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Jie Liu,1,&ast; Ke Zhao,2,&ast; Wei Kang,1,&ast; Siyu Tong,1 Yao Xu,1 Wei Jin,1 Mengxuan Qiao,1 Yuan Li,1 Lan Hong,3 Keqing Yao,4,5 Tiansheng Zheng6 1School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China; 2Lishui Second People’s Hospital Affiliated to Wenzhou Medical University, Lishui, People’s Republic of China; 3The Third Hospital of Quzhou, Quzhou, People’s Republic of China; 4Shenzhen Mental Health Center, Shenzhen, Guangdong, People’s Republic of China; 5Shenzhen Kangning Hospital, Shenzhen, Guangdong, People’s Republic of China; 6The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Keqing Yao, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, Guangdong, People’s Republic of China, Tel +86-755-82927264, Email KQKangning@gmail.com Tiansheng Zheng, The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, People’s Republic of China, Email sky.tsh@163.comIntroduction: Non-suicidal self-injury (NSSI) is becoming an increasingly prevalent phenomenon among adolescents, endangering their health. The aims of this study were to 1) explore the associations between borderline personality features, alexithymia and NSSI and 2) examine if alexithymia mediates the relationships between borderline personality features and both the severity of NSSI and the various functions that maintain NSSI in adolescents.Methods: This cross-sectional study recruited 1779 outpatient and inpatient aged 12– 18 years from psychiatric hospitals. All adolescents completed a structured four-part questionnaire including demographic items, the Chinese version of the Functional Assessment of Self-Mutilation, the Borderline Personality Features Scale for Children and the Toronto Alexithymia Scale.Results: The structural equation modelling results indicated that alexithymia partially mediated the associations between borderline personality features and both the severity of NSSI and the emotion regulation function of NSSI (B = 0.058 and 0.099, both p < 0.001), after controlling for age and sex.Discussion: These findings suggest that alexithymia may play a role in the mechanism and treatment of NSSI among adolescents with borderline personality features. Further longitudinal studies are essential to validate these findings.Keywords: self-harm, health, emotion regulation, structural equation modelling

Rui Wang,1– 4 Wei Zhang,1– 3 Yuanyuan Li,1– 3 Yuting Jiang,1– 3 Hongqi Feng,1– 3 Yang Du,1– 3 Zhe Jiao,1– 3 Li Lan,4 Xiaona Liu,1– 3 Bingyun Li,1– 3 Chang Liu,1– 3 Xingbo Gu,5 Fang Chu,1– 3 Yuncheng Shen,1– 3 Chenpeng Zhu,1– 3 Xinhua Shao,1– 3 Simeng Tong,1– 3 Dianjun Sun1– 3 1Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, People’s Republic of China; 2National Health Commission & Education Bureau of Heilongjiang Province, Key Laboratory of Etiology and Epidemiology, Harbin Medical University (23618504), Harbin, 150081, People’s Republic of China; 3Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, 150081, People’s Republic of China; 4Harbin Center for Disease Control and Prevention, Harbin, 150056, People’s Republic of China; 5Department of Biostatistics, School of Public Health, Hainan Medical University, Haikou, 571199, People’s Republic of ChinaCorrespondence: Dianjun Sun, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Baojian Road 157, Harbin, Heilongjiang Province, 150081, People’s Republic of China, Tel +86-13313685318, Fax +86 45186612695, Email hrbmusdj@163.comPurpose: To investigate the environmental, immune, and inflammatory factors associated with chronic obstructive pulmonary disease (COPD) in middle-aged and older Chinese individuals.Patients and Methods: A community-based case–control study was conducted among 471 patients with COPD and 485 controls. The information on COPD of the participants was collected through face-to-face interviews, and serum samples were measured at the laboratory. The main risk factors for COPD were analyzed using principal component analysis (PCA) and logistic regression.Results: Nine hundred and fifty-six respondents were included in the analysis. The results of the PCA-logistic regression analysis showed significant differences in the environmental factors, medical history, and serum C-reactive protein (CRP) levels between patients and controls. COPD was markedly more usual in those with smoking index > 200 (OR, 1.42; 