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Abstract Background Validated and comprehensive tools to measure treatment burden are needed for healthcare professionals to understand the treatment burden of patients in China. The study aimed to translate and validate the Chinese version of Patient Experience with Treatment and Self-management (PETS vs. 2.0) in patients with multimorbidity in primary care. Methodology The translation process of the 60-item PETS vs. 2.0 followed the Functional Assessment of Chronic Illness Therapy (FACIT) Translation, Formatting, and Testing Guidelines. Computer-assisted assessments were conducted in adult primary care patients with multimorbidity from three general out-patient clinics in Hong Kong. A sample of 502 patients completed the assessments from July to December 2023. Internal reliability was examined using Cronbach’s alphas for each domain of the PETS vs. 2.0. Concurrent validity was assessed through the correlations between different domains of PETS vs. 2.0 with established measures including quality of life, frailty, and depression. Confirmatory Factor Analysis (CFA) with maximum likelihood method was carried out to assess the construct validity. Results The mean age of participants was 64.9 years old and 56.2% were female. Internal consistency reliability was acceptable (alpha ≥ 0.70) for most domains. Higher scores of PETS domains were significantly correlated with worse quality of life, higher level of frailty, and more depressive symptoms (p

Abstract The Lys-Asp-Glu-Leu receptor (KDELR) family genes play critical roles in a variety of biological processes in different tumors. Our study aimed to provide a comprehensive analysis of the potential roles of KDELRs in lung adenocarcinoma (LUAD). Utilizing data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database, as well as clinical samples, we conducted a series of analyses and validations using R software tools and various online resources. The results showed that KDELR family genes and proteins were highly expressed and associated with a poor prognosis of LUAD. Promoter hypomethylation and the competing endogenous RNA (ceRNA) network of PCAT6/hsa-miR-326/KDELR1 might be potential causes of aberrant KDELR1 overexpression in LUAD. Three key Transcription factors (TFs) (SPI1, EP300, and MAZ) and a TFs-miRNAs-KDELRs network (involving 11 TFs) might be involved in modulating KDELRs expression abnormalities. Gene Set Enrichment Analysis (GSEA) indicated enrichment of genes highly expressing KDELR1, KDELR2, and KDELR3 in MTORC1_SIGNALING, P53_PATHWAY, and ANGIOGENESIS. Negative correlations between KDELRs expression and CD8 + T cell infiltration, as well as CTLA-4 expression. Our multiple analyses suggested that the KDELRs are important signaling molecules in LUAD. These results provided novel insights for developing prognostic markers and novel therapies of LUAD.

Abstract High-sensitivity strain sensing elements with a wide strain range, fast response, high stability, and small sensing areas are desirable for constructing strain sensor arrays with high temporospatial resolution. However, current strain sensors rely on crack-based conductive materials having an inherent tradeoff between their sensing area and performance. Here, we present a molecular-level crack modulation strategy in which we use layer-by-layer assembly to introduce strong, dynamic, and reversible coordination bonds in an MXene and silver nanowire-matrixed conductive film. We use this approach to fabricate a crack-based stretchable strain sensor with a very small sensing area (0.25 mm2). It also exhibits an ultrawide working strain range (0.001–37%), high sensitivity (gauge factor ~500 at 0.001% and >150,000 at 35%), fast response time, low hysteresis, and excellent long-term stability. Based on this high-performance sensing element and facile assembly process, a stretchable strain sensor array with a device density of 100 sensors per cm2 is realized. We demonstrate the practical use of the high-density strain sensor array as a multichannel pulse sensing system for monitoring pulses in terms of their spatiotemporal resolution.

