Significant Quadratic Association Research Articles

Evaluation of low vagally-mediated heart rate variability as an early marker of depression risk

BackgroundBoth low vagally-mediated heart rate variability (HRV) and depression have been shown to be risk factors for cardiovascular disease (CVD). We recently identified an HRV cutpoint below which persons have an increased risk for several cardiometabolic disorders. However, no cutpoint exists to identify those at risk for depression. MethodsThe association between daytime HRV and diagnostically validated depression cutoffs using the five-item World Health Organization Well-being Index (WHO-5) was examined in adults from the Mannheim Industrial Cohort Study (n = 9973; Mage = 41.9[10.9]; 20 % women [n = 1934]). The aim was to identify HRV cutpoints for individuals who may have clinical depression. ResultsRegression adjusting for age, sex, and linear trend showed a significant quadratic association between depression, indexed by WHO-5 scores and HRV, indexed by the root mean square successive differences (RMSSD) in milliseconds (ms) (p < 0.001). Logistic regression models adjusting for age, sex, and heart period (i.e., inter-beat intervals) compared the clinically depressed (WHO-5 ≤ 28) and those with a screening diagnosis of depression (WHO-5 ≤ 50) to the rest of the population. Significant odds ratios suggested two RMSSD values 25 ± 2 ms (OR = 1.39 [1.17, 1.64]) and 35 ± 2 ms (OR = 1.17 [1.02, 1.34]) that may be used to identify those with an elevated risk for depression. LimitationsThe sample was primarily German men. Fitness and anti-depressant use were not available. ConclusionsAs HRV is a brief measure that can be used in clinical settings, our HRV cutpoints have implications for the early detection of those at risk for psychological and cardiometabolic disorders.

Amyloid age and tau PET timeline to symptomatic Alzheimer's disease in Down syndrome.

Adults with Down syndrome (DS) are at risk for Alzheimer's disease (AD). Recent natural history cohort studies have characterized AD biomarkers, with a focus on PET amyloid-beta (Aβ) and PET tau. Leveraging these well-characterized biomarkers, the present study examined the timeline to symptomatic AD based on estimated years since reaching Aβ+, referred to as "amyloid age", and in relation to tau in a large cohort of individuals with DS. In this multicenter cohort study, 25 - 57-year-old adults with DS (n = 167) were assessed twice from 2017 to 2022, with approximately 32 months between visits as part of the Alzheimer Biomarker Consortium - Down Syndrome. Adults with DS completed amyloid and tau PET scans, and were administered the modified Cued Recall Test and the Down Syndrome Mental Status Examination. Study partners completed the National Task Group-Early Detection Screen for Dementia. Mixed linear regressions showed significant quadratic associations between amyloid age and cognitive performance and cubic associations between amyloid age and tau, both at baseline and across 32 months. Using broken stick regression models, differences in mCRT scores were detected beginning 2.7 years following Aβ+ in cross-sectional models, with an estimated decline of 1.3 points per year. Increases in tau began, on average, 2.7 - 6.1 years following Aβ+. On average, participants with mild cognitive impairment were 7.4 years post Aβ+ and those with dementia were 12.7 years post Aβ+. There is a short timeline to initial cognitive decline and dementia from Aβ+ (Centiloid = 18) and tau deposition in DS relative to late onset AD. The established timeline based on amyloid age (or equivalent Centiloid values) is important for clinical practice and informing AD clinical trials, and avoids limitations of timelines based on chronological age. Funding. National Institute on Aging and the National Institute for Child Health and Human Development. Evidence before this study: We searched PubMed for articles published involving the progression of Aβ and tau deposition in adults with Down syndrome from database inception to March 1, 2024. Terms included "amyloid", "Down syndrome", "tau", "Alzheimer's disease", "cognitive decline", and "amyloid chronicity," with no language restrictions. One previous study outlined the progression of tau in adults with Down syndrome without consideration of cognitive decline or clinical status. Other studies reported cognitive decline associated with Aβ burden and estimated years to AD symptom onset in Down syndrome. Amyloid age estimates have also been created for older neurotypical adults and compared to cognitive performance, but this has not been investigated in Down syndrome.Added value of this study: The timeline to symptomatic Alzheimer's disease in relation to amyloid, expressed as duration of Aβ+, and tau has yet to be described in adults with Down syndrome. Our longitudinal study is the first to provide a timeline of cognitive decline and transition to mild cognitive impairment and dementia in relation to Aβ+.Implications of all the available evidence: In a cohort study of 167 adults with Down syndrome, cognitive decline began 2.7 - 5.4 years and tau deposition began 2.7 - 6.1 years following Aβ+ (Centiloid = 18). Adults with Down syndrome converted to MCI after ~7 years and dementia after ~12-13 years of Aβ+. This shortened timeline to AD symptomology from Aβ+ and tau deposition in DS based on amyloid age (or corresponding Centiloid values) can inform clinical AD intervention trials and is of use in clinical settings.

