Muscle quality index is associated with trouble sleeping: a cross-sectional population based study

Association between physical activity patterns and symptoms of obstructive sleep apnea: a cross-sectional analysis of NHANES data

BACKGROUND

With the acceleration of modern life, the "Weekend Warrior" (WW) exercise pattern has become increasingly popular. This study based on data from the National Health and Nutrition Examination Survey (NHANES) from 2007-2008, 2015-2016, and 2017-2020, examines the association between physical activity (PA) patterns and symptoms of obstructive sleep apnea (OSA) in adults aged 18 and above.

METHODS

The analysis included 19,223 adults who provided self-reported data on their PA patterns. Participants were categorized into four PA groups: inactive, insufficiently active, weekend warrior (WW), and regularly active (RA). Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to determine the association between PA patterns and OSA symptoms. Stratified analyses were performed to assess variations across demographic and BMI subgroups.

RESULTS

After adjusting for relevant covariates, the WW (OR = 0.85, 95% CI: [0.72, 0.99]) and RA (OR = 0.83, 95% CI: [0.77, 0.90]) groups demonstrated significantly lower odds of OSA symptoms compared to the inactive group. The protective effect of the WW pattern was observed in specific subgroups, including non-Hispanic whites, low-income individuals, and males. In contrast, the RA pattern exhibited a more consistent protective effect across most demographic and BMI subgroups. No significant difference in OSA symptom likelihood was found between the RA and WW groups after adjusting for covariates (OR = 1.02, 95% CI: [0.87, 1.20]).

CONCLUSION

Both the WW and RA patterns are associated with a significantly lower prevalence of OSA symptoms compared to inactivity. While the WW pattern appears beneficial for certain subgroups, the RA pattern shows broader applicability. These findings highlight the potential of even non-daily PA, such as weekend activity, in reducing the likelihood of OSA symptoms, especially in specific populations.

Association between skeletal muscle mass to visceral fat area ratio and depression: A cross-sectional study based on the National Health and Nutrition Examination Survey

BACKGROUND

Skeletal muscle mass to visceral fat area ratio (SVR) has emerged as a key indicator for evaluating sarcopenic obesity (SO). The study aimed to elucidate the association between SVR and depression among US adults.

METHODS

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018, this cross-sectional study employed weighted multivariable logistic regression and restricted cubic splines (RCS) to explore the association between SVR and depression. Subgroup and interaction analyses were also performed.

RESULTS

The analysis encompassed 7,262 US adults. In the fully adjusted model, a significant negative association between SVR and depression was observed (OR = 0.35, 95%CI: 0.14-0.87). Additionally, SVR was significantly negatively correlated with mild (OR = 0.53, 95 % CI: 0.30-0.96) and severe depression (OR = 0.19, 95 % CI: 0.05-0.84). When SVR was stratified into quartile (Q1-Q4), individuals in the highest quartile exhibited a lower likelihood of depression compared to those in the lowest quartile (OR = 0.65, 95 % CI: 0.42-0.99). Additionally, the third quartile of SVR was significantly negatively associated with mild depression (OR = 0.72, 95 % CI: 0.53-0.98). No significant non-linear dose-response relationship between SVR and depression prevalence was detected (P-nonlinear = 0.3387). The association remained significant in several subgroup analyses. However, the interaction test revealed that none of the stratified variables were significant (all P for interaction > 0.05).

CONCLUSION

The study was pioneering in establishing a negative association between SVR and depression within the US population.

Current status and hotspots in breast cancer patient self-management research: A bibliometric and visual analysis via CiteSpace

BACKGROUND

Breast cancer remains a leading cause of cancer-related mortality worldwide. Patient self-management plays a pivotal role in enhancing outcomes and quality of life for individuals affected by this disease. This study employed bibliometric and visual analysis techniques utilizing CiteSpace to elucidate the current status and research hotspots in breast cancer patient self-management from January 1, 2005, to August 31, 2023.

METHODS

A comprehensive search was conducted in the Web of Science Core Collection (WoSCC). The retrieved literature was subjected to visualization and analysis using CiteSpace, focusing on publication timeline, article count, geographical distribution, institutional affiliations, journal sources, reference co-citation networks, and keyword analysis.

RESULTS

The analysis encompassed 1413 English-language documents. The United States emerged as the most prolific contributor, while the University of Toronto demonstrated the highest institutional output. The two-map overlay revealed prominent citation paths, indicating strong interconnections between publications in "Medicine, Medicine, Clinical" and "Health, Nursing, Medicine," as well as "Psychology, Education, Health" and "Health, Nursing, Medicine." The most frequently co-cited reference was "Self-Management: Enabling and Empowering Patients Living with Cancer as a Chronic Illness." High-frequency keywords identified included quality of life, chronic disease, self-management, patient education, randomized controlled trials, education, and intervention. These keywords formed 11 distinct clusters related to intervention content, methodologies, outcome indicators, and emerging research trends. Keyword burst analysis predicted future research hotspots focusing on patient needs, psychological distress, Internet technology, and mobile applications.

CONCLUSIONS

Research in breast cancer self-management is experiencing significant growth. Enhanced collaboration between countries, regions, and institutions is imperative. Further investigation is warranted, particularly in the domains of "quality of life," "patient education," and "mobile health." These findings provide valuable insights to guide future research directions in this critical field.

Mediating effect of physical activity on the relationship between high dietary live microbe intake and obesity among U.S adolescents, finding from NHANES 1999-2018

BACKGROUND AND AIMS

The impact of dietary live microbe intake on adolescent obesity is still not fully understood. This study aims to investigate the potential relationship between dietary live microbe intake and obesity among U.S adolescents, and to explore the mediating role of physical activity (PA).

METHODS AND RESULTS

Data from NHANES (1999-2018) were analyzed, and dietary live microbe intake was categorized into low, medium, and high groups using a developed framework. Survey-weighted logistic regression and mediation analysis models were used to examine the association between live microbe intake and adolescent obesity, as well as the potential mediating effect of PA. Our study included 8443 participants aged 6-18, representing the noninstitutionalized U.S population of 184.5 million. We found that participants with a high dietary intake of live microbes had lower odds of developing obesity compared to those with the lowest exposure to live microbes (AOR = 0.900, 95 % CI: 0.812, 0.997). Additionally, our mediation analysis revealed a significant indirect effect of live microbes on obesity risk through PA (P-value <0.001), with 39.4 % (95 % CI: 24.5 %, 86.5 %) of the effect mediated by PA.

CONCLUSION

Our study highlights the association between consuming a higher amount of live microbes in the diet and a decreased risk of obesity among U.S adolescents. It also suggests that PA may act as a mediator in this relationship. Therefore, it is crucial to emphasize the incorporation of both dietary interventions and PA in the development of prevention and therapy policies for managing adolescent obesity.

Exploration of physical activity, sedentary behavior and insulin level among short sleepers

Background

Sufficient physical activity and sleep duration are essential for overall health. While one-third of the US population reports short sleep (<7 h), which is proven to link with negative health status. Current evidence on the relationship between physical activity, sedentary behavior, and serum insulin level in short sleep groups is limited.

Methods

The National Health and Nutrition Examination Survey (NHANES) was used to conduct this cross-sectional study of 8,494 adults (NHANES) 2007-2018. Serum insulin was quantitatively tested by human insulin immunoassay. Short sleep conditions were defined as ≤7 h per night. Physical activity conditions, including work activity, recreational activity, and sedentary behavior, were self-reported in NHANES by the Physical Activity Questionnaire using a 7-day recall method. The main analyses utilized weighted linear regression models due to the complex multistage sampling design of NHANES. Subgroup analysis and the influence of different lipid indices were explored in this study. In addition, a sensitivity analysis of participants without diabetes was conducted.

Results

In fully adjusted models, increased levels of work and recreational activity significantly reduced insulin levels, with β values 95% CI = -0.002 (-0.003, 0.001) and β values 95% CI = -0.008 (-0.012, -0.003), respectively. However, sedentary behavior was positively associated with insulin levels, with a β value 95% CI =0.022 (0.009, 0.034). The sensitivity analysis further confirmed the benefits of recreational activity in controlling insulin levels. Through sex stratification analysis, it seemed that physical activity was more obviously impacted in the male than female groups.

Conclusions

Overall, our analysis demonstrates that in short sleepers, an increased level of work and recreational activity is beneficial to control the insulin level, and more sedentary time is harmful. However, this association might be discrepant in different sexes and different levels of lipid indices.

Association between diverse obesity indicators and sleep quality in elderly Chinese people: a National Study

Background

The association between obesity indicators and sleep quality remains unclear among elderly Chinese people. Therefore, we aimed to assess this association by utilizing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS).

Methods

A total of 10,505 participants aged 65 and above from the 2018 CLHLS were included. Calculate body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and weight-adjusted-waist index (WWI) based on measured weight, height, and waist circumference. Based on BMI values, individuals were classified as underweight (<18.5 kg/m2), normal weight (18.5-23.9 kg/m2) and overweight or obesity (BMI ≥24 kg/m2). In the survey, sleep quality was rated in a 5-point format ("1 = very good," "2 = good," "3 = fair," "4 = poor," or "5 = very poor"), and we categorized "1" and "2" as good sleep quality and "3," "4," and "5" as poor sleep quality. Logistic regression models were used to evaluate odds ratios (ORs) and 95% confidence intervals (CIs), with subgroup analysis and restricted-cubic-spline (RCS) conducted.

Results

The prevalence of poor sleep quality was 47.06%. There are significant differences in obesity indicators and other factors between the two groups of people with good sleep and poor sleep. After adjusting for potential confounding factors (including demographics, socioeconomic status, lifestyle behaviors, health-related issues and activities of daily living), our analyses revealed significant negative associations of BMI [OR 0.96 (95% CI 0.95-0.98)], WC [OR 0.99 (95% CI 0.98-0.99)] and WHtR [OR 0.18 (95% CI 0.09-0.35)] with poor sleep quality. RCS regression also showed that BMI, WC, WHtR and WWI were all strongly negatively correlated with poor sleep quality.