95% CI, 1.28– 1.57); exposure to outdoor straw burning (OR, 1.64; 95% CI, 1.47– 1.83); use of coal, wood, and straw indoors (OR, 2.31; 95% CI, 1.92– 2.78); history of respiratory disease and coronary heart disease (OR, 3.58; 95% CI, 3.12– 4.10), congestive heart failure (OR, 1.23; 95% CI, 1.09– 1.38), and cerebrovascular disease (OR, 1.15; 95% CI,1.02– 1.31); and higher serum level of CRP (OR, 1.20; 95% CI, 1.11– 1.30). Compared to the logistic regression analysis, PCA logistic regression analysis identified more important risk factors for COPD.Conclusion: PCA-logistic regression analysis was first utilized to explore the influencing factors among rural residents in Northeast China Environmental aged 40 years and above, it was found that environmental factors, medical history, and serum CRP levels mainly affected the prevalence of COPD.Keywords: chronic obstructive pulmonary disease, collinearity, principal component, logistic regression

Yiting Chen,1,&ast; Anda Zhao,2,&ast; Jiajun Lyu,3 Yabin Hu,4 Yong Yin,4 Jiajie Qu,5 Shilu Tong,1,4,6,7 Shenghui Li1,8 1School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 3Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 4Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 5Childcare Department, Shanghai Municipal Education Commission, Shanghai, People’s Republic of China; 6School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, People’s Republic of China; 7School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; 8MOE-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Shenghui Li, School of Public Health, Shanghai Jiao Tong University, 227 South Chongqing Road, Huangpu District, Shanghai, 200025, People’s Republic of China, Tel +86-21-63846590, Email lsh9907@163.com; submission9907@163.com Shilu Tong, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Road, Pudong New Area, Shanghai, 200127, People’s Republic of China, Tel +86-21-38625635, Email tongshilu@scmc.com.cnPurpose: To examine whether parasomnia symptoms are associated with increased odds of childhood asthma and wheeze, and the role of preterm birth.Patients and Methods: The Shanghai Children’s Allergy Study was cross-sectionally conducted in 31 kindergartens and 17 primary schools in Shanghai, China. After excluding the missing data of gestational week and child’s age, this study included a total of 16,487 individuals with a mean age of 7.74 years and 52.4% of males. The association between parasomnia symptoms and wheeze/asthma was assessed by univariate and multivariate analyses. The interaction effects of parasomnias and preterm birth were primarily evaluated by P for multiplicative interaction, and the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI) were also measured.Results: Parasomnias, especially rapid eye movement (REM) parasomnia symptoms, were associated with an increased risk of childhood wheeze/asthma, and the interaction between parasomnia and preterm birth exhibited an excess risk of current wheeze (RERI, 1.43; 95% CI, 0.41– 2.45) and ever asthma (RERI, 0.75; 95% CI, 0.01– 1.50). In the stratification analyses, the combination of parasomnia symptoms and preterm birth had higher odds of wheeze/asthma. And the odds of current wheeze (OR, 4.55; 95% CI, 1.69– 12.25; p=0.003) and ever asthma (OR, 6.17; 95% CI, 2.36– 16.11; p< 0.001) were much higher in cumulative parasomnia symptoms plus very preterm birth. And sensitive analyses were further conducted in populations without sleep disordered breathing (SDB), and an allergen test subgroup, yielding similar results.Conclusion: Parasomnia symptoms are associated with increased odds of childhood wheeze/asthma, and the odds were even higher in premature population. The findings suggest that parasomnia symptoms, as a developmental sleep disorder, are supposed to be closely watched among children who have asthma or are at risk for asthma, and that preterm children deserve more attention.Keywords: sleep, sleep disorders, premature, respiratory allergies