Abstract Introduction Emerging evidence supports mindfulness as a potential psychotherapy for post-traumatic stress disorder (PTSD). Individuals with subthreshold PTSD experience significant impairment in their daily life and functioning due to PTSD symptoms, despite not meeting the full diagnostic criteria for PTSD in DSM-5. Mindfulness skills, including non-judgmental acceptance, attentional control and openness to experiences may help alleviate PTSD symptoms by targeting characteristics such as intensified memory processing, dysregulated hyperarousal, avoidance, and thought suppression. This trial aims to test the effects of mindfulness-based cognitive therapy (MBCT) when compared to an active control. Method and analysis This 1:1 randomised controlled trial will enroll 160 participants with PTSD symptoms in 2 arms (MBCT vs. Seeking Safety), with both interventions consisting of 8 weekly sessions lasting 2 h each week and led by certified instructors. Assessments will be conducted at baseline (T0), post-intervention (T1), and 3 months post-intervention (T2), with the primary outcome being PTSD symptoms measured by the PTSD checklist for DSM-5 (PCL-5) at T1. Secondary outcomes include depression, anxiety, attention, experimental avoidance, rumination, mindfulness, and coping skills. Both intention-to-treat and per-protocol analyses will be performed. Mediation analysis will investigate whether attention, experimental avoidance, and rumination mediate the effect of mindfulness on PTSD symptoms. Discussion The proposed study will assess the effectiveness of MBCT in improving PTSD symptoms. The findings are anticipated to have implications for various areas of healthcare and contribute to the enhancement of existing intervention guidelines for PTSD. Trial registration number ChiCTR2200061863.

Pulmonary mucoepidermoid carcinoma (PMEC) is a rare tumor with limited clinical data available due to its low incidence. So far, there are no universal treatment guidelines for this malignant tumor. We present here the case of a 59-year-old female never smoker who was initially referred to our hospital with cough and hemoptysis and was eventually diagnosed with PMEC. Based on further genetic testing, echinoderm microtubule-associated protein-like4-anaplastic lymphoma kinase (EML4-ALK) fusion variants E20:A20 (V2) was found. The patient was treated with lorlatinib as the first-line treatment. This case is the first to describe the effectiveness of lorlatinib in treating an advanced high-grade PMEC with EML4-ALK fusion V2 mutation patient.

Abstract BackgroundPrevious literature lacks summative information on the mental health benefits achieved from different forms of walking. ObjectiveThe aim of this study was to assess the effectiveness of different forms of walking in reducing symptoms of depression and anxiety. MethodsThis was a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effects of walking on depressive and anxiety symptoms. MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, PsycINFO, Allied and Complementary Medicine Database (AMED), CINAHL, and Web of Science were searched on April 5, 2022. Two authors independently screened the studies and extracted the data. Random-effects meta-analysis was used to synthesize the data. Results were summarized as standardized mean differences (SMDs) with 95% CIs in forest plots. The risk of bias was assessed by using the Cochrane Risk of Bias tool. ResultsThis review included 75 RCTs with 8636 participants; 68 studies reported depressive symptoms, 39 reported anxiety symptoms, and 32 reported both as the outcomes. One study reported the results for adolescents and was not included in the meta-analysis. The pooled results for adults indicated that walking could significantly reduce depressive symptoms (RCTs: n=44; SMD −0.591, 95% CI −0.778 to −0.403; I22PI22PPI22I22PI22PI22P ConclusionsVarious forms of walking can be effective in reducing symptoms of depression and anxiety, and the effects of walking are comparable to active controls. Walking can be adopted as an evidence-based intervention for reducing depression and anxiety. More evidence on the effect of low-intensity walking is needed in the future.

Abstract Background To assess the long-term association between organised colorectal cancer (CRC) screening strategies and CRC-relate mortality. Methods We systematically reviewed studies on organised CRC screening through PubMed, Ovid Medline, Embase and Cochrane from the inception. We retrieved characteristics of organised CRC screening from included literature and matched mortality (over 50 years) of those areas from the International Agency for Research on Cancer in May 2023. The variations of mortality were reported via the age-standardised mortality ratio. A random-effects model was used to synthesis results. Results We summarised 58 organised CRC screening programmes and recorded > 2.7 million CRC-related deaths from 22 countries where rollout screening programmes were performed. The CRC screening strategy with faecal tests (guaiac faecal occult blood test (gFOBT) or faecal immunochemical tests (FIT)) or colonoscopy as the primary screening offer was associated with a 41.8% reduction in mortality, which was higher than those offered gFOBT (4.4%), FIT (16.7%), gFOBT or FIT (16.2%), and faecal tests (gFOBT or FIT) or flexible sigmoidoscopy (16.7%) as primary screening test. The longer duration of screening was associated with a higher reduction in the pooled age-standardised mortality ratio. In particular, the pooled age-standardised mortality ratio became non-significant when the screening of FIT was implemented for less than 5 years. Conclusions A CRC screening programme running for > 5 years was associated with a reduction of CRC-related mortality. Countries with a heavy burden of CRC should implement sustainable, organised screening providing a choice between faecal tests and colonoscopy as a preferred primary test.

