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Patients with bipolar disorder (BPD) are prone to engage in risk-taking behaviours and self-harm, contributing to higher risk of traumatic injuries requiring medical attention at the emergency room (ER).We hypothesize that pharmacological treatment of BPD could reduce the risk of traumatic injuries by alleviating symptoms but evidence remains unclear. This study aimed to examine the association between pharmacological treatment and the risk of ER admissions due to traumatic injuries.
Methods
Individuals with BPD who received mood stabilizers and/or antipsychotics were identified using a population-based electronic healthcare records database in Hong Kong (2001–2019). A self-controlled case series design was applied to control for time-invariant confounders.
Results
A total of 5040 out of 14 021 adults with BPD who received pharmacological treatment and had incident ER admissions due to traumatic injuries from 2001 to 2019 were included. An increased risk of traumatic injuries was found 30 days before treatment [incidence rate ratio (IRR) 4.44 (3.71–5.31), p < 0.0001]. After treatment initiation, the risk remained increased with a smaller magnitude, before returning to baseline [IRR 0.97 (0.88–1.06), p = 0.50] during maintenance treatment. The direct comparison of the risk during treatment to that before and after treatment showed a significant decrease. After treatment cessation, the risk was increased [IRR 1.34 (1.09–1.66), p = 0.006].
Conclusions
This study supports the hypothesis that pharmacological treatment of BPD was associated with a lower risk of ER admissions due to traumatic injuries but an increased risk after treatment cessation. Close monitoring of symptoms relapse is recommended to clinicians and patients if treatment cessation is warranted.
Excess body weight and hyperlipidaemia cause severe health problems and have social implications. Amycenone is an active substance extracted from Yamabushitake mushrooms with no reports of its activity against excess body weight and hyperlipidaemia. This research clarifies the effects and mechanisms of action of amycenone on the inhibition of body weight excess and hyperlipidaemia attenuation using KK-Ay mice. Amycenone or water was administered to 8-week-old male KK-Ay mice by gavage for 8 weeks. Their body weight and food intake were recorded during the experiment. At the end of the experimental period, the mice were dissected, and blood samples, lipid metabolism-related organs and tissues were collected and stored for further analysis. Amycenone treatment suppressed body weight gain and improved serum levels of fasting blood glucose and non-esterified fatty acids. Additionally, serum and hepatic cholesterol and triacylglycerol levels were reduced after this treatment, whereas the phosphorylation levels of AMPK, PKA and HSL increased and the expression level of FAS decreased. The protein level of C/EBPβ and gene expression level of Cpt1 were higher in the perirenal adipose tissue of amycenone-treated KK-Ay mice. Furthermore, amycenone phosphorylated AMPK, PKA and ACC, and PPARγ expression was lower in the mesenteric adipose tissue. The phosphorylation levels of AMPK, LKB1, PKA and ACC were also induced, and FAS expression level was reduced in the liver of the amycenone-treated group. Amycenone could reduce excess body weight and attenuate hyperlipidaemia in KK-Ay mice by inhibiting lipogenesis and promoting lipolysis through lipid metabolism pathway stimulation and fatty acid β-oxidation acceleration.
To assess the role of dietary creatine on myofiber characteristics and protein synthesis in muscle, we fed grass carp (Ctenopharyngodon idellus, initial body weight: 88.47 ± 1.44 g) creatine-supplemented diets (1.84, 5.91, 8.48, and 15.44 g/kg diet) for 8 weeks. Creatine supplementation did not affect growth performance, but significantly increased creatine contents in muscle and liver. At 8.48 g/kg, creatine decreased the activities of alanine transaminase and aspartate aminotransferase in serum, and improved hardness and chewiness of muscle due to shorter myofiber mean diameter, higher myofiber density and the frequencies of the diameters of class I and III and collagen content, longer sarcomere length, and upregulated mRNA levels of slow myosin heavy chains. Creatine supplementation upregulated the mRNA expressions of myogenic regulatory factors. The 8.48 g/kg creatine-supplemented diet significantly increased the contents of protein, total amino acids (AAs), essential AAs, and free flavor AAs in muscle, the protein levels of insulin-like growth factor I, myogenic differentiation antigen, and peroxisome proliferator-activated receptor-γ coactlvator-1α in muscle, and stimulated the phosphorylation of target of rapamycin (TOR) pathway in muscle. In summary, 8.48 mg/kg creatine improved fish health and skeletal muscle growth, and increased hardness and protein synthesis in muscle of grass carp by affecting myofiber characteristics and the TOR signaling pathway. A second-order regression model revealed that the optimal dietary creatine supplementation of grass carp ranges between 8.48 and 12.04 g/kg.
