Background: To quantitatively evaluate the evidence of duration and quality of sleep as measured by multiple health outcomes.Methods: This review is registered with PROSPERO, number CRD42021235587. We systematically searched three databases from inception until November 15, 2020. For each meta-analysis, the summary effect size using fixed and random effects models, the 95% confidence interval, and the 95% prediction interval were assessed; heterogeneity, evidence of small-study effects, and excess significance bias were also estimated. According to the above metrics, we evaluated the credibility of each association.Results: A total of 85 meta-analyses with 36 health outcomes were included in the study. We observed highly suggestive evidence for an association between long sleep and an increased risk of all-cause mortality. Moreover, suggestive evidence supported the associations between long sleep and 5 increased risk of health outcomes (stroke, dyslipidaemia, mortality of coronary heart disease, stroke mortality, and the development or death of stroke); short sleep and increased risk of overweight and/or obesity; poor sleep quality and increased risk of diabetes mellitus and gestational diabetes mellitus.Conclusions: Only the evidence of the association of long sleep with an increased risk of all-cause mortality was graded as highly suggestive. Additional studies are needed to be conducted.

Energy metabolism in the context of erythropoiesis and related diseases remains largely unexplored. Here, we developed a primary cell model by differentiating hematopoietic stem progenitor cells toward the erythroid lineage and suppressing the mitochondrial oxidative phosphorylation (OXPHOS) pathway. OXPHOS suppression led to differentiation failure of erythroid progenitors and defects in ribosome biogenesis. Ran GTPase-activating protein 1 (RanGAP1) was identified as a target of mitochondrial OXPHOS for ribosomal defects during erythropoiesis. Overexpression of RanGAP1 largely alleviated erythroid defects resulting from OXPHOS suppression. Coenzyme Q10, an activator of OXPHOS, largely rescued erythroid defects and increased RanGAP1 expression. Patients with Diamond-Blackfan anemia (DBA) exhibited OXPHOS suppression and a concomitant suppression of ribosome biogenesis. RNA-seq analysis implied that the substantial mutation (approximately 10%) in OXPHOS genes accounts for OXPHOS suppression in these patients. Conclusively, OXPHOS disruption and the associated disruptive mitochondrial energy metabolism are linked to the pathogenesis of DBA.

INTRODUCTION: During normal pregnancy, changes in the gut microbiota (GM) in response to physiological alterations in hormonal secretion, immune functions and homeostasis have received extensive attention. However, the dynamic changes in the GM during three consecutive trimesters of pregnancy and their relationship with glucose and lipid metabolism have not been reported. In this study, we aimed to investigate the dynamic changes in the diversity and species of the GM during three consecutive trimesters in women who naturally conceived, and their relationships with abnormal fasting blood glucose (FBG) and serum lipid levels.; METHODS: A total of 30 pregnant women without any known chronic or autoimmune inflammatory disease history before pregnancy were enrolled during the first trimester. Serum and stool samples were collected during the first trimester, the second trimester, and the third trimester. Serum samples were tested for FBG and blood lipid levels, and stool specimens were analyzed by 16S rDNA sequencing.; RESULTS: The abundance ratio of bacteroidetes/firmicutes showed an increasing tendency in most of the subjects (19/30, 63.3%) from the first to the third trimester. LEfSe analysis showed that the abundance of Bilophila was significantly increased from the first to the third trimester. In addition, at the genus level, the increased relative abundance of Mitsuokella, Clostridium sensu stricto and Weissella were potentially involved in the development of high FBG during pregnancy. The raised relative abundance of Corynebacterium, Rothia and Granulicatella potentially contributed to the occurrence of dyslipidemia during pregnancy.; CONCLUSIONS: There are dynamic changes in the GM during the three trimesters, and the alterations in some bacterium abundance may contribute to the development of high FBG and dyslipidemia during pregnancy. Monitoring enterotypes and correcting dysbiosis in the first trimester may become new strategies for predicting and preventing glucolipid metabolism disorders during pregnancy. © 2024. The Author(s).

