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Little is known about the trend and predictors of 21-year mortality and suicide patterns in persons with schizophrenia.
To explore the trend and predictors of 21-year mortality and suicide in persons with schizophrenia in rural China.
This longitudinal follow-up study included 510 persons with schizophrenia who were identified in a mental health survey of individuals (≥15 years old) in 1994 in six townships of Xinjin County, Chengdu, China, and followed up in three waves until 2015. Kaplan–Meier survival analysis and Cox hazard regressions were conducted.
Of the 510 participants, 196 died (38.4% mortality) between 1994 and 2015; 13.8% of the deaths (n = 27) were due to suicide. Life expectancy was lower for men than for women (50.6 v. 58.5 years). Males consistently showed higher rates of mortality and suicide than females. Older participants had higher mortality (hazard ratio HR = 1.03, 95% CI 1.01–1.05) but lower suicide rates (HR = 0.95, 95% CI 0.93–0.98) than their younger counterparts. Poor family attitudes were associated with all-cause mortality and death due to other causes; no previous hospital admission and a history of suicide attempts independently predicted death by suicide.
Our findings suggest there is a high mortality and suicide rate in persons with schizophrenia in rural China, with different predictive factors for mortality and suicide. It is important to develop culture-specific, demographically tailored and community-based mental healthcare and to strengthen family intervention to improve the long-term outcome of persons with schizophrenia.
Maternal supraphysiological estradiol (E2) environment during pregnancy leads to adverse perinatal outcomes. However, the influence of oocyte exposure to high E2 levels on perinatal outcomes remains unknown. Thus, a retrospective cohort study was conducted to explore the effect of high E2 level induced by controlled ovarian stimulation (COH) on further outcomes after frozen embryo transfer (FET). The study included all FET cycles (n = 10,581) between 2014 and 2017. All cycles were categorized into three groups according to the E2 level on the day of the human Chorionic Gonadotropin trigger. Odds ratios (ORs) and their confidence intervals (CIs) were calculated to evaluate the association between E2 level during COH and pregnancy outcomes and subsequent neonatal outcomes. From our findings, higher E2 level was associated with lower percentage of chemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth as well as increased frequency of early miscarriage. Preterm births were more common among singletons in women with higher E2 level during COH (aOR1 = 1.93, 95% CI: 1.22–3.06; aOR2 = 2.05, 95% CI: 1.33–3.06). Incidence of small for gestational age (SGA) was more common in both singletons (aOR1 = 2.01, 95% CI: 1.30–3.11; aOR2 = 2.51, 95% CI: 1.69–3.74) and multiples (aOR1 = 1.58, 95% CI: 1.03–2.45; aOR2 = 1.99, 95% CI: 1.05–3.84) among women with relatively higher E2 level. No association was found between high E2 level during COH and the percentage of macrosomia or large for gestational age. In summary, oocyte exposure to high E2 level during COH should be brought to our attention, since the pregnancy rate decreasing and the risk of preterm birth and SGA increasing following FET.
Mastery of strengthening strategies to achieve high-capacity anodes for lithium-ion batteries can shed light on understanding the nature of diffusion-induced stress and offer an approach to use submicro-sized materials with an ultrahigh capacity for large-scale batteries. Here, we report solute strengthening in a series of silicon (Si)–germanium (Ge) alloys. When the larger solute atom (Ge) is added to the solvent atoms (Si), a compressive stress is generated in the vicinity of Ge atoms. This local stress field interacts with resident dislocations and subsequently impedes their motion to increase the yield stress in the alloys. The addition of Ge into Si substantially improves the capacity retention, particularly in Si0.50Ge0.50, aligning with literature reports that the Si/Ge alloy showed a maximum yield stress in Si0.50Ge0.50. In situ X-ray diffraction studies on the Si0.50Ge0.50 electrode show that the phase change undergoes three subsequent steps during the lithiation process: removal of surface oxide layer, formation of cluster-size Lix(Si,Ge), and formation of crystalline Li15(Si,Ge)4. Furthermore, the lithiation process starts from higher index facets, i.e., (220) and (311), then through the low index facet (111), suggesting the orientation-dependence of the lithiation process in the Si0.50Ge0.50 electrode.