Traditionally, the strata of the Luonie Valley, Dechang County, SW Sichuan, China, are considered to contain a suite of felsic volcanic rocks (the Huili Group) that erupted after c. 1050 Ma. However, we report here new age constraints, elemental and Lu–Hf isotope geochemistry for a different suite of older basaltic agglomerate lava, basaltic tuff lava and basalt from the same area, which we name the Luonie Formation. New dating results show that the basaltic volcanic suite of the upper part of the Luonie Formation formed at 1126.1 ± 9.9 Ma, significantly earlier than deposition of the Huili Group, but comparable in age to the 1142 ± 16 Ma Laowushan Formation in central Yunnan Province. Granite intrusion into the Luonie Formation dated 1050.7 ± 12.7 Ma provides crucial supporting evidence for this earlier depositional age. We also report a maximum sedimentary age of c. 1158 Ma for the underlying arkose, implying stratigraphic conformity with the basaltic volcanic rock suite.
The ϵHf(t) values of the basaltic volcanic rocks are mainly positive, indicating that the rocks are mainly derived from the depleted mantle and slightly stained by crustal materials. The characteristics of P*, Nb* and Zr* anomalies also support this view. The distribution patterns of trace and rare earth elements indicate that the basaltic volcanic rocks formed in an extensional setting. The Zr/4–Y–2Nb and Th–Nb/16–Zr/117 discrimination diagrams also provide evidence for this understanding. Lithofacies analysis shows that basaltic volcanic wrocks with the characteristics of both continental and marine facies should be formed in a littoral–neritic environment. We propose here that the evidence is consistent with a phase of continental extension that preceded the convergence of the SW Yangtze Block to form part of Rodinia.
The effects of chordwise deformation and the half-amplitude asymmetry on the hydrodynamic performance and vortex dynamics of batoid fish have been numerically investigated, in which the two parameters were represented by the wavenumber ($W$) and the ratio of the half-amplitude above the longitudinal axis to that below ($HAR$). Fin kinematics were prescribed based on biological data. Simulations were conducted using the immersed boundary method. It was found that moderate chordwise deformation enhances the thrust, saves the power and increases the efficiency. A large $HAR$ can also increase thrust performance. By using the derivative-moment transformation theory at several subdomains to capture the local vortical structures and a force decomposition, it was shown that, at high Strouhal numbers ($St$), the tip vortex is the main source of thrust, whereas the leading-edge vortex (LEV) and trailing-edge vortex weaken the thrust generation. However, at lower $St$, the LEV would enhance the thrust. The least deformation ($W=0$) leads to the largest effective angle of attack, and thus the strongest vortices. However, moderate deformation ($W=0.4$) has an optimal balance between the performance enhancement and the opposite effect of different local structures. The performance enhancement of $HAR$ was also due to the increase of the vortical contributions. This work provides a new insight into the role of vortices and the force enhancement mechanism in aquatic swimming.