Background and AimDiet is a major contributor to irritable bowel syndrome (IBS) and is also a powerful tool for treatment of IBS. This study compared two diets and explored the effectiveness of the diets when combined with a probiotic for treatment of IBS-D patients. MethodsPhase I, patients were randomized into groups; control, cold/spicy/fried restricted diet (CSF res diet), IgG positive restricted diet (IgG res diet), and a combination both diets (CSF + IgG res diet). Phase II, patients were randomized into IgG res diet + placebo and IgG res diet + probiotic. Both interventions were 12 weeks in duration. Symptom Severity Scale (IBS-D-SSS) and IgG titer were assessed at the beginning and the end of the study. ResultsTotals of 214 and 167 patients completed the two parts of the study, respectively. After intervention, IBS-D-SSS and TIgG grade were significantly improved compared to baseline, with results similar to the control group. In general, there were decreases in IBS-D-SSS and TIgG grade that were significantly different among the groups. There were exceptions; no differences were observed for IBS-D-SSS between the IgG res diet and CSF + IgG res diet, or TIgG grade between the CSF res diet, IgG res diet, and CSF + IgG res diet. However, the CSF res diet and IgG res diet had a synergistic effect that decreased IBS-D-SSS and TIgG titer, with a greater contribution by the IgG res diet. Therefore, we evaluated the IgG res diet with either placebo or probiotic and found that IBS-D-SSS and TIgG grade decreased from baseline. There was a significant decrease in IBS-D-SSS with the probiotic but TIgG grade was not significantly different between the IgG diet + placebo and IgG diet + probiotic diet. ConclusionsBoth the CSF res diet and IgG res diet improved IBS symptoms and demonstrated synergy, although the IgG res diet had a greater contribution. Further, when intolerant foods cannot be eliminated from a diet, avoiding uncooked, cold, spicy, fried, and alcoholic foods is a superior choice. The IgG res diet combined with Bifidobacteria was the best dietary choice and may function though a non-IgG pathway.

Background and aim: The current study aimed to clarify the association between household polluting cooking fuels and adverse birth outcomes using previously published articles.Methods: In this systematic review and meta-analysis, a systematic literature search in PubMed, Embase, Web of Science, and Scopus databases were undertaken for relevant studies that had been published from inception to 16 January 2023. We calculated the overall odds ratio (OR) and 95% confidence interval (CI) for adverse birth outcomes [low birth weight (LBW), small for gestational age (SGA), stillbirth, and preterm birth (PTB)] associated with polluting cooking fuels (biomass, coal, and kerosene). Subgroup analysis and meta-regression were also conducted.Results: We included 16 cross-sectional, five case-control, and 11 cohort studies in the review. Polluting cooking fuels were found to be associated with LBW (OR: 1.37, 95% CI: 1.24, 1.52), SGA (OR: 1.48, 95% CI: 1.13, 1.94), stillbirth (OR: 1.38, 95% CI: 1.23, 1.55), and PTB (OR: 1.27, 95% CI: 1.19, 1.36). The results of most of the subgroup analyses were consistent with the main results. In the meta-regression of LBW, study design (cohort study: P < 0.01; cross-sectional study: P < 0.01) and sample size (>= 1000: P < 0.01) were the covariates associated with heterogeneity. Cooking fuel types (mixed fuel: P < 0.05) were the potentially heterogeneous source in the SGA analysis.Conclusion: The use of household polluting cooking fuels could be associated with LBW, SGA, stillbirth, and PTB. The limited literature, observational study design, exposure and outcome assessment, and residual confounding suggest that further strong epidemiological evidence with improved and standardized data was required to assess health risks from particular fuels and technologies utilized.

ObjectivesTo determine the incremental diagnostic value of radiomics signature of pericoronary adipose tissue (PCAT) in addition to the coronary artery stenosis and plaque characters for detecting hemodynamic significant coronary artery disease (CAD) based on coronary computed tomography angiography (CCTA).MethodsIn a multicenter trial of 262 patients, CCTA and invasive coronary angiography were performed, with fractional flow reserve (FFR) in 306 vessels. A total of 13 conventional quantitative characteristics including plaque characteristics (N = 10) and epicardial adipose tissue characteristics (N = 3) were obtained. A total of 106 radiomics features depicting the phenotype of the PCAT surrounding the lesion were calculated. All data were randomly split into a training dataset (75%) and a testing dataset (25%). Then three models (including the conventional model, the PCAT radiomics model, and the combined model) were established in the training dataset using multivariate logistic regression algorithm based on the conventional quantitative features and the PCAT radiomics features after dimension reduction.ResultsA total of 124/306 vessels showed functional ischemia (FFR <= 0.80). The radiomics model performed better in discriminating ischemia from non-ischemia than the conventional model in both training (area under the receiver operating characteristic (ROC) curve (AUC): 0.770 vs 0.732, p < 0.05) and testing datasets (AUC: 0.740 vs 0.696, p < 0.05). The combined model showed significantly better discrimination than the conventional model in both training (AUC: 0.810 vs 0.732, p < 0.05) and testing datasets (AUC: 0.809 vs 0.696, p < 0.05).ConclusionsThe PCAT radiomics model showed good performance in predicting myocardial ischemia. Addition of PCAT radiomics to lesion quantitative characteristics improves the predictive power of functionally relevant CAD.