Conclusions

In elderly Chinese people, overweight/obese elderly people may have a better sleep quality compared to elderly people with normal weight, while underweight elderly people are unfavorable for sleep quality.

Muscle quality index is associated with depression among non-elderly US adults

PURPOSE

Muscle Quality Index (MQI), defined as the muscle strength per unit of muscle mass, is considered an emerging indicator of health and physical function. This study aims to explore the relationship between MQI and the risk of depression among non-elderly US adults.

METHODS

This cross-sectional study collected data from participants aged between 20 and 59 years old, utilizing the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. The MQI was calculated by dividing the handgrip strength (HGS, kg) by the arm and appendicular skeletal muscle mass (ASM, kg). Depression assessments were conducted using the Patient Health Questionnaire (PHQ-9). The relationship between MQI and the risk of depression was explored by weighted logistic regression, smooth curve fitting, and subgroup analyses.

RESULTS

A total of 4773 participants were included in this study. After adjusting for confounding factors, low MQI levels were identified as an independent risk factor for depression (OR = 0.800, 95%CI:0.668-0.957, P = 0.015). Smooth curve fitting analysis indicated a nonlinear relationship. Subgroup analysis did not identify any specific populations.

CONCLUSIONS

Higher MQI levels were closely associated with a lower risk of depression among non-elderly US adults. MQI could enhance our understanding of the link between muscle and depression and might serve as a simple functional measure for evaluating and predicting depression.

Research on aerobic fitness in children and adolescents: a bibliometric analysis based on the 100 most-cited articles

Introduction

This study aims to conduct a bibliometric analysis of the 100 most-cited articles to examine research trends, hot topics, and gaps in aerobic fitness research in children and adolescents, addressing the lack of evidence synthesis.

Methods

The Web of Science Core Collection database was used for literature search, and bibliometric characteristics of the included research articles were imported and calculated. Descriptive statistics and visualizations by the VOS viewer were used for the presentation of bibliometric characteristics.

Results

The 100 most cited articles received an average of 104 citations. British Journal of Sports Medicine and Medicine and Science in Sports and Exercise were the two top journals that published aerobic fitness research in children and adolescents. The United States was the top country that contributed to the most-cited research articles. Three top research topics were identified from the analysis, such as neuroscience, developmental psychology, and aerobic health.

Conclusion

Aerobic fitness research in children and adolescents has received much attention and interest since 2000. The most contributing authors in this research field were from developed countries, such as the United States, and cognition and health-related research were priorities.

A sex-oriented analysis concerning skeletal muscle quantity and quality and associations to quality of life in hospitalized patients with cirrhosis

BACKGROUND

There is a paucity of data regarding sex-oriented analyses of connection between muscle quantity and quality and health-related quality of life (HRQoL), taking into account the pathophysiological differences of sarcopenia/myosteatosis in males versus females. We sought to investigate the associations between skeletal muscle index (SMI)-defined sarcopenia and intramuscular adipose tissue content (IMAC)-defined myosteatosis and EuroQol-5D (EQ-5D)-defined HRQoL in patients with decompensated cirrhosis concerning sex disparities.

METHODS

Totally, 382 patients were enrolled. The relationship between SMI/IMAC and HRQoL was evaluated with restricted cubic spline and Pearson correlation analyses. Furthermore, association between SMI or sarcopenia and EQ-5D utility index was determined by multiple linear regression, adjusted for age, BMI and concurrent disease severity.

RESULTS

The study population comprised evenly distributed male and female patients (190: 192), mean age 61.9 years. The prevalence of sarcopenia (40.5 versus 9.9%, P < 0.001) and SMI (48.8 versus 42.2 cm2/m2, P < 0.001) were significantly higher in males relative to females, with comparable myosteatosis prevalence (15.3 versus 16.7%, P = 0.708). Self-care, usual activities and pain within EQ-5D scale were more prevalent in the sarcopenia compared with non-sarcopenia groups across entire population and stratified by sex. The SMI values exhibited a significantly linear correlation with EQ-5D utility index in male but not female patients (P for non-linearity = 0.281). In multiple analysis, SMI or the presence of sarcopenia was both significantly associated with EQ-5D utility index. Subgroup analyses unveiled no discernible interactions between sarcopenia and EQ-5D utility index.

CONCLUSIONS

Muscle quantity measured by SMI was associated with declined HRQoL in males rather than females, whereas no associations were found regarding muscle quality measured by IMAC in both sexes. It is tempting to manage sarcopenia by increasing SMI levels as high as possible in hopes of achieving better health consequence. Our findings represent the importance of connecting CT-demarcated body composition abnormalities to meaningful patient-centered outcomes. Future targeted studies with sizable multi-center populations are warranted to clarify this causality, and in consequence develop optimized intervention against sarcopenia/myosteatosis or key determinants concerning impaired HRQoL.

Threshold effect of physical exercise on its association to diabetes mellitus in short sleep population: evidence from a nationwide study

Background

The prevalence of diabetes mellitus (DM) is a significant public health concern, especially among individuals with short sleep duration. Understanding the relationship between physical exercise and DM in this population is crucial for developing effective prevention strategies. However, the presence of a potential threshold effect of exercise on DM risk remains unclear.

Methods

Using data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2007 to 2018, this population-based study investigated the association between physical exercise and DM in individuals with short sleep duration (no more than 7 hours per night). Weighted logistic regression analyses were conducted, adjusting for demographic and lifestyle factors. Additionally, a two-piecewise linear regression model was employed to identify any threshold effect of exercise on DM risk.

Results

This study included 15,092 participants identified with short sleep duration. Demographic characteristics stratified by DM status indicate higher prevalence among certain groups, such as middle-aged and older adults, males, and non-Hispanic Whites. The analysis revealed an inverse association between exercise levels and DM prevalence among the short sleep population. In the fully adjusted model, individuals engaging in sufficient exercise (> 600 MET-minutes/week) exhibited significantly reduced odds of developing DM [OR (95% CI): 0.624(0.527,0.738), p < 0.001]. Furthermore, the segmented regression model identified an inflection point at 2000 MET-minutes/week, below which a significant correlation between exercise and DM was observed.

Conclusions

This study provides evidence of a threshold effect of physical exercise on its association with DM in individuals with short sleep duration. Tailored exercise interventions targeting this population may help mitigate DM risk and improve overall health outcomes. Further research is warranted to validate these findings and explore optimal exercise thresholds for DM prevention strategies.

The role of dietary intake of live microbes in the association between leisure-time physical activity and depressive symptoms: a population-based study

Current research has shown promising associations between factors such as diet, total physical activity, and mental health outcomes, acknowledging the intricate interplay between these variables. However, the role of dietary intake of live microbes, coupled with leisure-time physical activity (LTPA), in their relationship to depressive symptoms necessitates further exploration. The present study examined a cohort of 25 747 individuals who participated in the National Health and Nutrition Examination Survey between the years 2007 and 2018. Patient's Health Questionnaire (PHQ-9) was employed, whereby individuals scoring ≥ 10 were classified as exhibiting symptoms of depression. LTPA status was reported by the Global Physical Activity Questionnaire and calculated by metabolic equivalent-minutes/week. Foods consumed by participants were evaluated by live microbes per gram, which were categorized into three groups: low, medium, and high. After controlling for all covariates, findings indicated that LTPA was negatively associated with depressive symptoms (OR (95% confidence interval (CI): 0.983 (0.976, 0.990), p < 0.001). Participating in more LTPA was positively correlated with consuming all three levels of dietary live microbes (low, β (95% CI): 0.086 (0.063, 0.109); medium, β (95% CI): 0.009 (0.007, 0.012); high, β (95% CI): 0.002 (0.001, 0.002)). Moreover, taking more foods with medium live microbes was associated with lower depressive likelihood (OR (95% CI): 0.931(0.882, 0.982), p = 0.010). Intake of medium and high levels of live microbes mediated the association between LTPA and depressive symptoms by 4.15% and 0.83%, respectively. Dietary intake of foods containing medium and high levels of live microbes may be a mediator of LTPA's negative association with depressive symptoms.

Serum neurofilament light chain levels are associated with depression among US adults: a cross-sectional analysis among US adults, 2013-2014

BACKGROUND

Serum neurofilament light chain (sNfL) has been identified as a biomarker for neurologic diseases. However, sNfL remains unknown to be responsible for depression.

AIMS

The aim of this research was to explore the relationship between sNfL levels and depression in US adults.

METHODS

In this cross-sectional survey of the general population, we investigated representative data involving 10,175 participants from the 2013-2014 cycle of the National Health and Nutrition Examination Survey (NHANES). Depression was diagnosed using the Patient Health Questionnaire-9 (PHQ-9). The effect of related factors on depression was analyzed by conducting a univariate analysis. Stratified analysis was utilized to detect the stability and sensitivity of the relationship. After adjusting for race, education, marital status, smoking status, body mass index (BMI), sleep duration, income, and a history of hypertension, sedentary behavior and stroke, multivariable linear regression was performed to demonstrate the correlation between sNfL and depression.

RESULTS

A total of 1301 individuals between the ages of 20 and 75 were involved in this investigation, of which 108 (8.3%) were diagnosed with depression. A significant positive correlation between sNfL and depression among adults in the US was observed by conducting univariable analyses. After adjusting for confounding factors, the multivariate analyses indicated that elevated sNfL levels might play a pivotal role in the development of depression (odds ratio (OR) = 3.0; 95% confidence interval (CI): (1.5, 6.1), P = 0.002).