The objective of this study was to analyze differences in birth weight and overweight/obesity in a Shanghai twin cohort. We also wanted to study their association and explore possible risk factors for the discordance of overweight/obesity within twins. This was an internal case–control study designed for twins. The 2012 Shanghai Twin Registration System baseline survey data of a total of 3417 twin pairs were statistically analyzed using SPSS22 software. Results show that the body mass index (BMI) of the Shanghai twin population increased with age. Twins with a high birth weight had a higher BMI and a higher rate of overweight and obesity; 0- to 6-year-old twins, male twins and dizygotic (DZ) twins had higher rates of overweight/obesity than other groups. The greater the discordant birth weight rate of twins, the more obvious the difference in BMI (p < .05). There was a significant difference in overweight/obesity between twins with a relative difference of birth weight ≥15% in DZ twins (p < .05). DZ twins, male twins and 0- to 6-year-old twins were more likely to be discordant in overweight/obese than others. The discordant birth weight within twins was not a risk factor for discordant overweight/obesity. However, attention should be paid to childhood obesity, and appropriate interventions should be made at the appropriate time. Genetics may play an important role in the occurrence and development of overweight/obesity. In conclusion, discordant growth and development in the uterus early in life may not lead to discordant weight development in the future.
Coronavirus disease 2019 (COVID-19) has become a global pandemic. Previous studies showed that comorbidities in patients with COVID-19 are risk factors for adverse outcomes. This study aimed to clarify the association between nervous system diseases and severity or mortality in patients with COVID-19. We performed a systematic literature search of four electronic databases and included studies reporting the prevalence of nervous system diseases in COVID-19 patients with severe and non-severe disease or among survivors and non-survivors. The included studies were pooled into a meta-analysis to calculate the odds ratio (OR) with 95% confidence intervals (95%CI). We included 69 studies involving 17 879 patients. The nervous system diseases were associated with COVID-19 severity (OR = 3.19, 95%CI: 2.37 to 4.30, P < 0.001) and mortality (OR = 3.75, 95%CI: 2.68 to 5.25, P < 0.001). Specifically, compared with the patients without cerebrovascular disease, patients with cerebrovascular disease infected with COVID-19 had a higher risk of severity (OR = 3.10, 95%CI: 2.21 to 4.36, P < 0.001) and mortality (OR = 3.45, 95% CI: 2.46 to 4.84, P < 0.001). Stroke was associated with severe COVID-19 disease (OR = 1.95, 95%CI: 1.11 to 3.42, P = 0.020). No significant differences were found for the prevalence of epilepsy (OR = 1.00, 95%CI: 0.42 to 2.35, P = 0.994) and dementia (OR = 2.39, 95%CI: 0.55 to 10.48, P = 0.247) between non-severe and severe COVID-19 patients. There was no significant association between stroke (OR = 1.79, 95%CI: 0.76 to 4.23, P = 0.185), epilepsy (OR = 2.08, 95%CI: 0.08 to 50.91, P = 0.654) and COVID-19 mortality. In conclusion, nervous system diseases and cerebrovascular disease were associated with severity and mortality of patients with COVID-19. There might be confounding factors that influence the relationship between nervous system diseases and COVID-19 severity as well as mortality.
This study aimed to explore the impacts of COVID-19 outbreak on mental health status in general population in different affected areas in China.
Methods
This was a comparative study including two groups of participants: (1) general population in an online survey in Ya'an and Jingzhou cities during the COVID-19 outbreak from 10–20 February 2020; and (2) matching general population selected from the mental health survey in Ya'an in 2019 (from January to May 2019). General Health Questionnaire (GHQ-12), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) were used.
Results
There were 1775 participants (Ya'an in 2019 and 2020: 537 respectively; Jingzhou in 2020: 701). Participants in Ya'an had a significantly higher rate of general health problems (GHQ scores ⩾3) in 2020 (14.7%) than in 2019 (5.2%) (p < 0.001). Compared with Ya'an (8.0%), participants in Jingzhou in 2020 had a significantly higher rate of anxiety (SAS scores ⩾50, 24.1%) (p < 0.001). Participants in Ya'an in 2020 had a significantly higher rate of depression (SDS scores ⩾53, 55.3%) than in Jingzhou (16.3%) (p < 0.001). The risk factors of anxiety symptoms included female, number of family members (⩾6 persons), and frequent outdoor activities. The risk factors of depression symptoms included participants in Ya'an and uptake self-protective measures.