Amniotic sac reference interval in early pregnancy between 7 and 10 weeks' gestation.

To establish a normal reference interval for amniotic sac measurements between 7 and 10 weeks of gestation and its relative size in relation to the gestational sac and the embryo. This was a prospective, cross-sectional study of consecutive women presenting to UCLH Early Pregnancy Unit between August 2022 to June 2023. We included live, normally sited, singleton pregnancies with a normal 20-week anomaly scan. We collected 120 cases per gestational week totaling 360 cases. We performed an inter and intra-observer variability assessment in the measurement of mean ASD in 30 patients. Regression analyses were used to establish reference intervals for GSD to CRL, ASD to CRL, GSD to ASD and GSD:ASD ratio to CRL. The fitted regression line was calculated, along with a 90% prediction interval and the R2 value. There was good interobserver agreement (difference 0.007mm ± 1.105 (95%CI -2.160 to 2.174)) and good intra-observer agreement between Observer A (0.007 ± 1.105 (-2.160 to 2.174)) and Observer B (-0.014 ± 0.919 (-1.814 to 1.786)) in the measurement of mean ASD in 30 patients. Regression analyses showed a highly statistically significant association between each pair of values (all p-values <0.001). There were significant quadratic associations between mean GSD and CRL (R2 = 56%) and mean GSD and ASD (R2 = 60), significant cubic association between ASD and CRL (R2 = 90%) and significant quadratic association between GSD to ASD ratio and CRL (R2 = 68%). The regression equations were used to quantify the values of ASD and GSD to ASD ratios for a range of CRL values and gestational age in days. Our study has produced comprehensive reference intervals for amniotic sac size in early pregnancy which could be used in routine clinical practice. This article is protected by copyright. All rights reserved.

Changes in bone density and structure of proximal humerus with aging in Chinese women

AimsThis study aimed to investigate age- and menopause-related differences in bone mineral density (BMD), bone structure and estimated bone strength at surgical neck of humerus in Chinese female sample. MethodsWe conducted a cross-sectional cohort study of 171 Chinese women. Bone mass, indices of geometric properties and estimated mechanical strength of the surgical neck were evaluated by quantitative computed tomography (QCT). Comparisons were performed across menstrual status categories. Age-related changes in QCT-derived bone parameters were calculated. ResultsThe age-related difference of BMD and cortical thickness was 40.25 % and 32.86 % between the age of 20 and 86 years. Progressive periosteal and endosteal expansion was associated linearly with age. Estimated mechanical strength indexes showed significant quadratic associations with age, with their peak occurred at the age of 46–55 years. The quartile of women with the greatest medullary diameter also had the lowest valve of BMD and cortical thickness and the greatest in skeletal width. Compared to premenopausal individuals, perimenopausal women were distinguished by lower cortical thickness (18.63 %) and BMD (20.05 %). The continued decrease in cortical thickness and BMD was noted after menopause. The medullary and periosteal diameter increased by 17.98 % and 9.34 % respectively in perimenopausal period, but not after menopause. The accelerated loss of the maximum and polar section modulus was observed in late postmenopausal women. ConclusionsThe increase in bone size only occurred during the menopause transition. Obvious loss of resistance to bending was in late postmenopausal period.