CONCLUSION

These results indicated that sNfL is closely linked to depression in a nationally representative individual. However, further studies are needed to confirm the biological mechanism as well as the clinical implications of sNfL and depression.

Saturation effects of the relationship between physical exercise and systemic immune inflammation index in the short-sleep population: a cross-sectional study

BACKGROUND

Short sleep can lead to an increase in inflammation and regular exercise has been shown to have a mitigation effect. However, the association between physical exercise (PE) and inflammation in the short sleep population is an unknown and intriguing issue.

METHODS

NHANES dataset spanning the years 2007 to 2018 were analyzed. To investigate the relationship mentioned above, we carried out multivariate linear regression models controlling for sociodemographic and lifestyles factors. The systemic immune inflammation index (SII) served as a reflection of inflammatory potential, calculated as the product of platelet count, neutrophil count, and divided by the lymphocyte count. Self-reported questionnaires were used to collect sleep and exercise information.

RESULTS

A total of 14,664 participants were included for final analysis. Across the three models, PE showed significant negative associations with SII as a continuous variable [Crude Model, β (95% CI): -1.261(-1.600, -0.922), p < 0.001; Model 1, β (95% CI): -1.005(-1.344, -0.666), p < 0.001; Model 2, β (95% CI): -0.470(-0.827, -0.112), p = 0.011]. The consistent nature of the findings persisted when investigating physical exercise (PE) as a categorized variable. By two-piecewise linear regression model, we calculated a saturation effect of PE with the inflection point as 2400 MET-minutes/week.

CONCLUSION

This study suggested that performing no more than 2400 MET-minutes/week of PE was associated with lower SII levels in the short sleep population, while more PE might not bring additional benefits.

Predictors of physical activity and public safety perception regarding technology adoption for promoting physical activity in Jeddah, Saudi Arabia

Background

This study aims to identify the predictors of levels of physical activity among the residents of Jeddah, Saudi Arabia. Additionally, it seeks to understand the public's safety perception regarding the adoption of technology for promoting physical activity.

Method

This is an analytical cross-sectional study using self-administered web-based survey. A stratified sampling technique was used to select participants from adult population in Jeddah and data collection took place from May 2023 to December 2023. Multivariable logistic regression models were applied to identify predictors of low-intensity (walking steps) and high-intensity physical activities.

Result

A total of 462 participated in the study. Gender significantly influenced walking habits, with males more likely to walk than females (AOR = 2.37; 95 % CI: 1.55-3.62; P < 0.001). Smoking status was also a predictor, with smokers more inclined to walk compared to non-smokers (AOR = 2.15; 95 % CI: 1.20-3.82; P = 0.010). High-intensity physical activity strongly correlated with increased walking, especially among those active 3-7 days per week (AOR = 3.03; 95 % CI: 1.91-4.78; P < 0.001). Chronic diseases negatively impacted walking frequency (AOR = 0.57; 95 % CI: 0.34-0.95; P = 0.031). Furthermore, males were likelier to engage in high-intensity activities compared to females (AOR = 1.61; 95 % CI: 1.04-2.50; P = 0.033). Those walking ≥ 10,000 steps weekly were more likely to participate in high-intensity activities (AOR = 3.07; 95 % CI: 1.95-4.82; P < 0.001). Excellent self-rated health was associated with higher participation in such activities (AOR = 2.00; 95 % CI: 1.30-3.06; P = 0.002). Most respondents (84.9 %) felt safe on public walkways, and 78.1 % indicated safety perceptions influenced their walkway use. Technology use was divided, with about half (49.1 %) using apps for tracking physical activity. The majority (90.9 %) supported adding motivational features to the 'Sehhaty' app, and 73.6 % favored financial rewards for walking. However, only 45.5 % believed that public walkways are designed to encourage walking.

Conclusion

The study highlights significant predictors of physical activity among general population in Jeddah. The study also revealed the impact of safety perceptions and technology use on physical activity, with strong support for motivational features in health apps. However, there is a need for improved design of public walkways to encourage walking.

The association of physical activity and sedentary behavior with depression in US adults: NHANES 2007-2018

Objectives

Depression is largely preventable, and strategies that can effectively suppress its development are imperative. We aimed to examine whether physical activity and sedentary behavior were associated with depression and explore the possible mediatory role of complete blood count in this association.

Methods

In this cross-sectional study, data were integrated from the National Health and Nutrition Examination Study (2007-2018). Depression was defined using the Patient Health Questionnaire-9. The risk for depression, expressed as odds ratio (OR) and 95% confidence interval (CI), was quantified by survey-weighted logistic regression analyses.

Results

A total of 31,204 respondents were analyzed. Significance was identified for all, except walking or bicycling per week, types of physical activity, and sedentary behavior. Per 1 standard deviation (SD) increment in metabolic equivalent of task (MET) of weekly vigorous recreational physical activity was associated with 31.3% decreased depression risk (adjusted OR: 0.687, 95% CI: 0.5663-0.840). Per 1 SD increment in sitting time can increase depression risk by 22.4% (adjusted OR: 1.224, 95% CI: 1.131-1.325). In subsidiary analyses, the association with depression was reinforced in respondents aged ≤65 years and those overweight or obese. Mediation analyses revealed significant effects for red blood cell (RBC) on total MET (19.4%) and moderate work-related physical activity (MWPA) (22.0%), and for red cell distribution wide (RCDW) on vigorous work-related physical activity (17.7%), moderate work-related physical activity (13.1%), total MET (11.2%), and sitting time (16.4%) (p < 0.01).

Conclusion

Our findings indicate that more physical activity and less sitting time were associated with a lower likelihood of having depression among US adults, and this association was probably mediated by RBC and RCDW.

Exosomal noncoding RNAs: decoding their role in thyroid cancer progression

Exosomes, as pivotal entities within the tumor microenvironment, orchestrate intercellular communication through the transfer of diverse molecules, among which non-coding RNAs (ncRNAs) such as miRNAs, lncRNAs, and circRNAs play a crucial role. These ncRNAs, endowed with regulatory functions, are selectively incorporated into exosomes. Emerging evidence underscores the significance of exosomal ncRNAs in modulating key oncogenic processes in thyroid cancer (TC), including proliferation, metastasis, epithelial-mesenchymal transition (EMT), angiogenesis, and immunoediting. The unique composition of exosomes shields their cargo from enzymatic and chemical degradation, ensuring their integrity and facilitating their specific expression in plasma. This positions exosomal ncRNAs as promising candidates for novel diagnostic and prognostic biomarkers in TC. Moreover, the potential of exosomes in the therapeutic landscape of TC is increasingly recognized. This review aims to elucidate the intricate relationship between exosomal ncRNAs and TC, fostering a deeper comprehension of their mechanistic involvement. By doing so, it endeavors to propel forward the exploration of exosomal ncRNAs in TC, ultimately paving the way for innovative diagnostic and therapeutic strategies predicated on exosomes and their ncRNA content.

Modulating the Expression of Exercise-induced lncRNAs: Implications for Cardiovascular Disease Progression

Recent research shows exercise is good for heart health, emphasizing the importance of physical activity. Sedentary behavior increases the risk of cardiovascular disease, while exercise can help prevent and treat it. Additionally, physical exercise can modulate the expression of lncRNAs, influencing cardiovascular disease progression. Therefore, understanding this relationship could help identify prospective biomarkers and therapeutic targets pertaining to cardiovascular ailments. This review has underscored recent advancements concerning the potential biomarkers of lncRNAs in cardiovascular diseases, while also summarizing existing knowledge regarding dysregulated lncRNAs and their plausible molecular mechanisms. Additionally, we have contributed novel perspectives on the underlying mechanisms of lncRNAs, which hold promise as potential biomarkers and therapeutic targets for cardiovascular conditions. The knowledge imparted in this review may prove valuable in guiding the design of future investigations and furthering the understanding of lncRNAs as diagnostic, prognostic, and therapeutic biomarkers for cardiovascular diseases.

Elevated TyG index associated with increased prevalence of gallstones in a United States cross-sectional study

Objective

This study aimed to investigate the correlation between the triglyceride-glucose (TyG) index and the incidence of cholelithiasis.

Research approach

In this investigation, a cross-sectional analysis was undertaken utilizing data from the US National Health and Nutrition Examination Survey (NHANES) spanning the years 2017 to 2020. The TyG index served as an independent predictor, while gallstone prevalence was considered the dependent variable of interest. We employed a multivariate logistic regression model to evaluate the interplay between these independent and dependent variables. To assess the presence of potential non-linear associations, sensitivity analysis was executed, utilizing inverse probability weighted validation, smooth curve fitting, and threshold effect analysis. In cases where non-linear relationships were observed, likelihood ratios were utilized to pinpoint potential inflection points. Ultimately, subgroup analyses were conducted to identify specific populations demonstrating heightened susceptibility to gallstone prevalence.

Results

Encompassing 838 patients who self-reported gallstones, a total of 7,794 participants were included in the analytical cohort. A statistically significant disparity in the TyG index was observed when all individuals were categorized into gallstone patients and non-patients (p < 0.05). Logistic regression findings indicated a positive correlation between the TyG index and gallstone disease prevalence (OR = 1.28, 95% CI: 1.12, 1.47), with a strengthening association as the TyG index increased (p trend <0.01). The results were corroborated by the use of inverse probability weighting. Additionally, a non-linear connection between the TyG index and gallstone prevalence was identified (log-likelihood ratio p < 0.01), with the optimal inflection point for TyG calculated at 8.96. In subgroup analysis, the positive relationship between the TyG index and gallstone prevalence was notably pronounced among black Americans under the age of 40 and female participants.

Conclusion

Alterations in the TyG index may potentially correlate with shifts in the prevalence of gallstones among adult populations in the United States. Elevated TyG index values may coincide with an augmented likelihood of gallstone occurrence.