Conclusions
The prevalence of psychological symptoms has increased sharply in general population during the COVID-19 outbreak. People in COVID-19 severely affected areas may have higher scores of GHQ and anxiety symptoms. Culture-specific and individual-based psychosocial interventions should be developed for those in need during the COVID-19 outbreak.
The FNDC5 gene encodes the fibronectin type III domain-containing protein 5 that is a membrane protein mainly expressed in skeletal muscle, and the FNDC5 rs3480 polymorphism may be associated with liver disease severity in non-alcoholic fatty liver disease (NAFLD). We investigated the influence of the FNDC5 rs3480 polymorphism on the relationship between sarcopenia and the histological severity of NAFLD. A total of 370 adult individuals with biopsy-proven NAFLD were studied. The association between the key exposure sarcopenia and the outcome liver histological severity was investigated by binary logistic regression. Stratified analyses were undertaken to examine the impact of FNDC5 rs3480 polymorphism on the association between sarcopenia and the severity of NAFLD histology. Patients with sarcopenia had more severe histological grades of steatosis and a higher prevalence of significant fibrosis and definite non-alcoholic steatohepatitis than those without sarcopenia. There was a significant association between sarcopenia and significant fibrosis (adjusted OR 2·79, 95 % CI 1·31, 5·95, P = 0·008), independent of established risk factors and potential confounders. Among patients with sarcopenia, significant fibrosis occurred more frequently in the rs3480 AA genotype carriers than in those carrying the FNDC5 rs3480 G genotype (43·8 v. 17·2 %, P = 0·031). In the association between sarcopenia and liver fibrosis, there was a significant interaction between the FNDC5 genotype and sarcopenia status (P value for interaction = 0·006). Sarcopenia is independently associated with significant liver fibrosis, and the FNDC5 rs3480 G variant influences the association between sarcopenia and liver fibrosis in patients with biopsy-proven NAFLD.
The aim of the study was to investigate the continuous changing pattern of H4K12 acetylation, and the expression levels of histone acetyltransferases (HATs) and histone deacetyltransferases (HDACs) in mouse oocytes during meiosis and after parthenogenetic activation (PA). The immunofluorescence results showed hyperacetylation of lysine-12 on histone H4 (H4K12) in the germinal vesicle (GV) oocytes that then decreased during germinal vesicle breakdown (GVBD), and disappeared in metaphase II (MII). However, it reappeared in the early 1-cell embryos derived after 4 h of PA. The expression levels of some selected HATs and HDACs also validated the changing pattern of H4K12 acetylation during meiosis and PA. In conclusion, H4K12 is deacetylated in GVBD and MII, and re-hyperacetylated after PA.
Hepatitis C virus (HCV) infection was frequent in human immunodeficiency virus (HIV) patients in Yunnan province. We studied the epidemic characteristics of HCV in HIV/HCV co-infected patients. Serum from 894 HIV-1 patients was collected, together with basic information and biochemical features. All samples were infected with HIV through injecting drug users (IDUs) and sexual transmission (ST). The NS5B gene was amplified and sequenced to affirm HCV genotype. In total, 202 HIV patients were co-infected with HCV, and most (81.19%) of co-infected patients were IDUs. Genotype 3b was predominant (37.62%) in these samples, and its frequency was similar in patients with IDU and ST. The frequencies of genotypes 1a, 1b, 3a, 6a, 6n, 2a and 6u were 3.96%, 16.34%, 23.76%, 6.93%, 10.40%, 0.50% and 0.50%, respectively. However, genotype 3a showed significantly different frequency in HCV patients with IDU and ST (P = 0.019). When HCV patients were divided into subgroups, the haemoglobin (HGB) level was significantly higher in patients with genotype 3a than in patients with 3b (P = 0.033), 6a (P = 0.006) and 6n (P = 0.007), respectively. Although no difference existed among HCV subgroups, HIV-viral load was identified to be positively correlated with the HGB level and CD4+ cells when dividing HCV/HIV co-infected persons into male and female groups. In conclusion, genotype 3b was the predominant HCV genotype in Yunnan HIV/HCV co-infected persons. The HGB level was higher in patients with genotype 3a than others. HIV-viral load was positively correlated with the HGB level and CD4+ cells in the male or female HCV-infected group.