Abstract In terrestrial ecosystems, leaf litter is the main source of nutrients returning to the soil. Understanding how litter decomposition responds to stand age is critical for improving predictions of the effects of forest age structure on nutrient availability and cycling in ecosystems. However, the changes in this critical process with stand age remain poorly understood due to the complexity and diversity of litter decomposition patterns and drivers among different stand ages. In this study, we examined the effects of stand age on litter decomposition with two well-replicated age sequences of naturally occurring secondary forests and Chinese fir (Cunninghamia lanceolata) plantations in southern China. Our results showed that the litter decomposition rates in the secondary forests were significantly higher than those in the Chinese fir plantations of the same age, except for 40-year-old forests. The litter decomposition rate of the Chinese fir initially increased and then decreased with stand age, while that of secondary forests gradually decreased. The results of a structural equation model indicated that stand age, litter quality and microbial community were the primary factors driving nutrient litter loss. Overall, these findings are helpful for understanding the effects of stand age on the litter decomposition process and nutrient cycling in plantation and secondary forest ecosystems.

Abstract Background The use of online and mobile internet and social media has been increasing in healthcare service delivery. However, there is limited literature on the acceptance and use of online health services for older adults with multimorbidity who require more medical care and assistance. This study aims to explore the use of social media in older adults with multimorbidity in Hong Kong primary care and to assess the feasibility and usage of online health services in this population, including satisfaction, preference, and problems encountered. Methods This is a cross-sectional study among older adults with multimorbidity conducted between November 2020 and March 2021 in a Hong Kong primary care programme. Online and face-to-face services were offered based on the needs of the participants. Demographic characteristics and health conditions were assessed at baseline. Participants using online services were invited to complete a feedback questionnaire. Results The study included 752 participants, of which 66.1% use social media every day. Participants who declined to use online services were found to be significantly older, live alone, have lower income, have social security assistance, have greater cognitive decline, and be less depressed (p

Abstract Background Meaning in life could be of clinical importance in stimulating healthy and preventive behaviors. The study aimed to investigate the association between meaning in life and preventive healthcare use among Chinese adults, and to assess their age and gender differences in the association. Methods A cross-sectional online survey was conducted among 1444 adults aged 18–64 years in February 2020 in China. Logistic regression models were employed to examine the association of meaning in life with preventive health checkups and assess their age and gender differences. Results The mean score of meaning in life was 5.801 (Standard Deviation = 1.349) out of 7. Each unit increase on the level of meaning in life was associated with 12.2% higher likelihood of using preventive health checkups (any type) (adjusted odds ratio 1.122, 95% confidence interval 1.015–1.241) after adjustment for sociodemographic factors, comorbidity and other psychological health factors. Meaning in life was significantly associated with the uses of X-ray (1.125, 1.010–1.253), B-ultrasound (1.176, 1.058–1.306), and blood testing (1.152, 1.042–1.274). The associations between meaning in life and these types of preventive healthcare increased with age, but there were no gender differences in these associations. Conclusion Higher meaning in life was independently related to more preventive health checkups. Strategies to strengthen health education and interventions to improve experience of meaning in life might be an important component to increase preventive healthcare use in China.

Abstract Background Dysregulation of inhibitor of differentiation/DNA binding (ID) genes is linked to cancer growth, angiogenesis, invasiveness, metastasis and patient survival. Nevertheless, few investigations have systematically determined the expression and prognostic value of ID genes in acute myeloid leukemia (AML). Methods The expression and clinical prognostic value of ID genes in AML were first identified by public databases and further validated by our research cohort. Results Using public data, the expression of ID1/ID3 was markedly downregulated in AML, and the expression of ID2 was greatly upregulated in AML, whereas ID4 showed no significant difference. Among the ID genes, only ID3 expression may be the most valuable prognostic biomarker in both total AML and cytogenetically normal AML (CN-AML) and especially in CN-AML. Clinically, reduced ID3 expression was greatly associated with higher white blood cell counts, peripheral blood/bone marrow blasts, normal karyotypes and intermediate cytogenetic risk. In addition, low ID3 expression was markedly related to FLT3 and NPM1 mutations as well as wild-type TP53. Despite these associations, multivariate Cox regression analysis revealed that ID3 expression was an independent risk factor affecting overall survival (OS) and disease free survival (DFS) in CN-AML patients. Biologically, a total of 839 mRNAs/lncRNAs and 72 microRNAs were found to be associated with ID3 expression in AML. Importantly, the expression of ID3 with discriminative value in AML was further confirmed in our research cohort. Conclusion The bioinformatics analysis and experimental verification demonstrate that low ID3 expression independently affects OS and DFS in patients with CN-AML, which might be seen as a potential prognostic indicator in CN-AML.