Disclosing the diagnosis of Alzheimer's disease (AD) to a patient is controversial. There is significant stigma associated with a diagnosis of AD or dementia in China, but the attitude of the society toward disclosure of such a diagnosis had not been formally evaluated prior to our study. Therefore, we aimed to evaluate the attitude toward disclosing an AD diagnosis to patients in China with cognitive impairment from their caregivers, and the factors that may affect their attitude.
We designed a 17-item questionnaire and administered this questionnaire to caregivers, who accompanied patients with cognitive impairment or dementia in three major hospitals in Shanghai, China. The caregiver's attitude toward disclosing the diagnosis of AD as evaluated by the questionnaire was compared to that of disclosing the diagnosis of terminal cancer.
A majority (95.7%) of the 175 interviewed participants (mean 14.2 years of education received) wished to know their own diagnosis if they were diagnosed with AD, and 97.6% preferred the doctor to tell their family members if they were diagnosed with AD. If a family member of the participants suffered from AD, 82.9% preferred to have the diagnosis disclosed to the patient. “Cognitive impairment” was the most accepted term by caregivers to disclose AD diagnosis in Chinese.
This study suggests most of the well-educated individuals in a Chinese urban area favored disclosing the diagnosis when they or their family members were diagnosed with AD.
Findings from observational studies have suggested a possible relation between Ca and breast cancer risk. However, the results of these studies are inconclusive, and the dose–response relationship between Ca intake and risk of breast cancer remains to be determined. A meta-analysis of prospective studies was conducted to address these issues. PubMed and Embase databases were searched for relevant studies concerning the association between Ca intake and breast cancer up to March 2016. The summary relative risks (RR) with 95 % CI were calculated with a random-effects model. The final analysis included eleven prospective cohort studies involving 26 606 cases and 872 895 participants. The overall RR of breast cancer for high v. low intake of Ca was 0·92 (95 % CI 0·85, 0·99), with moderate heterogeneity (P=0·026, I2=44·2 %). In the subgroup analysis, the inverse association appeared stronger for premenopausal breast cancer (RR 0·75; 95 % CI 0·59, 0·96) than for postmenopausal breast cancer (RR 0·94; 95 % CI 0·87, 1·01). Dose–response analysis revealed that each 300 mg/d increase in Ca intake was associated with 2 % (RR 0·98; 95 % CI 0·96, 0·99), 8 % (RR 0·92; 95 % CI 0·87, 0·98) and 2 % (RR 0·98; 95 % CI 0·97, 0·99) reduction in the risk of total, premenopausal and postmenopausal breast cancer, respectively. Our findings suggest an inverse dose–response association between Ca intake and risk of breast cancer.
The long-term outcome of never-treated patients with schizophrenia is
To compare the 14-year outcomes of never-treated and treated patients
with schizophrenia and to establish predictors for never being
All participants with schizophrenia (n = 510) in Xinjin,
Chengdu, China were identified in an epidemiological investigation of 123
572 people and followed up from 1994 to 2008.
The results showed that there were 30.6%, 25.0% and 20.4% of patients who
received no antipsychotic medication in 1994, 2004 and 2008 respectively.
Compared with treated patients, those who were never treated in 2008 were
significantly older, had significantly fewer family members, had higher
rates of homelessness, death from other causes, being unmarried, living
alone, being without a caregiver and poor family attitudes. Partial and
complete remission in treated patients (57.3%) was significantly higher
than that in the never-treated group (29.8%). Predictors of being in the
never-treated group in 2008 encompassed baseline never-treated status,
being without a caregiver and poor mental health status in 1994.
Many patients with schizophrenia still do not receive antipsychotic
medication in rural areas of China. The 14-year follow-up showed that
outcomes for the untreated group were worse. Community-based mental
healthcare, health insurance and family intervention are crucial for
earlier diagnosis, treatment and rehabilitation in the community.
