Jun Liu

This study aims to explore the role of DNA methylation in the promoter region of the RANKL/OPG on fluorosis and the effect of betaine supplementation. A case-control study of 82 paired cases and controls was conducted among residents in coal-burning fluorosis areas in Guizhou Province, China. RANKL and OPG levels in serum of particpants were measured using ELISA. In addition, 60 SD rats were randomly divided into five groups ( n = 12): control group, model group, low-dose betaine group, medium-dose betaine group, and high-dose betaine group. 20 pairs case-control were randomly selected from 82 matched pairs to assess gene-specific DNA methylation. The methylation levels of RANKL/OPG in the human and rat whole blood were determined using targeted bisulfite sequencing (TBS). The expression of RANKL and OPG proteins in the femur tissues of rats was detected by Western blotting. The serum RANKL and OPG levels, and their ratios were elevated in the fluorosis patients compared with healthy individuals. A CpG site (pos651) in the OPG promoter exhibited hypomethylation in fluorosis patients, but this did not retain statistical significance after FDR correction( q > 0.05). Furthermore, betaine supplementation produced a dose-dependent reduction in dental fluorosis. Notably, dental fluorosis was present in 100% of the fluoride-exposed model group. Moreover, DNA methylation of CpG sites at pos1262, pos1289, pos1293, and pos1295 in the OPG gene of rat was reduced in the model group compared with the control group, and the methylation level was significantly restored in the betaine intervention group ( P < 0.05). Additionally, long-term fluoride exposure upregulated the expression of RANKL and OPG proteins in bone tissues of the rats however, whereas betaine supplementation could reverse these changes dose-dependently ( P < 0.05). Fluorosis may be associated with aberrant methylation of CpG sites in the OPG promoter. And betaine may potentially alleviate fluoride-induced bone changes, potentially through the regulation of the OPG/RANKL axis via epigenetic mechanisms.

Background: Hypertension is a leading risk factor for cardiovascular, cerebrovascular, and renal diseases, significantly worsening prognosis and quality of life. We aimed to develop and validate multimodal machine learning models integrating clinical and proteomic features for early prediction of hypertensive complications. Methods: We analyzed 502 166 participants from the UKB (UK Biobank). Proteomic profiling was performed using the Olink Explore platform. Clinical variables and complication outcomes were obtained from electronic health records. Features were selected using Cox proportional hazards models and light gradient boosting machine classifiers. Multimodal predictive models were constructed using random forest, with Shapley Additive Explanations applied for model interpretation. Results: During follow‐up, 1232, 166, and 549 participants developed heart, brain, and kidney complications, respectively. Among 3244 candidate features, 774, 600, and 1227 were associated with these outcomes. The integrated models achieved an area under the curve of 0.73 (95% CI, 0.68–0.77) for heart disease, 0.83 (95% CI, 0.73–0.92) for brain disease, and 0.79 (95% CI, 0.73–0.85) for kidney disease. Growth/differentiation factor 15 (hazard ratio [HR], 2.16 [95% CI, 1.93–2.42]), adaptor protein 3 complex subunit σ‐2 (HR, 0.57 [95% CI, 0.42–0.78]), and tumor necrosis factor receptor superfamily member 10B (HR, 4.06 [95% CI, 3.40–4.85]) were significantly associated with their respective complications, effectively predicting the risk of clinical progression (all P <0.001). Conclusions: Multimodal machine learning models combining proteomic and clinical data enable early identification of hypertensive complications. Growth/differentiation factor 15, adaptor protein 3 complex subunit σ‐2, and tumor necrosis factor receptor superfamily member 10B may serve as potential biomarkers for risk prediction and early intervention.

Moral injury (MI) and post-traumatic growth (PTG) are critical psychological outcomes for healthcare workers who are frequently exposed to ethically challenging and traumatic situations. Thriving from work (TFW), characterized by vitality and learning at work, is proposed as a key contextual resource linking these constructs. The current cross-sectional study examined the mediating role of TFW in the relationship between MI and PTG among 4685 Chinese healthcare workers with an overall response rate of 36%. Measures included the Moral Injury Symptoms Scale-Health Professional (MISS-HP), Posttraumatic Growth Inventory-Short Form (PTGI-SF), and Thriving from Work Questionnaire (TFWQ). Correlation and mediation analyses revealed that TFW fully mediated the MI-PTG relationship, accounting for 91.67% of the total effect. MI negatively affected PTG by impairing TFW, while greater TFW reduced MI's adverse effects on PTG. These findings help to explain how healthcare professionals adapt to trauma in healthcare settings and suggest practical pathways to help safeguard healthcare workers' mental health through organizational and individual interventions targeting TFW.