Exploring the potential relationship between short sleep risks and cognitive function from the perspective of inflammatory biomarkers and cellular pathways: Insights from population-based and mice studies

AIMS

The molecular mechanism of short-sleep conditions on cognition remains largely unknown. This research aimed to investigate associations between short sleep, inflammatory biomarkers and cognitive function in the US population (NHANES data 2011-2014) and explore cellular mechanisms in mice.

METHODS

Systemic immune-inflammation index (SII) was calculated using blood-cell based biomarkers. Further, we employed integrated bioinformatics and single-cell transcriptomics (GSE137665) to examine how short sleep exposure influenced the molecular pathways associated with inflammation in the brain. To explore the signaling pathways and biological processes of sleep deprivation, we carried out enrichment analyses utilizing the GO and KEGG databases.

RESULTS

Population results showed that, compared with normal sleep group, severe short sleep was associated with lower cognitive ability in all the four tests. Moreover, a higher SII level was correlated with lower scores of cognitive tests. In mice study, elevated activation of the inflammatory pathway was observed in cell subgroups of neurons within the sleep deprivation and recovery sleep cohorts. Additionally, heightened expression of oxidative stress and integrated stress response pathways was noted in GABAergic neurons during sleep deprivation.

CONCLUSION

This study contributed to the understanding of the influence of short sleep on cognitive function and its cellular mechanisms.

Association between vitamin C in serum and trouble sleeping based on NHANES 2017-2018

Vitamin C is an important micronutrient for human. Association between vitamin C and trouble sleeping was less studied. Therefore, the purpose of this study was to investigate the possible link between vitamin C in serum and trouble sleeping. The cross-sectional data was derived from the National Health and Nutrition Examination Survey (NHANES, 2017-2018). Trouble sleeping was measured by asking participants: "Have you ever told doctor had trouble sleeping". Responses to this question was "yes" or "no". vitamin C in serum was obtained by measuring the serum samples. We used multivariable binary logistic regressions to examine the possible link between vitamin C in serum and trouble sleeping, and then a subgroup analysis was performed. Moreover, the non-linear relationship between vitamin C in serum and trouble sleeping was further detected using a restricted cubic spline (RCS) model. A total of 3227 participants were included in the study. After adjusting all potential confounders, the results of multivariable logistic regression showed the significant negative association between vitamin C in serum and trouble sleeping(OR = 0.816; 95% CI:0.669 ~ 0.995). The significant inverse association was also found in female(OR = 0.713; 95% CI:0.546 ~ 0.931), age ≤ 65 years(OR = 0.773; 95% CI:0.600 ~ 0.996), and in participants with high cholesterol level(OR = 0.738; 95% CI:0.548 ~ 0.994). In addition, the RCS model demonstrated the significant non-linear relationship between vitamin C in serum and trouble sleeping (P value of nonlinear = 0.010). Our study demonstrates the significant negative association between vitamin C in serum and trouble sleeping.

The association between trouble sleeping and obesity among the U.S. elderly from NHANES 2011-2014: A moderated mediation model of depressive symptoms and cognitive function

BACKGROUND

Studies have shown a close association between trouble sleeping and obesity in older adults. However, no studies have explored the underlying mechanism of this relationship. The present study was designed to evaluate the roles of depressive symptoms and cognitive function in the association between trouble sleeping and obesity in older American adults.

METHODS

A cross-sectional study with 2575 participants (≥60 years old) in the National Health and Nutrition Examination Survey (NHANES) 2011-2014 was used for analysis. Obesity, depressive symptoms, and cognitive function (including Established Consortium for Word Learning in Alzheimer's Disease (CERAD-WL) (immediate learning and recall and delayed recall), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST)) were objectively measured, and trouble sleeping was assessed using a self-reported questionnaire. The moderated mediation analysis was conducted by Hayes' PROCESS macro.

RESULTS

Trouble sleeping was positively associated with obesity among older adults. Depressive symptoms partially and indirectly mediated this association, and DSST moderated the association between trouble sleeping and depressive symptoms. Trouble sleeping had a lower impact on depressive symptoms in older adults with higher cognitive function.

LIMITATIONS

The cross-sectional design prevents making causal inferences, and part of self-reported information was not objective enough.

CONCLUSION

Cognitive function moderated the mediation of depressive symptoms on the indirect, positive association between trouble sleeping and obesity; hence, incorporating methods to strengthen cognitive function and alleviate depressive symptoms may help weak the link between trouble sleeping and obesity among older adults.

Network analysis of depression and anxiety symptoms and their associations with life satisfaction among Chinese hypertensive older adults: a cross-sectional study

Background

Hypertension is one of the most prevalent chronic diseases among the older adult population in China and older adults with hypertension are more susceptible to mental health problems. This study aimed to explore the network structure of depression and anxiety, and their association with life satisfaction (LS) in older adults with hypertension.

Methods

A total of 4,993 hypertensive individuals aged 60 and above were selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 2017-2018). The design of the CLHLS study was approved by the Campus Institutional Review Board of Duke University (Pro00062871) and the Biomedical Ethics Committee of Peking University (IRB00001052-13,074). The Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and the Generalized Anxiety Disorder Scale-7 (GAD-7) were used to assess depressive and anxiety symptoms. Central and bridge symptoms were identified via "Expected Influence" and "Bridge Expected Influence", respectively. Network stability was assessed using the case-dropping bootstrap technique.

Results

Network analysis identified CESD3 (Feeling blue/depressed), GAD4 (Trouble relaxing), and GAD2 (Uncontrollable worry) as the most influential central symptoms in the network of depression and anxiety. Concurrently, GAD1 (Nervousness or anxiety), CESD10 (Sleep disturbances), and CESD1 (Feeling bothered) stand as critical bridge symptoms between depression and anxiety disorders. Moreover, CESD7 (Lack of happiness) exhibited the strongest negative correlation with LS in Chinese hypertensive older adults.

Conclusion

This exploratory study represents the first investigation to examine the mutual relationship between depressive and anxiety symptoms among Chinese hypertensive older adults. Interventions addressing targeting bridge symptoms have the potential to alleviate depressive and anxiety symptoms. Furthermore, improving happiness, hope, and sleep quality in this population may mitigate the adverse effects of depression and anxiety on LS.

Inverted U-shaped relationship between sleep duration and phenotypic age in US adults: a population-based study

Sleep is a modifiable behavior that can be targeted in interventions aimed at promoting healthy aging. This study aims to (i) identify the sleep duration trend in US adults; (ii) investigate the relationship between sleep duration and phenotypic age; and (iii) explore the role of exercise in this relationship. Phenotypic age as a novel index was calculated according to biomarkers collected from US adults based on the National Health and Nutrition Examination Survey (NHANES). Sleep information was self-reported by participants and discerned through individual interviews. The principal analytical method employed was weighted multivariable linear regression modeling, which accommodated for the complex multi-stage sampling design. The potential non-linear relationship was explored using a restricted cubic spline (RCS) model. Furthermore, subgroup analyses evaluated the potential effects of sociodemographic and lifestyle factors on the primary study outcomes. A total of 13,569 participants were finally included in, thereby resulting in a weighted population of 78,880,615. An examination of the temporal trends in sleep duration revealed a declining proportion of individuals with insufficient and markedly deficient sleep time since the 2015-2016 cycle. Taken normal sleep group as a reference, participants with extreme short sleep [β (95% CI) 0.582 (0.018, 1.146), p = 0.044] and long sleep [β (95% CI) 0.694 (0.186, 1.203), p = 0.010] were both positively associated with phenotypic age using the fully adjusted model. According to the dose-response relationship between sleep duration and phenotypic age, long sleep duration can benefit from regular exercise activity, whereas short sleep duration with more exercise tended to have higher phenotypic age. There is an inverted U-shaped relationship between short and long sleep durations and phenotypic age. This study represents an important step forward in our understanding of the complex relationship between sleep and healthy aging. By shedding light on this topic and providing practical exercise recommendations for promoting healthy sleep habits, researchers can help individuals live longer, healthier, and more fulfilling lives.

Mediation Role of Recreational Physical Activity in the Relationship between the Dietary Intake of Live Microbes and the Systemic Immune-Inflammation Index: A Real-World Cross-Sectional Study

The main topic of this research is the relationship between dietary intake of live microbe-containing (LMC) foods, recreational physical activity (RPA), and the systemic immune-inflammation index (SII). This study presented a cohort of 26,254 individuals in the National Health and Nutrition Examination Survey (NHANES), representing an estimated weighted population of 193,637,615 in the United States. Weighted multivariable linear regression models were used in consideration of the multi-stage sampling design. Results: The study found that medium-LMC foods were negatively associated with the SII [β (95% CI): -4.807 (-7.752, -1.862), p = 0.002], indicating that their intake was correlated with lower levels of the SII. However, no significant associations were found with low- or high-LMC foods. The study also explored the relationship between RPA and the SII, finding that more time spent in RPA was negatively associated with the SII [β (95% CI): -0.022 (-0.034, -0.011), p < 0.001]. A mediation analysis was conducted to investigate the role of RPA in the relationship between medium-LMC food intake and the SII. The analysis revealed that RPA had a notable indirect effect, contributing to 6.7% of the overall change in the SII. Overall, this study suggests that medium-LMC food intake and RPA may have beneficial effects on systemic immune inflammation.

