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This study aimed to explore the mediation effects of one-carbon metabolism (OCM) related nutrients on the association between MTHFR rs1801133 polymorphism and gestational diabetes mellitus (GDM). Folate, vitamin B12 and homocysteine (Hcy) were measured in the serum of 1254 pregnant women. Linear and logistic regressions were used to estimate the associations of OCM nutrients and MTHFR rs1801133 polymorphism with blood glucose levels and GDM risk. Mediation analysis was applied to test the mediation effects of folate, vitamin B12 and Hcy on the association of MTHFR rs1801133 polymorphism with blood glucose concentrations and GDM. Pregnant women with MTHFR rs1801133 CC genotype had higher serum folate (10·75 v. 8·90 and 9·40 ng/ml) and lower serum Hcy (4·84 v. 4·93 and 5·20 μmol/l) than those with CT and TT genotypes. Folate concentrations were positively associated with fasting plasma glucose (FPG), 1-h plasma glucose (1-h PG), 2-h plasma glucose (2-h PG) and GDM risk. Vitamin B12 levels were negatively correlated with FPG and GDM. Although no direct association was found between MTHFR rs1801133 genotypes and GDM, there were significant indirect effects of MTHFR rs1801133 CC genotype on FPG (β: 0·005; 95 % CI: 0·001, 0·013), 1-h PG (β: 0·006; 95 % CI: 0·001, 0·014), 2-h PG (β: 0·007; 95 % CI: 0·001, 0·015) and GDM (β: 0·006; 95 % CI: 0·001, 0·014) via folate. In conclusion, serum folate mediates the effect of MTHFR rs1801133 on blood glucose levels and GDM. Our findings potentially provide a feasible GDM prevention strategy via individualised folate supplementation according to the MTHFR genotypes.
Many studies suggest that both psychotherapy and drug therapy are effective in the treatment of bipolar disorders (BDs). However, the pathophysiology of both types of intervention has not been established definitively.
Methods
An activation likelihood estimation meta-analysis was performed to identify the distinct brain activity alterations between psychotherapy and drug therapy for the treatment of BDs. Articles were identified by searching databases including PubMed, Embase, Cochrane Library, and Web of Science databases. Eligible studies on BDs were published up until 10 June 2021.
Results
21 studies were included and we conducted a meta-analysis for different therapies and imaging tasks. After receiving psychotherapy, BD patients showed increased activation in the inferior frontal gyrus (IFG) and superior temporal gyrus. While after taking drug therapy, BD patients displayed increased activation in the anterior cingulate cortex, medial frontal gyrus, IFG, and decreased activation in the posterior cingulate cortex. The regions of brain activity changes caused by psychotherapy were mostly focused on the frontal areas, while drug therapy mainly impacted on the limbic areas. Different type of tasks also affected brain regions which were activated.
Conclusions
Our comprehensive meta-analysis indicates that these two treatments might have effect on BD in their own therapeutic modes. Psychotherapy might have a top-down effect, while drug therapy might have a bottom-up effect. This study may contribute to differential diagnosis of BDs and would be helpful to finding more accurate neuroimaging biomarkers for BD treatment.
Shock-induced instability developments of two successive interfaces have attracted much attention, but remain a difficult problem to solve. The feedthrough and reverberating waves between two successive interfaces significantly influence the hydrodynamic instabilities of the two interfaces. The evolutions of two successive slow/fast interfaces driven by a weak shock wave are examined experimentally and numerically. First, a general one-dimensional theory is established to describe the movements of the two interfaces by studying the rarefaction waves reflected between the two interfaces. Second, an analytical, linear model is established by considering the arbitrary wavenumber and phase combinations and compressibility to quantify the feedthrough effect on the Richtmyer–Meshkov instability (RMI) of two successive slow/fast interfaces. The feedthrough significantly influences the RMI of the two interfaces, and even leads to abnormal RMI (i.e. phase reversal of a shocked slow/fast interface is inhibited) which is the first observational evidence of the abnormal RMI provided by the present study. Moreover, the stretching effect and short-time Rayleigh–Taylor instability or Rayleigh–Taylor stabilisation imposed by the rarefaction waves on the two interfaces are quantified considering the two interfaces’ phase reversal. The conditions and outcomes of the freeze-out and abnormal RMI caused by the feedthrough are summarised based on the theoretical model and numerical simulation. A specific requirement for the simultaneously freeze-out of the instability of the two interfaces is proposed, which can potentially be used in the applications to suppress the hydrodynamic instabilities.