Objective: Previous research showed soy isoflavones have antioxidant properties beneficial to bone health, but no epidemiological studies reported effects of soy isoflavones on fluorosis. Therefore, the aim of this study was to investigate the relationship between soy isoflavones in diet/urine and coal-burning fluorosis.Methods: A comprehensive cross-sectional study with 896 participants in Zhijin County, Guizhou, China, assessed dietary intake through face-to-face interviews using a 75-item food frequency questionnaire. Urine samples were analyzed for soy isoflavone concentrations by HPLC. Unconditional logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations.Results: We observed a significant inverse association between dietary soy isoflavones and fluorosis. The adjusted OR (95% CI) in the highest quartile of intake compared with the lowest was 0.61 (0.38–0.97) (p-trend = 0.032) for total soy isoflavones intake, 0.59 (0.37–0.95) (p-trend = 0.032) for daidzein intake. Results of soy isoflavones in urine were consistent with the dietary results.Conclusion: Soy isoflavones are associated with the occurrence of coal-burning fluorosis.

During extreme conditions such as the COVID-19 pandemic, health professionals were susceptible to mental health issues. A series of network analyses were performed to explore the relationship between moral injury and depressive symptoms, anxiety symptom, PTSD symptom, and suicidal behaviors in 14,993 health professionals. Depressive symptoms were identified as the main pathway through which moral injury led to suicidal behavior, and betrayal was the most significant bridge symptom for moral injury with PTSD, anxiety, and depressive symptoms. The symptom profiles of MI associated with the common mental outcomes included betrayal, self-condemnation, and feeling punished by God. The most central mental symptoms of health professionals were irritability, nervousness, and feeling afraid. It is crucial to implement targeted measures addressing the bridge symptoms of moral injury and the core symptoms of anxiety to prevent and treat mental health consequences among health professionals.

Objective Hyperoxic exposure induces acute lung injury (ALI). We analyzed the mechanism of long non-coding RNA (lncRNA) growth-arrested DNA damage-inducible gene 7 (gadd7) regulating mitofusin 1 (MFN1) in Hyperoxia-induced ALI (HALI) type II alveolar epithelial cell (AEC II) apoptosis. Methods The HALI rat model was generated using hyperoxic induction and treated with shRNA-gadd7 and rapamycin (Rapa), with ALI, apoptotic level, total protein concentration and total cell, neutrophil and macrophage counts assessed. The HALI cell model was developed on hyperoxia-induced RLE-6TN cells and processed with oe-MFN1, si-gadd7 and Rapa. Cell viability, apoptosis, TOM20/LC3BII co-localization, mitochondrial membrane potential (MMP), superoxide dismutase activity, malonaldehyde, reactive oxygen species (ROS), tumor necrosis factor-α, interleukin (IL)-10, IL-6, IL-1β, gadd7, MFN1, Cleaved caspase-3, Cleaved poly (ADP-ribose) polymerase, B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X, LC3BI/II, lysine-specific demethylase 1 (LSD1), p62, and H3K9me3 protein levels were measured. gadd7-LSD1 interaction was predicted and verified by RPISeq database, RIP, and RNA pull-down assay. Results In HALI rats, gadd7 was up-regulated in lung tissues, and gadd7 silencing alleviated oxidative stress, ALI and apoptosis. gadd7 knockdown inhibited oxidative stress and apoptosis though MFN1, and mediated mitophagy (evidenced by diminished LC3BII/LC3BI ratio, TOM20/LC3BII co-localization and ROS level, and elevated p62 level and MMP), which were reversed by mitophagy activation. By recruiting LSD1 to down-regulate H3K9me3 level and promote MFN1 expression, gadd7-mediated mitophagy affected ALI and apoptosis in HALI rats. Conclusion LncRNA gadd7 regulated MFN1 expression by recruiting LSD1 to down-regulate H3K9me3 level and mediate mitophagy, thereby promoting AEC II apoptosis in HALI.