As a nutrient rich emulsion extracted from plant materials, plant-based milk (PBM) has been the latest trend and hot topic in the food industry due to the growing awareness of consumers toward plant-based products in managing the environmental (carbon footprint and land utility), ethical (animal well-fare) and societal (health-conscious) issues. There have been extensive studies and reviews done to discuss the distinct perspective of PBM including its production, health effects and market acceptance. However, not much has been emphasized on the valuable antioxidants present in PBM which is one of the attributes making them stand apart from dairy milk. The amounts of antioxidants in PBM are important. They offered tremendous health benefits in maintaining optimum health and reducing the risk of various health disorders. Therefore, enhancing the extraction of antioxidants and preserving their activity during production and storage is important. However, there is a lack of a comprehensive review of how these antioxidants changes in response to different processing steps involved in PBM production. Presumably, antioxidants in PBM could be potentially lost due to thermal degradation, oxidation or leaching into processing water. Hence, this paper aims to fill the gaps by addressing an extensive review of how different production steps (germination, roasting, soaking, blanching, grinding and filtration, and microbial inactivation) affect the antioxidant content in PBM. In addition, the effect of different microbial inactivation treatments (thermal or non-thermal processing) on the alteration of antioxidant in PBM was also highlighted. This paper can provide useful insight for the industry that aims in selecting suitable processing steps to produce PBM products that carry with them a health declaration. [ABSTRACT FROM AUTHOR]

Juanjuan Dong,1 Sihao Tong,1 Xianfeng Shi,1 Chao Wang,1 Xin Xiao,1 Wenping Ji,2 Yimian Sun3 1Department of Oncology, Anhui Medical University-Affiliated Chaohu Hospital, Hefei 238000, Anhui, People’s Republic of China; 2Department of Education, Anhui Medical University-Affiliated Chaohu Hospital, Hefei 238000, Anhui, People’s Republic of China; 3Department of Gynecology and Obstetrics, Huaian City Second People’s Hospital, Huaian 223000, Jiangsu, People’s Republic of ChinaCorrespondence: Yimian SunDepartment of Gynecology and Obstetrics, Huaian City Second People’s Hospital, Huaian 223000, Jiangsu, People’s Republic of ChinaTel +86 15955175587Fax +86 55182324656Email 281763390@qq.comPurpose: Lung cancer is the leading cause of cancer-related mortality and non-small-cell lung cancer (NSCLC) accounts for 80– 90% of all lung cancers. However, biomarkers to predict the prognosis of NSCLC patients upon treatment with tyrosine kinase inhibitors remain unreliable. Different types of EGFR mutations can help predict the efficacy of tyrosine kinase inhibitor (TKI) treatment among advanced NSCLC patients harboring them. However, survival varies among individuals harboring the same mutation after targeted therapy. This study aimed to investigate the value of serum tumor markers (STMs) and EGFR mutations in the prognostic assessment of progression-free survival (PFS) in advanced-stage EGFR-mutated NSCLC.Patients and Methods: A retrospective clinical review was performed on 81 NSCLC patients harboring EGFR mutations and for whom STM data, measured before commencement of first‐line treatment with tyrosine kinase inhibitors, were available. Associations among EGFR mutations, STMs, baseline clinical features, and PFS were analyzed. Kaplan−Meier method was used to plot survival curves, and Cox logistic regression models were used to identify independent prognostic factors.Results: Exon 19 deletion (19-del) in EGFR, negative neuron-specific enolase (NSE), negative pro-gastrin-releasing peptide precursor (ProGRP) value, and “never smoking” status were significantly associated with improved PFS (P=0.007, P=0.001, P< 0.001, and P< 0.001, respectively). Multivariate Cox analysis revealed that 19-del in EGFR, never smoking, negative ProGRP value, and negative NSE were independent predictors of PFS.Conclusion: This study demonstrated that 19-del in EGFR may predict longer PFS in advanced-stage EGFR-mutated NSCLC treated with TKIs. Additionally, longer PFS can be predicted by serum tumor markers with negative ProGRP value, negative NSE value before initial treatment, and “never smoking.” Therefore, in addition to the EGFR mutation type and smoking status, physicians can also prognosticate the PFS of tyrosine kinase inhibitors treatment according to the values of ProGRP and NSE before treatment.Keywords: non-small-cell lung cancer, serum tumor markers, prognosis, progression-free survival

