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College freshmen are special populations facing great challenges in adapting to the brand new environment, and their lifestyle and emotional states are worthy of attention. Especially during the COVID-19 pandemic, their screen time and prevalence of negative emotions were significantly increased, but few studies have focused on such situation of college freshmen and illustrated relevant mechanisms. Thus, based on a sample of Chinese college freshmen during the COVID-19 pandemic, the current study aimed to investigate the association between their screen time and negative emotions (depression, anxiety and stress), and further explore the mediating effects of sleep quality. Data from 2,014 college freshmen was analyzed. The screen time was self-reported by participants using predesigned questionnaires. The Pittsburgh Sleep Quality Index (PSQI) and Chinese Version of Depression Anxiety and Stress Scale-21 (DASS-21) were used to assess sleep quality and emotional states, respectively. The mediation analysis was conducted to examine the meditation effect. Results indicated that participants with negative emotions tended to have longer daily screen time and worse sleep quality, sleep quality partially mediated the association between screen time and negative emotions.The critical role of sleep quality and related intervention measures should be recognized and implemented. [ABSTRACT FROM AUTHOR]

Research indicates that sleep problem is a behavioral risk factor of obesity. However, few research have applied a multi-dimensional approach to investigate the relationship between sleep health and adiposity. Therefore, the current study aimed to examine the associations of sleep characteristics (duration, quality) and chronotype with overweight/obesity as measured by body mass index. Data were obtained from 2014 college students from the Dali University in the Yunnan province of China in the year 2021. Sleep characteristics and chronotype were measured using self-reported questionnaires. The presence of overweight/obesity was assessed by anthropometric measurements. Multiple logistic regression models and restricted cubic spline hazard models were established to examine associations between sleep characteristics, chronotype and adiposity. After adjusting for demographic characteristics and other obesity-related behavioral risk factors, evening type was positively associated with overweight/obesity, and an L-shaped dose-effect relationship was observed between chronotype scores and the presence of overweight/obesity. However, sleep duration and quality were not associated with the presence of overweight/obesity in the logistic regression models and restrictive cubic splines models. This study indicated that Chinese college students who had the evening chronotype were more likely to be affected by overweight/obesity. Chronotype as an important dimension of sleep health should be incorporated in obesity intervention programs. [ABSTRACT FROM AUTHOR]

Association between gene-environment interaction and myopia/spherical equivalent has not been systematically reported. This paper reviewed nine studies concerning gene-environment interaction in myopia. We obtained relevant studies concerning gene-environment interaction in myopia by systematically searching the MEDLINE(PubMed), Cochrane, Web of Science, CNKI, Wanfang databases before 31 March 2020. Data were analyzed by STATA version 16.0 software, and figures were drawn by ArcGIS V.10.0 software. Nine studies were included in this review concerning gene-environment interaction. Gene and education interaction in adult cohorts suggested a more significant genetic effect in higher education levels than lower education levels, using both candidate genes and PRS approaches. Several interacted genetic variants, including ZMAT4(rs2137277), GJD2(rs524952), TJP2 (rs11145488) from adult study and ZMAT4(rs7829127) from child study are pinpointed out, but the replication attempts were limited. Besides, the genetic effect was associated with a significant shift at a higher educational level (Pooled β = −0.15,95%CI = −0.19–0.11) towards myopia than that at a lower education level (Pooled β = −0.10,95%CI = −0.11–0.09). This study summarizes the relationship between gene-environment interaction and myopia, and interaction effect of the gene or genetic risk score with the environment could be found in these studies. The effect of gene-environment (higher education) interaction substantially impacts myopia in adult studies. Evidence that environmental factors (Increased near-work time/decreased outdoor activities) increase the genetic risk is still limited, and specific SNPs contributing to gene-environment effect are not determined yet. [ABSTRACT FROM AUTHOR]

Objectives: It is well known that sleep quality was associated with falls. This study aimed to examine whether the presence of depressive symptoms mediate the association of self-reported sleep quality with falls. Methods: Data of community-based study including 4,579 adults aged 60 years or older were analyzed. Information regarding sleep quality and falls was self-reported by participants using pre-designed questionnaires. The nine-item Patient Health Questionnaire (PHQ-9) without the sleep item was used to assess the presence of depressive symptoms. A bootstrapping approach was performed to explore whether the relationship between self-reported sleep quality and falls was partially mediated by depressive symptoms. The mediator was considered significant if the 95% confidence interval (CI) did not include 0. Results: Older adults with poor sleep quality had higher odds of falls than their counterparts with normal sleep. In the equation regressed falls on self-reported sleep quality and PHQ-9 score, the association between self-reported sleep quality and falls disappeared. Depressive symptoms partially mediated the association between self-reported sleep quality and falls based on the significance of indirect effect (β = 0.15, 95% bootstrap CI = 0.08, 0.22). Conclusions: The presence of depressive symptoms might partially mediate the association of self-reported sleep quality with falls among older adults. [ABSTRACT FROM AUTHOR]