Acute myeloid leukemia (AML) is the most common type of hematological malignancy. Recently, an increasing number of reports have shown that many circular RNAs can act as effective targets for AML. However, the roles of circ_0059707 in AML remain largely unclear. In this study, we found that the expression levels of circ_0059707 were significantly decreased in AML patients with respect to normal controls (p < 0.001). Low expression levels of circ_0059707 were also associated with a poor prognosis. Furthermore, circ_0059707 overexpression inhibited cell growth and promoted apoptosis in leukemia cells, compared with control cells. Circ_0059707- and empty plasmid-transfected cells were injected subcutaneously into BALB/c nude mice. We found that the tumor volume was significantly lower in mice in the circ_0059707 group than in control mice (p < 0.01). Nuclear pyknosis, nuclear fragmentation, nuclear dissolution, and cell necrosis were observed in the circ_0059707 group by HE staining. CircInteractome analysis showed that 25 microRNAs (miRNAs), including miR-1287-5p, ©-miR-1825, a©hsa-miR-326, may be potential targets for circ_0059707. The expression of these miRNAs was analyzed in both the GEO GSE51908 and the GSE142700 databases. miR-1287-5p expression was lower in AML patients compared with controls in both the GSE51908 and the GSE142700 datasets. Moreover, we demonstrated that miR-1287-5p expression was down-regulated in AML patients and up-regulated in circ_0059707-overexpressing cells. Collectively, our research demonstrated that the down-regulation of circ_0059707 was highly evident in de novo AML patients. Our analysis also demonstrated that circ_0059707 inhibited cell growth and promoted apoptosis by up-regulating miR-1287-5p.

BackgroundPrimary care patients, especially those with an older age, are one of the most vulnerable populations for post-COVID-19 symptoms. Identifying predictors of post-COVID symptoms can help identify high-risk individuals for preventive care.MethodsOut of 977 primary care patients aged 55 years or above with comorbid physical and psychosocial conditions in a prospective cohort in Hong Kong, 207 patients infected in the previous 5–24 weeks were included. The three most common post-COVID-19 symptoms (breathlessness, fatigue, cognitive difficulty), which lasted beyond the 4-week acute infection period, were assessed using items from the COVID-19 Yorkshire Rehabilitation Scale (C19-YRS), together with other self-reported symptoms. Multivariable analyses were conducted to identify predictors of post-acute and long COVID-19 symptoms (5–24 weeks after infection).ResultsThe 207 participants had a mean age of 70.8 ± 5.7 years, 76.3% were female, and 78.7% had ≥2 chronic conditions. In total, 81.2% reported at least one post-COVID symptom (mean: 1.9 ± 1.3); 60.9, 56.5 and 30.0% reported fatigue, cognitive difficulty, and breathlessness respectively; 46.1% reported at least one other new symptom (such as other respiratory-related symptoms (14.0%), insomnia or poor sleep quality (14.0%), and ear/nose/throat symptoms (e.g., sore throat) (10.1%), etc.). Depression predicted post-COVID-19 fatigue. The female sex predicted cognitive difficulty. Receiving fewer vaccine doses (2 doses vs. 3 doses) was associated with breathlessness. Anxiety predicted a higher overall symptom severity level of the three common symptoms.ConclusionDepression, the female sex, and fewer vaccine doses predicted post-COVID symptoms. Promoting vaccination and providing intervention to those at high-risk for post-COVID symptoms are warranted.