Testing the hormesis hypothesis on motor behavior under stress

While much research has focused on the deleterious effects of stress on goal-directed behavior in recent decades, current views increasingly discuss growth under stress, often assuming dose-dependent effects of stress in a curvilinear association. This is based on the concept of hormesis, which postulates a strengthening effect of stress at low-to-moderate doses. Leveraging this approach, hormetic curves indicate under which stress dose an individual is able to maintain or even increase goal-directed behavior. The present study aimed to test the hormetic effect of low-to-moderate stress on tactical movement performance in the context of police operational scenarios in virtual reality. In teams of three to four, 37 riot police officers had to search a building for a potentially aggressive perpetrator in three scenarios with escalating stress potential (i.e., increasing weapon violence and number of civilians). Tactical movement performance as behavioral response was quantified by the sample entropy of each officer's velocity derived from positional data. To account for inter-individuality in response to the scenarios, we assessed self-reported stress, anxiety, mental effort, and vagally mediated heart rate variability. Specifically, we tested the quadratic associations between tactical movement performance and stress parameters, respectively. Random-intercept-random-slope regressions revealed neither significant linear nor quadratic associations between any of the stress parameters and performance. While we did not find evidence for hormesis in the present study, it stimulates theoretical discussions about the definition of “baseline” functioning and how the understanding of hormesis can move from psychological to behavioral adaptations to stressors.

The Reflective Functioning Questionnaire-Revised- 7 (RFQ-R-7): A new measurement model assessing hypomentalization.

Although it is a widely used questionnaire, limitations regarding the scoring procedure and the structural validity of the eight-item Reflective Functioning Questionnaire (RFQ-8) were raised. The present study aimed to examine further the latent dimensionality of the RFQ-8 and to examine linear and non-linear associations between mentalization difficulties and maladaptive psychological characteristics. Data from two separate representative samples of young adults (N = 3890; females: 51.68%; mean age: 27.06 years [SD = 4.76]) and adults (N = 1385; females: 53.20%; mean age: 41.77 years [SD = 13.08]) were used. In addition to the RFQ-8, standardized questionnaires measured the levels of impulsivity, sensation seeking, rumination, worry and well-being. Confirmatory factor analysis (CFA) was used to test the model fit of competing measurement models. CFA revealed that a revised, seven-item version of the RFQ (RFQ-R-7) with a unidimensional structure showed the most optimal levels of model fit in both samples. Impulsivity, sensation seeking, rumination and worry consistently presented significant, positive, linear associations with general mentalization difficulties in both samples. Significant quadratic associations were also identified, but these relationships closely followed the linear associations between the variables and increased only marginally the explained variance. The supported unidimensional measurement model and the associations between the general mentalization difficulties factor and maladaptive psychological characteristics indicated that the RFQ-R-7 captures a dimension of hypomentalization ranging between low and high levels of uncertainty. Increasing levels of hypomentalization can indicate a risk for less adaptive psychological functioning. Further revisions of the RFQ-8 might be warranted in the future to ensure adequate measurement for hypermentalization.

Using Wet Bulb Globe Temperature and Physiological Equivalent Temperature as Predicative Models of Medical Stress in a Marathon: Analysis of 30 Years of Data From the Twin Cities Marathon.

: Assess the relationships between wet bulb globe temperature (WBGT) and physiologic equivalent temperature (PET) at the start of a northern latitude marathon and their associations with medical stress and transfers to the emergency room (ER) when the race environment is unexpectedly warm, and participants are not acclimatized. : Retrospective review. : Twin Cities Marathon from 1990 to 2019. : Runners competing in the Twin Cities Marathon. : Start WBGT (prospectively collected) and PET (retrospectively calculated). : Marathon race starters and finishers and race day medical data (eg, medical stress, number of medical encounters, and number of ER visits). : The mean WBGT was 7.4°C (range -1.7°C to 22.2°C), and the meant PET was 5.2°C (range -16.7°C to 25.9°C). PET was not determined to be a significant predictor of medical stress (P = 0.71); however, a significant quadratic association between WBGT and medical stress was found (P = 0.006). WBGT (P = 0.002), but not PET (P = 0.07), was a significant predictor of the number of ER visits. Start WBGT was a better predictor of medical stress and ER visits than PET at the Twin Cities Marathon over a 30-year period. The start WBGT may be a better tool to predict race day environment medical safety.

Linear and non-linear associations of device-measured sedentary time with older adults' skeletal muscle mass.

