About-Weekly Pattern in the Dynamic Complexity of a Healthy Subject's Cellular Immune Activity: A Biopsychosocial Analysis

Diurnal Variation of 8-hydroxy-2'-deoxyguanosine in Continuous Time Series of Two Breast Cancer Survivors

8-hydroxy-2'deoxyguanosine (8-OHdG) is an oxidative product removed from DNA following radical oxygen species-induced damage. As a water-soluble molecule, it can be measured non-invasively in urine and is commonly used as a marker for 'whole-body' oxidative stress. However, its validity and reliability in assessing oxidative stress across various chronic diseases and in early carcinogenesis screening in clinical diagnosis and research remain subjects of debate. To determine optimal measurement timing and duration, it is essential to establish the circadian profile of 8-OHdG under everyday life conditions. Here, applying the integrative single-case design, we show the presence of day-night differences for 8-OHdG in continuous time series of two breast cancer survivors while considering different correction approaches. The participants sampled their urine in 12-h-pooled collections over one month. In both subjects, 8-OHdG levels were significantly higher during the day than at night regardless of whether they were corrected by creatinine or urine volume (creatinine corrected: t = -6.43, p < 0.01 [subject 1], t = -2.69, p = 0.01 [subject 2]; volume corrected: t = -7.30, p < 0.01 [subject 1], t = -3.69, p < 0.01 [subject 2]). Notably, urinary 8-OHdG levels show higher variability in night samples compared to day samples. These findings underscore the importance of considering daily fluctuations in 8-OHdG levels in both clinical and research studies, as well as the need to account for the dynamic characteristics of stress markers to minimize the risk of inconsistent or misleading results in clinical diagnostics.

The effect of tropospheric low-value ozone exposure on the mortality risk of ischemic heart disease and stroke on the example of Yibin (southwestern China)

The association of low-level ozone (O3) exposure with the mortality risk of ischemic heart disease (IHD) and stroke remains to be investigated. This study aimed to investigate the relationship between low-level O3 exposure and mortality risk of IHD and stroke in Yibin, a city in southwestern China. A Poisson distribution lagged nonlinear model was used to assess the effect of O3 exposure on IHD and stroke mortality and to explore the susceptible population according to gender and age subgroups and the susceptible season according to seasonal subgroups and to analyse the health effects under low O3 exposure compared with high O3 exposure. The mean O3 exposure concentration from 2014 to 2020 was approximately 48.3 μg/m3. There was a major lagged effect of O3 exposure on IHD and stroke. For every 10.0 μg/m3 increase in O3 concentration, the cumulative risks of death for the two diseases were 1.0211 (95% Confidence Interval [CI]: 1.0064, 1.0358) and 1.0211 (95% CI: 1.0064, 1.0357), respectively. The mortality risks of IHD and stroke for women were 1.0064 (95% CI: 1.0016, 1.0113) and 1.0030 (95% CI: 1.0008, 1.0051), and for those aged > 65 years, they were 1.0082 (95% CI: 1.0026, 1.0139) and 1.0018 (95% CI: 1.0002, 1.0034), and the mortality risks in the warm season were 1.0043 (95% CI: 1.0007, 1.0080) and 1.0038 (95% CI: 1.0005, 1.0072), respectively. The introduction of other pollutants (PM2.5, PM10, NO2, CO) to construct a dual-pollutant model showed that the effect of O3 on the mortality risk of IHD and stroke remained statistically significant. This study consolidates the evidence for a positive correlation between low-level O3 exposure and the mortality risk of IHD and stroke. The findings provide preliminary exploratory insights into the potential impact of air pollution on these diseases, offering a valuable reference for future research.

Wearables in Chronomedicine and Interpretation of Circadian Health

Wearable devices have gained increasing attention for use in multifunctional applications related to health monitoring, particularly in research of the circadian rhythms of cognitive functions and metabolic processes. In this comprehensive review, we encompass how wearables can be used to study circadian rhythms in health and disease. We highlight the importance of these rhythms as markers of health and well-being and as potential predictors for health outcomes. We focus on the use of wearable technologies in sleep research, circadian medicine, and chronomedicine beyond the circadian domain and emphasize actigraphy as a validated tool for monitoring sleep, activity, and light exposure. We discuss various mathematical methods currently used to analyze actigraphic data, such as parametric and non-parametric approaches, linear, non-linear, and neural network-based methods applied to quantify circadian and non-circadian variability. We also introduce novel actigraphy-derived markers, which can be used as personalized proxies of health status, assisting in discriminating between health and disease, offering insights into neurobehavioral and metabolic status. We discuss how lifestyle factors such as physical activity and light exposure can modulate brain functions and metabolic health. We emphasize the importance of establishing reference standards for actigraphic measures to further refine data interpretation and improve clinical and research outcomes. The review calls for further research to refine existing tools and methods, deepen our understanding of circadian health, and develop personalized healthcare strategies.

