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Caused by multiple risk factors, heavy burden of major depressive disorder (MDD) poses serious challenges to public health worldwide over the past 30 years. Yet the burden and attributable risk factors of MDD were not systematically known. We aimed to reveal the long-term spatio-temporal trends in the burden and attributable risk factors of MDD at global, regional and national levels during 1990–2019.
Methods
We obtained MDD and attributable risk factors data from Global Burden of Disease Study 2019. We used joinpoint regression model to assess the temporal trend in MDD burden, and age–period–cohort model to measure the effects of age, period and birth cohort on MDD incidence rate. We utilized population attributable fractions (PAFs) to estimate the specific proportions of MDD burden attributed to given risk factors.
Results
During 1990–2019, the global number of MDD incident cases, prevalent cases and disability-adjusted life years (DALYs) increased by 59.10%, 59.57% and 58.57%, respectively. Whereas the global age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) of MDD decreased during 1990–2019. The ASIR, ASPR and ASDR in women were 1.62, 1.62 and 1.60 times as that in men in 2019, respectively. The highest age-specific incidence, prevalence and DALYs rate occurred at the age of 60–64 in women, and at the age of 75–84 in men, but the maximum increasing trends in these age-specific rates occurred at the age of 5–9. Population living during 2000–2004 had higher risk of MDD. MDD burden varied by socio-demographic index (SDI), regions and nations. In 2019, low-SDI region, Central sub-Saharan Africa and Uganda had the highest ASIR, ASPR and ASDR. The global PAFs of intimate partner violence (IPV), childhood sexual abuse (CSA) and bullying victimization (BV) were 8.43%, 5.46% and 4.86% in 2019, respectively.
Conclusions
Over the past 30 years, the global ASIR, ASPR and ASDR of MDD had decreased trends, while the burden of MDD was still serious, and multiple disparities in MDD burden remarkably existed. Women, elderly and populations living during 2000–2004 and in low-SDI regions, had more severe burden of MDD. Children were more susceptible to MDD. Up to 18.75% of global MDD burden would be eliminated through early preventing against IPV, CSA and BV. Tailored strategies-and-measures in different regions and demographic groups based on findings in this studywould be urgently needed to eliminate the impacts of modifiable risk factors on MDD, and then mitigate the burden of MDD.
Energy loss of protons with 90 and 100 keV energies penetrating through a hydrogen plasma target has been measured, where the electron density of the plasma is about 1016 cm−3 and the electron temperature is about 1-2 eV. It is found that the energy loss of protons in the plasma is obviously larger than that in cold gas and the experimental results based on the Bethe model calculations can be demonstrated by the variation of effective charge of protons in the hydrogen plasma. The effective charge remains 1 for 100 keV protons, while the value for 90 keV protons decreases to be about 0.92. Moreover, two empirical formulae are employed to extract the effective charge.
Human cystic echinococcosis (CE) is a zoonotic disorder triggered by the larval stage of Echinococcus granulosus (E. granulosus) and predominantly occurred in the liver and lungs. The M2 macrophage level is considerably elevated among the liver of patients with hepatic CE and performs an integral function in liver fibrosis. However, the mechanism of CE inducing polarisation of macrophage to an M2 phenotype is unknown. In this study, macrophage was treated with E. granulosus cyst fluid (EgCF) to explore the mechanism of macrophage polarisation. Consequently, the expression of the M2 macrophage and production of anti-inflammatory cytokines increased after 48 h treatment by EgCF. In addition, EgCF promoted polarisation of macrophage to an M2 phenotype by inhibiting the expression of transcriptional factor hypoxia-inducible factor 1-alpha (HIF-1α), which increased the expression of glycolysis-associated genes, including hexokinase 2 (HK2) and pyruvate kinase 2 (PKM2). The HIF-1α agonist ML228 also inhibited the induction of macrophage to an M2 phenotype by EgCF in vitro. Our findings indicate that E. granulosus inhibits glycolysis by suppressing the expression of HIF-1α.