This study aimed to analyse the temporal and spatial trends in the burden of anxiety disorders and major depressive disorder related to bullying victimisation on global, regional and country scales.
Methods
Data were from the 2019 Global Burden of Disease (GBD) Study. We assessed the global disability-adjusted life years (DALYs, per 100 000 population) of anxiety disorders and major depressive disorder attributable to bullying victimisation by age, sex and geographical location. The percentage changes in age-standardised rates of DALYs were used to quantify temporal trends, and the annual rate changes across 204 countries and territories were used to present spatial trends. Furthermore, we examined the relationship between the sociodemographic index (SDI) and the burden of anxiety disorders as well as major depressive disorder attributable to bullying victimisation and its spatial and temporal characteristics globally.
Results
From 1990 to 2019, the global DALY rates of anxiety disorders and major depressive disorder attributable to bullying victimisation increased by 23.31 and 26.60%, respectively, with 27.27 and 29.07% for females and 18.88 and 23.84% for males. Across the 21 GBD regions, the highest age-standardised rates of bullying victimisation-related DALYs for anxiety disorders were in North Africa and the Middle East and for major depressive disorder in High-income North America. From 1990 to 2019, the region with the largest percentage increase in the rates of DALYs was High-income North America (54.66% for anxiety disorders and 105.88% for major depressive disorder), whereas the region with the slowest growth rate or largest percentage decline was East Asia (1.71% for anxiety disorders and −25.37% for major depressive disorder). In terms of SDI, this study found overall upward trends of bullying-related mental disorders in areas regardless of the SDI levels, although there were temporary downward trends in some stages of certain areas.
Conclusions
The number and rates of DALYs of anxiety disorders and major depressive disorder attributable to bullying victimisation increased from 1990 to 2019. Effective strategies to eliminate bullying victimisation in children and adolescents are needed to reduce the burden of anxiety disorders and major depressive disorder. Considering the large variations in the burden by SDI and geographic location, future protective actions should be developed based on the specific cultural contexts, development status and regional characteristics of each country.
Shock-tube experiments on various two-bubble and two-spike interfaces are performed to examine the dependence of bubble competition and spike competition on the initial spectra and density ratio of the interface. The differences in the influences of bubble competition and spike competition on the Richtmyer–Meshkov instability are highlighted for the first time. The bubble-competition effect is mainly dependent on the initial spectra of the two-bubble configuration. In contrast, the spike-competition effect is determined by both the initial spectra and density ratio. The extended buoyancy–drag model is adopted to explain the variation of the drag force imposed on the long-wavelength and short-wavelength structures as the initial conditions change. Based on the spectrum analysis, it is found that the constituent modes of two-bubble and two-spike interfaces have different contributions to the long-wavelength and short-wavelength perturbation growths. A generalised, nonlinear, analytical model is then established to quantify the bubble-competition effect and spike-competition effect considering arbitrary initial spectra and density ratio. The bubble-competition effect is believed to be stronger than the spike-competition effect at a high density ratio because it suppresses the high-frequency perturbation growth more evidently.
Modal global linear stability analysis of thermal convection is performed with the linearized lattice Boltzmann method (LLBM). The onset of Rayleigh–Bénard convection in rectangular cavities with conducting and adiabatic sidewalls and the instability of two-dimensional (2-D) and three-dimensional (3-D) natural convection in cavities are studied. The method of linearizing the local equilibrium probability distribution function that was first proposed by Pérez et al. (Theor. Comp. Fluid Dyn., vol. 31, 2017, pp. 643–664) is extended to solve the coupled linear Navier–Stokes equations together with the linear energy equation in this work. A multiscale analysis is also performed to recover the macroscopic linear Navier–Stokes equations from the discrete lattice Boltzmann equations for both the single and multiple relaxation time models. The present LLBM is implemented in the framework of the Palabos library. It is validated by calculating the linear critical value of 2-D natural convection that the LLBM with the multiple relaxation time model has an error less than 1 % compared with the spectral method. The instability mechanism of the flow is explained by kinetic energy transfer analysis. It is shown that the buoyancy mechanism and inertial mechanism tend to stabilize the Hopf bifurcation of the 2-D natural convection at Pr < 0.08 and Pr > 1, respectively. For 3-D natural convection, subcritical bifurcation of the Hopf type is found for low-Prandtl-number fluids (Pr < 0.1).