The Integrative Single-Case Design as a Biosemiotic-Systemic Research Tool in Psychoneuroimmunology

Psychoneuroimmunology (PNI) is a field of research that deals with the interactions between psyche, nervous, endocrine, and immune systems. Investigating these complex PNI relationships under as ecologically valid as possible conditions ("life as it is lived") necessitates a paradigm change in research. This shift places factors such as "time" and "subjective meaning" of personal experiences at the center of the research methodology. For this purpose, the biosemiotic-systemic research design "Integrative Single-Case Study" was developed. Initial results from healthy individuals as well as patients with systemic lupus erythematosus (SLE), breast cancer, and rheumatoid arthritis (RA) support the validity of the research approach. Specifically, in connection with the occurrence of emotionally meaningful everyday incidents, we repeatedly observed stress system reactions, which were (1) delayed over several days, (2) cyclically patterned, (3) anticipatory, and (4) opposing, depending on a) whether participants experienced emotionally positive or negative everyday incidents, b) whether they were healthy or ill, and c) which stress system parameter was investigated. In this chapter, the Integrative Single-Case Study design is introduced as a holistic research option, presented in detail in its methodology, and critically discussed in terms of its limitations.

Timing matters: A meta-analysis on the dynamic effect of stress on salivary immunoglobulin

The impact of psychological stress on physiological systems has been a focus of extensive research, particularly in understanding its diverse effects on immune system activity and disease risk. This meta-analysis explores the dynamic effect of acute stress on salivary immunoglobulin-A (S-IgA) levels, a key biomarker for secretory immunity within the oral environment. Analyzing data from 34 samples comprising 87 effect sizes and a total of 1,025 subjects, a multi-level approach is employed to account for the temporal variability in measuring the stress response. The results reveal a significant increase in S-IgA levels peaking around 10 min after stress exposure, followed by a return to baseline levels approximately 30 min later. In addition, the meta-analysis identified several research gaps of the extant literature, such as limitations in the considered time lag after stress. In conclusion, the findings emphasize the temporal nuances of the S-IgA response to stress, which can help to infer potential biological pathways and guide sampling designs in future studies. Further, we highlight the use of a multi-level meta-analysis approach to investigate the temporal dependencies of the interplay between stress and immune functioning.

Improving mental health by improving the mental health literacy? Study protocol for a randomised controlled evaluation of an e-mental health application as a preventive intervention for adolescents and young adults

Background

From the age of 14, many adolescents enter a vulnerable developmental phase, with a sharp increase in mental illness at 16. The COVID19 pandemic has further exacerbated this issue. Hence, universal and easily accessible prevention in the young is needed. E-mental health interventions are on the rise due to numerous benefits such as potential low-costs, low-threshold and high scalability. However, effectiveness and acceptance of mobile health (mHealth) preventive interventions remain unresearched.

Method

In a two-armed, randomised controlled study design adolescents and young adults from 14 years old will be recruited. Following an initial baseline assessment, they will be randomised to a) the intervention group (IG, n = 75), which will receive a mHealth intervention (the application 'Mental Health Guide', co-developed by lived experience experts) or b) the waiting list control group (CG, n = 75). Both groups will be followed up after 3 and 6 months following post assessment. We hypothesize an increase in mental health literacy in the IG compared to the CG for post and follow-up assessment (primary outcome: Mental Health Literacy Scale). In addition, we expect an improvement in mental health and psychological well-being, improved emotion regulation, reduced psychological distress, as well as good quality ratings in usability and acceptance in the use of the 'Mental Health Guide' We performed multiple simulations of possible outcome scenarios, incorporating an array of factors, to generate realistic datasets and obtain accurate estimates of statistical power.

Conclusion

As a first-of-its-kind in this field, this study investigates whether a mHealth intervention based on mental health literacy may improve the mental health literacy and further aspects of psychological functioning of young people in a vulnerable phase. Furthermore, the results promise to provide important knowledge of how universal prevention may be implemented with low costs for diverse populations.

Trial registration

This trial was registered in the DRKS register (DRKS-ID: DRKS00031810) on 23 June 2023.

