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Subthreshold depression (sD) negatively impacts well-being and psychosocial function and is more prevalent compared with major depressive disorder (MDD). However, as adults with sD are less likely to seek face-to-face intervention, internet-based cognitive-behavioral therapy (ICBT) may overcome barriers of accessibility to psychotherapy. Although several trials explored the efficacy of ICBT for sD, the results remain inconsistent. This study evaluated whether ICBT is effective in reducing depressive symptoms among Chinese adults with sD.
Methods
A randomized controlled trial was performed. The participants were randomly assigned to 5 weeks of ICBT, group-based face-to-face cognitive-behavioral therapy (CBT), or a waiting list (WL). Assessments were conducted at baseline, post-intervention and at a 6-month follow-up. The primary outcome measured depressive symptoms using the Center for Epidemiological Studies Depression Scale (CES-D). Outcomes were analyzed using a mixed-effects model to assess the effects of ICBT.
Results
ICBT participants reported greater reductions on all the outcomes compared to the WL group at post-intervention. The ICBT group showed larger improvement on the Patient Health Questionnaire-9 (PHQ-9) at post-intervention (d = 0.12) and at follow-up (d = 0.10), and with CES-D at post-intervention (d = 0.06), compared to the CBT group.
Conclusions
ICBT is effective in reducing depressive symptoms among Chinese adults with sD, and improvements in outcomes were sustained at a 6-month follow-up. Considering the low rates of face-to-face psychotherapy, our findings highlight the considerable potential and implications for the Chinese government to promote the use of ICBT for sD in China.
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.
Mounting evidence showed that insula contributed to the neurobiological mechanism of suicidal behaviors in bipolar disorder (BD). However, no studies have analyzed the dynamic functional connectivity (dFC) of insular Mubregions and its association with personality traits in BD with suicidal behaviors. Therefore, we investigated the alterations of dFC variability in insular subregions and personality characteristics in BD patients with a recent suicide attempt (SA).
Methods
Thirty unmedicated BD patients with SA, 38 patients without SA (NSA) and 35 demographically matched healthy controls (HCs) were included. The sliding-window analysis was used to evaluate whole-brain dFC for each insular subregion seed. We assessed between-group differences of psychological characteristics on the Minnesota Multiphasic Personality Inventory-2. Finally, a multivariate regression model was adopted to predict the severity of suicidality.
Results
Compared to NSA and HCs, the SA group exhibited decreased dFC variability values between the left dorsal anterior insula and the left anterior cerebellum. These dFC variability values could also be utilized to predict the severity of suicidality (r = 0.456, p = 0.031), while static functional connectivity values were not appropriate for this prediction. Besides, the SA group scored significantly higher on the schizophrenia clinical scales (p < 0.001) compared with the NSA group.
Conclusions
Our findings indicated that the dysfunction of insula–cerebellum connectivity may underlie the neural basis of SA in BD patients, and highlighted the dFC variability values could be considered a neuromarker for predictive models of the severity of suicidality. Moreover, the psychiatric features may increase the vulnerability of suicidal behavior.
Evidence of couples’ BMI and its influence on birth weight is limited and contradictory. Therefore, this study aims to assess the association between couple’s preconception BMI and the risk of small for gestational age (SGA)/large for gestational age (LGA) infant, among over 4·7 million couples in a retrospective cohort study based on the National Free Pre-pregnancy Checkups Project (NFPCP) between December 1, 2013 and November 30, 2016 in China. Among the live births, 256,718 (5·44%) SGA events and 506,495 (10·73%) LGA events were documented, respectively. After adjusting for confounders, underweight men had significantly higher risk [OR 1·17 95%CI (1·15-1·19)] of SGA infants compared with men with normal BMI, while a significant and increased risk of LGA infants was obtained for overweight and obese men [OR 1·08 (95% CI: 1·06-1·09); OR 1·19 (95%CI 1·17-1·20)] respectively. The restricted cubic spline (RCS) result revealed a non-linearly decreasing dose-response relationship of paternal BMI (less than 22·64) with SGA. Meanwhile, a non-linearly increasing dose-response relationship of paternal BMI (more than 22·92) with LGA infants was observed. Moreover, similar results about the association between maternal preconception BMI and SGA/LGA infants were obtained. Abnormal preconception BMIs in either women or men were associated with increased risk of SGA/LGA infants, respectively. Overall, couple’s abnormal weight before pregnancy may be an important preventable risk factor for SGA/LGA infants.
We aimed to investigate the coronavirus disease 2019 (COVID-19)-related knowledge and practices of cancer patients and to assess their anxiety- and depression-related to COVID-19 during the early surge phase of the pandemic.
Methods:
An online questionnaire survey of cancer patients was conducted from February 10-29, 2020. Knowledge and practices related to COVID-19 were assessed using a custom-made questionnaire. The Hospital Anxiety and Depression Scale was used to assess the presence of anxiety and depression, with scores beyond 7 indicating anxiety or depressive disorder. Univariate and multiple linear regression analyses were used to identify the high-risk groups according to the level of knowledge, practices, anxiety, and depression scores.