The health-related quality of life (HRQOL) of college students is not promising and needs to be improved through effective interventions. This study aimed to investigate the associations of nutrition literacy (NL) with HRQOL and anxiety among college students, and to identify the role of anxiety in the relationship between NL and HRQOL. The cross-sectional survey was conducted via the “Wenjuanxing” platform from September to November 2023. The Food and Nutrition Literacy Questionnaire (FNLQ), the Generalized Anxiety Disorder (GAD-7) diagnostic tool and the SF-12 scale were used to assess NL, anxiety, and HRQOL, respectively. Logistic regression models, mediation analysis, additive and multiplicative interaction analyses were used. 2066 college students participated in the analysis. After adjusting for potential confounders, we found that college students with higher NL had higher HRQOL (OR = 2.52, 95% CI: 2.09–3.03, p < 0.001) and a lower risk of anxiety (OR = 0.53, 95% CI: 0.39–0.73, p < 0.001). Additionally, anxious college students had lower HRQOL (OR = 0.16, 95% CI: 0.11–0.24, p < 0.001). Furthermore, mediation analysis confirmed that anxiety was a partial mediator of the relationship between NL and HRQOL (β = 0.600, 95% CI: 0.406–0.779/0.430–0.818). Significant additive interactions were found between NL and Anxiety (RERI = 6.96, 95% CI: 2.74–11.17; AP = 0.51, 95% CI: 0.37–0.64; SI = 2.21, 95% CI: 1.58–3.07). Higher levels of NL are associated with better HRQOL and lower anxiety among college students. Additionally, anxiety partially mediated the relationship between NL and HRQOL. Furthermore, there is a synergy between NL and anxiety.

Moral injury has attracted attention widely in various occupations, particularly health professionals. Personality traits involve the professional values in clinical decision-making associated with mental outcomes. The current study examines the relationship between “light personality” style and moral injury. Scores on three subscales of the Light Triad Scale were negatively correlated with the Moral Injury Symptoms Scale-Health Professional. Health professionals more likely to have light personality styles may be less likely to suffer from moral injury under high-stake situations. The findings provide evidence to better understand the inner core of the moral injury, suggesting a potential pathway to improve the moral well-being of health professionals by strengthening key elements of light personality.

Background: Persistently increased workload and stress occurred in health professionals (HPs) during the past 3 years as the COVID-19 pandemic continued. The current study seeks to explore the prevalence of and correlators of HPs' burnout during different stages of the pandemic.Methods: Three repeated online studies were conducted in different stages of the COVID-19 pandemic: wave 1: after the first peak of the pandemic, wave 2: the early period of the zero-COVID policy, and wave 3: the second peak of the pandemic in China. Two dimensions of burnout, emotional exhaustion (EE) and declined personal accomplishment (DPA), were assessed using Human Services Survey for Medical Personnel (MBI-HSMP), a 9-item Patient Health Questionnaire (PHQ-9), and a 7-item Generalized Anxiety Disorder (GAD-7) to assess mental health conditions. An unconditional logistic regression model was employed to discern the correlators.Results: There was an overall prevalence of depression (34.9%), anxiety (22.5%), EE (44.6%), and DPA (36.5%) in the participants; the highest prevalence of EE and DPA was discovered in the first wave (47.4% and 36.5%, respectively), then the second wave (44.9% and 34.0%), and the third wave had the lowest prevalence of 42.3% and 32.2%. Depressive symptoms and anxiety were persistently correlated with a higher prevalence risk of both EE and DPA. Workplace violence led to a higher prevalence risk of EE (wave 1: OR = 1.37, 95% CI: 1.16–1.63), and women (wave 1: OR = 1.19, 95% CI: 1.00–1.42; wave 3: OR =1.20, 95% CI:1.01–1.44) and those living in a central area (wave 2: OR = 1.66, 95% CI: 1.20–2.31) or west area (wave 2: OR = 1.54, 95% CI: 1.26–1.87) also had a higher prevalence risk of EE. In contrast, those over 50 years of age (wave 1: OR = 0.61, 95% CI: 0.39–0.96; wave 3: OR = 0.60, 95% CI: 0.38–0.95) and who provided care to patients with COVID-19 (wave 2: OR = 0.73, 95% CI: 0.57–0.92) had a lower risk of EE. Working in the psychiatry section (wave 1: OR = 1.38, 95% CI: 1.01–1.89) and being minorities (wave 2: OR = 1.28, 95% CI: 1.04–1.58) had a higher risk of DPA, while those over 50 years of age had a lower risk of DPA (wave 3: OR = 0.56, 95% CI: 0.36–0.88).Conclusion: This three-wave cross-sectional study revealed that the prevalence of burnout among health professionals was at a high level persistently during the different stages of the pandemic. The results suggest that functional impairment prevention resources and programs may be inadequate and, as such, continuous monitoring of these variables could provide evidence for developing optimal strategies for saving human resources in the coming post-pandemic era.