Personalized therapy in rheumatoid arthritis (PETRA): a protocol for a randomized controlled trial to test the effect of a psychological intervention in rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects cartilage and bone. Psychological stress can both trigger disease exacerbation and result from disease activity. As standard pharmacological interventions alone have limited success in treating RA, a more comprehensive biopsychosocial approach to treatment has been recommended. In this prospective randomized controlled trial (RCT), a psychotherapeutically guided, group-based intervention program will be conducted with RA patients over a period of 9 months. This program combines a dynamic-interactional model with disorder-specific coping-oriented perspectives to improve patients' social, emotional, and problem-solving competencies as well as stress system functional status. The enrolment of 440 patients, randomly allocated to either an intervention (n = 220) or control group (n = 220), is planned. To evaluate the intervention effect, various indicators of RA disease activity, stress system activity, and psychological condition will be assessed through sets of standardized questionnaires and biochemical analyses of blood and saliva samples. Moreover, healthcare-related costs for each patient will be obtained using routine health insurance data. Outcome variables will be measured in all patients at regular intervals prior to intervention (baseline), during the 9-month intervention (five time points), and during a 9-month follow-up phase (three time points), allowing the comprehensive analysis of within- and between-subject effects, i.e. trajectories of the target variables in the intervention and control groups. In addition, to investigate the intervention effects on real-life stress system functioning in RA, 10 integrative single-case studies (n = 5 from the intervention group, n = 5 from the control group) will be conducted. In each study, once before and after the 9-month intervention, urine samples will be collected, and patients will fill out questionnaires for approximately 1 month at 12-h intervals. Moreover, weekly in-depth interviews will be conducted with patients to determine their previous week's emotionally positive and negative incidents. Using time series analysis, it is then possible to investigate whether and how stress system function in these RA patients has improved from the applied intervention. By using both an investigational macro- and microperspective, this project aims to evaluate a psychological intervention in the routine care of individuals with RA.Trial registration German Clinical Trials Register DRKS00028144. Registered on 1 March 2022.

Emotional states predict cellular immune system activity under conditions of life as it is lived: A multivariate time-series analysis approach

The relationship between emotional states and immune system activity is characterized by bidirectional influences; however, limited information is available regarding the temporal dynamics of these effects. The goal of this investigation was to examine how these psychoimmunological interdependencies unfold over time under conditions of "life as it is lived". For this purpose, three healthy women collected their entire urine over a period of approximately two months at 12-h intervals (8 am-8 pm, 8 pm-8 am), resulting in a total of 112 to 126 consecutive measurements per subject. In addition, among other regular psychological assessments, the subjects completed the EWL-60-S, an emotional state questionnaire, each morning and evening. To assess the extent of T-helper type 1 immune activation, the neopterin per creatinine concentration was measured in the urine samples using high-pressure liquid chromatography. The dynamic relationships between the time series of the six emotional states (performance-related activity, general inactivity, extraversion/introversion, general feeling of comfort, emotional irritation, anxiety/depressiveness) and urinary neopterin levels were estimated in vector-autoregressive models and evaluated using Granger-causality tests, impulse-response functions and forecast error variance decompositions. The findings showed that emotional states explained up to 20% of the variance of urinary neopterin per creatinine levels, whereby most of the effects occurred within a period of approximately three days. Across all subjects, increases in anxiety/depressiveness and extraversion led to increases in neopterin levels, while a general feeling of comfort led to decreases in neopterin. These results emphasize the importance of the interdependencies between emotional states and immune system activity and showcase the potential that intensive longitudinal study designs offer for psychoneuroimmunology.

Transcriptomics-based analysis of sex-differentiated mechanisms of hepatotoxicity in zebrafish after long-term exposure to bisphenol AF

Bisphenol AF (BPAF) is an emerging endocrine-disrupting chemical (EDC) prevalent in the environment as one of the main substitutes for bisphenol A. Sex-specific effects of EDCs have been commonly reported and closely linked to sexually dimorphic patterns of hormone metabolism and related gene expression during different exposure windows, but our understanding of these mechanisms is still limited. Here, following 28-day exposure of adult zebrafish to an environmentally relevant concentration of BPAF at 10 μg/L, the global transcriptional networks applying RNA sequencing (RNA-seq) and Ingenuity Pathway Analysis (IPA) were respectively investigated in the male and female fish liver, connecting the sex-dependent toxicity of the long-term exposure of BPAF to molecular responses. As a result, more differentially expressed genes (DEGs) were detected in males (811) than in females (195), and spermatogenesis was the most enriched Gene Ontology (GO) functional classification in males, while circadian regulation of gene expression was the most enriched GO term in females. The expression levels of selected DEGs were routinely verified using qRT-PCR, which showed consistent alterations with the transcriptional changes in RNA-seq data. The causal network analysis by IPA suggested that the adverse outcomes of BPAF in males including liver damage, apoptosis, inflammation of organ, and liver carcinoma, associated with the regulation of several key DEGs detected in RNA-seq, could be linked to the activation of upstream regulatory molecules ifnα, yap1, and ptger2; while, the inhibition of upstream regulators hif1α, ifng, and igf1, leading to the down-regulated expression of several key DEGs, might be involved in BPAF's effects in females. Furthermore, BPAF exposure altered hepatic histological structure and inhibited antioxidant capability in both male and female livers. Overall, this study revealed different regulation networks involved in the sex-dependent effects of BPAF on the fish liver, and these detected DEGs upon BPAF exposure might be used as potential biomarkers for further assessing sex-specific hepatotoxicity following environmental EDC exposure.