Growing propensity of internet addiction among Asian college students: meta-analysis of pooled prevalence from 39 studies with over 50,000 participants

OBJECTIVES

Rapid internet penetration and technological advancements have facilitated accessibility to internet-enabled devices globally. Since Asia lacks comprehensive data on internet addiction among college students, this review aims to estimate its pooled prevalence.

STUDY DESIGN

This was a systematic review and meta-analysis.

METHODS

Searches were conducted in PubMed, Scopus, CINAHL, and MEDLINE from their inception through August 2022 using terms appropriate to internet addiction and Asian countries/territorial for publications in English peer-reviewed journals. The studies included those done on current college students and provided unambiguous indicators of the threshold of internet addiction. The pooled prevalence was calculated through a random-effects meta-analysis by RStudio software, and I2 statistic was used to assess heterogeneity. The Joanna Briggs Institute critical appraisal checklist was used for quality assessment.

RESULTS

Overall, between 2007 and 2021, 39 papers comprising 45 effect sizes and totaling 58,058 participants met the inclusion criteria. The pooled prevalence of internet addiction among Asian college students was 24.3% (95% confidence interval: 19.8%-29.5%, Q = 6234, df = 44, τ2 = 0.79, I2 = 99.29%), and strikingly, this percentage increased over time. A high degree of heterogeneity was seen, and no publication bias was found.

CONCLUSIONS

To our knowledge, this is the first comprehensive review report on Asian college students, which found that one-fifth suffer from internet addiction. The findings emphasize the significance of multidisciplinary prevention and management strategies to mitigate the harmful effects of internet addiction. Further research is warranted to develop a standardized diagnostic tool for a more precise estimation of internet addiction among this population.

The prevalence of excess weight among Vietnamese adults: A pooled analysis of 58 studies with more 430 thousand participants over the last three decades

BACKGROUND

Chronic noncommunicable diseases (NCDs) associated with excess weight as a significant risk factor, but few studies have been sufficient enough to examine the magnitude of excess weight of Vietnamese adults. This review aimed to provide a generalized estimate of the prevalence of excess weight among Vietnamese adults.

METHODS

PubMed, Scopus and national database were used to identify articles published up to May 2022. The Newcastle-Ottawa Quality Assessment Scale was used to rate the study quality. The data was analyzed using RStudio software, and the combined effects were estimated using random-effects meta-analysis. The Cochran's Q-test and the I2 test were employed to examine heterogeneity, and subgroups were conducted. Egger's test and visual inspection of the symmetry in funnel plots were used to determine publication bias.

RESULTS

58 studies with 432,585 participants from 1998 to 2020 were suitable for inclusion in the final model after meeting the prerequisites. Over the last three decades, the combined pooled prevalence of excess weight among adults in Vietnam was 20.3% (95% CI: 15.2-26.6). Notably, this proportion has a tendency to go up between 1998 and 2020. Moreover, rates of excess weight were found to be substantially higher in non-national studies (23.1%, 17.3-30.1) compared to national studies (8.4%, 3.6-18.3) and significantly higher when Asian and Pacific cut-offs (27.6%, 20.0-36.7) were used rather than WHO classification (11.2%, 6.7-18.0).

CONCLUSION

The findings suggest healthcare professionals and policymakers should focus more on designing and implementing preventive initiatives to lower the rising prevalence of excess weight adults in Vietnam.