Abstract RNA methylation plays a key role across biological processes, which could be utilized as new weapons for cancer management. However, the implication of RNA methylation regulators in cancers, especially in clear cell renal cell cancer (ccRCC), remains largely unknown. We investigated the multiomics profile of RNA methylation regulators at the pan‐cancer level. We found most RNA methylation regulators were dysregulated in cancers, which might be explained by genomic mutation and copy number variation. A novel subtype of ccRCC, RNA modification cancer subtype 2 (RMCS2), was identified and verified among different ccRCC cohorts. RMCS2 led to a shortened overall survival and had an activated state of PI3K‐AKT‐mTOR, KRAS, and retinoic acid metabolism signals, which resulted in an immune exhausted phenotype. In summary, our findings demonstrated that the aberrance of RNA methylation regulators was a common biological phenomenon pan‐cancer. Dysregulated RNA methylation patterns could reshape tumor immunity thus impacting patients' prognosis and therapeutic response, and could function as a promising tool for ccRCC patients.

Nanoplastics (NPs) are a matter of widespread concern, as they are easily absorbed by a wide variety of organisms and accumulate in biological tissues. While there is evidence that nanoplastics are toxic to various organisms, few studies have investigated the mechanisms underlying the toxicities of NPs with different surface functionalizations to macrophage cells. In this study, mouse mononuclear macrophage (RAW264.7) cells were exposed to polystyrene nanoplastics (PS-NPs) with three different surface functionalizations, namely pristine polystyrene (PS), carboxyl-functionalized polystyrene (PS-COOH), and amino-functionalized polystyrene (PS-NH2), to evaluate the cellular endocytosis, lactate dehydrogenase (LDH) release, cell viability, reactive oxygen species (ROS), mitochondrial membrane potential, apoptosis, and related gene expression. Results showed that all three PS-NPs were endocytosed into cells. However, in the concentration range of 0–100 μg/mL, PS had no effect on cell viability or apoptosis, but it slightly increased cellular ROS and decreased mitochondrial membrane potential. PS-NH2 exhibited the highest cytotoxicity. PS-COOH and PS-NH2 induced ROS production, altered the mitochondrial membrane potential, and caused cell apoptosis regulated by the mitochondrial apoptosis pathway. Results also showed that cell membrane damage induced by PS-NH2 is one of the primary mechanisms of its cytotoxicity to RAW264.7 cells. The results of this study clarify the toxicities of PS-NPs with different surface functionalizations to macrophages, thereby improving the identification of immune system risks related to nanoplastics.

Background: Various circular RNA (circRNA) molecules are abnormally expressed in acute myeloid leukemia (AML), and associated with disease occurrence and development, as well as patient prognosis. The roles of circ_0059706, a circRNA derived from ID1, in AML remain largely unclear.Results: Here, we reported circ_0059706 expression in de novo AML and its association with prognosis. We found that circ_0059706 expression was significantly lower in AML patients than in controls (p < 0.001). Survival analysis of patients with AML divided into two groups according to high and low circ_0059706 expression showed that overall survival (OS) of patients with high circ_0059706 expression was significantly longer than that of those with low expression (p < 0.05). Further, female patients with AML and those aged >60 years old in the high circ_0059706 expression group had longer OS than male patients and those younger than 60 years. Multiple regression analysis showed that circ_0059706 was an independent factor-affecting prognosis of all patients with AML. To evaluate the prospects for application of circ_0059706 in machine learning predictions, we developed seven types of algorithm. The gradient boosting (GB) model exhibited higher performance in prediction of 1-year prognosis and 3-year prognosis, with AUROC 0.796 and 0.847. We analyzed the importance of variables and found that circ_0059706 expression level was the first important variables among all 26 factors included in the GB algorithm, suggesting the importance of circ_0059706 in prediction model. Further, overexpression of circ_0059706 inhibited cell growth and increased apoptosis of leukemia cells in vitro.Conclusion: These results provide evidence that high expression of circ_0059706 is propitious for patient prognosis and suggest circ_0059706 as a potential new biomarker for diagnosis and prognosis evaluation in AML, with high predictive value and good prospects for application in machine learning algorithms.