The strong coupling interactions of non-equilibrium flow, microscopic particle collisions and radiative transitions within the shock layer of hypersonic atmospheric re-entry vehicles makes accurate prediction of the aerothermodynamics challenging. Therefore, in this study a self-consistent non-equilibrium flow, collisional–radiative reactions and radiative transfer fully coupled model are established to study the non-equilibrium characteristics of the flow field and radiation of vehicle atmospheric re-entry. The comparison of the present calculation results with flight data of FIRE II and previous results in the literature shows a reasonable agreement. The thermal, chemical and excited energy level non-equilibrium phenomena are obtained and analysed for the different FIRE II trajectory points, which form the critical basis for studying the heat transfer and radiation. The non-equilibrium distribution of excited energy levels significantly exists in the post-shock and near-wall regions due to the rapid vibrational dissociation and electronic under-excitation, as well as the wall catalytic reactions. The analysis of stagnation-point heating of FIRE II illustrates that the translational–rotational convection and the dissociation component diffusion play key roles in the aerodynamic heating of the wall region. The spectrally resolved radiative intensity in the entire flow field indicates that the vacuum ultraviolet radiation caused by the high-energy nitrogen atomic spectral lines makes the main contribution to the radiative transfer. Finally, it is found that the non-equilibrium flow–radiation coupling effect can exacerbate the excited energy level non-equilibrium, and further affect the gas radiative properties and radiative transfer. This fully coupled study provides an effective method for reasonable prediction of atmospheric re-entry flow and radiation fields.
Environment-induced epigenetics are involved in diapause regulation, but the molecular mechanism that epigenetically couples nutrient metabolism to diapause regulation remains unclear. In this study, we paid special attention to the significant differences in the level of N6-adenosine methylation (m6A) of dihydroxyacetone phosphate acyltransferase (DHAPAT) and phosphatidate phosphatase (PAP) genes in the lipid metabolism pathway of the bivoltine silkworm (Bombyx mori) strain Qiufeng developed from eggs incubated at a normal temperature (QFHT, diapause egg producer) compared to those from eggs incubated at a low temperature (QFLT, non-diapause egg producer). We knocked down DHAPAT in the pupal stage of the QFLT group, resulting in the non-diapause destined eggs becoming diapausing eggs. In the PAP knockdown group, the colour of the non-diapause destined eggs changed from light yellow to pink 3 days after oviposition, but they hatched as normal. Moreover, we validated that YTHDF3 binds to m6A-modified DHAPAT and PAP mRNAs to promote their stability and translation. These results suggest that RNA m6A methylation participates in the diapause regulation of silkworm by changing the expression levels of DHAPAT and PAP and reveal that m6A epigenetic modification can be combined with a lipid metabolism signal pathway to participate in the regulation of insect diapause traits, which provides a clearer image for exploring the physiological basis of insect diapause.
Copy number variation (CNV) is a very common type of gene variation with high frequency. In recent years, CNV has been paid more attention in various fields, especially in livestock and poultry breeding, which has promoted the progress of breeding. WW domain binding protein 1-like (WBP1L) is a protein coding gene, which plays an important role in cattle populations, and its function has been extensively studied, but it is not clear whether the copy number of the gene can affect the growth and development of cattle populations. In this study, CNV of WBP1L gene was detected in 732 cattle of seven breeds (Qinchuan cattle, QC; Pinan cattle, PN; Yuengling cattle, YL; Xianan cattle, XN; Jiaxian cattle, JX; natural Guyuan cattle, NGY; Jian cattle, JA). In addition, the relationship between CNV and growth phenotype of cattle was studied. The experimental data indicate that the copy number of WBP1L was obviously correlated with heart girth of PN cattle (**P < 0.01), rump length (RL) and body weight (BW) of PN cattle (*P < 0.05), withers height (WH), RL, body length, chest depth and BW of JX cattle (*P < 0.05), WH of NGY cattle (*P < 0.05) and WH of JA cattle (*P < 0.05). It was proved that CNV of WBP1L gene could be used as molecular marker locus for genetic breeding of the above four cattle breeds.
The purpose of the current study was to research the factors influencing thyroid volume (TVOL) in 6–12-year-old children and update the reference values. A cross-sectional study was carried out in iodine-sufficient areas of four provinces in China. Urine, edible salt and drinking water samples were collected from children. Children’s height, weight and TVOL were measured. Ridge regression was used to screen variables for solving the multicollinearity problem. Quantile regression was used to analyse the relationship between the quantiles of TVOL and other variables. In total, 5653 children aged 6–12 years were enrolled in this study, including 2838 boys and 2815 girls. There was no significant difference in TVOL between boys and girls (P > 0·05). Spearman correlation analysis showed that total TVOL was positively correlated with age, height, weight, body surface area (BSA) and BMI, and the correlation coefficients were 0·616, 0·663, 0·669, 0·685 and 0·479, respectively. Among them, the correlation between TVOL and BSA was the strongest. According to the ridge regression results, age and BSA influenced TVOL, and the ridge regression coefficients were 0·13 and 0·94, respectively. Quantile regression further showed that age and BSA had significant influences on the whole TVOL distribution (P < 0·001). Therefore, the TVOL of children aged 6–12 years in China was mainly influenced by age and BSA, and reference values for TVOL of different genders based on age and BSA were established.