Time spent sitting is associated adversely with health outcomes in older adults. Nevertheless, it is not clear how sedentary time may be related to appendicular skeletal muscle mass (ASM) - a key attribute of sarcopenia. This cross-sectional study examined associations of total sedentary time with ASM among community-dwelling older Japanese males and females. Participants (n = 281, 74.3 ± 5.2 yr) wore a tri-axial accelerometer for seven days. Body mass index-adjusted ASM (kg/BMI) was derived from bioimpedance measures. Multivariate linear and quadratic regression models examined the associations of ASM with total sedentary time, stratified by sex. Restricted cubic spline models were fitted to estimate non-linear associations. Isotemporal substitution (IS) models were used to estimate the impacts of replacing 30-minute of sedentary time with light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). After adjustment, total sedentary time had a significant linear and negative association with ASM among females (β = -0.014; p = 0.023). For males, total sedentary time had a significant quadratic association (p = 0.020). Spline models indicated a reverse U-shaped association (p < 0.001) with total sedentary time over 9.3 h/day being associated with lower ASM. The IS models indicated that replacing 30 min/day of sedentary time with LPA would be positively and significantly associated with older females' ASM (β = 0.007, p = 0.022). In older Japanese adults, higher volumes of time spent sedentary were associated with lower ASM. For males, only very high volumes of sedentary time appeared to be detrimental. These adverse relationships may in part be offset by more time spent in either LPA or MVPA.

Non-linear associations between HPA axis activity during infancy and mental health difficulties during early childhood among children in rural Pakistan.

Hypothalamic pituitary adrenal (HPA) axis activity may be a mechanism linking early adversity to child mental health difficulties. However, there is a dearth of longitudinal evidence for the association between HPA axis activity and mental health among children in low-resource contexts. The goal of this study is to examine linear and curvilinear associations between HPA axis activity during infancy and mental health difficulties in early childhood among children in rural Pakistan. Participants included 104 children (46% male) from the Bachpan study, a longitudinal cohort embedded within a maternal depression trial in Pakistan. We examined the associations between hair-derived cortisol and dehydroepiandosterone (DHEA) at 12 months old and mental health difficulties, measured with the Strengths and Difficulties Questionnaire (SDQ), at 36 months old. There was a significant quadratic association between hair cortisol and SDQ scores, with results showing a U-shaped relationship (i.e., having relatively high or low cortisol predicted increased mental health difficulties). DHEA showed a quadratic association with SDQ scores with an inverted U-shaped relationship (i.e., high and low DHEA was associated with decreased mental health difficulties). Results provide evidence of longitudinal and curvilinear effects of cortisol and DHEA during infancy on mental health difficulties in early childhood.

Haemoglobin Concentration and Cognitive Ability in the Aberdeen Children of the 1950s.

IntroductionHaemoglobin concentrations decrease with age. Abnormally low and high haemoglobin concentrations are associated with reduced cognition; however, the evidence for these associations in cohort data is limited. This study aims to assess the relationship between haemoglobin concentration and cognition in a well-characterised cohort of older adults.MethodsTwo hundred and fifty-two healthy participants were drawn from the Aberdeen Children of the 1950s cohort, aged between 59 to 65 years. Participants underwent cognitive tests of processing speed, memory, verbal and nonverbal reasoning, and language ability and these were used to construct a global cognitive score, g, using principal component analysis. Haemoglobin concentration in the blood was measured concurrently. Hierarchical multiple regression models were constructed assessing the relationship between haemoglobin concentration and each cognitive measure and these were corrected for age, sex, education, C-reactive protein, hypertension, and body mass index.ResultsSignificant linear association between haemoglobin concentration and nonverbal reasoning demonstrated that low haemoglobin levels are associated with lower scores. A quadratic relationship was found for haemoglobin concentration and immediate memory scores in which low and high haemoglobin levels were associated with lower scores.ConclusionsHaemoglobin concentration was found to have a significant linear association with nonverbal reasoning scores and a significant quadratic association with memory scores. The results from this study help to understand the association between haemoglobin and different aspects of cognition.