This study aimed to investigate the organization, workload, and psychological impact of COVID-19 on healthcare workers from the domestic Medical Aid Teams (MATs) sent to Wuhan in China.
Methods:
Leaders and members of MATs involved in the care for COVID-19 patients were invited to participate in a study by completing 2 separate self-report questionnaires from April 1 to 24, 2020.
Results:
A total of 9 MAT leaders were involved and 464 valid questionnaires were collected from 140 doctors and 324 nurses. Mean age of the doctors and nurses were 39.34 ± 6.70 (26∼58 years old) and 31.88 ± 5.29 (21∼52 years old), with 72 (15.5%) being males. Nurses were identified as an independent risk factor (HR 1.898; P = 0.001) for a day working time in the multivariate analysis. The proportions of psychological consulting received among nurses were higher than those among doctors (49.7 vs 30.0%, P < 0.001). More than 50% of the anesthetists and emergency doctors who have received psychological consulting thought that it was effective according to self-evaluation.
Conclusions:
This study focused on healthcare workers’ situation during the early period of the pandemic. Nurses worked longer than doctors. The effectiveness of psychological consulting depends on the physicians’ specialties and the working conditions of the nurses and psychological consulting targeting different specialties need to be improved.
The shock-induced evolution of a gas layer with two fast/slow interfaces is investigated theoretically and experimentally. Specifically, the gas layer is located between a lighter gas and a heavier gas, forming a light/medium/heavy (LMH) configuration. Linear stability analysis is utilised to derive a new analytical model to quantify the Richtmyer–Meshkov instability (RMI) on the two interfaces of such an A/B/C-type fluid layer. Three quasi-one-dimensional (1-D) LMH fluid layers with different initial layer thicknesses are generated to study the wave patterns and interface motions. A general 1-D theory is established to describe the motions of the shock/rarefaction waves reverberating inside the fluid layer and the displacements of the two interfaces. Six quasi-2-D LMH fluid layers with diverse initial layer-thickness and amplitude combinations are created to explore the hydrodynamic instabilities of the two interfaces. It is found that the interface coupling significantly influences the interface evolution, even resulting in an abnormal phase reversal of a shocked fast/slow interface if the two interfaces are anti-phase and the initial layer is very thin. The specific conditions for the abnormal phase reversal and the instability freeze out are deduced. Moreover, the additional RMI (or Rayleigh–Taylor stabilisation) imposed by the shock (or rarefaction waves) reverberating inside an LMH fluid layer on the first (or second) interface is quantified. It is proved that the reverberating waves inside an LMH fluid layer stabilise the two interfaces. Finally, a nonlinear model is obtained by incorporating the nonlinearity effect into the linear model, which well describes the perturbation growths of the two interfaces in a later regime.
T long-term effects of cognitive therapy and behavior therapy (CTBT) for menopausal symptoms are unknown, and whether the effects are different between natural menopause and treatment-induced menopause are currently unclear. Therefore, we sought to conduct an accurate estimate of the efficacy of CTBT for menopausal symptoms.
Methods
We conducted searches of Cochrane Library, EMBASE, PsycINFO, PubMed, and Web of Science databases for studies from 1 January 1977 to 1 November 2021. Randomized controlled trials (RCTs) comparing intervention groups to control groups for menopausal symptoms were included. Hedge's g was used as the standardized between-group effect size with a random-effects model.
Results
We included 14 RCTs comprising 1618 patients with a mean sample size of 116. CTBT significantly outperformed control groups in terms of reducing hot flushes [g = 0.39, 95% confidence interval (CI) 0.23–0.55, I2 = 45], night sweats, depression (g = 0.50, 95% CI 0.34–0.66, I2 = 51), anxiety (g = 0.38, 95% CI 0.23–0.54, I2 = 49), fatigue, and quality of life. Egger's test indicated no publication bias.