Frontiers and hotspots of high-intensity interval exercise in children and adolescents: text mining and knowledge domain visualization

Background: During the past two decades, research on high-intensity interval exercise (HIIE) in children and adolescents has steadily accumulated, especially on the subthemes of improving cardiometabolic and cardiovascular health. However, there is still little scientific understanding of using scientometric analysis to establish knowledge maps. Exploring the relationship between known and new emerging ideas and their potential value has theoretical and practical implications in the context of a researcher's limited ability to read, analyze, and synthesize all published works. Objective: First, this study aims to provide extensive information on HIIE research in children and adolescents, including authors, institutions, countries, journals, and references. Second, the objective is to use co-occurrence, burst, and co-citation analyses based on hybrid node types to reveal hotspots and forecast frontiers for HIIE research in children and adolescents. Methods: Using the bibliographic data of the Web of Science Core Collection (WoSCC) as the data source, publications, authors, and journals were analyzed with the help of bibliometric methods and visualization tools such as CiteSpace, VOSviewer, Pajek, and Bibliometrix R package. Authorial, institutional, and national collaboration networks were plotted, along with research hotspots and research frontiers based on keyword bursts and document co-citations. Results: This study found that executive function, high-intensity interval training, heart rate variability, and insulin resistance are emerging research topics; high-intensity training, mental health, exercise intensity, and cardiometabolic risk factors are continual frontier research areas in the subthemes. Conclusion: Our study has three novel contributions. First, it explicitly and directly reflects the research history and current situation of the HIIE intervention strategy in children and adolescents. This approach makes it clear and easy to trace the origin and development of this strategy in specific groups of children and adolescents. Second, it analyzes the research hotspots of HIIE in the field and predicts the research frontiers and development trends, which will help researchers get a deeper understanding of HIIE and pediatric health research. Third, the findings will enable researchers to pinpoint the most influential scholars, institutions, journals, and references in the field, increasing the possibility of future collaborations between authors, institutions, and countries.

Accelerometer-measured physical activity and sedentary behaviour are associated with C-reactive protein in US adults who get insufficient sleep: A threshold and isotemporal substitution effect analysis

This study aimed to investigate the association between physical activity, sedentary behaviour and chronic inflammation in short sleep adults. The study included 2,113 NHANES participants with self-reported insufficient sleep. C-reactive protein (CRP) was used as the inflammatory biomarker. Physical activity and sedentary behaviour were objectively measured by accelerometers. Weighted regression model, two - piecewise linear regression model, and restricted cubic splines were applied to evaluate associations mentioned above. An isotemporal substitution model was used to assess the modelled effects of replacing sedentary time (ST) with moderate-to-vigorous levels of physical activity (MVPA) or light physical activity (LPA). After adjusting for potential confounding factors, higher levels of ST and lower levels of LPA or MVPA were associated with higher CRP levels. Isotemporal substitution analysis indicated that replacing 30 minutes of ST with 30 minutes of MVPA was associated with a significant decrease in CRP levels. Saturation analysis suggested that the association between MVPA and CRP may plateau at over 20 minutes of MVPA per day. Findings of this study provides insight into the potential benefits of replacing ST with MVPA. This study also suggests that increasing MVPA beyond a certain point may not provide additional anti-inflammatory benefits in a short sleep population.

Relationship between accelerometer-measured sleep duration and Stroop performance: a functional near-infrared spectroscopy study among young adults

Objectives

Short sleep is becoming more common in modern society. This study aimed to explore the relationship between accelerometer-measured sleep duration and cognitive performance among young adults as well as the underlying hemodynamic mechanisms.

Methods

A total of 58 participants were included in this study. Participants were asked to wear an ActiGraph GT3X+ accelerometer to identify their sleep duration for 7 consecutive days. Cognitive function was assessed by the Stroop test. Two conditions, including the congruent and incongruent Stroop, were set. In addition, stratified analyses were used to examine sensitivity. 24-channel functional near-infrared spectroscopy (fNIRS) equipment was applied to measure hemodynamic changes of the prefrontal cortex (PFC) during cognitive tasks.

Results

Results showed that sleep duration was positively associated with accuracy of the incongruent Stroop test (0.001 (0.000, 0.002), p = 0.042). Compared with the regular sleep (≥7 h) group, lower accuracy of the incongruent Stroop test (-0.012 (-0.023, -0.002), p = 0.024) was observed in the severe short sleep (<6 h). Moreover, a stratified analysis was conducted to examining gender, age, BMI, birthplace, and education's impact on sleep duration and the incongruent Stroop test accuracy, confirming a consistent correlation across all demographics. In the severe short sleep group, the activation of left middle frontal gyri and right dorsolateral superior frontal gyri were negatively associated with the cognitive performance.

Conclusions

This study emphasized the importance of maintaining enough sleep schedules in young college students from a fNIRS perspective. The findings of this study could potentially be used to guide sleep time in young adults and help them make sleep schemes.

Unraveling the mechanisms of NK cell dysfunction in aging and Alzheimer's disease: insights from GWAS and single-cell transcriptomics

Background

Aging is an important factor in the development of Alzheimer's disease (AD). The senescent cells can be recognized and removed by NK cells. However, NK cell function is gradually inactivated with age. Therefore, this study used senescence as an entry point to investigate how NK cells affect AD.

Methods

The study validated the correlation between cognition and aging through a prospective cohort of the National Health and Nutrition Examination Survey database. A cellular trajectory analysis of the aging population was performed using single-cell nuclear transcriptome sequencing data from patients with AD and different ages. The genome-wide association study (GWAS) cohort of AD patients was used as the outcome event, and the expression quantitative trait locus was used as an instrumental variable. Causal associations between genes and AD were analyzed by bidirectional Mendelian randomization (MR) and co-localization. Finally, clinical cohorts were constructed to validate the expression of key genes.

Results

A correlation between cognition and aging was demonstrated using 2,171 older adults over 60 years of age. Gene regulation analysis revealed that most of the highly active transcription factors were concentrated in the NK cell subpopulation of AD. NK cell trajectories were constructed for different age populations. MR and co-localization analyses revealed that CHD6 may be one of the factors influencing AD.

Conclusion

We explored different levels of AD and aging from population cohorts, single-cell data, and GWAS cohorts and found that there may be some correlations of NK cells between aging and AD. It also provides some basis for potential causation.

The role of education attainment on 24-hour movement behavior in emerging adults: evidence from a population-based study

Purpose

The purpose of this study was to explore the relationship between education level and health behavior including sleep, work activity, exercise activity, and sedentary behavior among emerging adults.

Methods

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) collected between 2007 and 2018. The study sample included 4,484 emerging adults aged 18-25 years and the weighted participants were 30,057,813. Weighted multivariable regression analysis was performed to investigate the association between education level and the aforementioned health behavior, adjusting for age, gender, race/ethnicity, marital status, poverty-income ratio, BMI, smoking, and alcohol drinking status.

Results

This study revealed that higher education level was associated with shorter sleep duration [Fully adjusted model, β (95% CI): -0.588 (-0.929, -0.246), p < 0.001]. Additionally, those with higher education levels were more likely to allocate time in sedentary behavior [β (95% CI): 90.162 (41.087, 139.238), p < 0.001]. Moreover, higher education level was related to less work activity [β (95% CI): -806.991 (-1,500.280, -113.703), p = 0.023] and more exercise activity time [β (95% CI): 118.196 (-21.992, 258.385), p = 0.097]. Subgroup analysis further verified this trend and detected that males with higher education level tended to participate in less work activity [β (95% CI): -1,139.972 (-2,136.707, -143.237), p = 0.026] while females with higher education level tended to engage in more exercise activity [Fully adjusted model, β (95% CI): 141.709 (45.468, 237.950), p = 0.004].

Conclusion

This study highlighted the importance of education level as a significant factor in promoting healthy behavior among emerging adults. The findings underscored the need for the Ministry of Education to prioritize educating this demographic about the significance of maintaining adequate sleep patterns and reducing sedentary habits. Encouraging them to allocate more time for work and physical activities can significantly contribute to their overall wellbeing and success, ultimately fostering a healthier next generation.

The effects of different types of Tai Chi exercise on anxiety and depression in older adults: a systematic review and network meta-analysis

Background

The body of evidence supporting the beneficial effects of Tai Chi in reducing anxiety and depressive symptoms in older adults is steadily increasing. Nonetheless, there remains a scarcity of studies directly comparing the clinical effectiveness of various Tai Chi exercises in addressing anxiety and depressive symptoms in older adults. Thus, this study aimed to systematically review and analyze the therapeutic efficacy of four types of Tai Chi interventions in enhancing anxiety and depressive symptoms in older adults.

Methods

During the period up to July 26, 2023, searches were conducted in the Web of Science, PubMed, the Cochrane Library, CNKI, and the Chinese Scientific Journal Database (VIP). The language scope encompassed both English and Chinese. Two independent reviewers conducted the literature review and data extraction. Review Manager 5.4 was employed for traditional meta-analysis and risk assessment, while version 15 of STATA software was used for generating evidence and funnel plots for network meta-analysis. This study was registered in PROSPERO number CRD 42023442270.

Result

In this analysis, a total of 20 studies were included, involving 1798 participants. The findings of the pairwise meta-analysis revealed that Tai Chi intervention was more effective than the control group in reducing anxiety (SMD: -1.19, 95% CI: -2.04, -0.34, p < 0.05) and depression (SMD: -0.65, 95% CI: -0.95, -0.65, p < 0.05) symptoms among older adults. The network meta-analysis specifically focused on anxiety symptoms and found that Yang-style Tai Chi (69.9%) had the most favorable outcome, followed by the 24-form Simplified Tai Chi (66.8%). In terms of depression symptoms, the Tai Chi Exercise Program (92.6%) had the highest performance, followed by Yang-style Tai Chi (77.9%).

Conclusion

The findings of this study imply that Tai Chi can have beneficial outcomes in the reduction of anxiety and depressive symptoms among older individuals. Specifically, when examining various forms of Tai Chi interventions, it was observed that Yang-style Tai Chi exhibited a greater efficacy in alleviating anxiety symptoms, whereas Tai Chi exercise programs demonstrated a higher effectiveness in improving depressive symptoms. Nonetheless, it is strongly advised that older adults select an exercise program that aligns with their interests and preferences, as this can enhance social integration and overall well-being.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023442270, identifier [CRD42023442270].