Background: To determine the associations of reduced presenting visual acuity (VA), refractive errors and health-related quality of life (HRQoL) in healthy adolescents in rural China.Methods: A total of 2,235 grade 7 students without systemic medical problems from 10 middle schools aged 13-14 years in Mojiang, a small county located in southwestern China, were included in the analysis. Reduced VA was defined as presenting VA of worse than 6/12 in the presence of an ophthalmic aetiology which could be identified. The refractive status of each participant was measured after cycloplegia using an autorefractor. The Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales was used for measuring HRQoL of the participants.Results: Among all the participants included in the data analysis, 279 (12.5 per cent) individuals were affected by reduced VA based on the better-seeing eye data. After adjusting for the effect of gender, body mass index, the education level of the father, and the use of a corrective device, the total (adjusted mean difference: -3.27; 95 per cent confidence interval [CI] -4.95 to -1.59; p = 0.01), social functioning (adjusted mean difference: -3.44; 95 per cent CI -5.87 to -1.01; p = 0.02) and school functioning scores (adjusted mean difference: -3.12; 95 per cent CI -5.89 to -0.35; p = 0.04) of the adolescents with reduced presenting VA were significantly lower compared with those with normal vision. The associations between corrected refractive errors and HRQoL were not significant.Conclusions: Healthy adolescents with reduced VA reported lower HRQoL scores including total, social functioning and school functioning scores, compared with those with normal vision. [ABSTRACT FROM AUTHOR]

Purpose: Parental rural-to-urban migration has a wide range of health effects on children's but its impact on children's refractive status remains unclear. We aim to examine whether parental rural-to-urban migration could influence the refractive status of their children in rural areas of China. Methods: Among the 2346 grade 7 students in the Mojiang Myopia Progression Study, information regarding parental migration was collected by questionnaires and was successfully obtained in 2105 participants. Refractive error was measured in diopters (D) with cycloplegia using an autorefractor and axial length (AL) was measured using an IOL Master. One-to-one nearest-neighbor matching techniques with a 0.01 caliper level were used to estimate the propensity score matching (PSM) models. Results: Among all the participants, 472 pairs (1 student with vs. 1 student without migrant parents) were successfully matched based on propensity scores. Students with migrant parents had a lower proportion of myopia (29.2% vs. 40.7%; P <.001) and more hyperopic refractions (−0.25D vs. −0.31D; P =.04) compared with those without. They also had shorter ALs (23.4 mm vs. 23.6 mm) but the difference was not significance (P =.18). In addition, students with migrant parents spent less time reading after school per day (0.87 vs. 1.01 hours; P =.01). Conclusions: Myopia is less prevalent among children with migrant parents compared with those without. This study indicated that living without parents might be a protect factor for myopia in Chinese school student via giving them less pressure on study. [ABSTRACT FROM AUTHOR]

Purpose: To examine the distribution and determinants of central corneal thickness (CCT) including birth weight and gestational age in a school-based samples of Grade 7 students in rural China. Methods: 2346 (93.5%) grade 7 students with a mean age of 13.8 years participated in the study. CCT was measured for both eyes using the LenStar LS900. Information regarding birth weight and gestational age was retrieved from the participants' delivery records. A linear regression model was established to examine the relationship of birth weight, gestational age and other factors with CCT. Results: The mean CCT in this population was 534.7 µm and boys had a greater CCT compared with girls (P =.06). CCT was positively related to axial length (r = 0.056) while negatively related to anterior chamber depth (r = −0.076) and corneal power (r = −0.105). In multivariate analyses, the cornea was 19.35µm thinner in individuals with low birth weight compared with those with normal. In addition, the cornea was 25.25µm thinner in prematurely born adolescents compared with full-term ones. The combined effect of birth weight and gestational age on CCT was not statistically significant (P for interaction = 0.12) Conclusions: Low birth weight and small gestational age are associated with thinner corneas in adolescence. This disparity across groups with different levels of birth parameters should be taken into account by future studies investigating CCT as risk factors or diagnostic tests for glaucoma. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine the prevalence of refractive errors and their association with glycaemic control among adults with type 2 diabetes mellitus (T2DM) in eastern China.Methods: A community-based survey, including 913 adults with T2DM aged 30 to 89 years, was conducted. Refractive error was assessed by autorefraction, after which subjective refraction was performed. Ocular biometric parameters were measured by non-contact partial coherence laser interferometry. Myopia was defined as spherical equivalent (SE) less than -0.50 dioptres (D), high myopia as SE less than -5.00 D, hyperopia as SE greater than 0.50 D and astigmatism as cylinder less than -0.50 D.Results: After excluding participants who had undergone cataract surgery, 839 were included in the data analyses and 96.1 per cent were found to have refractive errors. The overall prevalences of myopia, high myopia, hyperopia and astigmatism were 28.2 per cent (95 per cent confidence interval [CI] 25.2-31.3), 6.3 per cent (95 per cent CI 4.7-8.0), 46.4 per cent (95 per cent CI 43.0-49.7) and 81.0 per cent (95 per cent CI 78.4-83.7) with no gender differences observed (all p > 0.10). In multivariate analysis, myopia was associated with decreasing age (odds ratio [OR] = 0.86, p = 0.01; per year increase), higher blood levels of haemoglobin A1c (HbA1c ) (OR = 1.12, p = 0.05; per unit increase), higher education levels (OR = 5.10, p < 0.001; university or college versus illiterate or primary school) and the presence of nuclear cataract (OR = 2.36, p < 0.001).Conclusions: Refractive errors may be associated with glycaemic control among T2DM patients. Longitudinal analyses are warranted to examine the relationship between changes in HbA1c and the development of refractive errors. [ABSTRACT FROM AUTHOR]