Declining trend in anemia prevalence among non-pregnant women of reproductive age in Vietnam over two decades: A systematic review and meta-analysis of population studies

Background: Anaemia is a public health concern in developing nations, particularly among women of reproductive age. However, the present prevalence and recent trend in anaemia among this population are unclear. This systematic review aimed to evaluate the prevalence of anaemia among non-pregnant women in Vietnam. Methods: We systematically searched databases such as PubMed, Scopus, and reference lists of earlier prevalence studies from their inception until July 2022. For statistical analysis to check for heterogeneity, random or fixed effects models were employed to summarize the prevalence of anaemia. Visual examination of a funnel plot was used to determine the presence of publication bias, which was then verified using the Egger regression test. Subgroup analyses were also undertaken to evaluate how the proportion of anaemia differs across various study groups. Results: A total of 188 studies were found as a result of the bibliographical search. Finally, of the 12 included studies, anaemia affected 5089 non-pregnant women out of a total of 19744, making the prevalence of this condition 23.2% (95% CI: 16.1-32.2). From 1995 to 2013, the prevalence of anaemia in this population declined significantly, from 42.6% to 16.9%. Notably, the prevalence of anaemia among non-pregnant women differed by geography and increased by mountains, Northern Vietnam, rural areas, and ethnic minority groups. Furthermore, no publication bias was found in this meta-analysis. Conclusion: To enhance the health of women and meet global objectives for eliminating anaemia, more efforts are required in specific regions and ethnic minority groups in Vietnam.

Second-Hand Smoking Prevalence in Vietnamese Population Aged 15 and older: A Systematic Review and Meta-Analysis

Background:

Second-hand smoking (SHS) is associated with many health problems. However, its prevalence in the community population aged 15 years and older in Vietnam is unknown.

Objectives:

To quantify the prevalence of SHS in Vietnamese communities aged 15 and above.

Methods:

This is a meta-analysis that reviewed studies of the prevalence of SHS in Vietnam published in MEDLINE, Scopus, Pubmed and the WHO library database between 1 January 2010 and 31 December 2019. MedCalc was used to perform all the analyses, and publication bias was determined using funnel plots and Egger regression asymmetry tests. Q-test and I2 statistic were used to identify heterogeneity across studies.

Results:

There were 7 articles that met our inclusion criteria 2 surveys at the national level, 3 Cross-sectional studies and 2 Case-control studies) involving 184 921 participants. According to the meta-analysis, the overall random-effects pooled prevalence of SHS was 54.6% (95% CIs: 44.900-64.154) with a high level of heterogeneity ( P = .0001, Q = 2245.60, I2 = 99.73%). It is noteworthy that the pooled prevalence of SHS rose throughout the course of the survey years. Our research found no evidence of publication bias.

Conclusions:

Vietnam has ratified the implementation the WHO Framework Convention on Tobacco Control (FCTC) in 2004, there are still a large number of people who are adversely impacted by SHS. Given the tremendous cost that SHS imposes on health systems, our results underscore the critical need for the Vietnamese government to expedite an implementation of a set of stronger tobacco control practices, thus reducing the incidence of smoking-related illnesses and fatalities.

Low-Normal Thyroid Function Predicts Incident Anemia in the General Population With Euthyroid Status

CONTEXT

Thyroid hormones (THs) have direct and indirect effects on hematopoiesis. However, few studies have directly evaluated the effect of THs on incident anemia among euthyroid subjects. This cohort study aimed to explore whether THs under physiological conditions can affect the development of anemia in the general population.

DESIGN

A total of 12,310 participants were enrolled in the cohort study (∼5-year follow-up period; mean, 3.1 years). A chemiluminescence immunoassay was used to measure free T3 (FT3), free T4 (FT4), and TSH, and anemia was defined according to the World Health Organization recommendation. THs, TSH, and Hb were assessed yearly during follow-up. Multivariable Cox proportional hazards regression models were used to assess the association between THs, TSH, and incident anemia.

RESULTS

The fully adjusted hazards ratios (95% CI) of anemia per 1-unit change in FT3, FT4, and TSH concentrations were 0.70 (0.56, 0.87), 0.93 (0.88, 0.98), and 1.19 (0.94, 1.50) (P < 0.01, P < 0.01, and P = 0.14, respectively). Moreover, a significant and positive association between FT3, FT4, and annual changes in Hb (standard regression coefficients of 0.056 and 0.028, respectively; both P < 0.01) was observed. Similar associations were observed when the participants who had thyroid dysfunction upon follow-up were excluded.