As one of the most influential CCP campaigns that dramatically transformed the Chinese pre-revolutionary society, the early 1950s land reform has not been fully explored in the case of China's ethnic periphery. This article sheds light on the CCP's land reform and its impact on China's ethnic frontier by examining the official policies, implementation, and the reactions of the southern Muslim community in Yunnan between 1949 and 1958. Drawing on county government work team reports and the Party's land reform policy and evaluation records, it argues that although southern Yunnan Muslims were able to selectively internalize some Communist secular ideologies to cope with social and political changes that land reform brought about, the inconsistency between the Party's freedom of religion policy on paper and its local implementation failed to mitigate the ideological discord between Maoist revolutionaries’ atheist worldview and Muslim villagers’ religiosity. This jeopardized the possibility of reconciliation between the class-struggle-focused radical state and the community life of its religious subjects.
This survey examined and compared the disaster perception and preparedness of 2421 residents with and without chronic disease in Shenzhen, China.
Methods:
The participants were recruited and were asked to complete a survey in 2018.
Results:
Three types of disasters considered most likely to happen in Shenzhen were: typhoons (73.5% vs 74.9%), major transport accidents (61.5% vs 64.7%), and major fires (60.8% vs 63.0%). Only 5.9% and 5% of them, respectively, considered infectious diseases pandemics to be likely. There were significant differences between those with and without chronic disease in disaster preparedness, only a small percentage could be considered to have prepared for disaster (20.7% vs 14.5%). Logistic regression analyses showed that those aged 65 or older (odds ratio [OR] = 2.76), who had attained a Master’s degree or higher (OR = 2.0), and with chronic disease (OR = 1.38) were more prepared for disasters.
Conclusions:
Although participants with chronic disease were better prepared than those without, overall, Shenzhen residents were inadequately prepared for disasters and in need of public education.
The Brain Health Test-7 (BHT-7) is a revised tool from the original BHT, containing more tests about frontal lobe function. It was developed with theaim of identifying patients with mild cognitive impairment (MCI) and early dementia.
Research objective
Here we report the validity of the BHT-7 versus the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in differentpsychiatry or neurology clinics.
Methods
Patients with memory complaints were recruited in this study from the outpatient clinic of psychiatry or neurology in 3 different kinds of hospitals. Allpatients underwent the evaluation of the BHT-7, MMSE, MoCA, and clinical dementia rating (CDR). The clinical diagnosis (normal, MCI, dementia) was made by consensus meeting, taking into account all available data.
Demographic data and the scores of the MMSE, MoCA, and BHT-7 between groups were compared. Logistic regression was adopted for analysis of optimal cutoff values, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), receiver operating characteristic (ROC) curve,and the area under the ROC curve (AUC).
Results
We enrolled a total of 1090 subjects (normal 402, MCI 317, dementia 371); of them, 705 (64.7%) were female. There was a statistically significant differencein age, years of education, and 3 cognitive test scores among the 3 groups.
Compared with the MMSE and MoCA, the BHT-7 performed slightly betterthan MMSE and MoCA in differentiating MCI or dementia from the normalcontrols (Table 1). For BHT- 7, the cutoff point was 17 between normal andMCI, and 14 between normal and dementia. These cutoff points for BHT-7were consistent through 3 different clinical settings, but inconsistent for MMSE and MoCA. The testing time for the BHT-7 was about 5-7 minutes, shorter than that of the MMSE and MoCA.
Conclusion
Compared with MMSE and MoCA, the BHT-7 showed slightly better performance in differentiating normal from MCI or dementia subjects. The testing time for the BHT-7 was shorter, and its cutoff points were consistent through different outpatient clinic settings. The results support that BHT-7 is auseful cognitive screening tool for MCI or early dementia in various hospital settings.