Association between combined exposure to dioxins and arthritis among US adults: a cross-sectional study

Dioxins and dioxin-like compounds (DLCs) are common pollutants hazardous to human health. We applied 12 dioxins and DLCs data of 1851 participants (including 484 arthritis patients) from National Health Examination Survey (NHANES) 2001-2004 and quadrupled them into rank variables. Multivariate logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models were used to explore the relationship between individual or mixed exposure to the pollutants and arthritis after adjusting for multiple covariates. In multivariable logistic regression with an individual dioxin or DLC, almost every chemical was significantly positively associated with arthritis, except PCB66 (polychlorinated biphenyl 66) and 1,2,3,4,6,7,8-heptachlorodibenzofuran (hpcdf). The WQS model indicated that the combined exposure to the 12 dioxins and DLCs was positively linked to arthritis (OR: 1.884, 95% CI: 1.514-2.346), with PCB156 (weighted 0.281) making the greatest contribution. A positive trend between combined exposure and arthritis was observed in the BKMR model, with a posterior inclusion probability (PIP) of 0.987 for PCB156, which was also higher than the other contaminants.

Investigation of effects of Circadian Rhythm in Sport: A bibliometric analysis

PURPOSE

This study conducted a bibliometric analysis of the literature on circadian rhythms and sports to identify research trends, knowledge gaps, and future directions.

METHODS

A total of 301 manuscripts, including 245 articles and 56 reviews, were extracted from the Web of Science Core Collection (WoSCC) database, and the bibliometric analysis was performed using VOSviewer 1.6.16.

RESULTS

The analysis revealed a continuous increase in the volume of literature on circadian rhythms and sports over the past 38 years, with a focus on the effects of circadian rhythms on physical performance, sleep quality, and jet lag. The study identified 1107 authors who have contributed to this field, with the highest number of publications from Reilly T, Chtourou H, and Atkinson G. The publications were from 512 institutions in 59 countries/regions, with Liverpool John Moores University, University of Sfax, and Manouba University being the leading institutions. The USA, UK, and Australia had the largest number of publications. The top 3 journals were Chronobiology International, Biological Rhythm Research, and Sports Medicine.

CONCLUSION

Despite the increase in research, there are still several underexplored areas, such as the effects of circadian rhythms on cognitive and emotional processes in sports, the role of individual differences in circadian rhythms on sports outcomes, and the potential applications of circadian interventions for sports performance optimization. Future research should address these gaps to advance our understanding of the complex relationship between circadian rhythms and sports.

Positive association between different triglyceride glucose index-related indicators and psoriasis: evidence from NHANES

Background

Psoriasis is a chronic inflammatory skin disease with effects that extend beyond the skin. Insulin resistance (IR) has been associated with psoriasis, but it remains unclear how indicators related to the triglyceride glucose (TyG) index, which were associate with IR, are associated with the condition.

Objective

The purpose of this study was to investigate the association between psoriasis and three TyG-related indicators: triglyceride glucose-body mass index (TyG-BMI), triglyceride glucose-waist to height ratio (TyG-WHtR), and triglyceride glucose-waist circumference (TyG-WC).

Methods

Data from adults aged 20 to 80 years in the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006 and 2009 to 2014 were utilized. Institutional Review Board approval and documented written consent was obtained from participants by NHANES (Protocol #2005-06). The patients were divided into three groups based on TyG-BMI, TyG-WC, and TyG-WHtR: Q1 (1st quintile), Q2 (2nd-3rd quintiles), and Q3 (4th-5th quintiles). Differences between the groups were further explored. Multivariate logistic regressions were used to investigate the correlation between these three indicators and psoriasis, with results expressed as odds ratios (OR) and 95% confidence intervals (CI). Subgroup analysis and supplementary analysis was further conducted to explore potential influencing factors.

Results

The study included 9,291 participants, of which 260 had psoriasis. Compared Q2 and Q3 of TyG-BMI, TyG-WC, and TyG-WHtR to Q1, there were significantly associate with psoriasis. Among the three indicators, TyG-WC consistently had the highest OR values in Models 1 and 2 (Model 1: Q3 OR (95% CI) = 2.155 (1.442-3.220); Model 2: Q3 OR (95% CI) = 2.029 (1.341-3.069)). While in Model 3, the TyG-BMI shows more significant relationship with psoriasis (Model 3 of TyG-BMI: Q3 OR (95% CI) = 1.948 (1.300-3.000)). Similar results were observed in the majority of subgroups and in supplementary analysis.

Conclusion

This study identified a stable and strong positive association between TyG-related indicators (TyG-BMI, TyG-WC, and TyG-WHtR) and psoriasis. This association persisted even after adjusting for multiple factors. It is suggested that high IR is significantly associated with psoriasis.

Therapeutic efficacy of rare earth carbonate with chemoradiotherapy in late-stage non-small cell lung cancer: a cohort prospective study

Objective

To compare the therapeutic effects and adverse reactions of sterilizing rare earth carbonate combined with concurrent chemoradiotherapy and simple concurrent chemoradiotherapy in the treatment of late-stage non-small cell lung cancer (NSCLC), and to analyze the reasons for the differences.

Method

A total of 817 patients with pathologically diagnosed late-stage NSCLC from June 1, 2021 to December 30, 2022, in the affiliated hospital of Kunming University of Science and Technology, were selected. They were randomly divided into a control group of 394 people and an experimental group of 423 people. The control group was given concurrent chemoradiotherapy (cisplatin + etoposide), while the experimental group simultaneously took a low dose of sterilized rare earth carbonate (0.05mg/Kg). The χ² test and Fisher's test were used to compare the clinical pathological features, objective response rate (ORR), ECOG score, and adverse reactions of the two groups of patients, while survival analysis was used to compare the progression-free survival (PFS) of the two groups. Cox regression analysis was used to test factors related to prognosis.

Results

The differences in clinical pathological features between the two groups of patients were not statistically significant, with all P>0.05. The ORR of the control group was 45.18% (178/394), and the experimental group was 89.83% (380/423), with a statistically significant difference (P=0.001). After treatment, the ECOG score of the experimental group was lower than that of the control group, P<0.001. The adverse reaction grading of patients in both groups was below level 3 after treatment, and no treatment-related fatalities occurred. The risk of pulmonary infection and bone marrow suppression in the experimental group was lower than that in the control group.

Conclusion

In late-stage NSCLC patients, compared with simple concurrent chemoradiotherapy, the combination of concurrent chemoradiotherapy and sterilizing rare earth carbonate can significantly improve the short-term therapeutic effect and prognosis of patients, with good safety.

Muscle quality index and cardiovascular disease among US population-findings from NHANES 2011-2014

BACKGROUND AND OBJECTIVE

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States. However, current evidence on the association between muscle quality and CVD is limited. This study investigates the potential association between the muscle quality index (MQI) and the prevalence of CVD and CVD-related mortality.

METHODS

Participants were selected from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Data on mortality and causes of death were obtained from the National Death Index (NDI) records through December 31, 2019. Statistical analysis used in this study, including weighted multivariable linear and logistic regression, cox regression and Kaplan-Meier (K-M) analysis, to estimate the association between MQI and all-cause mortality as well as CVD mortality. In addition, subgroup analysis was used to estimate the association between MQI and CVD subtypes, such as heart attack, coronary heart disease, angina, congestive heart failure, and stroke.

RESULTS

A total of 5,053 participants were included in the final analysis. Weighted multivariable linear regression models revealed that a lower MQI.total level was independently associated with an increased risk of CVD development in model 3, with t value =-3.48, 95%CI: (-0.24, -0.06), P = 0.002. During 5,053 person-years of 6.92 years of follow-up, there were 29 deaths from CVD. Still, the association between MQI.total and CVD mortality, as well as all-cause mortality did not reach statistical significance in the fully adjusted model (HR = 0.58, 95% CI: 0.21-1.62, P = 0.30; HR = 0.91, 95% CI:0.65,1.28, P = 0.59, respectively). Subgroup analysis confirmed that MQI.total was negatively associated with congestive heart failure (OR = 0.35, 95% CI = 0.18,0.68, P = 0.01).

CONCLUSION

This study highlights the potential of MQI as a measure of muscle quality, its negative correlation with congestive heart failure (CHF). However, MQI was not very useful for predicting the health outcomes such as CVD and mortality. Therefore, more attention should be paid to the early recognition of muscle weakness progression in CHF. Further studies are needed to explore more effective indicator to evaluate the association between muscle quality and health outcomes.

Unraveling the link between hypertension and depression in older adults: a meta-analysis

Objective

To perform a meta-analyses to understand the current status of and risk factors for depression in older adults with hypertension.

Methods

Eight electronic databases and two clinical trial registries were searched to identify studies examining the incidence of and risk factors for depression among older adults with hypertension. The databases were searched from inception to June 2023. The included studies were evaluated using the Newcastle-Ottawa scale and the evaluation tool recommended by the Agency for Health care Research and Quality.

Results

A total of 18 studies with 29,694 patients were included. Meta-analysis results showed that the prevalence of depression in older adults with hypertension was 29%. The risk factors for depression among this population included sex [OR value 95% confidence interval 2.24 (1.32, 3.82)], education level [OR 95% CI 1.79 (1.02, 3.14)], residence [OR 95% CI 1.37 (1.24, 1.52)], comorbidities [OR 95% CI 1.79 (1.69, 1.90)], hypertension classification [OR 95% CI 2.81 (1.79, 4.42)], marital status [OR 95% CI 1.50 (1.33, 1.69)], sleep status [OR 95% CI 2.86 (2.21, 3.69)], activity limitation [OR 95% CI 3.42 (2.84, 4.13)], drinking [OR 95% CI 2.25 (1.58, 3.19)], social support [OR 95% CI 3.26 (2.42, 4.41)], living alone [OR 95% CI 1.79 (1.57, 2.04)], stressful events [OR 95% CI 1.62 (1.39, 1.90)], and course of diseases [OR 95% CI 3.23 (2.10, 4.97)].