Background: Different childhood experiences may affect adult health differently. Objective: To explore the association of different types of positive childhood experiences(PCEs) and adverse childhood experiences (ACEs) with risky behaviours and mental health indicators, andhow PCEs and ACEs are associated with health outcomes in the context of each other. Method: This was an exploratory cross-sectional online survey including 332 university students in Hong Kong. ACEs (abuse and household challenges), PCEs (perceived safety, positive quality of life, and interpersonal support), risky behaviours (smoking, binge drinking, and sexual initiation), and mental health indicators(depression, anxiety, loneliness, self-rated health, multimorbidity, meaning in life, and life satisfaction)were measured. Results: The multivariable logistic regression analysis indicated cumulative effects of PCEs in lowered risks of depression, anxiety, loneliness, as well as better self-rated health, life satisfaction, and meaning in life (p

Emergency online education has been adopted worldwide due to coronavirus disease 2019 (COVID-19) pandemic. Prior research regarding online learning predominantly focused on the perception of parents, teachers, and students in tertiary education, while younger children’s perspectives have rarely been examined. This study investigated how family, school, and individual factors would be associated with primary school students’ satisfaction, perceived effectiveness, and preference in online learning during COVID-19. A convenient sample of 781 Hong Kong students completed an anonymous online survey from June to October 2020. Logistic regression was conducted for 13 potential factors. Results indicated that only 57% of students were satisfied with their schools’ online learning arrangement and 49.6% regarded the online learning as an effective learning mode. Only 12.8% of students preferred online learning, while 67.2% of students preferred in-person schooling. Multiple analyses suggested that teacher–student interaction during online classes was positively associated with students’ satisfaction, perceived effectiveness, and preferences in online learning. Compared to grades 1–2 students, grades 3–6 students perceived more effectiveness and would prefer online learning. Happier schools were more likely to deliver satisfying and effective online education. Students who reported less happiness at school would prefer online learning, and students who reported less happiness at home would be less satisfied with online learning and reflected lower effectiveness. Teachers are encouraged to deliver more meaningful interactions to students and offer extra support to younger children during online classes. Primary schools and parents are encouraged to create a healthy and pleasant learning environment for children. The government may consider building up happy schools in the long run. The study findings are instrumental for policymakers, institutions, educators, and researchers in designing online education mechanisms.

Recurrent spontaneous abortion (RSA) is a highly heterogeneous complication of pregnancy with the underlying mechanisms remaining uncharacterized. Dysregulated decidualization is a critical contributor to the phenotypic alterations related to pregnancy complications. To understand the molecular factors underlying RSA, we explored the role of longnoncoding RNAs (lncRNAs) in the decidual microenvironment where the crosstalk at the fetal–maternal interface occurs. By exploring RNA-seq data from RSA patients, we identified H19, a noncoding RNA that exhibits maternal monoallelic expression, as one of the most upregulated lncRNAs associated with RSA. The paternally expressed fetal mitogen IGF2, which is reciprocally coregulated with H19 within the same imprinting cluster, was also upregulated. Notably, both genes underwent loss of imprinting, as H19 and IGF2 were actively transcribed from both parental alleles in some decidual tissues. This loss of imprinting in decidual tissues was associated with the loss of the H3K27m3 repressive histone marker in the IGF2 promoter, CpG hypomethylation at the central CTCF binding site in the imprinting control center (ICR), and the loss of CTCF-mediated intrachromosomal looping. These data suggest that dysregulation of the H19/IGF2 imprinting pathway may be an important epigenetic factor in the decidual microenvironment related to poor decidualization.

Background: There is a lack of study comprehensively comparing the effects of all existing types of interventions on global cognition among patients with mild cognitive impairment (MCI).Aims: To conduct a network meta-analysis to evaluate the effectiveness of different types of interventions in improving global cognition among MCI patients.Methods: Randomized controlled trials (RCTs) assessing the effects of pharmacological or non-pharmacological interventions on the Mini-Mental State Examination (MMSE) in MCI patients were included. Two authors independently screened the studies and extracted the data. Random-effects network meta-analysis was used to synthesize the data. Results were summarized as mean difference (MD) and corresponding 95% CIs of MMSE in forest plots.Results: Fifty RCTs with 5,944 MCI patients met the inclusion criteria and 49 were included in the network meta-analysis. Compared with the control group, cognition-based intervention (MD = 0.80, 95% CI 0.04–1.57), physical exercise (MD = 1.92, 95% CI 1.19–2.64), combined physical exercise and cognition-based intervention (MD = 1.86, 95% CI 0.60–3.12), and antioxidants (MD = 0.94, 95% CI 0.04–1.83) had positive effects on MMSE in participants with MCI. There was no significant difference between all other interventions included and the control group.Conclusions: This study suggested that cognition-based intervention, physical exercise, combined physical exercise and cognition-based intervention, and antioxidants could be among the most effective interventions on global cognition in older adults with MCI. The availability, acceptability, and cost-effectiveness of interventions should also be taken into consideration when selecting interventions.Registration: PROSPERO CRD42020171985.