Jiajun Lyu, 1,* Xiuxia Ye, 2,* Yiting Chen, 1 Yuanqing Xia, 1 Jianzhen Zhu, 3 Shilu Tong, 1, 2, 4 Yong Yin, 2 Jiajie Qu, 5 Shenghui Li 1, 6 1School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 3School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 4School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia; 5Shanghai Municipal Education Commission, Shanghai, People’s Republic of China; 6MOE-Shanghai Key Laboratory of Children’s Environmental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shenghui LiSchool of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Huangpu District, Shanghai 200025, People’s Republic of ChinaTel +86-21-63846590Email lsh9907@163.comJiajie QuShanghai Municipal Education Commission, 100 Dagu Road, Huangpu District, Shanghai 200003, People’s Republic of ChinaTel +86-21-23111111Email qujiajie@vip.163.comBackground: Animal studies suggested that maternal sleep during pregnancy was associated with sleep pattern in offspring; however, it has not been clear in human populations.Aim: Our study discusses the relationships of maternal sleep duration with sleep characteristics in their offspring through an epidemiological study.Methods: A retrospective cross-sectional study including 6236 mother–child dyads was conducted in 31 preschools in May 2019, in Shanghai, China. Information regarding maternal sleep duration in three trimesters of pregnancy was collected retrospectively. Children’s current sleep characteristics were evaluated through the Children’s Sleep Habits Questionnaire (CSHQ). Linear regressions and logistic regression models were applied to estimate β and adjusted odds ratios with 95% confidence intervals (95% CI).Results: Maternal sleep duration was positively associated with childhood sleep duration, which was shown in the first (β=0.113), second (β=0.131), and third trimesters (β=0.088). Meanwhile, insufficient maternal sleep duration could increase the risk of children’s short sleep duration (first trimester: AOR=1.25; second trimester: AOR=1.33; third trimester: AOR=1.33). Maternal sleep duration was also associated with childhood CSHQ score: β=− 0.308, − 0.392, and − 0.300 for the first, second, and third trimesters, respectively. Similarly, insufficient maternal sleep duration could predict childhood sleep disturbance as AOR=1.28 in the second trimester and AOR=1.26 in the third trimester.Conclusion: Our findings established a relationship between maternal sleep during pregnancy and their children’s sleep pattern through a population-based epidemiology study. Poor childhood sleep was found when their mother experienced less sleep duration during pregnancy, especially in the second and third trimesters.Keywords: Children’s Sleep Habit Questionnaire, pregnant women, preschooler, sleep duration

Survival benefit (SB) for first liver transplantation (LT) is favorable at Model for End-Stage Liver Disease (MELD)≥15. Herein, we identify the MELD threshold for SB from repeat liver transplantation (ReLT) by recipient hepatitis C virus (HCV) status and donor risk index (DRI). We analyzed lab MELD scores in new United Network for Organ Sharing registrants for ReLT from March 2002 to January 2010. Risk of ReLT graft failure≤1 year versus waitlist mortality was calculated using Cox regression, adjusting for recipient characteristics. Of 3057 ReLT candidates, 54% had HCV and 606 died while listed. There were 1985 ReLT recipients, 52% had HCV and 567 ReLT graft failures by 1 year. Unadjusted waitlist mortality and post-ReLT graft failure rates were 416 (95% confidence interval [CI] 384-450) and 375 (95% CI 345-407) per 1000 patient-years, respectively. Waitlist mortality was higher with increasing waitlist MELD (p