Conclusion

The incidence of depression in older adults with hypertension is high, and there are many risk factors. Clinical health care professionals should intervene early to target the above risk factors to reduce the incidence of depression in older adults with hypertension worldwide.

Systematic review registration

PROSPERO (york.ac.uk), identifier [CRD42023417106].

Mechanisms connecting square dance to sleep quality among middle-aged and older Chinese females: serial mediation roles of social support and depressive symptoms

Background

Square dance is gaining increasing popularity among middle-aged and older Chinese women who are also at high risk of sleep disturbance. Although previous studies have shown exercise could improve sleep quality, the association between square dance and sleep quality remains to be discussed, and even less is known about the potential mechanism underlying this association.

Purpose

This study aims to investigate the relationship between square dance and sleep quality and test if social support and depressive symptoms together play a serial mediating role in the influence of square dance on sleep quality.

Methods

A cross-sectional study was conducted among 549 middle-aged and older Chinese females from September to December 2020 in Shao Yang City, Hunan Province of China, with ethics approval granted (SYU [2020]002). Square dance involvement was assessed by three questions about the time participants spent in square dance. Social support, depressive symptoms, and sleep quality were measured using the Pittsburgh Sleep Quality Index (PSQI), Social Support Self-Rating Scale (SSRS), and 9-item Patient Health Questionnaire (PHQ-9), respectively. The serial mediation model was analyzed by the bootstrapping method to assess whether social support and depressive symptoms mediate the relationship between square dance and sleep quality.

Results

Two-thirds of the participants had high involvement in square dance and most reported a moderate and high level of social support (98.54%). The prevalence of depressive symptoms and sleep disturbance was 19.49 and 26.78%, respectively. The serial mediation model showed a significant association between square dance and sleep quality, which was fully mediated by social support and depressive symptoms in a serial model (total effect c = -0.114, 95%CI = -0.227 to -0.001; direct effect c' = -0.036, 95% CI = -0.138 to 0.065; total indirect effect ab = -0.077, 95% CI = -0.139 to-0.016).

Conclusion

Our study extends the understanding of how square dance is associated with sleep quality through the serial mediating roles of social support and depressive symptoms. It provides crucial implications for developing square dance interventions to improve sleep quality among middle-aged and older Chinese females.

The differences in troponin values among gender in COVID-19 patients

The aim of this study is to investigate the differences on admission troponin values among gender in hospital outcomes and in the 2-year follow-up period in coronavirus disease (COVID-19) patients. Data of 826 patients with moderate-to-severe COVID-19 disease were analyzed retrospectively. All patients had nasal and oropharyngeal swab samples taken according to Ministry of Health guidelines on admission. Patients were divided into female (n = 438) and male (n = 388) groups and were follow-up for 2 years. Clinical events such as need for intensive care unit, respiratory failure, need for inotropic initiation, acute renal failure, cardiac injury, and in-hospital mortality were also recorded. The cumulative endpoints were determined as all-cause mortality, re-hospitalization, and stroke during the 2-year follow-up period. Also, factors affecting the cumulative endpoints were investigated. In clinical events and cumulative endpoints, the differences of troponin values between the gender were investigated and the factors causing cardiac injury were determined separately in men and women. Mean age (59.43 ± 19.15 vs 58.14 ± 16.66) and comorbidities were significantly higher in the female group. There were no differences between genders in terms of clinical events except respiratory failure, which was more frequent in the male group (P = .016). In-hospital survivor rate in the female group was 16 ± 2.5 days (95% confidence interval: 11.08-20.91), in the male group was 14 ± 0.92 days (95% confidence interval: 12.18-15.81) P = .008, while there were no differences between groups among in-hospital morality rates (P = .208). During the 2-year follow-up period cumulative endpoints were more in the male group (P < .05). Troponin value in female ≥ 93 pg/mL, in male ≥ 28 pg/mL was related with cardiac injury. All clinical events occur at lower troponin values in the male group. In both groups, independent risk factors for in-hospital mortality were troponin and the existence of fragmented QRS; for cumulative endpoints were respiratory failure, cardiac injury, and age. We observed that in COVID-19 disease, troponin value differs by gender. A lesser increase in troponin levels in men was indicative of cardiac injury. Even slight increases in troponin levels in men should alert clinicians for cardiac injury and other clinical events.

Neural mechanisms of long-term exercise intervention on cognitive performance among short-sleep young adults: A hemodynamic study

OBJECTIVES

Short-sleep is becoming increasingly common and may negatively affect brain function including cognitive ability. Physical exercise has been proved to improve cognitive function while intensity matters. This study was conducted to examine the effects of 12-week exercise interventions on cognitive performance and prefrontal cortex activation related to task performance in short-sleep young adults.

METHODS

A total of 50 subjects (23.62 ± 5.28 years and 24 men) with regular short-sleep conditions (<7 h per night) participated in this study and were divided into three groups: control, moderate-intensity continuous training (MICT), and high-intensity interval training (HIIT) group. As task performance (congruent and incongruent Stroop) was monitored, changes in prefrontal oxygenated hemoglobin (oxyHb), an indicator of cortical activation, were measured using functional near-infrared spectroscopy (fNIRS) to explore the hemodynamics mechanism.

RESULTS

Post 12-week intervention, significant differences in reaction time for congruent [β (95%CI): -0.045 (-0.088, -0.002), p = 0.039] and incongruent Stroop tests [β (95%CI): -0.058 (-0.113, -0.003), p = 0.038] were found only in the MICT intervention group. However, HIIT did not show significant improvements in cognitive function. Left middle frontal gyrus (Frontal Mid L) and right dorsolateral superior frontal gyrus (Frontal Sup R) were both stimulated by MICT and HIIT. Moreover, left dorsolateral superior frontal gyrus (Frontal Sup L) was stimulated by MICT.

CONCLUSION

The findings indicated that 12-week MICT improved cognition by significantly increasing cortical activity across more brain regions. Thus, we suggested that maintaining moderate-intensity exercise could benefit cognitive function despite short sleep.

Systematic and meta-based evaluation of the relationship between the built environment and physical activity behaviors among older adults

Objectives

Existing assertions about the relationship between various factors of the built environment and physical activity behaviors are inconsistent and warrant further exploration and analysis.

Methods

This study systematically searched PubMed, Embase, Web of Science, Scopus, the Cochrane Library and Google Scholar for the effect of the built environment on the physical activity behaviors of older adults. R software was used to calculate the meta-estimated odds ratio with a 95% confidence interval. Simultaneously, the quality of included studies was evaluated using an observational study quality evaluation standard recommended by American health care quality and research institutions.

Results

A total of 16 original researches were included in this meta-analysis and eight factors of the built environment were evaluated. These factors which ranked from high to low according to their impact were traffic safety (OR = 1.58, 95% CI [1.14-2.20]), destination accessibility (OR = 1.24, 95% CI [1.06-1.44]), aesthetics of sports venues (OR = 1.21, 95% CI [1.07-1.37]), virescence of sports venues (OR = 1.14, 95% CI [1.06-1.23]), building density (OR = 1.07, 95% CI [1.02-1.13]). Additionally, it seemed that there was no potential association between mixed land use (OR = 1.01, 95% CI [0.92-1.10]), the quality of pedestrian facilities (OR = 1.00, 95% CI [0.92-1.08]) or commercial facilities (OR = 0.94, 95% CI [0.88-1.00]) and physical activity behaviors of older adults.

Conclusions

The built environment has been found to exhibit a significant relationship with the physical activity behaviors of older adults. It is proposed that factors such as traffic safety, destination accessibility, aesthetics of sports venues, virescence of sports venues, and building density be given more consideration when aiming to promote physical activity levels among older adults.

A literature review: mechanisms of antitumor pharmacological action of leonurine alkaloid

Leonurine refers to the desiccated aerial portion of a plant in the Labiatae family. The primary bioactive constituent of Leonurine is an alkaloid, Leonurine alkaloid (Leo), renowned for its substantial therapeutic efficacy in the treatment of gynecological disorders, in addition to its broad-spectrum antineoplastic capabilities. Over recent years, the pharmacodynamic mechanisms of Leo have garnered escalating scholarly interest. Leo exhibits its anticancer potential by means of an array of mechanisms, encompassing the inhibition of neoplastic cell proliferation, induction of both apoptosis and autophagy, and the containment of oncogenic cell invasion and migration. The key signal transduction pathways implicated in these processes include the Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand (TRAIL), the Phosphoinositide3-Kinase/Serine/Threonine Protein Kinase (PI3K/AKT), the Signal Transducer and Activator of Transcription 3 (STAT3), and the Mitogen-Activated Protein/Extracellular Signal-Regulated Kinase (MAP/ERK). This paper commences with an exploration of the principal oncogenic cellular behaviors influenced by Leo and the associated signal transduction pathways, thereby scrutinizing the mechanisms of Leo in the antineoplastic sequence of events. The intention is to offer theoretical reinforcement for the elucidation of more profound mechanisms underpinning Leo's anticancer potential and correlating pharmaceutical development.

Nonlinear relationship between sleep midpoint and depression symptoms: a cross-sectional study of US adults

BACKGROUND

Despite the close relationship between sleep-wake cycles and depression symptoms, the relationship between sleep midpoint and depression symptoms in adults remains understudied.

METHODS

In this cross-sectional study, 18280 adults aged ≥ 18 years from the National Health and Nutrition Examination Survey (NHANES) 2015-2020 were analyzed. Covariates included age, sex, race/ethnicity, education level, marital status, family income, body mass index, smoking status, drinking status, physical activity, comorbid condition, sleep duration, and sleep disturbance were adjusted in multivariate regression models.

