory function were examined at 6 and 24 months (N = 1892).Higher maternal distress at 12 M postpartum was associated with fewer distraction methods, and more distraction at 24 M was associated with higher attention shifting at 24 M. [ABSTRACT FROM AUTHOR]

Abstract Background The COVID-19 pandemic’s “Great Online Transition” significantly impacted teachers. Existing research on Emergency Remote Teaching (ERT) lacks longitudinal designs and consideration of subject-specific contexts. This study, using the Stressor-Strain-Outcome framework, investigates psychological needs thwarting (PNT) during ERT on teachers’ well-being and online teaching intentions, considering subject of instruction as a potential factor. Methods Data were collected from 1,369 Chinese primary and middle school teachers of Chinese literature, mathematics, and English as a Foreign Language (EFL) at two time points: two weeks after ERT implementation (Time 1, mid-November 2021) and two months later, after returning to face-to-face teaching (Time 2, mid-January 2022). PNT, emotional exhaustion, psychological distress, and intention towards online teaching were evaluated. Results Among the types of PNT, competence thwarting emerged as the strongest predictor of emotional exhaustion, which was, in turn, associated with reduced online teaching intention and increased psychological distress. EFL teachers showed stronger associations between PNT, emotional exhaustion, and adverse outcomes, indicating higher susceptibility to strain during ERT. Conclusion Subject of instruction, particularly for EFL teachers, significantly influences the relationship between PNT and teacher outcomes during ERT. Our findings underscore the need for subject-specific support strategies in online teaching environments.

Abstract This study examined the modifying effects of surgery status on the association between the Standard Deviation of NN Intervals (SDNN) of the heart rate variability and the post-traumatic stress disorder (PTSD) development. Participants with physical injury were recruited from a trauma center and followed for two years. Baseline assessment included SDNN and surgery status. Socio-demographic and clinical covariates were collected. PTSD was diagnosed at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5. Logistic regression analyses were performed. Among 538 participants, 58 (10.8%) developed PTSD during the study, with prevalence rates of 8.4% at 3 months, 6.5% at 6 months, 4.7% at 12 months, and 2.5% at 24 months. A significant modifying effect was found that lower SDNN were significantly associated with PTSD in non-surgical patients but not in surgical patients, with significant interaction terms. This pattern was observed from 3 to 12 months but not at 24 months. Surgery-dependent associations between SDNN and PTSD development were observed, highlighting the need for tailored PTSD prevention strategies considering SDNN and surgery status.

Abstract Background Lactation has many established benefits for women’s long-term health; however, its influence on menopause is less clear. This study investigated the association between lifetime duration of lactation and the timing and type of menopause in midlife women. Methods We analyzed survey data on 19,783 parous women aged 40 to 65 years at enrollment in the Alberta’s Tomorrow Project (2000–2022), a prospective community-based cohort study in Alberta, Canada. Duration of lifetime lactation across all births was categorized as:

Abstract This study is based on the Conservation of Resources theory and investigates the impact of the COVID-19 pandemic and associated resource loss on gambling behaviour among Polish gamblers. The study surveyed 585 individuals engaged in land-based gambling before the pandemic. Participants completed computer-assisted web interviews, responding to questions regarding land-based and online gambling frequencies, the Problem Gambling Severity Index, and the Inventory of Loss of Resources in Pandemics. The findings revealed significant shifts in gambling behaviour due to pandemic-related restrictions. Land-based gambling declined during lockdowns and the third wave of the study, while online gambling surged as gamblers transitioned from land-based venues. Gamblers tended to return to land-based options as restrictions eased. Over consecutive waves, participants reported decreasing resource loss levels. Significantly, resource loss was influenced by gambling frequency rather than vice versa. Both types of gambling experienced parallel declines at the beginning of the pandemic, which subsided as the new situation became normalised. Players engaging more in gambling experienced more significant resource losses during the pandemic. Those with more resources at the pandemic’s onset adapted more readily, whereas individuals with limited resources faced resource loss. Conclusions Even with stable gambling levels, heavy gamblers at baseline were at higher risk for issues. The dynamics between resource loss and gambling and problem gambling supported the resource loss spiral concept.