176 Linear and Nonlinear Associations Between Sleep and Academic Achievement in Middle Childhood: The Role of Early Life SES

Abstract Introduction Elementary-aged children in low socioeconomic environments are more likely to experience poor sleep, which can negatively impact academic performance. However, it is unknown whether early-life socioeconomic status (SES) influences associations between sleep and academic achievement later in childhood. Using a demographically diverse sample of children followed longitudinally from 1 to 8 years, we tested linear and nonlinear associations between actigraphy-based sleep duration, midpoint time, sleep duration variability, and parent-reported sleep problems with academic achievement. In addition, we examined whether these associations varied by early SES. Methods The sample comprised 707 twins (52% female; Mage=8.44 years; 28.7% Hispanic/Latinx; 29.7% at or below the poverty line). SES was ascertained at 1 and 8 years, and children wore actigraph watches to assess sleep for 7 nights (Mnights=6.79) and completed the Applied Math, Picture Vocabulary, and Passage Comprehension subtests of the Woodcock-Johnson IV Tests of Achievement. Primary caregivers also reported on their children’s sleep and academic performance (Children’s Sleep Habits Questionnaire and Health and Behavior Questionnaire, respectively). Results Sleep was not linearly related to academic achievement, but there was a significant quadratic association between sleep midpoint with Picture Vocabulary (b=0.28, p&amp;lt;.01) and Passage Comprehension (b=0.17, p&amp;lt;.05). More parent-reported sleep problems were negatively related to Applied Problems performance for lower (b=-1.16, p&amp;lt;.001) and positively associated for higher early SES (b = 1.00, p &amp;lt; .01). More parent-reported sleep problems predicted lower Passage Comprehension for lower (b = -0.59, p &amp;lt; .05), but not higher early SES. Longer sleep duration predicted higher parent-reported academic achievement for lower early SES (b=0.14, p&amp;lt;.01) and lower achievement for higher early SES (b=-0.23, p&amp;lt;.001). Conclusion Our findings illustrate the complex, sometimes nonlinear associations between children’s sleep and academic performance. Many associations varied by early-life SES, suggesting that early childhood environments have long-lasting implications for child functioning, over and above the effect of concurrent SES. Increasing the quantity and quality of children’s sleep could improve academic outcomes, particularly for children who have experienced socioeconomic disadvantage. Support (if any) This research was supported by grants from NICHD (R01HD079520 and R01HD086085) and ASU T. Denny Sanford School of Social and Family Dynamics.

Sleep Duration, Sleep Apnea, and Gray Matter Volume.

This study aimed to evaluate the effect of sleep duration on brain structures in the presence versus absence of sleep apnea in middle-aged and older individuals. The study investigated a population-based sample of 2,560 individuals, aged 49-80 years. The presence of sleep apnea and self-reported sleep duration were examined in relation to gray matter volume (GMV) in total and lobar brain regions. We identified ranges of sleep duration associated with maximal GMV using quadratic regression and bootstrap sampling. A significant quadratic association between sleep duration and GMV was observed in total and lobar brain regions of men with sleep apnea. In the fully adjusted model, optimal sleep durations associated with peak GMV between brain regions ranged from 6.7 to 7.0 hours. Shorter and longer sleep durations were associated with lower GMV in total and 4 sub-regions of the brain in men with sleep apnea.

Age-related changes in chimpanzee (Pan troglodytes) cognition: Cross-sectional and longitudinal analyses.

Chimpanzees are the species most closely related to humans, yet age-related changes in brain and cognition remain poorly understood. The lack of studies on age-related changes in cognition in chimpanzees is particularly unfortunate in light of the recent evidence demonstrating that this species naturally develops Alzheimer's disease (AD) neuropathology. Here, we tested 213 young, middle-aged, and elderly captive chimpanzees on the primate cognitive test battery (PCTB), a set of 13 tasks that assess physical and social cognition in nonhuman primates. A subset of these chimpanzees (n = 146) was tested a second time on a portion of the PCTB tasks as a means of evaluating longitudinal changes in cognition. Cross-sectional analyses revealed a significant quadratic association between age and cognition with younger and older chimpanzees performing more poorly than middle-aged individuals. Longitudinal analyses showed that the oldest chimpanzees at the time of the first test showed the greatest decline in cognition, although the effect was mild. The collective data show that chimpanzees, like other nonhuman primates, show age-related decline in cognition. Further investigations into whether the observed cognitive decline is associated with AD pathologies in chimpanzees would be invaluable in understanding the comparative biology of aging and neuropathology in primates.