Recent evidence shows that excess nicotinamide can cause epigenetic changes in developing rats. The aim of the present study was to investigate the effects of maternal nicotinamide supplementation on the fetus. Female rats were randomised into four groups fed a standard chow diet (control group) or diets supplemented with 1 g/kg of nicotinamide (low-dose group), 4 g/kg of nicotinamide (high-dose group) or 4 g/kg of nicotinamide plus 2 g/kg of betaine (betaine group) for 14–16 d before mating and throughout the study. Fetal tissue samples were collected on the 20th day of pregnancy. Compared with the control group, the high-dose group had a higher fetal death rate, and the average fetal body weight was higher in the low-dose group but lower in the high-dose group. Nicotinamide supplementation led to a decrease in placental and fetal hepatic genomic DNA methylation and genomic uracil contents (a factor modifying DNA for diversity) in the placenta and fetal liver and brain, which could be completely or partially prevented by betaine. Moreover, nicotinamide supplementation induced tissue-specific alterations in the mRNA expression of the genes encoding nicotinamide N-methyltransferase, DNA methyltransferase 1, catalase and tumour protein p53 in the placenta and fetal liver. High-dose nicotinamide supplementation increased fetal hepatic α-fetoprotein mRNA level, which was prevented by betaine supplementation. It is concluded that maternal nicotinamide supplementation can induce changes in fetal epigenetic modification and DNA base composition. The present study raises the concern that maternal nicotinamide supplementation may play a role in the development of epigenetic-related diseases in the offspring.
The poly(vinylidene fluoride-trifluoroethylene) (P(VDF-TrFE)) based ferroelectric and relaxor materials have been proved to be good electrocaloric (EC) materials. To further enhance the EC effect in ferroelectric relaxor terpolymer poly(vinylidene fluoride–trifluoroethylene-chlorofluoroethylene) (P(VDF-TrFE-CFE)), composites such as polymer-polymer blends and nanocomposites filled with inorganic nanoparticles are fabricated and investigated. It is found that the addition of small amount of filler (such as P(VDF-TrFE) or nano-ZrO2) can increase terpolymer’s crystallinity and enhance its relaxor behavior through interface couplings. The increased crystallinity and enhanced relaxor behavior together result in enhanced electrocaloric effect. The results demonstrate the promise of composite approaches in tailoring and enhancing ECE in the relaxor terpolymers.
An atmospheric pressure plasma jet is generated with a cold arc discharge in ambient air. The current-voltage characteristics and optical emission spectra of plasma discharges are investigated. The molecular nitrogen (N2), hydroxyl radical (OH), and oxygen atom (O) are observed and analyzed. Based on the best fit of the simulated spectra of N2 (C3∏u+ − B3∏g+) band and OH (A2∑+ − X2∏) band transition and the experimentally recorded spectra, the rotational temperature and the vibrational temperature of atmospheric pressure cold arc plasma jet (APCAPJ) are estimated.
Iron oxides, including maghemite (γ-Fe2O3) and magnetite (Fe3O4), have been widely applied in many fields. For technological advances in the future, further improvements of their ferromagnetic properties are desirable. The development of iron ferrites with a large coercive field (Hc) is one of issues of consequence. For ferrites, however, enlarging the Hc value is not easy because of their low magnetocrystalling anisotropy constant. Here we report single-crystalline Cu-doped γ-Fe2O3 nanowires in which the controlled diameter (70–100 nm) and the graded Cu dopant (7, 10, and 15%) are directly obtained by a simple chemical vapor deposition technique. In particular, the coercive value (over 2 T) of 10% Cu-doped γ-Fe2O3 nanowires is much higher than that (<80 Oe) of undoped γ-Fe2O3 nanowires at room temperature. On the basis of the experimental magnetization data, the achievement of such a higher coercive field of Cu-doped γ-Fe2O3 (10%) nanowires is tentatively suggested.
We have demonstrated and studied polymeric solid-state dye lasers (SSDLs) fabricated by three-dimensional (3D) polystyrene colloidal crystals and tert-butyl roadamine B (t-Bu RhB) doped Poly (methyl methacrylate) (PMMA) films with different film thickness. The sandwich-typed resonator cavities with different active layer thickness display single-mode lasing oscillations in the reflection bandgap of the colloidal crystals. The lasing thresholds could be optimized by changing the thickness of t-Bu RhB doped PMMA films, which is as low as 7.43 W/cm2. Adjusting active layer thickness would provide an opportunity to accelerate the development of fabricating polymeric SSDLs with low threshold.