Abstract Purpose The longitudinal association between changes in depressive symptoms (improvement/worsening) and arthritis is unclear. Methods Study data were obtained from the China Health and Retirement Longitudinal Study (CHARLS) 2011–2018. The 10-item Center for Epidemiological Studies Depression Scale (CES-D-10) was used to examine participant depressive symptoms and data on self-reported history of arthritis were collected. Depressive symptoms improving is defined as depression at baseline and no depression at follow-up. Similarly, depressive symptoms worsening is defined as no depression at baseline and depression at follow-up. Cox proportional hazards models were used to evaluate the effects of improvement or deterioration in depressive symptoms on arthritis. Participants with missing data on depression and arthritis, having arthritis in 2011 CHARLS and lost to follow-up was excluded. Results A total of 8556 participants free of arthritis were included from 2011 to 2018. After adjustment for confounders, depressive symptoms were associated with a 54% increased risk of developing arthritis. Each 1-point increase in CES-D-10 score was associated with a 4% higher risk of arthritis. Participants with depressive symptoms at baseline but improved symptoms (without depressive symptoms) at follow-up had a 25% lower rate of arthritis, and a 1-point reduction in CES-D-10 score during 8 years of follow-up was associated with a 5% lower risk of developing arthritis. Participants with no depressive symptoms at baseline but depression at follow-up had a 66% higher rate of arthritis, and a 1-point increase in CES-D-10 score during 8 years of follow-up was associated with a 5% higher risk of arthritis. Conclusions Improvement in depressive symptoms was associated with lower risk of arthritis and worsening of depression was associated with higher risk of arthritis. These findings suggest that the relationship between depression and arthritis is complex.

Summary: Purposes: The association between alcohol consumption, health, and mortality is intricate, with marital status being a determinant of drinking behavior. This study investigated the combined effect of alcohol consumption patterns and marital status on mortality in middle-aged and older Korean individuals. Methods: This prospective longitudinal study used data from the Korean Longitudinal Study of Aging, conducted from 2006 to 2020. The study population comprised individuals who were consuming alcohol around the time of the basic survey and participated in the 1st wave 2006 study. We divided 3,823 drinkers older than 45 into four groups: “normal drinker and married (NM),” “normal drinker and unmarried (NUM),” “excessive drinker and married (EM),” and “excessive drinker and unmarried (EUM).” A Cox proportional hazards regression analysis was performed for survival analysis. Results: The median survival time of the EUM group was 11.9 years. After adjusting for the covariates, the mortality risk among the NUM, EM, and EUM were approximately 1.67 times, 1.33 times, and 3.10 times higher than that among the NM, respectively. Conclusion: Middle- and old-aged unmarried people with excessive drinking patterns constitute a high-risk group for mortality. Community healthcare providers should focus on characteristics that differ by age, considering family-related factors, and assessing alcohol consumption patterns to reduce mortality. Among middle- and old-aged people, support for unmarried and excessive drinkers should be strengthened, and consultation on visiting community-based clinics should be promoted to improve firmly established alcohol consumption patterns.

Abstract The COVID-19 pandemic has been associated with a general decline in well-being. However, there is limited evidence on the effect of the pandemic on the general population, and especially among the ageing population. We assessed the overall impact of the pandemic on the well-being of middle-aged and older adults residing in 27 European countries, focusing on the time-period before summer 2021. We used a sample of 46,209 respondents from the two population-based longitudinal Corona Surveys collected during summer 2020 and summer 2021. To test our hypotheses, we used latent change score models. All analyses were stratified by sex. The COVID-19 pandemic affected middle-aged and older Europeans’ well-being irrespective of their sex. Being infected by the COVID-19 virus at the start of the pandemic had a negative impact on well-being. As expected, adults with Long COVID experienced the most pronounced decline in well-being. A novel finding was the decline in the level of well-being among adults not infected by the COVID-19 virus. Support should be provided at community levels with specific attention towards individuals with Long COVID symptoms and those infected with COVID-19 at earlier stages of the pandemic.