Plant-based diets are recommended for cancer survivors; however, their effects on lung cancer mortality are limited. We conducted this study to evaluate the association between plant-based dietary patterns and lung cancer mortality. A total of 408 newly diagnosed lung cancer patients aged 18 to 79 years were enrolled in the study. Dietary intake was assessed using a validated 111-item food frequency questionnaire (FFQ). The survival status was confirmed by medical records and an active follow-up until March 31, 2023. We calculated three dietary indices: the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI). Cox proportional hazards regression models were used to evaluate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of plant-based indices with lung cancer mortality. During the follow-up period (median: 40.97 months; interquartile: 29.77-45.63 months), 240 patients died from lung cancer. An inverse association was observed between hPDI scores and lung cancer mortality (Q4 vs. Q1, HR, 0.66, 95% CI, 0.45-0.97, the P value for trend, 0.042), while each 10-unit increment was associated with a decreased risk of lung cancer mortality (HR, 0.75; 95% CI, 0.57-0.99). Regarding PDI and uPDI, no significant association was found with lung cancer mortality. Our study suggests that adherence to a diet with a high hPDI score may reduce lung cancer mortality. © 2023 The Royal Society of Chemistry.

目的:近年来,多个国家已完成卫生信息人才岗位胜任力模型或评价指标体系的制定。但这些模型都不符合中国卫生信息人才的本土化特点,无法真实体现我国卫生信息人才的能力。国内也逐渐有学者进行卫生信息人才岗位胜任力领域的研究,但目前尚没有一个科学系统的岗位胜任力模型。本研究目的是探索并构建卫生信息人才岗位胜任力模型,以期为高等医学院校开发和优化卫生信息人才培养模式提供科学借鉴。研究方法:本研究利用文献分析法及专家咨询法编制卫生信息人才岗位胜任力特征词典,并对卫生信息相关从业人员进行行为事件访谈,构建卫生信息人才岗位胜任力初始模型。基于初始模型编制问卷,对中国卫生信息学会卫生信息学教育专业委员会2017学术年会中来自全国24家卫生机构的卫生信息相关从业人员进行问卷调查,根据问卷结构效度建立模型框架,并进行因子命名,采用“洋葱模型”理论构建卫生信息人才岗位胜任力洋葱模型。结果:1、根据相关文献编制卫生信息人才岗位胜任特征初步词典,共纳入35项胜任特征指标。对10位专家进行3轮咨询,收集各位专家对各项特征指标的重要性评价及修改意见,最终确定词典包括28项胜任力指标,每个指标均有详细的行为描述。2、共对18名卫生信息从业人员进行访谈,并根据专家组确定的标准,划分绩效优秀者与绩效普通者各9人。对两组访谈字数和访谈时长进行两独立样本t检验,访谈字数t1=1.28（P＞0.05）,访谈时长t2=0.41（P＞0.05）。18份访谈文本总的归类一致性为0.81,总的编码信度系数为0.89。对绩优组和普通组的胜任力特征平均等级分数进行差异分析,发现16项胜任力特征得分差异有统计学意义。3、选取中国卫生信息学会卫生信息学教育专业委员会2017年学术年会中来自全国24家卫生机构的165名卫生信息相关从业人员进行问卷调查,问卷16项条目的平均得分为3.95~4.77,变异系数为0.09~0.23,满分比为0.30~0.77。模型总体Cronbach’sα系数为0.82。对问卷的结构效度采用探索性因子显示KMO（Kaiser–Meyer–Olkin）值为0.76,Bartlett球形检验χ~2=920.10（P＜0.01）。应用主成分分析法经正交旋转,提取6个特征值大于1的公因子,累计贡献率达72.62%。根据因子组成和“洋葱模型”理论构建包括3个层次,6个维度及16个条目的卫生信息人才岗位胜任力洋葱模型,其中,“职业精神”位于模型的中心层,“社交能力”、“学习创新能力”为次外层,“业务能力”、“计算机技术”及“学科基础知识”为最外层。结论:本研究基于胜任力“洋葱模型”理论,通过定性和定量相结合的方式进行卫生信息人才岗位胜任力研究,最终得到包含3个层次,6个维度,16个条目的卫生信息人才岗位胜任力洋葱模型,为我国高等医学院校有针对性地加大卫生信息人才培养力度提供科学借鉴,助力进一步探索和优化卫生信息人才培养模式。