Jennifer Luk,1 Yong Lu,1 Amanda Ackermann,1 Xiaoxue Peng,1 Diane Bogdan,1 Michelino Puopolo,1 David E Komatsu,2 Simon Tong,3 Iwao Ojima,3,4 Mario J Rebecchi,1 Martin Kaczocha1,4 1Department of Anesthesiology, 2Department of Orthopedics, 3Department of Chemistry, 4Institute of Chemical Biology and Drug Discovery, Stony Brook University, Stony Brook, NY, USA Background: Metabolism of the endocannabinoid 2-arachidonoylglycerol (2-AG) yields arachidonic acid (AA), the precursor to proalgesic eicosanoids including prostaglandin E2 (PGE2). Diacylglycerol lipase β (DAGLβ) is an enzyme that synthesizes 2-AG and its inhibition reduces eicosanoid levels and produces antinociceptive effects in models of inflammatory pain. Here we test whether inhibition of DAGLβ produces antinociceptive effects in a model of postoperative pain.Methods: Rats were administered the selective DAGLβ inhibitor KT109 or vehicle and underwent plantar incision. Postsurgical pain/disability was examined using evoked (mechanical hyperalgesia), functional (incapacitance/weight bearing), and functional/spontaneous (locomotion) modalities.Results: Activity-based protein profiling confirmed that KT109 inhibited DAGLβ in the lumbar spinal cord (LSC) and brain, confirming that it is a systemically active DAGLβ inhibitor. Treatment with KT109 reduced basal 2-AG, AA, and PGE2 levels in the liver but not the brain, indicating that DAGLβ activity does not significantly contribute to basal PGE2 production within the central nervous system. Plantar incision elevated the levels of 2-AG and PGE2 in the LSC. Although KT109 did not alter postsurgical 2-AG levels in the LSC, it slightly reduced PGE2 levels. In contrast, the clinically efficacious cyclooxygenase inhibitor ketoprofen completely suppressed PGE2 levels in the LSC. Similarly, KT109 had no significant effect upon postsurgical 2-AG, AA, or PGE2 levels at the incision site, while ketoprofen abolished PGE2 production at this location. KT109 and ketoprofen reversed the weight bearing imbalance induced by plantar incision, yet neither KT109 nor ketoprofen had any significant effect on mechanical hyperalgesia. Treatment with ketoprofen partially but significantly rescued the locomotor deficit induced by incision while KT109 was without effect. Conclusion: DAGLβ is not the principal enzyme that controls 2-AG derived AA and PGE2 production after surgery, and inhibitors targeting this enzyme are unlikely to be efficacious analgesics superior to those already approved to treat acute postoperative pain. Keywords: pain, incision, surgery, endocannabinoid, 2-AG

Ping Zhong,1,2,* Danhong Wu,3,* Xiaofei Ye,4 Ying Wu,2 Tuming Li,2 Shuwen Tong,2 Xueyuan Liu1,5 1Department of Neurology, Shanghai Tenth People’s Hospital, Nanjing Medical University, 2Department of Neurology, Shanghai Traditional Chinese and Western Medicine Hospital, Shanghai University of Traditional Chinese Medicine, 3Department of Neurology, Shanghai Fifth People’s Hospital, Fudan University, 4Department of Statistics, Second Military Medical University, 5Department of Neurology, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: Statins have been recommended for the use in atherosclerotic cardiovascular diseases, but different statins have distinct pharmacological characteristics. This multi-treatment meta-analysis aimed to evaluate the efficacy of seven statins in the secondary prevention of major cerebrovascular events (CVEs). Methods and analyses: The PubMed, Embase, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials were searched to identify studies published between January 1, 2011, and June 30, 2016. The included randomized controlled trials investigated the efficacy of lovastatin, atorvastatin, fluvastatin, simvastatin, pitavastatin, pravastatin or rosuvastatin in the secondary prevention of CVEs. The primary outcomes were CVEs; the secondary outcomes were all-cause death, fatal stroke and nonfatal stroke. Meta-analysis and network meta-analysis were used for data synthesis. Results: A total of 42 studies with 82,601 patients were included for analysis. In the secondary prevention of cardiovascular diseases, the major CVEs in pravastatin (risk ratio [RR] 0.87, 0.76–0.99)- and atorvastatin (RR 0.59, 0.49–0.72)-treated patients reduced significantly compared with controls. Indirect comparisons with network meta-analysis showed that RR was 0.60 (0.40–0.92) for atorvastatin compared with rosuvastatin. Compared to controls, the all-cause death was reduced by 12% in statins-treated patients (RR 0.88, 0.81–0.96). Indirect comparisons with network analysis showed a significant difference in the nonfatal stroke between fluvastatin-treated patients and lovastatin-treated patients (RR 0.28, 0.07–0.95). Conclusion: Different statins have distinct pharmacological characteristics, and there are differences in statistical and clinical outcomes among several statins. Keywords: atherosclerotic cardiovascular disease, cerebrovascular event, randomized, controlled trial, primary outcome