CONCLUSIONS

The current study demonstrated that THs significantly predict future anemia and annual changes in Hb, even in the euthyroid population.

The relationship between red blood cell distribution width and atrial fibrillation in Asian population: A cross-sectional study

BACKGROUND

Red blood cell distribution width (RDW) was related with increased risk of mortality and adverse cardiovascular outcomes. However, it is uncertain whether RDW is related to the prevalence of atrial fibrillation (AF) in Asian population. The aim of this study was to assess the relationship between RDW and AF in a large Chinese population.

METHODS

We performed a cross-sectional study to examine the relationship between RDW and AF among 106 998 subjects who were from the Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. AF was diagnosed using electrocardiography, and RDW was measured using an automated hematology analyzer. Multiple logistic regression models were conducted to examine the relation between tertiles of RDW and AF.

RESULTS

The overall prevalence of AF was 0.1% (129/106 998). After adjustments for potential confounding factors, the odds ratios (95% confidence intervals) of AF across increasing tertiles of RDW were 1.00 (reference), 1.08 (0.69, 1.67), and 2.65 (1.75, 4.07) (P for trend < .0001), respectively.

CONCLUSIONS

The study demonstrated that elevated RDW is significantly related to higher prevalence of AF in a general Chinese population. Large prospective studies are needed to confirm this finding.

Relationship Between Grip Strength and Prediabetes in a Large-Scale Adult Population

INTRODUCTION

Prediabetes has been a growing health problem in China, and it is a high-risk state for developing diabetes and cardiovascular disease. In previous studies, low grip strength has been associated with diabetes. However, few population-based studies have examined the relationship between grip strength and prediabetes. Thus, the purpose of this study was to investigate whether grip strength is related to prediabetes in a large-scale adult population.

METHODS

A total of 27,295 participants aged 20 to 90 years were included from the 2013-2016 Tianjin Chronic Low-grade Systemic Inflammation and Health Cohort Study. Grip strength was assessed using an electronic hand-grip dynamometer and the greatest force was normalized to body weight. Prediabetes was diagnosed based on the American Diabetes Association criteria. Multiple logistic regression analysis was conducted in 2018 to assess the relationship of grip strength to the prevalence of prediabetes, while controlling for age, BMI, smoking, drinking, physical activities, dietary patterns, and other confounders.

RESULTS

Of the 27,295 participants, 28.5% (7,783) had prediabetes. After adjusting for potential confounders, a one unit increase in grip strength per body weight was associated with 52% lower odds of having prediabetes for men (OR=0.48, 95% CI=0.30, 0.74, p<0.01) and 62% lower odds of having prediabetes for women (OR=0.38, 95% CI=0.20, 0.70, p<0.01).

CONCLUSIONS

Increased grip strength is independently associated with lower prevalence of prediabetes in Chinese adults, suggesting that grip strength may be a useful marker for screening individuals at risk of prediabetes.

Vitamin D is related to handgrip strength in adult men aged 50 years and over: A population study from the TCLSIH cohort study

OBJECTIVE

Handgrip strength (HGS) begins an accelerating decline around 50 years. Many of the studies performed in old adults have demonstrated a significant relationship between vitamin D and HGS, but the studies performed in participants with a broad age range have yielded conflicting results. The purpose of the study was to investigate the relationship between vitamin D and HGS using age 50 as a specific cut-off.

DESIGN

Population-based, cross-sectional study.

PARTICIPANTS

Totally 5102 participants (2911 males, 2191 females) from the TCLSIH Cohort.