Many people with schizophrenia remain untreated in the community.
Long-term mortality and suicidal behaviour among never-treated
individuals with schizophrenia in the community are unknown.
To explore 10-year mortality and suicidal behaviour among never-treated
individuals with schizophrenia.
We used data from a 10-year prospective follow-up study (1994–2004) among
people with schizophrenia in Xinjin County, Chengdu, China.
The mortality rate for never-treated individuals with schizophrenia was
2761 per 100 000 person-years during follow-up. There were no significant
differences of rates of suicide and all-cause mortality between
never-treated and treated individuals. The standardised mortality ratio
(SMR) for never-treated people was 10.4 (95% CI 7.2–15.2) and for treated
individuals 6.5 (95% CI 5.2–8.5). Compared with treated people,
never-treated individuals were more likely to be older, poorer, have a
longer duration of illness, marked symptoms and fewer family members.
The never-treated individuals have similar mortality to and a higher
proportion of marked symptoms than treated people, which may reflect the
poor outcome of the individuals without treatment. The higher rates of
mortality, homelessness and never being treated among people with
schizophrenia in low- and middle-income nations might challenge presumed
wisdom about schizophrenia outcomes in these countries.
The hollow mesoporous spheres (HMS) with cubic pore network have been synthesized via a simple two-step method. Two drugs of different molecules size, Aspirin and Gentamicin, were tested by one simple adsorption process. Up to 336 mg Aspirin molecules can be stored in 1.0 g HMS, while Gentamicin molecules of much larger size are much more difficult to be introduced into the pore channels of HMS. The same results can be obtained by using MCM-48 and MCM-41 as comparative mesoporous carriers. The HMS shows significantly higher storage amount of Aspirin than conventional MCM-48 and MCM-41 due to its hollow core structure. The release process of HMS-Aspirin, MCM-48-Aspirin and MCM-41-Aspirin are found to have a sustained-release property and follow a Fickian diffusion mechanism. Moreover, the HMS is suitable for storage of drug molecules of much smaller size.
A pair of mutant mice with a first sparse coat appeared spontaneously in the production stock of
BALB/c mice with a normal coat. After being sib-mated, they produced three phenotypes in their
progeny: mice with normal hair, mice with a first sparse coat and then a fuzzy coat, and
uncovered mice. Genetic studies revealed the mutants had inherited an autosomal monogene that
was semi-dominant. By using 11 biochemical loci – Idh, Car2,
Mup1, Pgm1, Hbb, Es1, Es10, Gdc,
Ce2, Mod1 and Es3 – as genetic markers, two-point linkage tests were made. The results showed
the gene was assigned to chromosome 11. The result of a three-point test with Es3 and D11Mit8
(microsatellite DNA) as markers showed that the mutation was linked to Es3 with the
recombination fraction 7·89±2·19%, and linked to D11Mit8 with the recombination fraction
26·30±3·57%. The recombination fraction between Es3 and D11Mit8 was 32·90±3·81%. It is
suggested that the mutation is a new genetic locus that affected the skin and hair structure of the
mouse. The mutation was named uncovered, with the symbol Uncv. Further studies showed the
mutation affected not only the histology of skin and hair but also the growth and reproductive
performance of the mice. The molecular characterization of the Uncv locus needs to be further
A method of absolutely unfolding the atomic spectrum by a pinhole transmission grating spectrometer (TGS) is discussed in detail. The numerical process considers both the factors of higher-dispersive-order overlapping of TGS and source-size widening effects. Real soft-X-ray spectra of aluminum, copper, and gold plasmas are presented of experiments performed on the Six-Beam Laser Facility at the Shanghai Institute of Optics and Fine Mechanics.
Gold cavity targets were irradiated with λ = 0.44 μm laser light at intensities ≤ 2.6 ×1013 W/cm2. The outward motion of the cavity wall was investigated by simultaneous optical and x-ray shadowgraphy. The wall motion is attributed to the pressure generated by an ablative heat wave, driven by the soft x-rays in the cavity. The observed transparency of the cavities for the x-rays used for shadowgraphy allowed the determination of the density profile of the cavity wall which decays possibly due to fragmentation.
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