Results:
A total of 341 patients were included. The rate of lower level of knowledge and practices was 49.9% and 18.8%, respectively. Education level of junior high school degree or lower showed a significant association with lower knowledge score (β: −3.503; P < 0.001) and lower practices score (β: −2.210; P < 0.001) compared to the education level of college degree and above. The prevalence of anxiety and depression among the respondents was 17.6% and 23.2%, respectively. A higher depression score was associated with older age, marital status of the widowed, and lower level of education, knowledge score, and practices score (P < 0.05).
Conclusions:
Targeted COVID-19-related education interventions are required for cancer patients with a lower level of knowledge to help improve their practices. Interventions are also required to address the anxiety and depression of cancer patients.
Previous studies have demonstrated structural and functional changes of the hippocampus in patients with major depressive disorder (MDD). However, no studies have analyzed the dynamic functional connectivity (dFC) of hippocampal subregions in melancholic MDD. We aimed to reveal the patterns for dFC variability in hippocampus subregions – including the bilateral rostral and caudal areas and its associations with cognitive impairment in melancholic MDD.
Methods
Forty-two treatment-naive MDD patients with melancholic features and 55 demographically matched healthy controls were included. The sliding-window analysis was used to evaluate whole-brain dFC for each hippocampal subregions seed. We assessed between-group differences in the dFC variability values of each hippocampal subregion in the whole brain and cognitive performance on the MATRICS Consensus Cognitive Battery (MCCB). Finally, association analysis was conducted to investigate their relationships.
Results
Patients with melancholic MDD showed decreased dFC variability between the left rostral hippocampus and left anterior lobe of cerebellum compared with healthy controls (voxel p < 0.005, cluster p < 0.0125, GRF corrected), and poorer cognitive scores in working memory, verbal learning, visual learning, and social cognition (all p < 0.05). Association analysis showed that working memory was positively correlated with the dFC variability values of the left rostral hippocampus-left anterior lobe of the cerebellum (r = 0.338, p = 0.029) in melancholic MDD.
Conclusions
These findings confirmed the distinct dynamic functional pathway of hippocampal subregions in patients with melancholic MDD, and suggested that the dysfunction of hippocampus-cerebellum connectivity may be underlying the neural substrate of working memory impairment in melancholic MDD.
We characterized the proteome profile of mid-lactation small-tailed Han (STH) and DairyMeade (DM) ovine milk in order to explore physiological variation and differences in milk traits between the two breeds. Methodology combined a tandem mass tag (TMT) proteomic approach with LC-MS/MS technology. A total of 656 proteins were identified in STH and DM ovine milk, of which 17and 29 proteins were significantly upregulated (P < 0.05) in STH and DM, respectively. Immune-related proteins and disease-related proteins were highly expressed in STH milk, whereas S100A2 and AEBP1 were highly expressed in DM milk, which had beneficial effects on mammary gland development and milk yield. Our results provide a theoretical basis for future breeding of dairy sheep.
Noncompressible torso hemorrhage (NCTH) is a major challenge in prehospital bleeding control and is associated with high mortality. This study was performed to estimate medical knowledge and the perceived barriers to information acquisition among health-care workers (HCWs) regarding NCTH in China.
Methods:
A self-administered and validated questionnaire was distributed among 11 WeChat groups consisting of HCWs engaged in trauma, emergency, and disaster rescue.
Results:
A total of 575 HCWs participated in this study. In the knowledge section, the majority (87.1%) denied that successful hemostasis could be obtained by external compression. Regarding attitudes, the vast majority of HCWs exhibited positive attitudes toward the important role of NCTH in reducing prehospital preventable death (90.4%) and enthusiasm for continuous learning (99.7%). For practice, fewer than half of HCWs (45.7%) had heard of NCTH beforehand, only a minority (14.3%) confirmed they had attended relevant continuing education, and 16.3% HCWs had no access to updated medical information. The most predominant barrier to information acquisition was the lack of continuing training (79.8%).
Conclusions:
Knowledge and practice deficiencies do exist among HCWs. Obstacles to update medical information warrant further attention. Furthermore, education program redesign is also needed.
Honeybees cannot synthesize arachidonic acid (ARA) themselves, only obtain it from food. Most pollen is deficient or contains a small amount of ARA. The necessity of supplementary ARA in bees’ diet has not been studied. The objective of this study was to investigate the effects of dietary ARA levels on the growth and immunity of Apis mellifera ligustica. A total of 25 honeybee colonies were randomly assigned to five dietary groups which were fed basic diets supplemented with 0, 2, 4, 6, and 8% of ARA. The diet with 4% ARA improved the body weight of newly emerged worker bees compared with the control group. Supplement of ARA in honeybee diets changed the fatty acid composition of honeybee body. SFA and MUFA contents of bees’ body declined, and PUFA content rised in the ARA group. Compared with the control group, the supplement of ARA in honeybee diets increased the contents of ARA, C22:6n-3 (DHA) and C18:3n-6 in bees’ body significantly, but decreased the contents of C16:1 and C18:3n-3. The diet supplied with 4% ARA reduced the mortality rate of honeybee infected with Escherichia coli. The activity of immune enzymes (phenoloxidase, antitrypsin, and lysozyme) and the mRNA expression levels of immune genes (defensin-2, toll, myd88, and dorsal) were improved by ARA diets to varying degrees depending on the ARA levels, especially 4% ARA. These results suggested that dietary ARA could improve the growth, survival, and immune functions of honeybees. Supplement of ARA in bees’ diet would be valuable for the fitness of honeybees.