Table 1
Comparisons of the performance of BHT-7, MMSE, MoCA
The prevalence of malnutrition is high among oncology patients in Northern China. Malnutrition is related to the longer hospital stay, and it can be used to predict the prognostic outcome of patients. This work focused on investigating the relationship of nutritional condition with the length of hospital stay (LOS) in Northern Chinese patients with lung adenocarcinoma (LUAD). The Patient-Generated Subjective Global Assessment (PG-SGA), Nutritional Risk Screening 2002 (NRS 2002) score, recent weight loss and BMI were assessed in a probabilistic sample of 389 LUAD patients without epidermal growth factor receptor (EGFR) mutations. This study collected the demographic and clinical features of patients in a prospective manner. Then, we examined the association of nutritional status with LOS among the population developing LUAD. According to the PG-SGA, 63 (16·3 %), 174 (44·7 %) and 78 (20·1 %) patients were at risk for undernutrition, moderate undernutrition and severe undernutrition, respectively. Nutritional risk was found in 141 (36·2 %) patients based on the NRS 2002. The average LOS for tumour patients in Northern China was 12·5 d. At admission, a risk of undernutrition or undernutrition according to the PG-SGA (P < 0·001), NRS 2002 (P < 0·001) and latest weight loss (P < 0·001) predicted the longer LOS. LOS was related to nutritional status and hospitalisation expenses (P < 0·001). LUAD patients who stayed in the ICU had a poorer nutritional status and a longer LOS (P < 0·001). In Northern Chinese patients with LUAD, a risk for undernutrition evaluated by the PG-SGA, the NRS 2002 and recent weight loss, but not BMI, could predict a longer LOS.
No relevant studies have yet been conducted to explore which measurement can best predict the survival time of patients with cancer cachexia. This study aimed to identify an anthropometric measurement that could predict the 1-year survival of patients with cancer cachexia. We conducted a nested case–control study using data from a multicentre clinical investigation of cancer from 2013 to 2020. Cachexia was defined using the Fearon criteria. A total of 262 patients who survived less than 1 year and 262 patients who survived more than 1 year were included in this study. Six candidate variables were selected based on clinical experience and previous studies. Five variables, BMI, mid-arm circumference, mid-arm muscle circumference, calf circumference and triceps skin fold (TSF), were selected for inclusion in the multivariable model. In the conditional logistic regression analysis, TSF (P = 0·014) was identified as a significant independent protective factor. A similar result was observed in all patients with cancer cachexia (n 3084). In addition, a significantly stronger positive association between TSF and the 1-year survival of patients with cancer cachexia was observed in participants aged > 65 years (OR: 0·94; 95 % CI 0·89, 0·99) than in those aged ≤ 65 years (OR: 0·96; 95 % CI 0·93, 0·99; Pinteraction = 0·013) and in participants with no chronic disease (OR: 0·92; 95 % CI 0·87, 0·97) than in those with chronic disease (OR: 0·97; 95 % CI 0·94, 1·00; Pinteraction = 0·049). According to this study, TSF might be a good anthropometric measurement for predicting 1-year survival in patients with cancer cachexia.
This study explored the clinical effect of employing breast milk oral care for infants who underwent surgical correction of ventricular septal defect.
Methods:
A prospective randomised controlled study was conducted in a provincial hospital between January, 2020 and July, 2020 in China. Patients were randomly divided into an intervention group (breast milk oral care, n = 28) and a control group (physiological saline oral care, n = 28). The intervention group was given oral nursing using breast milk for infants in the early post-operative period, and the control group was given oral nursing using physiological saline. Related clinical data were recorded and analysed.
Results:
There were no significant differences in age, gender, weight, operation time, cardiopulmonary bypass time, or aortic cross-clamping time between the two groups. Compared with the physiological saline oral care group, the mechanical ventilation duration, the length of ICU stay in the breast milk oral care group were significantly shorter. The time of start feeding and total enteral nutrition were significantly earlier in the intervention group than those in the control group. The incidence of post-operative pneumonia in the breast milk oral care group was 3.6%, which was significantly lower than that of the physiological saline oral care group.
Conclusion:
The use of breast milk for oral care in infants who underwent surgical correction of VSD can reduce the incidence of post-operative pneumonia and promote the recovery of gastrointestinal function.