Qiong Chen,1,* Yanjin Huang,2,* Xiaomei Chen,3 Limin Xu1 1Department of Intensive Care Medicine, Xiamen Haicang Hospital, Xiamen, Fujian, People’s Republic of China; 2Department of Nursing, Xiamen Haicang Hospital, Xiamen, Fujian, People’s Republic of China; 3Department of Pain, Xiamen Haicang Hospital, Xiamen, Fujian, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qiong Chen, Department of Intensive Care Medicine, Xiamen Haicang Hospital, No. 89 haiyu Road, Haicang District, Xiamen, Fujian, 361026, People’s Republic of China, Tel +86 177 50612461, Email chenqiongfff@163.comPurpose: Post-traumatic stress disorder (PTSD) is a major psychiatric health issue among intensive care unit (ICU) survivors with post-intensive care syndrome (PICS). Although early PTSD intervention has been demonstrated to decrease the risk of progression from acute to chronic PTSD, information on the progression trajectory of short-term PTSD symptoms and modifiable risk factors in PICS patients is limited. This study aimed to explore the clinical progression trajectories of short-term PTSD symptoms and the associated factors in PICS patients by conducting a prospective longitudinal observational study.Patients and Methods: This study was conducted at a tertiary hospital in China. The impact of event scale-revised was used to collect data on the PTSD symptoms of patients at 1, 2, 3, and 4 months post-discharge from the ICU. The latent growth mixture model was used to construct trajectory models for PTSD symptoms and multivariate logistic regression was used to determine the factors associated with the trajectories.Results: A total of 130 ICU survivors with PICS completed the 4-month short-term follow-up. Our results showed that PTSD symptoms in PICS patients manifested as three trajectories, namely, moderate chronic (n = 17, 13.1%), recovery (n = 25, 19.2%), and resilience (n = 88, 67.7%). Compared with the resilience trajectory, age and female were identified as risk factors for the moderate chronic trajectory, while prolonged ICU stay was a risk factor for the recovery trajectory.Conclusion: Our study showed that short-term PTSD symptoms in PICS patients manifested as moderate chronic, recovery, and resilience trajectories. Additionally, our results showed that PTSD screening should be conducted for critically ill patients, especially younger, female, or long-term ICU patients, immediately after their discharge from the ICU.Keywords: post-traumatic stress disorder, latent growth mixture model, longitudinal study, post-intensive care syndrome

Abstract Background Few studies have longitudinally assessed the determinants of depressive symptoms among persons 80 years and older. The aim of this study was to estimate the determinants of depressive symptoms among persons 80 years and older based on 4-wave national longitudinal data from Thailand. Methods Data from the Health, Aging, and Retirement in Thailand study from 2015, 2017, 2020 and 2022 were utilized. The sample was restricted to community-dwelling persons 80 years and older (analytic sample: n = 2763 observations). For the pooled sample, average age was 85.0 years (range 80–117 years). Established measurements were used to assess depressive symptoms. Linear fixed effects regression was applied to assess the time-variant determinants and outcomes. Results Regressions found that higher functional disability and an increase in the number of chronic conditions worsened depressive symptoms. More favourable self-rated physical health, and higher exercise frequency improved depressive symptoms. In addition, among women higher subjective economic status decreased depressive symptoms. Conclusions This longitudinal study enhances our understanding of the determinants of depressive symptoms among persons 80 years and older. Strategies to delay or decrease functional disability, chronic conditions, increase physical activity, and improve subjective economic status may help in reducing depressive symptoms.

Abstract Background Greenspace is an important modifiable environmental factor that is associated with health and well-being. Although previous research has shown that exposure to greenspace is beneficial for cardiovascular diseases, studies have rarely focused on early subclinical health outcomes such as electrocardiogram (ECG) abnormality. Methods We developed a longitudinal study using data from the China National Stroke Screening Survey (2013–2019). Monthly exposure to greenspace was assessed by the Normalized Difference Vegetation Index (NDVI) values. ECG abnormality was diagnosed by physicians based on the results of the 12-lead electrocardiogram. We used fixed-effects logistic regression with participant-specific intercepts to estimate the association between exposure to greenspace and ECG abnormalities. Results A total of 132,108 visits from 61,029 participants with ≥ 2 ECG measurements were included. At baseline, the lag-1 month average NDVI value was 0.29 (SD = 0.15). In the fully adjusted model, per 0.1-unit increment in lag-1 month average NDVI value was associated with a 3.0% (95% CI -1.6 ∼ 7.4%) decreased risk of ECG abnormality. In urban areas, the decreased risk associated with per 0.1-unit increment in NDVI was 14.81% (95% CI 9.38 ∼ 19.92%). Conclusion Our study found that higher exposure to greenspace was associated with a decreased risk of ECG abnormality, especially in urban areas. Our findings suggested that monthly exposure to greenspace might be beneficial to cardiovascular health, and greenspace provision and maintenance could be considered an important public health intervention in urban planning.