Isoflurane-induced reduction in neurogenesis derived from the tertiary dentate matrix.

Anesthetics-induced disruption of dentate neurogenesis in the young brain is strongly suggested to contribute to delayed neurocognitive deficit. In postnatal rodents, the neurogenesis of the dentate gyrus (DG) is sequentially derived from the secondary dentate matrix, tertiary dentate matrix and subgranular zone (SGZ). However, the effects of anesthetics on the dentate neurogenesis derived from specific sites are poorly understood. To trace the new cells generated from the postnatal secondary dentate matrix, peak stage of the tertiary dentate matrix and early stage of the SGZ after isoflurane exposure, mice at postnatal day 1 (P1), P7 and P31 were injected with BrdU at 12 h before the exposure. We found that isoflurane exposure significantly reduced the numbers of proliferating cells (1 day old), immature granule cells (21 days old) or mature granule cells (42 days old) derived from the peak stage of the tertiary dentate matrix and postnatal secondary dentate matrix, but not from the SGZ. Quantitative assessment of BrdU-/BrdU+NeuN-positive cells and cleaved caspase-3 level in the DG indicated that the reduction was correlated with cell loss rather than neuronal differentiation. Mechanistically, we demonstrated that the PI3K/Akt/GSK-3ß pathway enriched by mRNA-sequencing is a requirement for the isoflurane-induced loss of 1-day-old proliferating cells generated from the tertiary dentate matrix. In addition, this study demonstrated that P1 and P7 mice, but not P31 mice exposure to isoflurane resulted in subsequent deficits in performance of the tasks of the Morris Water Maze.

Modeling and Predicting Pulmonary Tuberculosis Incidence and Its Association with Air Pollution and Meteorological Factors Using an ARIMAX Model: An Ecological Study in Ningbo of China.

The autoregressive integrated moving average with exogenous regressors (ARIMAX) modeling studies of pulmonary tuberculosis (PTB) are still rare. This study aims to explore whether incorporating air pollution and meteorological factors can improve the performance of a time series model in predicting PTB. We collected the monthly incidence of PTB, records of six air pollutants and six meteorological factors in Ningbo of China from January 2015 to December 2019. Then, we constructed the ARIMA, univariate ARIMAX, and multivariate ARIMAX models. The ARIMAX model incorporated ambient factors, while the ARIMA model did not. After prewhitening, the cross-correlation analysis showed that PTB incidence was related to air pollution and meteorological factors with a lag effect. Air pollution and meteorological factors also had a correlation. We found that the multivariate ARIMAX model incorporating both the ozone with 0-month lag and the atmospheric pressure with 11-month lag had the best performance for predicting the incidence of PTB in 2019, with the lowest fitted mean absolute percentage error (MAPE) of 2.9097% and test MAPE of 9.2643%. However, ARIMAX has limited improvement in prediction accuracy compared with the ARIMA model. Our study also suggests the role of protecting the environment and reducing pollutants in controlling PTB and other infectious diseases.

Identification of microRNA/target gene in the dentate gyrus of 7­day­old mice following isoflurane exposure.

Studies on rodents and nonhuman primates suggest that exposure to anesthetics, particularly in the young brain, is associated with neuronal apoptosis as well as hippocampal­dependent cognitive dysfunction. Disruption of the development of dentate gyrus may play an important role in anesthetics­induced neurotoxicity. However, the anesthetics triggered molecular events in the dentate gyrus of the developing brain are poorly understood. By integrating two independent data sets obtained from miRNA­seq and mRNA­seq respectively, this study aims to profile the network of miRNA and potential target genes, as well as relevant events occurring in the dentate gyrus of isoflurane exposed 7­day­old mice. We found that a single four hours exposure to isoflurane yielded 1059 pairs of differently expressed miRNAs/target genes in the dentate gyrus. Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis further indicates that dysregulated miRNAs/target genes have far­reaching effects on the cellular pathophysiological events, such as cell apoptosis, axon development, and synaptic transmission. Our results would greatly broaden our functional understanding of the role of miRNA/target gene in the context of anesthetics­induced neurotoxicity.