MEASUREMENTS

Serum concentration of 25-hydroxyvitamin D (25(OH)D) was measured using an enzyme immunoassay. We divided participants into quartiles according to 25(OH)D, and the ranges for increasing quartiles were as follows: (males [≥50 years]: 10.94-31.85, 31.88-43.01, 43.20-56.06, 56.20-143.0; males [<50 years]: 11.11-34.68, 34.71-46.91, 46.96-59.45, 59.50-143.7; females [≥50 years]: 7.21-30.01, 30.02-40.18, 40.21-52.44, 52.49-275.4; females [<50 years]: 5.29-28.91, 28.92-40.19, 40.20-51.90, 51.91-140.2). HGS was measured with a hydraulic hand-held dynamometer. Analysis of covariance was employed to explore the relationship.

RESULTS

Among males aged above 50 years, the means (95% confidence interval) for HGS per body weight across the categories of serum 25(OH)D concentration were 0.523 (0.430-0.638), 0.545 (0.447-0.664), 0.543 (0.446-0.661), 0.546 (0.449-0.664) (P_trend  < 0.01) after adjustment for potential confounding factors. However, no relationships were observed between serum 25(OH)D concentration and HGS in males aged below 50 years and females in the whole age range.

CONCLUSIONS

Serum 25(OH)D concentration was significantly related to HGS in males aged above 50 years, independent of confounding factors. Future studies are needed to clarify the age and sex relationship between serum 25(OH)D concentration and HGS.

Association between neutrophil to lymphocyte ratio and depressive symptoms among Chinese adults: A population study from the TCLSIH cohort study

BACKGROUND

The prevalence of depression in the general population has risen sharply over the past few decades and has become a major health problem throughout the world. Increasing evidence suggests that inflammation plays an important role in the pathogenesis of depression. To better understand the role of inflammation in the pathogenesis of depression we can use the neutrophil-to-lymphocyte ratio (NLR) because it is a simple and effective marker of inflammation and immunity.

METHODS

This cross-sectional study was conducted among adults from the healthy general population in Tianjin, China. NLR was measured according to the complete blood count. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS), and a cutoff score of 45 was used to indicate the presence of depressive symptoms in the study participants. The relationship between NLR and the prevalence of depressive symptoms was evaluated separately for men and women using the multiple logistic regression analysis.

RESULTS

In the present study, the overall prevalence of depressive symptoms was 17.0% among all participants. In women, the multivariable-adjusted OR of having depressive symptoms was 1.28 (95% CI 1.10, 1.49; p for trend <0.01) for the fifth compared with the first quintile of NLR, and was 1.22 (95% CI 1.07,1.39; p < 0.01) per unit increase of NLR. However, no significant association was found between NLR and depressive symptoms in men.

CONCLUSION

This study suggests that increased NLR levels are independently related to depressive symptoms in women, but not in men. Further research is required to investigate this relationship with longitudinal data to establish the temporal ordering between these variables.

Handgrip strength is inversely associated with metabolic syndrome and its separate components in middle aged and older adults: a large-scale population-based study

BACKGROUND

Muscle weakness is followed by insulin resistance which is associated with metabolic disorders leading to metabolic syndrome (MetS). Therefore, muscle strength decline may be associated with MetS. The aim of this study was to investigate the relationships between muscle strength and MetS and its separate components.

METHODS

A cross-sectional study was performed in 17,703 participants aged 40 years and older living in Tianjin, China. Handgrip strength was measured using a handheld digital dynamometer. MetS was defined in accordance with the criteria of the American Heart Association scientific statements of 2009. Multiple logistic regression analyses were used to assess the association between handgrip strength and MetS and its separate components.

RESULTS

The overall prevalence of MetS was 33.6%. The prevalence of MetS was significantly higher in men than in women (41.6% vs 22.9%, P < 0.0001). After adjustment for potential confounding factors (including sociodemographic variables, lifestyle factors, total energy intake, and family history of disease), the odds ratios (95% confidence interval) of MetS across decreasing handgrip strength quartiles were: 1.00 (reference), 1.87 (1.66, 2.11), 2.40 (2.13, 2.71), and 3.36 (2.97, 3.80) in men and 1.00 (reference), 1.80 (1.48, 2.21), 2.77 (2.29, 3.36), and 3.89 (3.22, 4.71) in women, respectively (P for all trend <0.0001). Similarly, handgrip strength was also observed to be negatively associated with separate components of MetS both in men and women.