Correlation of subclinical gastrointestinal nematode parasitism with growth and reproductive performance in ewe lambs in Ontario

Infection with gastrointestinal nematode parasites (GINs) is an important cause of productivity loss on sheep farms in Ontario and worldwide. However, efforts to quantify the effect of GIN infection on growth have demonstrated mixed results. Furthermore, there has been limited investigation of their effect on reproductive performance. This study evaluated the effect of subclinical GIN parasitism on growth and reproductive performance of ewe lambs under Ontario grazing conditions. Rideau cross ewe lambs (n = 140) born in spring 2016 on a farm in central Ontario were followed for two years from before weaning through to November 2017, including their first lambing and lactation. These animals grazed from May to November of each year and were sampled every 6−8 weeks during both grazing seasons and once at mid-gestation in March 2017. At each sampling the ewe lambs were weighed, body condition scores assigned, fecal egg counts (FECs) performed, and pasture samples collected to assess number of infective GIN larvae. Study animals with a FEC of 500 eggs per gram or higher were selectively treated with anthelmintics to prevent morbidity and mortality. Fecal samples were cultured to determine infecting GIN species, and climate data were obtained from a weather station 26 km away from the farm. Precipitation levels and numbers of infective larvae on pasture were low during the first grazing season but were more typical of Ontario conditions in the second grazing season. The three most common GIN species were Haemonchus contortus, Teladorsagia circumcincta, and Trichostrongylus spp. General linear mixed models were generated for weight change over time, litter size at lambing, and weaning weights of offspring. Despite moderate peak GIN burdens in both grazing seasons, FEC was not significantly associated with weight change or litter size, apart from periparturient egg rise in study ewe lambs with larger litters (p = 0.05). Significant positive quadratic and negative linear associations were identified between late lactation FECs and offspring weaning weights; the association between FECs and weaning weights changed from negative to positive at a FEC of 361 eggs per gram. These results indicate that when GIN burdens are moderate as evidenced by fecal egg counts and infection is subclinical, there appears to be low to no impact on growth and reproductive performance in ewe lambs in the first 18 months of life. This suggests that when GIN parasitism is regularly monitored and controlled using targeted selective treatment, animal performance is minimally affected.

Ethnic Restaurant Nutrition Environments and Cardiovascular Health: Examining Hispanic Caribbean Restaurants in New York City.

To adapt and apply the Nutrition Environment Measures Survey for Restaurants (NEMS-R) to Hispanic Caribbean (HC) restaurants and examine associations between restaurant characteristics and nutrition environment measures. We adapted the NEMS-R for HC cuisines (Cuban, Puerto Rican, Dominican) and cardiovascular health-promoting factors, and applied the instrument (NEMS-HCR) to a random sample of HC restaurants in New York City (NYC) (N=89). Multivariable linear regression was used to assess independent associations between NEMS-HCR score and restaurant characteristics (cuisine, size, type [counter-style vs sit-down] and price). None of the menus in the restaurants studied listed any main dishes as "healthy" or "light." More than half (52%) offered mostly (>75%) nonfried main dishes, and 76% offered at least one vegetarian option. The most common facilitator to healthy eating was offering reduced portion sizes (21%) and the most common barrier was having salt shakers on tables (40%). NEMS-HCR scores (100-point scale) ranged from 24.1-55.2 (mean=39.7). In multivariable analyses, scores were significantly related to cuisine (with Puerto Rican cuisine scoring lower than Cuban and Dominican cuisines), and size (with small [<22 seats] restaurants scoring lower than larger restaurants). We found a significant quadratic association with midpoint price, suggesting that scores increased with increasing price in the lowest price range, did not vary in the middle range, and decreased with increasing price in the highest range. Our application of the NEMS-R to HC restaurants in NYC revealed areas for potential future interventions to improve food offerings and environmental cues to encourage healthful choices.