The economic costs of limited health literacy in China: evidence from China's National Health Literacy Surveillance data.

BACKGROUND: Limited health literacy is a public health challenge contributing to the rising health care costs. We assess the economic costs of limited health literacy in China using data from the National Health Literacy Surveillance survey. METHODS: Our data includes a sample of 6316 residents aged 15-69 years old living in Ningbo, China, in 2019. We use box plots to examine the distribution of out-of-pocket health expenditure by the level of health literacy. We then use the estimates from a two-part model to assess the contribution of limited health literacy to individual medical spending and the aggregate health expenditure at different levels of health literacy for the adult population in Ningbo. RESULTS: Medical costs of limited health literacy are about 10% (177 CNY or about 25 USD) of the annual medical expense of a resident aged 15-69 living in Ningbo. The medical cost of limited health literacy is greater among the rural, female, and older groups than others. If the proportion of people with adequate health literacy increases from 22 to 30% (the target level by 2030), the aggregate out-of-pocket health expenditure in Ningbo will decrease by 100 million CNY (14 million USD), or 0.88% of the 2019 Ningbo government expenditure on health care. CONCLUSIONS: This paper highlights the direct and indirect economic costs associated with limited health literacy. The results should help policymakers evaluate the cost-effectiveness of relevant programs that aim to improve residents' health literacy.

The Community Health Supporting Environments and Residents' Health and Well-Being: The Role of Health Literacy.

We evaluate the impacts that health supporting environments have on residents' health and well-being. Using a stratified multi-stage sampling method, we select a sample of 12,360 permanent adult residents aged 15-69, and collect information on their health literacy level, as well as their demographic background and health. This individual level data is then merged with the administrative health supporting environment data. More than two thirds of residents self-reported having good/excellent health, and the percent of adults living in communities with healthy parks, healthy trails, and healthy huts in their community is 23 percent, 43 percent, and 25 percent, respectively. Controlling for a series of confounding factors at the community and individual levels, we find that healthy parks and healthy trails are positively correlated with self-reported health, which increases the probability of self-reporting good health by 2.0 percentage points (p < 0.10) and 6.0 percentage points (p < 0.01), respectively. Access to healthy huts is negatively associated with self-reported health, decreasing the probability of self-reporting good health by 5.0 percentage points (p < 0.01). Health literacy plays a role in moderating the effect of health parks, and a positive effect is more likely to be observed among adults with lower health literacy. Health supporting environments may play a role in reducing the likelihood of undiagnosed diseases and changing residents' lifestyles, which promotes the health and well-being of residents, especially among those with inadequate health literacy.

Health Knowledge about Smoking, Role of Doctors, and Self-Perceived Health: A Cross-Sectional Study on Smokers' Intentions to Quit.

Limited empirical work has been done to compare the effects that health knowledge and advice from doctors have on smokers' intentions to quit. This paper examines the association of smokers' intentions to quit with health knowledge, advice from doctors, and self-perceived health. A sample of 2509 smokers aged 15-69 years old in Ningbo was used from China's National Health Literacy Surveillance survey, conducted in 2018 and 2019. Respondents were asked whether they agree smoking causes stroke, heart attack, lung cancer; and heart diseases in adults, lung illnesses in children, and lung cancer in adults, by secondhand smoke, respectively. Using the logistic model, we found that knowing that smoking causes stroke and lung cancer more than doubles the odds of one's intention to quit (OR = 2.705, p < 0.01), the effect of which is much greater than knowing that smoking causes lung cancer only (OR = 1.795, p < 0.01). Doctors' advice to quit is more important than health knowledge, in terms of predicting smokers' past cessation behaviours. In addition, smokers' self-perceived health is negatively associated with their decisions to quit. This paper highlights that more resources should be directed towards training health care providers to advise smokers to quit, which might be more effective than health education alone.