RESULTS

Weighted restricted cubic spline based on the complex sampling design of NHANES showed that in participants with a sleep midpoint from 2:18 AM to 6:30 AM, the prevalence of depression symptoms increased by 0.2 times (adjusted odds ratio [OR] = 1.20, 95% confidence interval [CI]: 1.08-1.33) per 1-h increment in sleep midpoint compared to the reference point of 2:18 AM. For participants with a sleep midpoint after 6:30 AM and before 2:18 AM the next day, the relationship between sleep midpoint and depression symptoms was not significant after adjusting for all covariates (adjusted OR = 1.01, 95% CI: 0.99-1.03).

CONCLUSIONS

The findings indicate a significant nonlinear association between sleep midpoint and depression symptoms in a nationally representative sample of adults.

Accelerometer-measured physical activity patterns are associated with phenotypic age: Isotemporal substitution effects

Prolonged sitting appears to accelerate aging, while optimal physical activity patterns have been found to delay the process. It is an emerging topic, and no conclusions have been reached regarding the relationship between physical activity patterns and biomarkers-measured aging. Hence, the aim of this study was to investigate the association between sensor-based objectively measured physical activity and phenotypic age using a nationwide population from the National Health and Nutrition Examination Survey (NHANES) in the United States. Weighted linear regression models were performed to evaluate the association between sedentary behavior, light-intensity physical activity (LPA), moderate-to-vigorous physical activity (MVPA) and phenotypic age. A total of 6439 eligible participants were included and the weighted respondents were 49,964,300. Results showed that prolonged sitting was positively associated with phenotypic age in the fully adjusted model [β (95% CI): 0.009(0.007,0.011), p < 0.001], while increasing volume of LPA and MVPA was associated with younger phenotypic age using the fully adjusted model [β (95% CI): -0.010(-0.013,-0.006), p < 0.001; -0.062(-0.075,-0.048), p < 0.001]. By utilizing the Isotemporal Substitution Model, it was found that replacing 30 min of sedentary behavior with 30 min of LPA or MVPA per day was associated with estimated 0.4 or 1.9 years of phenotypic age reduction. According to the study's findings, maintaining a certain level of physical activity could delay the process of aging and intensity matters.

Mitigation role of physical exercise participation in the relationship between blood cadmium and sleep disturbance: a cross-sectional study

The neurotoxicity of heavy metals received increasingly attention in recent years. Sleeping is regulated and coordinated by nervous system, however, the health hazard of heavy metal like cadmium (Cd) exposure on sleep health remained unknown. Rescue strategies like physical exercise (PE) has emerged to mitigate such influence. An epidemiological design with cross-sectional data from National Health and Nutrition Examination Survey 2007-2010 was applied. The relationship between three blood heavy metals [cadmium (Cd), lead (Pb), mercury (Hg)] and sleep disturbance was analyzed. A total of 8,751 participants were finally included in and the weighted participants were 330,239,463. Weighted quantile sum (WQS) regression indicated that mixed blood metals were positively related to risk of sleep disturbance and the mixture effect of exposure to heavy metals was mainly attributable to Cd (89.1%). Weighted logistic regression showed a significant positive association between the highest quartile of blood Cd and sleep disturbance [(OR (95% CI)): 1.191 (1.014,1.400), p = 0.036] in the fully adjusted model, while no association was found under Pb and Hg exposure. In the association between Q3 and Q4 level of blood Cd and sleep disturbance, moderate-to-vigorous physical exercise group had lower risks than none and low exercise group. In the restricted cubic spline model, it was also verified that higher PE participation was associated with the lowest incidence of sleep disturbance with the increment in Cd concentration. Our study suggested that both policy makers and the public should minimize heavy metal exposure. Moreover, conducting moderate to vigorous physical exercise is a protecting factor to mitigate Cd's influence on sleep health.

Threshold effects of the relationship between physical exercise and cognitive function in the short-sleep elder population

Background

It has been demonstrated that elderly people's cognitive capacities can be improved with exercise, and short sleep is linked to cognitive decline. However, the impact of physical exercise on cognitive performance in seniors who do not get enough sleep is largely unknown. This makes it an intriguing subject to explore further.

Methods

This study consisted of elders (over 60 years old) who participated throughout the National Health and Nutrition Examination Survey's 2011-2014 cycle (NHANES). Weighted linear regression model and restricted cubic splines analysis were performed to evaluate the association between physical exercise and cognitive function. In the end, 1,615 samples were scrutinized and the total number of weighted respondents was 28,607,569.

Results

Results showed that in the Animal Fluency test and the Digit Symbol Substitution test, a positive association was found between physical exercise volume and scores in the fully adjusted model. A two-piecewise linear regression model was then applied to explore the threshold effect of exercise on cognitive performance. Before 960 and 800 MET-minutes/week, there were consistent positive relationship between exercise and scores of the Animal Fluency test [ß (95% CI): 0.233 (0.154, 0.312), p < 0.001] and Digit Symbol Substitution test [β (95% CI): 0.555 (0.332, 0.778), p < 0.001], respectively. However, there was a saturation effect where physical exercise volume reached the two inflection points.

Conclusion

According to our research, the benefit of exercise did not always expand with the exercise volume increment under the short-sleep condition, which challenged existing knowledge. The short-sleep elder group could maintain cognitive performance with no more than 800 MET-minutes/week of physical exercise. Verification of these findings requires further biological investigations.

Global research hotspots and frontiers of myasthenia gravis from 2002 to 2021: A bibliometric study

The objective of this study is to utilize bibliometric and visual analysis techniques to identify hotspots and frontiers of research in myasthenia gravis (MG) and provide valuable references for future research. The Web of Science Core Collection (WoSCC) database was used to retrieve literature data related to MG research, which was then analyzed using VOSviewer 1.6.18, CiteSpace 6.1.R3, and the Online Platform for Bibliometric Analysis. The analysis revealed 6734 publications distributed across 1612 journals and contributed by as many as 24,024 authors affiliated with 4708 institutions across 107 countries/regions. The number of annual publications and citations for MG research has steadily increased over the past 2 decades, with the last 2 years alone witnessing a remarkable increase in annual publications and citations to over 600 and 17,000, respectively. In terms of productivity, the United States emerged as the top producing country, while the University of Oxford ranked first in terms of research institutions. Vincent A was identified as the top contributor in terms of publications and citations. Muscle & Nerve and Neurology ranked first in publications and citations respectively, with clinical neurology and neurosciences among the main subject categories explored. The study also identified pathogenesis, eculizumab, thymic epithelial cells, immune checkpoint inhibitors, thymectomy, MuSK antibodies, risk, diagnosis, and management as the current hot research topics in MG, while burst keywords like quality of life, immune-related adverse events (irAEs), rituximab, safety, nivolumab, cancer, and classification indicated the frontiers of MG research. This study effectively identifies the hotspots and frontiers of MG research, and offers valuable references for researchers interested in this area.

Evolutionary Game Analysis of Artificial Intelligence Such as the Generative Pre-Trained Transformer in Future Education

As an emerging research area since generative artificial intelligence (represented by Chat Generative Pre-trained Transformer (ChatGPT)) has been accessible to the public, especially in education, appropriate AI application could bring numerous benefits to education; however, its abuse has the potential to be harmful. In this paper, we aimed to explore the potential of AI in the future of education with the analytical method of evolutionary game analysis (EGA). By studying the behavior of two agents, the school and the students, EGA can be used to identify strategies that can be used to improve the effectiveness of the education model in the context of the AI era. A stable evolutionary strategy for the school and students was devised under a variety of scenarios. Additionally, we conducted a numerical analysis to further explore the impact of several key factors on the stable strategy. The results indicated that schools should adopt positive supervision to standardize the use of AI in education, and students should be more active in becoming involved in AI technology. Based on this study, we believe that the school has the ability to provide effective suggestions and practical guidelines to help students succeed academically and embrace future trends in AI education.

The association between recreational physical activity and depression in the short sleep population: a cross-sectional study

Background

Short sleep is more common in the modern society. Recreational physical activity (RPA) like exercise brings both mental and physiological benefits to depression; paradoxically, lack of sleep is harmful. Evidence on the association between RPA and depression in the short sleep population is limited.

Methods

Participants with short sleep condition from the National health and Nutrition Examination Surveys (NHANES 2007-2018) were included in the present study. Short sleep condition was defined as ≤ 7 h per night. Sleep duration and RPA status were self-reported in NHANES by the Physical Activity Questionnaire using a 7-day recall method. Multivariable logistic regression was applied to evaluate the association between RPA and depression. Additionally, the non-linear relationship between RPA and depression was evaluated using the threshold effect analysis and restricted cubic spline.

Results

This cross-sectional study comprised 6,846 adults' data, and the weighted participants were 52,501,159. The weighted prevalence of depression was higher in females, which took up 65.85% of all depression patients. In fully adjusted models, sufficient volume of RPA was associated with lower depression risks, with OR (95% CI) =0.678 (0.520, 0.883). Further analysis revealed a U-shaped association between RPA and incident depression, and the inflection point was 640 MET-minutes/week. When RPA <640 MET-minutes/week, increased RPA was associated with lower risk of incident depression, with OR (95% CI) = 0.891 (0.834, 0.953). When RPA ≥ 640 MET-minutes/week, the benefits of RPA seemed to be not significant, with OR (95% CI) = 0.999 (0.990, 1.009).

Conclusion

Our findings observed associations between RPA condition and incident depression in the short sleep population. Moderate RPA was beneficial to maintain mental health and associated with lower incidence of depression for short sleepers, but excessive RPA might increase the risk of depression. For general short sleepers, keeping the RPA volume approximately 640 MET-minutes/week was beneficial to lower risks of depression. Gender difference should be considered as an important factor for further studies to examine these relationships and explore mechanisms.