Prostate cancer (PCa) is one of the most frequently diagnosed cancers in males worldwide. Approximately 25% of all patients experience biochemical recurrence (BCR) after radical prostatectomy (RP) and BCR indicates increased risk for metastasis and castration resistance. PCa patients with highly glycolytic tumors have a worse prognosis. Thus, this study aimed to explore glycolysis-based predictive biomarkers for BCR. Expression data and clinical information of PCa samples were retrieved from three publicly available datasets. One from The Cancer Genome Atlas (TCGA) dataset was used as the training cohort, and two from the Gene Expression Omnibus (GEO) dataset (GSE54460 and GSE70769) were used as validation cohorts. Using the training cohort, univariate Cox regression survival analysis, robust likelihood-based survival model, and stepwise multiply Cox analysis were sequentially applied to explore predictive glycolysis-related candidates. A five-gene risk score was then constructed based on the Cox coefficient as the following: (−0.8367*GYS2) + (0.3448*STMN1) + (0.3595*PPFIA4) + (−0.1940*KDELR3) + (0.4779*ABCB6). Receiver operating characteristic curve (ROC) analysis was used to identify the optimal cut-off point, and patients were divided into low risk and high risk groups. Kaplan–Meier analysis revealed that high risk group had significantly shorter BCR free survival time as compared with that in low risk group in training and validation cohorts. In conclusion, our data support the glycolysis-based five-gene signature as a novel and robust signature for predicting BCR of PCa patients.

The novel coronavirus (COVID-19) infection has spread worldwide since late 2019. People who have social contacts with COVID-19 patients might be at higher risk of physical or mental health problems. This study investigated whether people who had social contacts with COVID-19 patients would have poorer physical or mental outcomes, and different attitudes and behaviors. Chinese adults were recruited to fill in an online survey using snowball sampling during 21st-26nd February 2020. Physical symptoms, psychological outcomes, quality of life, COVID-19 related attitudes, and behaviors were measured. The differences in the outcomes between participants who had COVID-19 social contacts and those who had not were analyzed. The survey included 1,447 non-infected eligible participants. Among those, 173 (12.0%) reported at least one confirmed/suspected case in their social contacts. In the multiple regression adjusted for demographic data, the presence of confirmed/suspected infection cases in one's social contacts was significantly associated with poorer physical and mental outcomes, lower health-related quality of life, and different COVID-19 related attitudes and behaviors (p

Objectives This study aims to investigate the potential factors associated with mental health outcomes among Chinese adults during the Coronavirus disease 2019 (COVID-19) epidemic. Methods This is an online cross-sectional survey conducted among Chinese adults in February 2020. Outcome measurements included the three-item UCLA Loneliness Scale (UCLA-3), two-item Patient Health Questionnaire (PHQ-2), two-item Generalized Anxiety Disorder Questionnaire (GAD-2), and two items from the Clinician-Administered Post-traumatic Stress Disorder (PTSD) Scale. COVID-19 related factors, physical health, lifestyle, and self-efficacy were also measured. Univariable and multivariable logistic regressions were performed. Results This study included 1456 participants (age: 33.8±10.5 years; female: 59.1%). The prevalence of depressive symptoms, anxiety symptoms, loneliness, and PTSD symptoms were 11.3%, 7.6%, 38.7%, and 33.9%, respectively. In multivariable analysis, loneliness was associated with being single, separated/divorced/widowed, low level of education, current location, medication, more somatic symptoms, lower self-efficacy, and going out frequently. Depression was associated with fear of infection, binge drinking, more somatic symptoms, lower self-efficacy, and longer screen time. Anxiety was associated with more somatic symptoms and lower self-efficacy. PTSD symptoms were associated with more somatic symptoms, lower self-efficacy, higher perceived risk of infection, fear of infection, and self-rated more negative influence due to the epidemic (pConclusions Mental health problems during the COVID-19 epidemic were associated with various biopsychosocial and COVID-19 related factors. Psychological interventions should be aware of these influencing factors and prioritize support for those people at higher risk.