Conclusions
CTBT is an effective psychological treatment for menopausal symptoms, with predominantly small to moderate effects. The efficacy is sustained long-term, although it declines somewhat over time. The efficacy was stronger for natural menopause symptoms, such as vasomotor symptoms, than for treatment-induced menopause symptoms. These findings provide support for treatment guidelines recommending CTBT as a treatment option for menopausal symptoms.
Shock-induced light-fluid-layer evolution is firstly investigated experimentally and theoretically. Specifically, three quasi-one-dimensional helium gas layers with different layer thicknesses are generated to study the wave patterns and interface motions. Six quasi-two-dimensional helium gas layers with diverse layer thicknesses and amplitude combinations are created to explore the Richtmyer–Meshkov instability of a light-fluid layer. Due to the multiple reflected shocks reverberating inside a light-fluid layer, the speeds of the two interfaces gradually converge, and the layer thickness saturates eventually. A general one-dimensional theory is adopted to describe the two interfaces’ motions and the layer thickness variations. It is found that, for the first interface, the end time of its phase reversal determines the influence of the reflected shocks on it. However, the reverberated shocks indeed lead to the second interface being more unstable. When the two interfaces are initially in phase, and the initial fluid layer is very thin, the two interfaces’ spike heads collide and stabilise the two interfaces. Linear and nonlinear models are successfully adopted by considering the interface-coupling effect and the reverberated shocks to predict the two interfaces’ perturbation growths in all regimes. The interfacial instability of a light-fluid layer is quantitatively compared with that of a heavy-fluid layer. It is concluded that the kind of waves reverberating inside a fluid layer significantly affects the fluid-layer evolution.
Shock-induced fluid-layer evolution has attracted much attention but remains a challenge mainly because the coupling between layers remains unknown. Linear solutions are first derived to quantify the layer-coupling effect on the shocked dual-layer evolution. Next, the motions of the waves and interfaces of a dual layer are examined based on the one-dimensional gas dynamics theory. Shock-tube experiments on the dual-layer, single-layer and single-mode interface are then performed to validate the linear solutions and investigate the reverberating waves inside the layers. It is proved that the layer-coupling effect destabilises the dual layer, especially when the initial layers are thin, and the reverberating waves impose additional instabilities on all interfaces. Our findings suggest that a slow/fast configuration with a large thickness in a dual layer can facilitate the suppression of hydrodynamic instabilities.
Shock-tube experiments on eight kinds of two-dimensional multi-mode air–SF$_6$ interface with controllable initial conditions are performed to examine the dependence of perturbation growth on initial spectra. We deduce and demonstrate experimentally that the amplitude development of each mode is influenced by the mode-competition effect from quasi-linear stages. It is confirmed that the mode-competition effect is closely related to initial spectra, including the wavenumber, the phase and the initial amplitude of constituent modes. By considering both the mode-competition effect and the high-order harmonics effect, a nonlinear model is established based on initial spectra to predict the amplitude growth of each individual mode. The nonlinear model is validated by the present experiments and data in the literature by considering diverse initial spectra, shock intensities and density ratios. Moreover, the nonlinear model is successfully extended based on the superposition principle to predict the growths of the total perturbation width and the bubble/spike width from quasi-linear to nonlinear stages.
To investigate the association between the Metabolic Score for Visceral Fat (METS-VF) and risk of type 2 diabetes mellitus (T2DM) and compare the predictive value of the METS-VF for T2DM incidence with other obesity indices in Chinese people. A total of 12 237 non-T2DM participants aged over 18 years from the Rural Chinese Cohort Study of 2007–2008 were included at baseline and followed up during 2013–2014. The cox proportional hazards regression was used to calculate hazard ratios (HR) and 95 % CI for the association between baseline METS-VF and T2DM risk. Restricted cubic splines were used to model the association between METS-VF and T2DM risk. Area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the ability of METS-VF to predict T2DM incidence. During a median follow-up of 6·01 (95 % CI 5·09, 6·06) years, 837 cases developed T2DM. After adjusting for potential confounding factors, the adjusted HR for the highest v. lowest METS-VF quartile was 5·97 (95 % CI 4·28, 8·32), with a per 1-sd increase in METS-VF positively associated with T2DM risk. Positive associations were also found in the sensitivity and subgroup analyses, respectively. A significant nonlinear dose–response association was observed between METS-VF and T2DM risk for all participants (Pnonlinearity = 0·0347). Finally, the AUC value of METS-VF for predicting T2DM was largest among six indices. The METS-VF may be a reliable and applicable predictor of T2DM incidence in Chinese people regardless of sex, age or BMI.