Which objective sleep elements predict children's perceptions of good sleep quality? A preliminary investigation based on polysomnography and actigraphy

ObjectivesObjective sleep elements that underlie child ratings of sleep quality are largely unknown. Child-based sleep recommendations, therefore, typically focus on duration. An expert panel recently provided specific recommendations regarding objective sleep parameters that correspond with higher quality sleep, but child-based studies from which to draw conclusions were notably limited. The present study used actigraphy and polysomnography to explore sleep continuity and architectural variables that correspond with higher ratings of sleep quality in a sample of school-aged children. MethodsFifty-two healthy, prepubertal children (aged 7–11 years) completed one night of unattended ambulatory polysomnography at home with concurrent actigraphy and provided sleep quality ratings the following morning. Associations between sleep variables and subjective ratings were examined using polynomial regression models to examine potential linear and nonlinear relationships. ResultsIn contrast to findings among adults, total sleep time, sleep onset latency, and sleep efficiency values were unrelated to child ratings of sleep quality. Wake after sleep onset (WASO) showed a curvilinear (reversed j-shaped) relationship such that perceptions of sleep quality were high when WASO values were less than approximately 30 minutes. For sleep architecture, N1% showed a significant quadratic association with sleep quality such that N1% between 2% and 6% corresponded with high sleep quality ratings. ConclusionsOur findings support expert recommendations regarding WASO values that predict high quality sleep in children, but also await replication. There is need for additional research aimed at understanding objective sleep elements and other influences of children's perceptions of sleep quality using linear and nonlinear models.

Relationships Between the Usage of Televisions, Computers, and Mobile Phones and the Quality of Sleep in a Chinese Population: Community-Based Cross-Sectional Study.

BackgroundNo study has comprehensively investigated the association between the usage of typical screen-based electronic media devices and sleep quality in a Chinese population with individuals in a wide range of ages.ObjectiveThis study aimed to understand the characteristics of television (TV) viewing, computer usage, and mobile phone usage in a representative Chinese population in Macau and to examine their roles in predicting the variations in sleep quality.MethodsThis cross-sectional study was an analysis of 1500 Macau residents aged 15 to 90 years based on a community-based health needs assessment study entitled, “Healthy Living, Longer Lives.” Data collection was conducted in 7 districts of Macau from 2017 to 2018 through face-to-face interviews. The durations of daily TV viewing, computer usage, and mobile phone usage were recorded in a self-administered questionnaire. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality.ResultsThe prevalence of TV, computer, and mobile phone usage was 78.4% (1176/1500), 51.6% (769/1490), and 85.5% (1276/1492), respectively. The average daily hours of usage were 1.75 (1.62), 1.53 (2.26), and 2.85 (2.47) hours, respectively. Females spent more time watching TV (P=.03) and using mobile phones (P=.02) and less time on the computer (P=.04) as compared to males. Older adults were more likely to watch TV while young people spent more time using the computer and mobile phones (P for all trends<.001). The mean PSQI global score was 4.79 (2.80) among the participants. Females exhibited significantly higher PSQI scores than males (5.04 vs 4.49, respectively; P<.001). No linear association was observed between the PSQI score and the amount of time spent on the 3 electronic devices (P=.58 for PSQI-TV, P=.05 for PSQI-computer, and P=.52 for PSQI-mobile phone). Curve estimation showed significant quadratic curvilinear associations in PSQI-TV (P=.003) and PSQI-computer (P<.001) among all the participants and in PSQI-mobile phone among youths (age, 15-24 years; P=.04). After adjustment of the gender, age, body mass index, demographics, and lifestyle factors, more than 3 hours of TV viewing and 4 hours of computer usage or mobile phone usage was associated with 85% (95% CI 1.04-1.87; P=.008), 72% (95% CI 1.01-2.92; P=.045), and 53% (95% CI 1.06-2.22; P=.03) greater odds of having poor sleep quality (PSQI score>5), respectively.ConclusionsThe mobile phone was the most popular screen-based electronic device used in the Macau population, especially among young people. “J” shape associations were observed between sleep quality and the duration of TV viewing, computer usage, and mobile phone usage, indicating that the extreme use of screen-based electronic devices predicted poorer sleep status, whereas moderate use would be acceptable.