(1) Background: To summarize the achievements of the performance indicators of colorectal cancer (CRC) screening programs that used the fecal immunochemical test (FIT) as a primary screening modality and colonoscopy as a subsequent confirmatory test. (2) Methods: PubMed, Ovid MEDLINE, Embase, and Cochrane were searched from inception to September 2020. We included original articles published in English, and performed hand searching for relevant national reports. We generated pooled achievement estimates of the performance indicators by “metaprop” (R software 3.6.3). Meta-regression analyses and subgroup analyses were also conducted. (3) Results: We included 93 studies involving nearly 90 million people-times. The participation rate ranged from 6.80% to 95.98%, which was associated with study type, continents, FIT number, age, and round. The pooled FIT invalid rate and positivity rate were 1.08% and 7.28%, respectively. The pooled estimates of FIT detection were 2.26% for adenoma, 1.26% for advanced adenoma, and 0.28% for CRC. In addition, only seven studies reported that their colonoscopy compliance rate reached 90% among 69 studies. The colonoscopy completion rate (21/40 studies > 95%) and the complication rate (18/27 studies < 0.5%) were acceptable. (4) Conclusions: Our findings could help to identify the areas that could be improved and finally optimize the CRC screening programs.

Objectives To examine the feasibility and preliminary effectiveness of (1) combining cognitive training, mind-body physical exercise, and nurse-led risk factor modification (CPR), (2) nurse-led risk factor modification (RFM), and (3) health advice (HA) on reducing cognitive decline among older adults with mild cognitive impairment (MCI). Methods It was a 3-arm open-labeled pilot randomized controlled trial in the primary care setting in Hong Kong. Nineteen older adults with MCI were randomized to either CPR (n = 6), RFM (n = 7), or HA (n = 6) for 6 months. The primary outcome was the feasibility of the study. Secondary outcomes included the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), the Montreal Cognitive Assessment Hong Kong version (HK-MoCA), the Clinical Dementia Rating (CDR), the Disability Assessment for Dementia (DAD), quality of life, depression, anxiety, physical activity, health service utilization, and diet. Results Nineteen out the 98 potential patients were recruited, with a recruitment rate of 19% (95% CI [12–29]%, P = 0.243). The adherence rate of risk factor modification was 89% (95% CI [65–98]%, P = 0.139) for CPR group and 86% (95% CI [63–96]%, P = 0.182) for RFM group. In the CPR group, 53% (95% CI [36–70]%, P = 0.038) of the Tai Chi exercise sessions and 54% (95% CI [37–71]%, P = 0.051) of cognitive sessions were completed. The overall dropout rate was 11% (95% CI [2–34]%, P = 0.456). Significant within group changes were observed in HK-MoCA in RFM (4.50 ± 2.59, P = 0.008), cost of health service utilization in CPR (−4000, quartiles: −6800 to −200, P = 0.043), fish and seafood in HA (−1.10 ± 1.02, P = 0.047), and sugar in HA (2.69 ± 1.80, P = 0.015). Group × time interactions were noted on HK-MoCA favoring the RFM group (P = 0.000), DAD score favoring CPR group (P = 0.027), GAS-20 favoring CPR group (P = 0.026), number of servings of fish and seafood (P = 0.004), and sugar (P

BACKGROUND:Osteoporosis is a chronic disease whose prevention is more effective than treatment, but it may be necessary to change people's self-efficacy to prevent this condition. This article aimed to study the pathway among information, beliefs and self-efficacy in osteoporosis prevention, and support further intervention. METHODS:A cross-sectional study was conducted among community residents over 40 years old from two volunteer communities in urban Shanghai, China. Of 450 middle-aged and older community residents who volunteered to participate in the study, 421 (93.5%) finished the field survey effectively. RESULTS:62.9% of the residents were females. Their mean age was 64.4 ± 11.2 years. The residents showed low knowledge of osteoporosis-related information, and the mean percentage of correct response was just 61.2%. In univariate analysis, information (univariate β = 0.27, 95% CI = 0.15-0.38) and beliefs (univariate β = 0.31, 95% CI = 0.25-0.38) were associated with self-efficacy. Multivariate analysis showed that information (multiple β = 0.19, 95% CI = 0.09-0.36) and belief (multiple β = 0.30, 95% CI = 0.23-0.36) remained significant. And in the path analysis, self-efficacy was significantly predicted by beliefs (β = 0.81, p