CONCLUSIONS

Muscle strength is inversely associated with MetS and its separate components. Further prospective studies are needed to confirm this issue.

Steroidal Glucosides from the Rhizomes of Tacca Chantrieri and Their Inhibitory Activities of NO Production in BV2 Cells

Two new steroidal glucosides, chantriolides D and E (1 and 2), along with four known compounds, chantriolide A (3), chantriolide B (4), chantriolide C (5), and (25 S)-spirost-5-en-3-ol 3- O-α-L-rhamnopyranosyl-(1→2)- O-[α-L-rhamnopyranosyl-(1→3)]-β-D-glucopyranoside (6) were isolated from the rhizomes of Tacca chantrieri. Their structures were determined by 1D and 2D NMR spectroscopic and HR-ESI-MS data, as well as by comparison with reported data. Compounds 1 and 2 were found to show strong inhibitory NO effect in BV2 cells, with IC50 values of 12.45 and 59.03 μM, respectively.

Steroidal Glucosides from the Rhizomes of Tacca chantrieri and Their Inhibitory Activities of NO Production in BV2 Cells

Two new steroidal glucosides, chantriolides D and E (1 and 2), along with four known compounds, chantriolide A (3), chantriolide B (4), chantriolide C (5), and (25S)-spirost-5-en-3-ol 3-O-α-L-rhamnopyranosyl-(1-->2)-O-[α-L-rhamnopyranosyl-(1-->3)]-β-D-glucopyranoside (6) were isolated from the rhizomes of Tacca chantrieri. Their structures were determined by 1D and 2D NMR spectroscopic and HR-ESI-MS data, as well as by comparison with reported data. Compounds 1 and 2 were found to show strong inhibitory NO effect in BV2 cells, with IC₅₀ values of 12.45 and 59.03 µM, respectively.

Sequence analysis and potentials of the native RbcS promoter in the development of an alternative eukaryotic expression system using green Microalga Ankistrodesmus convolutus

The availability of highly active homologous promoters is critical in the development of a transformation system and improvement of the transformation efficiency. To facilitate transformation of green microalga Ankistrodesmus convolutus which is considered as a potential candidate for many biotechnological applications, a highly-expressed native promoter sequence of ribulose-1,5-bisphosphate carboxylase/oxygenase small subunit (AcRbcS) has been used to drive the expression of β-glucuronidase (gusA) gene in this microalga. Besides the determination of the transcription start site by 5'-RACE, sequence analysis revealed that AcRbcS promoter contained consensus TATA-box and several putative cis-acting elements, including some representative light-regulatory elements (e.g., G-box, Sp1 motif and SORLIP2), which confer light responsiveness in plants, and several potential conserved motifs (e.g., CAGAC-motif, YCCYTGG-motifs and CACCACA-motif), which may be involved in light responsiveness of RbcS gene in green microalgae. Using AcRbcS promoter::gusA translational fusion, it was demonstrated that this promoter could function as a light-regulated promoter in transgenic A. convolutus, which suggested that the isolated AcRbcS promoter was a full and active promoter sequence that contained all cis-elements required for developmental and light-mediated control of gene expression, and this promoter can be used to drive the expression of heterologous genes in A. convolutus. This achievement therefore advances the development of A. convolutus as an alternative expression system for the production of recombinant proteins. This is the first report on development of gene manipulation system for unicellular green alga A. convolutus.