Examining Community Restaurant Nutrition Environments for Cardiovascular Health: An Assessment of Hispanic Caribbean Restaurants in New York City

Abstract Objectives Examine the nutrition environment in Hispanic Caribbean (HC) restaurants, and identify restaurant-level factors associated with healthier nutrition restaurant environments. Methods We adapted the Nutrition Environment Measure Survey for Restaurants (NEMS-R) to HC cuisines and applied the instrument (NEMS-HCR) to a random sample of Cuban, Puerto Rican, and Dominican restaurants in New York City (n = 89). Descriptive and regression analysis examined the associations between the NEMS-HCR score and restaurant characteristics (HC cuisine, restaurant type, and midpoint price). Results No restaurant offered dishes labeled as healthy and almost none (2%) offered whole grains or fruit. Half of the restaurants (52%) had menus with a large proportion (&amp;gt;75%) of nonfried (NF) main dishes and three-quarters (76%) offered at least one vegetarian option. The most common environmental facilitator to healthy eating was offering reduced portion sizes (21%) and the most common barrier was having salt shakers on tables (40%). NEMS-HCR scores (100-point scale) ranged from 24.1–55.2 (mean = 39.7). Scores varied by cuisine and size category, but not by restaurant type (sit-down vs fast casual). Puerto Rican restaurants had the lowest mean score, compared with Dominican and Cuban restaurants (33.7 ± 6.8, 39.6 ± 6.4, 43.3 ± 6.9, respectively, P &amp;lt; 0.001). Small restaurants (&amp;lt;22 seats) had significantly lowest scores, compared with large and medium sized (36.7 ± 7.1, 41.3 ± 7.2, 41.6 ± 6.1, respectively, P &amp;lt; 0.05). Multivariate regression indicated that HC cuisine, restaurant size, and price were significantly associated with the score (P &amp;lt; 0.05). Price was found to have a significant quadratic association, where lower scores were found among lower and higher priced restaurants. Conclusions HC communities present more dietary risk factors than other Hispanic groups. Our study is the first to adapt and apply the NEMS-R to HC restaurants. Restaurants are increasingly important daily sources of food. As interventions targeting individual behavior change have shown limited impact, restaurants represent an important environmental target for health promotion. The assessment showed areas for potential improvements in food offerings and environmental cues to encourage healthful choices in HC restaurants. Funding Sources CUNY PSC Award and NIH/NHLBI Career Development Award (K01).

The impact of aging on the subregions of the fusiform gyrus in healthy older adults.

The fusiform gyrus is known to decrease in size with increasing age. However, reported findings are inconsistent and existing studies differ in terms of the cohorts examined and/or the methods applied. Here, we analyzed age-related links in four distinct subregions of the fusiform gyrus through integrating imaging-based intensity information with microscopically defined cytoarchitectonic probabilities. In addition to age effects we investigated sex effects as well as age-by-sex interactions in a relatively large sample of 468 healthy subjects (272 females/196 males) covering a broad age range (42-97years). We observed significant negative correlations between age and all four subregions of the fusiform gyrus indicating volume decreases over time, albeit with subregion-specific trajectories. Additionally, we observed significant negative quadratic associations with age for some subregions, suggesting an accelerating volume loss over time. These findings may serve as a frame of reference for future cross-sectional as well as longitudinal studies, not only for normative samples but also potentially for clinical conditions that present with abnormal atrophy of the fusiform gyrus. We did not detect any significant sex differences or sex-by-age interactions, suggesting that the size of the fusiform gyrus is similar in male and female brains and that age-related atrophy follows a similar trajectory in both men and women.

Inhibitory control moderates the quadratic association between resting respiratory sinus arrhythmia and prosocial behaviors in children.

Resting respiratory sinus arrhythmia (RSA) is thought to be an important physiological correlate of prosocial behaviors. A negative quadratic association between resting RSA and prosocial behaviors has been found in recent studies. However, it remains unknown whether inhibitory control (IC), as an aspect of cognitive regulation, moderates this quadratic association. This issue was examined in the present study. One hundred and forty-eight children (81 girls, 54.7%) aged 7-8years completed a go/no-go task to assess their IC, and the children's parents completed the Strengths and Difficulties Questionnaire-Chinese version (SDQ-CV) to assess children's prosocial behaviors. Resting RSA was calculated by electrocardiogram (ECG) data collected during a resting period in the laboratory. The results showed a significant quadratic association between resting RSA and children's prosocial behaviors. More importantly, IC had a significant moderating effect on the quadratic association between resting RSA and prosocial behaviors. Specifically, the quadratic effect of resting RSA on prosocial behaviors was observed only among children with low and average IC and disappeared in children with better IC. The findings suggest that IC interacts with resting RSA to contribute to prosocial behaviors in children. High levels of IC could attenuate the negative impact of high and low resting RSA on prosocial behaviors.