The neurotoxic effect of isoflurane on age-defined neurons generated from tertiary dentate matrix in mice.

INTRODUCTION: Recent animal studies showed that isoflurane exposure may lead to the disturbance of hippocampal neurogenesis and later cognitive impairment. However, much less is known about the effect of isoflurane exposure on the neurons generated form tertiary dentate matrix, even though a great increase of granule cell population during the infantile period is principally derived from this area. METHODS: To label the new cells originated from the tertiary dentate matrix, the mice were injected with BrdU on postnatal day 6 (P6). Then, the mice were exposed to isoflurane for 4 hr at 1, 8, 21, and 42 days after BrdU injection, and the brains were collected 24 hr later. The loss of newly generated cells/neurons with different developmental stage was assessed by BrdU, BrdU + DCX, BrdU + NeuN, or BrdU + Prox-1 staining, respectively. RESULTS: We found that the isoflurane exposure significantly decreased the numbers of nascent cells (1 day old) and mature neurons (42 days old), but had no effect on the immature (8 days old) and early mature neurons (8 and 21 days old, respectively). CONCLUSION: The results suggested isoflurane exposure exerts the neurotoxic effects on the tertiary dentate matrix-originated cells with an age-defined pattern in mice, which partly explain the cognitive impairment resulting from isoflurane exposure to the young brain.

Identification of microRNA-target genes in mice hippocampus at 1 week after pilocarpine-induced status epilepticus.

MicroRNAs (miRNA) are believed to play a crucial role in the cause and treatment of temporal lobe epilepsy (TLE) by controlling gene expression in different stages of the disease. To investigate role of miRNA in the latent stage following status epilepticus, we first compared microRNA expression profiles in mice hippocampus at 1 week after pilocarpine-induced status epilepticus (SE) vs. controls in hippocampal tissues using Exiqon miRCURY LNA™ miRNAs Array. Then, the target genes of altered miRNAs were predicted using both TargetScan 7.1 and miRDB V5, and were further selected by intersecting with another independent mRNA expression profile dataset from the samples at the same time point. We found out 14 common genes as down miRNA target (up-mRNA) and 4 common genes as up miRNA target (down mRNA) in SE mice. miR-669m-3p-TRHR (thyrotropin releasing hormone receptor), miR-669m-3p-B3galt2 (ß-1,3-Galactosyltransferase 2), miR-105-PDPN (Podoplanin) and miR-883b-3p-CLEC-2 (C-type-lectin-like-2) were found to be potential molecular mechanisms to modulate the calcium signaling pathway, glycosylation pathways and chemokine mediated inflammatory processes in mice hippocampus at 1 week after pilocarpine-induced SE, respectively. Our results offered potential novel insights into the cellular events in the mice hippocampus mediated by miRNASs-target genes that shape SE-evoked epileptogenesis.

Health literacy and its effect on chronic disease prevention: evidence from China's data.

BACKGROUND: Improving health literacy is an important public health goal in many countries. Although many studies have suggested that low health literacy has adverse effects on an individual's health outcomes, confounding factors are often not accounted. This paper examines the interplay between health literacy and chronic disease prevention. METHODS: A population-based sample of 8194 participants aged 15-69 years old in Ningbo were used from China's 2017 National Health Literacy Surveillance Data. We use multivariate regression analysis to disentangle the relationship between health literacy and chronic disease prevention. RESULTS: We find the association between health literacy and the occurrence of the first chronic condition is attenuated after we adjust the results for age and education. This might arise because having one or more chronic conditions is associated with better knowledge about chronic diseases, thus improve their health literacy. More importantly, we find health literacy is associated with a reduction in the likelihood of having a comorbid condition. However, this protective effect is only found among urban residents, suggesting health literacy might be a key factor explaining the rural-urban disparity in health outcomes. CONCLUSION: Our findings highlight the important role of health literacy in preventing comorbidities instead of preventing the first chronic condition. Moreover, family support could help improve health literacy and result in beneficial effects on health.