Purpose: Observational studies have suggested a possible relationship between disordered sleep and myopia, but the association may be subject to selection biases. We aimed to minimize selection biases and assess the association by applying a propensity score matching (PSM) approach. Methods: The study was designed as a school-based cross-sectional study on a Chinese cohort aged 13–14 years in rural areas of China. The Chinese version of the Children's Sleep Habits Questionnaire was used for the measurement of sleep quality and a score of 41 or more was used to define the presence of disordered sleep. Each participant's refractive status was measured after cycloplegia using an autorefractor and myopia was defined as spherical equivalent <−0.50 D. The propensity scores for disordered sleep were formulated using nine potential confounders. We matched the propensity scores for subjects with and without disordered sleep within a caliper of 0.01 of logit function of propensity scores. Results: In this study, 474 pairs (1 subject with vs. 1 subject without disordered sleep) were successfully matched based on propensity scores. The odds ratio (OR) of myopia for disordered sleep before PSM reached conventional levels of statistical significance (OR: 1.43 95% confidence interval [CI] 1.05, 2.58, p = 0.01). After matching, the magnitude of association was reduced and the OR of myopia was not significant (OR: 1.54 95% CI 0.90, 2.57, p = 0.46). Conclusions: At current stage, there are insufficient evidence indicating that disordered sleep could affect the development of myopia in adolescents. [ABSTRACT FROM AUTHOR]

Objective: To explore the association between tea consumption and cognitive impairment (CoI). Methods: 4579 adults (≥60 years) from the Weitang Geratric Diseases Study were assessed for characteristics of tea consumption and cognitive function by administering questionnaires and the Abbreviated Mental Test (AMT), respectively. We divided the subjects into normal cognitive function group (AMT score ≥8) and CoI group (AMT score ≤7).   The association between tea consumption and risk of CoI was determined by logistic regression models. Results: The least-squared means of the AMT scores for the subjects who seldom consumed tea were less favorable than those who habitually consumed tea. An inverse association was found between tea consumption (of any type) and prevalence of CoI (odds ratio = 0.74, 95% confidence interval = 0.57-0.98, P = 0.032). Interestingly, the protective correlation of tea was more obvious in never smokers (odds ratio = 0.63), but vanished in current/former smokers (odds ratio = 1.10). In never smokers, frequency of tea consumption was significantly associated with CoI (P for trend = 0.010). Conclusion: Habitual tea consumption is suggested to be associated with a decreased risk of CoI among elders in Suzhou, and a higher frequency of tea consumption was associated with a lower prevalence of CoI among never smokers. [ABSTRACT FROM AUTHOR]

Purpose: We aim to determine the association of the types of lamp for homework including incandescent lamp, fluorescent lamp, and light-emitting diode (LED) lamp with the prevalence of myopia in Chinese children. Methods: 2346 grade 7 students from ten middle schools (93.5% response rate) aged 13 to 14 years in Mojiang, a small county located in Southwestern China, participated in the study. Refractive error was measured with cycloplegia using an autorefractor by optometrists or trained technicians. An IOL Master was used to measure ocular biometric parameters including axial length (AL). Information regarding the types of lamp for homework af``ter schools was collected by questionnaires. Results: Of all the study participants, 693 (29.5%) were affected by myopia, with the prevalence estimates being higher in girls (36.8%; 95% confidence interval [CI]: 34.0, 39.6) than in boys (22.8%; 95% CI: 20.4, 25.1) (P < 0.001). After adjusting for potential confounders such as gender, height, parental history of myopia, time on computer use, time on watching TV, time outdoors, and time on reading and writing, participants using LED lamps for homework had a more myopic refractive error and a longer AL compared with those using incandescent or fluorescent lamps. There were no significant differences in myopia prevalence between children using incandescent and fluorescent lamps for homework. The population attributable risk percentage for myopia associated with using LED lamps for homework after schools was 11.2%. Conclusions: Using LED lamps for homework after schools might contribute to the development of myopia among school-aged children. [ABSTRACT FROM AUTHOR]