Echinococcus granulosus sensu lato has complex defence mechanisms that protect it from the anti-parasitic immune response for long periods. Echinococcus granulosus cyst fluid (EgCF) is involved in the immune escape. Nevertheless, whether and how EgCF modulates the inflammatory response in macrophages remains poorly understood. Here, real-time polymerase chain reaction and enzyme-linked immunosorbent assay revealed that EgCF could markedly attenuate the lipopolysaccharide (LPS)-induced production of pro-inflammatory factors including tumour necrosis factor-α, interleukin (IL)-12 and IL-6 but increase the expression of IL-10 at mRNA and protein levels in mouse peritoneal macrophages and RAW 264.7 cells. Mechanically, western blotting and immunofluorescence assay showed that EgCF abolished the activation of nuclear factor (NF)-κB p65, p38 mitogen-activated protein kinase (MAPK) and ERK1/2 signalling pathways by LPS stimulation in mouse macrophages. EgCF's anti-inflammatory role was at least partly contributed by promoting proteasomal degradation of the critical adaptor TRAF6. Moreover, the EgCF-promoted anti-inflammatory response and TRAF6 proteasomal degradation were conserved in human THP-1 macrophages. These findings collectively reveal a novel mechanism by which EgCF suppresses inflammatory responses by inhibiting TRAF6 and the downstream activation of NF-κB and MAPK signalling in both human and mouse macrophages, providing new insights into the molecular mechanisms underlying the E. granulosus-induced immune evasion.
Cystic echinococcosis (CE) occurs in the intermediate host's liver, assuming a bladder-like structure surrounded by the host-derived collagen capsule mainly derived from activated hepatic stellate cells (HSCs). However, the effect of CE on liver natural killer (NK) cells and the potential of transforming growth factor-β (TGF-β) signalling inhibition on alleviating CE-related liver damage remain to be explored. Here, by using the CE-mouse model, we revealed that the inhibitory receptors on the surface of liver NK cells were up-regulated, whereas the activating receptors were down-regulated over time. TGF-β1 secretion was elevated in liver tissues and mainly derived from macrophages. A combination of TGF-β signalling inhibitors SB525334 and pirfenidone could reduce the expression of TGF-β1 signalling pathway-related proteins and collagen production. Based on the secretion of TGF-β1, only the pirfenidone group showed a depressing effect. Also, the combination of SB525334 and pirfenidone exhibited a higher potential in effectively alleviating the senescence of the hepatocytes and restoring liver function. Together, TGF-β1 may be a potential target for the treatment of CE-associated liver fibrosis.
The aim of this study was to explore the impact of polymorphism of PD-1 gene and its interaction with tea drinking on susceptibility to tuberculosis (TB). A total of 503 patients with TB and 494 controls were enrolled in this case–control study. Three single-nucleotide polymorphisms of PD-1 (rs7568402, rs2227982 and rs36084323) were genotyped and unconditional logistic regression analysis was used to identify the association between PD-1 polymorphism and TB, while marginal structural linear odds models were used to estimate the interactions. Genotypes GA (OR 1.434), AA (OR 1.891) and GA + AA (OR 1.493) at rs7568402 were more prevalent in the TB patients than in the controls (P < 0.05). The relative excess risk of interaction (RERI) between rs7568402 of PD-1 genes and tea drinking was −0.3856 (95% confidence interval −0.7920 to −0.0209, P < 0.05), which showed a negative interaction. However, the RERIs between tea drinking and both rs2227982 and rs36084323 of PD-1 genes were not statistically significant. Our data demonstrate that rs7568402 of PD-1 genes was associated with susceptibility to TB, and there was a significant negative interaction between rs7568402 and tea drinking. Therefore, preventive measures through promoting the consumption of tea should be emphasised in the high-risk populations.
The positioning technique employing the ubiquitous signals of opportunity of non-cooperative satellites does not send special navigation signals, instead it passively receives satellite signals as noise, presenting advantages of concealment and difficulty for potential attackers. Thus, this study investigates the ranging principle and model using non-cooperative communication satellites and a time difference estimation algorithm. The technology of time difference measurement under non-cooperative observation mode was determined and simulated. A test platform for time difference measurement was built to receive the signal from an unknown geostationary Earth orbit communication satellite and verify the ranging feasibility and performance. The ranging accuracy was found to be smaller than 6 m, as demonstrated by experimental data, which shows the viability of the proposed positioning technique for ranging technology.