Investigation on the shock-induced finite-thickness fluid-layer evolution is very desirable but remains a challenge because it not only involves both the Richtmyer–Meshkov instability (RMI) and the Rayleigh–Taylor instability (RTI), but also strongly depends on the waves reverberated inside the layer. We experimentally and theoretically examined the evolution of a shocked $\textrm {SF}_6$ gas layer with a finite thickness surrounded by air. Specifically, three kinds of quasi-one-dimensional $\textrm {SF}_6$ gas layers with different layer thicknesses are generated to study the wave patterns and interface motions, and six types of quasi-two-dimensional $\textrm {SF}_6$ gas layers with diverse layer thicknesses and amplitude combinations are created to explore the interfacial instabilities of the layer. When the initial fluid layer is thin, the two interfaces of the layer coalesce at a late time. The present study is the first to report that except for the RMI induced by a shock wave on the two interfaces, the rarefaction waves (RW) inside the fluid layer induce the additional RTI and decompression effect on the first interface, and the compression waves (CW) inside the fluid layer cause the additional Rayleigh–Taylor stabilisation (RTS) and compression effect on the second interface. A general one-dimensional theory is established to describe the motions of the two interfaces. Linear and nonlinear models are successfully established by considering the interface-coupling effect on the RMI and the additional interfacial instabilities induced by these waves inside the heavy fluid layer. The established models predict well the perturbation growths on the two interfaces at all regimes.
Chinese university students are at high risk for depressive symptoms and the ongoing coronavirus disease 2019 (COVID-19) pandemic may have exacerbated the mental health of university students. However, existing studies on depressive symptoms in Chinese university students during the COVID-19 pandemic reported a wide range of prevalence estimates, making mental health planning for this population difficult. The objective of this study was to conduct a systematic review and meta-analysis of surveys that assessed the prevalence of depressive symptoms in Chinese university students amid the COVID-19 pandemic.
Methods
Major Chinese (CNKI, Wanfang, VIP) and English (PubMed, Embase, PsycInfo) databases and preprint platforms were searched to identify cross-sectional studies containing data on the prevalence of depressive symptoms in Chinese university students during the pandemic. Two authors independently retrieved the literature, evaluated the eligibility of potential studies, assessed the risk of bias (RoB) of included studies, and extracted data. RoB was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.
Results
In total, 1177 records were retrieved, and 84 studies involving 1 292 811 Chinese university students during the pandemic were included. None of the included studies were rated as completely low RoB. Statistically significant heterogeneity in the prevalence estimates of included studies was detected (I2 = 99.9%, p < 0.001). The pooled prevalence of depressive symptoms was 26.0% (95%CI: 23.3–28.9%), which was significantly higher in female than in male students (30.8% v. 28.6%, p < 0.001), in postgraduates than in undergraduates (29.3% v. 22.9%, p < 0.001), in students living inside than in those living outside the COVID-19 epicentre (27.5% v. 22.3%, P < 0.001), in students from universities at the epicentre than in those from universities outside the epicentre (26.2% v. 23.1%, p < 0.001), in students who had close contact with COVID-19 than in those who did not (46.0% v. 25.0%, p < 0.001), and in students who had acquaintances or relatives infected with COVID-19 (39.7% v. 24.0%, p < 0.001) than in those who did not. Five sources of heterogeneity were identified from the subgroup analysis: survey period, % of males among the survey sample, scale of depressive symptoms, cutoff score of the scale and level of RoB.