Efficiency of ligation-mediated PCR and TAIL-PCR methods for isolation of RbcS promoter sequences from green microalgae Ankistrodesmus convolutus

Isolation of promoter sequences from known gene sequences is a tedious task in genome-related research. An efficient method of obtaining the promoter sequences is necessary in order to successfully use targeted promoters for genetic manipulations. Here, efficiency and usefulness of two PCR-based methods, namely: ligation-mediated PCR and thermal asymmetric interlaced (TAIL) PCR, for isolation of promoter sequences of the ribulose-1,5-bisphosphate carboxylase/oxygenase small subunit (RbcS) gene from green microalgae Ankistrodesmus convolutus (A. convolutus) were evaluated. The results showed that the amplification efficiency of TAIL-PCR was higher than that of the ligation-mediated PCR method, i.e. the amplified promoter fragments of 1.2 and 0.8 kb in length or promoter sequences of 813 and 606 bp (after eliminating the unreadable sequences). The use of TAIL-PCR described here presents a low cost and efficient strategy for the isolation of promoter sequences of known genes, especially in GC-rich regions, and species with little or no available genome information such as A. convolutus.

Construction of cDNA library and preliminary analysis of expressed sequence tags from green microalga Ankistrodesmus convolutus Corda

Green microalga Ankistrodesmus convolutus Corda is a fast growing alga which produces appreciable amount of carotenoids and polyunsaturated fatty acids. To our knowledge, this is the first report on the construction of cDNA library and preliminary analysis of ESTs for this species. The titers of the primary and amplified cDNA libraries were 1.1×10(6) and 6.0×10(9) pfu/ml respectively. The percentage of recombinants was 97% in the primary library and a total of 337 out of 415 original cDNA clones selected randomly contained inserts ranging from 600 to 1,500 bps. A total of 201 individual ESTs with sizes ranging from 390 to 1,038 bps were then analyzed and the BLASTX score revealed that 35.8% of the sequences were classified as strong match, 38.3% as nominal and 25.9% as weak match. Among the ESTs with known putative function, 21.4% of them were found to be related to gene expression, 14.4% ESTs to photosynthesis, 10.9% ESTs to metabolism, 5.5% ESTs to miscellaneous, 2.0% to stress response, and the remaining 45.8% were classified as novel genes. Analysis of ESTs described in this paper can be an effective approach to isolate and characterize new genes from A. convolutus and thus the sequences obtained represented a significant contribution to the extensive database of sequences from green microalgae.

Genetic diversity of Hevea IRRDB'81 collection assessed by RAPD markers

The majority of Hevea (Hevea brasiliensis Muell. Arg.) genetic resource in Vietnam derived from the IRRDB'81 germplasm collected in the Amazonian habitats of the genus. Random amplified polymorphic DNA (RAPD) analysis was used to examine the genetic diversity and structure of the IRRDB'81 germplasm. A total of 59 accessions from 13 different districts of the Brazilian states namely Acre, Rondonia, and Mato Grosso were brought into the study using six arbitrarily preselected primers. Sixty-five RAPD band patterns ranging in size from 0.2 to 3.0 kbp were scored for analysis. Differences in the level of DNA polymorphism among the districts and states were revealed. The percentage of the polymorphic DNA fragments calculated for 13 individual districts varied from 15.38 to 70.77%. The mean values of heterozygosity within the district varied from 0.064 to 0.264. Pairwise district Nei's genetic distance values ranged from 0.046 for Catriquacu and Itanba of Mato Grosso to 0.304 for Tarauaca of Acre and Aracatuba of Mato Grosso. The estimated values of Shannon's diversity index ranged from 0.093 for the Assis-Brasil district of Acre to 0.389 for the Jiparana district of Rondonia. The analysis of molecular variance (AMOVA) indicated that most of the genetic variations were found among accessions within the districts, while interdistrict variance component accounted for 14.1% only. The low interdistrict differentiation probably implied an extensive gene flow among them. Both the principal coordinate analysis and UPGMA cluster analysis based on genetic distance values revealed a varying degree of separation among the districts and that conformed to geographical origins of Hevea IRRDB'81 collection.