The present study was undertaken to investigate the antiparasitic activity of extracellular products of Streptomyces albus. Bioactivity-guided isolation of chloroform extracts affording a compound showing potent activity. The structure of the compound was elucidated as salinomycin (SAL) by EI-MS, 1H NMR and 13C NMR. In vitro test showed that SAL has potent anti-parasitic efficacy against theronts of Ichthyophthirius multifiliis with 10 min, 1, 2, 3 and 4 h (effective concentration) EC50 (95% confidence intervals) of 2.12 (2.22–2.02), 1.93 (1.98–1.88), 1.42 (1.47–1.37), 1.35 (1.41–1.31) and 1.11 (1.21–1.01) mg L−1. In vitro antiparasitic assays revealed that SAL could be 100% effective against I. multifiliis encysted tomonts at a concentration of 8.0 mg L−1. In vivo test demonstrated that the number of I. multifiliis trophonts on Erythroculter ilishaeformis treated with SAL was markedly lower than that of control group at 10 days after exposed to theronts (P < 0.05). In the control group, 80% mortality was observed owing to heavy I. multifiliis infection at 10 days. On the other hand, only 30.0% mortality was recorded in the group treated with 8.0 mg L−1 SAL. The median lethal dose (LD50) of SAL for E. ilishaeformis was 32.9 mg L−1.
Environment can impact the wear behavior of metals and alloys substantially. The tribological properties of Al0.6CoCrFeNi high-entropy alloys (HEAs) were investigated in ambient air, deionized water, simulated acid rain, and simulated seawater conditions at frequencies of 2–5 Hz. The as-cast alloy was composed of simple face-centered cubic and body-centered cubic phases. The wear rate of the as-cast HEA in the ambient air condition was significantly higher than that in the liquid environment. The wear resistance in seawater was superior to that in ambient air, deionized water, and acid rain. Both the friction coefficient and wear rate in seawater were the lowest due to the formation of oxidation film, lubrication, and corrosion action in solution. The dominant wear mechanism in the ambient air condition and deionized water was abrasive wear, delamination wear, and oxidative wear. By contrast, the wear mechanism in acid rain and seawater was mainly corrosion wear, adhesive wear, abrasive wear, and oxidative wear.
Diabetic nephropathy (DN) is a major cause of chronic kidney disease. We aimed to investigate the effect of the low-protein diets (LPD) supplemented with ketoacids (LPD+KA) in KKAy mice, an early type 2 DN model. KKAy mice were treated with normal protein diet (NPD), LPD or LPD+KA from 12 to 24 weeks of age. A period of 12-week treatment with LPD significantly reduced albuminuria as compared with that observed after NPD treatment. Treatment with LPD+KA further reduced albuminuria as compared with that observed with LPD treatment alone. Moreover, LPD treatment reduced mesangial expansion, thickness of glomerular basement membrane and the severity of the podocyte foot process effacement in KKAy mice; these effects were more pronounced in KKAy mice treated with LPD+KA. Both LPD and LPD+KA treatments slightly reduced total body weight, but had no significant effect on kidney weight and blood glucose concentrations when compared with NPD-treated KKAy mice. LPD treatment slightly attenuated oxidative stress in kidneys as compared with that observed in NPD-treated KKAy mice; however, LPD+KA treatment remarkably ameliorated oxidative stress in diabetic kidneys as shown by decreased malondialdehyde concentrations, protein carbonylation, nitrotyrosine expression and increased superoxide dismutase expression. Nutritional therapy using LPD+KA confers additional renal benefits as compared with those of LPD treatment alone in early type 2 DN through inhibition of oxidative stress.