Conclusions
Over one-fourth of Chinese university students experienced depressive symptoms during the COVID-19 pandemic. Mental health services for this population should include periodic evaluation of depressive symptoms, expanded social support and psychiatric assessment and treatment when necessary. It is also necessary to design depression prevention programmes that target higher-risk cohorts of university students.
Interception by plant canopies during wind dispersal can affect the final destination of diaspores. However, how the interaction of wind speed, canopy type and diaspore attributes affects interception of diaspores by the plant canopy has rarely been studied. We investigated canopy interception for 29 species with different diaspore attributes, six canopy types and six wind speeds in controlled experiments in a wind tunnel. Shrub canopy interception of diaspores were controlled by wind speed and diaspore attributes, but the latter had a greater influence on canopy interception than the former. At low wind speed, diaspore wing loading had a large influence on canopy interception, whereas at high wind speed, diaspore projection area had a large influence. The chance of canopy interception at a particular wind speed was additionally affected by the type of canopy. This study increases our knowledge of the dispersal process, corrects the previous understanding of diaspore dispersal potential and improves the theoretical basis for predicting spatial pattern and dynamics of plant populations.
The epidemic of coronavirus disease 2019 (COVID-19) began in China and had spread rapidly to many other countries. This study aimed to identify risk factors associated with delayed negative conversion of SARS-CoV-2 in COVID-19 patients. In this retrospective single-centre study, we included 169 consecutive patients with confirmed COVID-19 in Zhongnan Hospital of Wuhan University from 15th January to 2nd March. The cases were divided into two groups according to the median time of SARS-CoV-2 negative conversion. The differences between groups were compared. In total, 169 patients had a median virus negative conversion time of 18 days (interquartile range: 11–25) from symptom onset. Compared with the patients with short-term negative conversion, those with long-term conversion had an older age, higher incidence of comorbidities, chief complaints of cough and chest distress/breath shortness and severer illness on admission, higher level of leucocytes, neutrophils, aspartate aminotransferase, creatine kinase and erythrocyte sedimentation rate (ESR), lower level of CD3+CD4+ lymphocytes and albumin and more likely to receive mechanical ventilation. In multivariate analysis, cough, leucocytes, neutrophils and ESR were positively correlated with delayed virus negative conversion, and CD3+CD4+ lymphocytes were negatively correlated. The integrated indicator of leucocytes, neutrophils and CD3+CD4+ lymphocytes showed a good performance in predicting the negative conversion within 2 weeks (area under ROC curve (AUC) = 0.815), 3 weeks (AUC = 0.804), 4 weeks (AUC = 0.812) and 5 weeks (AUC = 0.786). In conclusion, longer quarantine periods might be more justified for COVID-19 patients with cough, higher levels of leucocytes, neutrophils and ESR and lower levels of CD3+CD4+ lymphocytes.
We report the first shock-tube experiments on dual-mode Richtmyer–Meshkov instability (RMI). An extended soap-film technique is adopted to generate a dual-mode gaseous interface such that its initial wavenumber ($k_0$) and phase of the fundamental waves are well controlled. By extracting interfacial contours from the distinct schlieren images, a Fourier analysis is performed from linear to weakly nonlinear stages and the growth of each basic wave is obtained. A noticeable difference between the growth of each basic mode and the corresponding single-mode RMI is observed, which suggests evident mode coupling effects in the dual-mode RMI. For dual-mode interfaces with in-phase $k_0$ and $k_0/2$ waves, the mode coupling suppresses (promotes) the growth of the $k_0$ ($k_0/2$) mode, while for interfaces with anti-phase $k_0$ and $k_0/2$ modes, the growth of the $k_0$ ($k_0/2$) mode is weakly influenced (evidently inhibited). However, for the combination of $k_0$ and $k_0/3$ waves, the mode coupling has a negligible influence on the growth of each basic wave. The modal theory of Haan (Phys. Fluids B, vol. 3, 1991, pp. 2349–2355), originally for multi-mode Rayleigh–Taylor instability, is reformulated for the dual-mode RMI, and it is found that this model overestimates the present experimental results for ignoring the nonlinear saturation. This model is then modified by accounting for both the mode coupling and nonlinear saturation, which well predicts the experimental results not only for the growth of the basic waves but also for the growth of second harmonics.