Purpose: To understand the prevalence, awareness, and risk factors for diabetic retinopathy (DR) among Chinese with known type-2 diabetes mellitus (T2DM) in eastern China communities. Methods: A community-based survey including 913 patients with known T2DM was conducted in Suzhou, China. Diabetes was defined as hemoglobin A1c (hbA1c) ≥6.5%, use of diabetic medication or a physician diagnosis of diabetes. Retinal photographs were graded for the presence of DR using the Airlie House classification system. Binary logistic regression models were established to examine the associations of risk factors with DR and vision-threatening diabetic retinopathy (VTDR). Results: The overall prevalence of any DR was 18.0% (95% confidence interval [CI]: 15.5–20.6%) in this population. VTDR affected 4.4% (95% CI: 3.1–5.8%) of the study participants. In multivariate analysis, the presence of DR among T2DM patients was associated with decreased age (odds ratio [OR] = 0.97;p= 0.01; per year increase), longer durations of diabetes (OR = 1.02; per year increase;p= 0.03), higher blood levels of hbA1c (OR = 1.15; per unit increase;p= 0.03). Of the 158 participants with DR, only 12 (8%) had been aware of their condition or had been diagnosed previously as having DR. Conclusions: The prevalence of DR among diabetes patients in eastern China was lower than those in northern China. The awareness of DR was poor, which emphasizes the pressing need for increasing the public awareness of this vision-threatening eye disorder and routine eye screening should be performed among T2DM patients in the communities. [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence and associations of pterygium in a multiethnic adult population in rural China and to examine potential ethnic differences Methods: A total of 6418 adults (2133 ethnic Bai, 2130 ethnic Yi, and 2155 ethnic Han) aged 50 years or older participated in the study. Anterior segment examination was performed without pupil dilation using a slit lamp. Pterygium was defined as a raised fleshy triangular fibrovascular tissue growth of the conjunctiva encroaching onto a clear cornea. Results: Pterygium was least prevalent among adults of Yi ethnicity (29.5%) compared with Bai (39.0%,p< 0.001) or Han (39.5%,p< 0.001) ethnicities. Those of Bai ethnicity were most likely to be affected by severe pterygium (7.5%), while Yi were least likely to be affected (3.8%). Multivariate analysis revealed that increasing age (odds ratio, OR, 1.017), female sex (OR 1.53), lower educational level (OR 1.25), higher blood pressure levels (OR 1.002), and greater time spent outdoors per day (OR 1.09) were significantly associated with a higher prevalence of pterygium, while Yi ethnicity (OR 0.65, comparing Yi with Han) and wearing brimmed hats outdoors (OR 0.82) were protective factors. Conclusion: Ethnicity was significantly associated with prevalence of pterygium. Our findings may be applicable to many other countries located within the “pterygium belt” for health resource allocation among different ethnic groups. [ABSTRACT FROM PUBLISHER]

Purpose: To describe ethnic differences in the distribution of central corneal refractive power and steep cornea in a multiethnic Asian population. Methods: A total of 2968 Chinese, 2957 Indian and 2928 Malay participants aged over 40 years were included in this study. Each subject underwent standardized systematic and ocular examinations, interviewer-administered questionnaires, and blood investigations for risk factor assessment. Central corneal refractive power was measured using an autorefractor. Steep cornea was defined as central corneal refractive power exceeding 48 diopters (D) measured by keratometry. Results: Mean keratometry readings were 43.9 ± 1.5 D in Malays, 44.2 ± 1.5 D in Indians and 43.9 ± 1.5 D in Chinese. The prevalence of steep cornea was 0.6% (95% confidence interval, CI, 0.3-0.9%) in Malays, 1.0% (95% CI 0.7-1.4%) in Indians and 0.5% (95% CI 0.3-0.8%) in Chinese. In multivariate analysis, increasing central corneal refractive power was associated with Indian race, shorter body height, non-smokers, absence of pterygium, shorter axial length, thinner corneas and greater anterior chamber depth, while the presence of steep cornea was significantly associated with Indian race, shorter axial length and thinner corneas. Conclusions: Indian participants had the steepest corneas among the three major ethnic groups in Singapore. Central corneal refractive power was related to several ocular parameters including anterior chamber depth, axial length and central corneal thickness. These data have important clinical implications for understanding the risk of keratoconus. [ABSTRACT FROM AUTHOR]