This paper focuses on the problem of robust time-optimal trajectory planning of robotic manipulators to track a given path under a probabilistic limited actuation, that is, the probability for the actuation to be limited is no less than a given bound κ. We give a general and practical method to reduce the probabilistic constraints to a set of deterministic constraints and show that the deterministic constraints are equivalent to a set of linear constraints under certain conditions. As a result, the original problem is reduced to a linear optimal control problem which can be solved with linear programming in polynomial time. In the case of κ = 1, the original problem is proved to be equivalent to the linear optimal control problem. Overall, a very general, practical, and efficient algorithm is given to solve the above problem and numerical simulation results are used to show the effectiveness of the method.
A diode-pumped alkali vapor laser (DPAL) is one of the most promising candidates of the next-generation high-powered laser source. As the saturated number density of alkali vapor is highly dependent on the temperature inside a vapor cell, the temperature distribution in the cross-section of a cell will greatly affect the homogeneity of a laser medium and the output characteristics of a DPAL. In this paper, we developed an algorithm based on the regime concluding quasi-Hilbert transform to evaluate the phase aberration of a wavefront when the probe beam passes through the vapor cell placed in one arm of a Mach–Zehnder interference setup. According to the theoretical algorithm, we deduced the temperature distribution of a cesium vapor cell for different heating conditions. The study is thought to be useful for development of a high-powered laser.
A diode-pumped alkali laser (DPAL) provides the significant promise for high-powered performances. In this paper, a mathematical model is introduced for examination of the kinetic processes of a diode-pumped cesium vapor hollow-core photonic-crystal fiber (HC-PCF) laser, in which the cesium vapor is filled in the center hole of a photonic-bandgap fiber instead of a glass cell. The influence of deleterious processes including energy pooling, photo-ionization, and Penning ionization on the physical features of a fiber DPAL is studied in this report. It has been theoretically demonstrated that the deleterious processes cannot be ignored in a high-powered fiber-DPAL system.
Multiferroic nanostructures have been attracting tremendous attention not only for novel phenomena associated with fundamental physics, but also due to exciting application potentials in future nanoelectronic devices. In this mini-review, we first introduce several fabrication techniques recently developed for single phase and composite multiferroic nanostructures. Then, the topologic vortex domain structures in various ferroic nanostructures, which may bring about additional fundamental discoveries and applications in ultrahigh density recording, are discussed. Particular attention is paid to magnetoelectric effects in multiferroic nanodots, including room temperature electric field induced magnetic domain switching. Finally, existing challenges and new directions, e.g., cross-couplings among multiple functionalities, are prospected. We genuinely hope that this mini-review will arouse the readers' interest in this fascinating field.
Research suggests that an 8-week mindfulness-based cognitive therapy
(MBCT) course may be effective for generalised anxiety disorder
(GAD).
Aims
To compare changes in anxiety levels among participants with GAD randomly
assigned to MBCT, cognitive–behavioural therapy-based psychoeducation and
usual care.
Method
In total, 182 participants with GAD were recruited (trial registration
number: CUHK_CCT00267) and assigned to the three groups and followed for
5 months after baseline assessment with the two intervention groups
followed for an additional 6 months. Primary outcomes were anxiety and
worry levels.
Results
Linear mixed models demonstrated significant group × time interaction
(F(4,148) = 5.10, P = 0.001) effects
for decreased anxiety for both the intervention groups relative to usual
care. Significant group × time interaction effects were observed for
worry and depressive symptoms and mental health-related quality of life
for the psychoeducation group only.
Conclusions
These results suggest that both of the interventions appear to be
superior to usual care for the reduction of anxiety symptoms.
As a relatively new class of hierarchically structured materials, nanotwinned (NT) metals exhibit an exceptional combination of high strength, good ductility, large fracture toughness, remarkable fatigue resistance, and creep stability. This article reviews current studies on fracture, fatigue, and creep of NT metals, with an emphasis on the fundamental deformation and failure mechanisms. We focus on the complex interactions among cracks, dislocations, and twin boundaries, the influence of microstructure, twin size, and twinning/detwinning on damage evolution, and the contribution of nanoscale twins to fatigue and creep under indentation and irradiation conditions. The article also includes critical discussions on the effects of twin thickness and grain size on the fracture toughness, fatigue resistance, and creep stability of NT metals.