Accurate assessments of potassium intake in children are important for the early prevention of CVD. Currently, there is no simple approach for accurate estimation of potassium intake in children. We aim to evaluate the accuracy of 24-h urinary potassium excretion (24UKV) estimation in children using three common equations: the Kawasaki, Tanaka and Mage formulas, in a hospital-based setting. A total of 151 participants aged 5–18 years were initially enrolled, and spot urine samples were collected in the whole 24-h duration to measure the concentrations of potassium and creatinine. We calculated the mean difference, absolute and relative difference and misclassification rate between measured 24UKV and the predicted ones using Kawasaki, Tanaka and Mage formulas in 129 participants. The mean measured 24UKV was 1193·3 mg/d in our study. Mean differences between estimated and measured 24UKV were 1215·6, −14·9 and 230·3 mg/d by the Kawasaki, Tanaka and Mage formulas, respectively. All estimated 24UKV were significantly different from the measured values in all the time point (all P < 0·05), except for the predicted values from Tanaka formula using morning, afternoon and evening spot urine. The proportions with relative differences over 40 % were 87·2%, 32·5% and 47·3 % for Kawasaki, Tanaka and Mage formulas, respectively. Misclassification rates were 91·5 % for Kawasaki, 44·4 % for Tanaka and 58·9 % for Mage formula at the individual level. Our findings showed that misclassification could occur on the individual level when using Kawasaki, Tanaka and Mage formulas to estimate 24UKV from spot urine in the child population.
The North China Plain (NCP) is an important agricultural area, where conventional tillage (CT) is used year-round. However, long-term CT has damaged the soil structure, threatening agricultural sustainability. Since 2002, we have conducted a long-term tillage experiment in the NCP to explore the effects of different types of tillage on soil and crop yield. As part of long-term conservation tillage, we conducted a 2-year study in 2016/2017 to determine the impact of no tillage (NT), subsoiling (SS), rotary tillage (RT) and CT on soil aggregate distribution, aggregate-associated organic carbon (AOC), aggregate-associated microbial biomass carbon (AMBC), and maize yield. Compared to CT, NT increased the content of macro-aggregates (+4.8%), aggregate-AOC (+8.3%), and aggregate-AMBC (+18.3%), but decreased maize yield (−11.5%). SS increased the contents of macro-aggregates (+5%), aggregate-AOC (+14.7%), and aggregate-AMBC (+16%); although the yield increase was not significant (+0.22%), it had the highest economic benefit among the four tillage measures. RT had no significant advantage when considering the above soil variables; moreover, it reduced maize yield by 16.1% compared with CT. Overall, SS is a suitable tillage measure to improve soil macro-aggregate content, carbon content, yield, and economic benefit in the NCP area.
From 24 January 2020 to 18 May 2020, Chaoshan took measures to limit the spread of coronavirus disease 2019 (COVID-19), such as restricting public gatherings, wearing masks and suspending classes. We explored the effects of these measures on the pathogen spectrum of paediatric respiratory tract infections in Chaoshan. Pharyngeal swab samples were collected from 4075 children hospitalised for respiratory tract infection before (May–December 2019) and after (January–August 2020) the COVID-19 outbreak. We used liquid chip technology to analyse 14 respiratory pathogens. The data were used to explore between-group differences, age-related differences and seasonal variations in respiratory pathogens. The number of cases in the outbreak group (1222) was 42.8% of that in the pre-outbreak group (2853). Virus-detection rates were similar in the outbreak (48.3%, 590/1222) and pre-outbreak groups (51.5%, 1468/2853; χ2 = 3.446, P = 0.065), while the bacteria-detection rate was significantly lower in the outbreak group (26.2%, 320/1222) than in the pre-outbreak group (44.1%, 1258/2853; χ2 = 115.621, P < 0.05). With increasing age, the proportions of respiratory syncytial virus (RSV) and cytomegalovirus (CMV) infections decreased, while those of Mycoplasma pneumoniae and adenovirus infections increased. Streptococcus pneumoniae, CMV and rhinovirus infections peaked in autumn and winter, while RSV infections peaked in summer and winter. We found that the proportion of virus-only detection decreased with age, while the proportion of bacteria-only detection increased with age (Table 2). Anti-COVID-19 measures significantly reduced the number of paediatric hospitalisations for respiratory tract infections, significantly altered the pathogen spectrum of such infections and decreased the overall detection rates of 14 common respiratory pathogens. The proportion of bacterial, but not viral, infections decreased.
The staining procedure is critical for investigating intra- and extra-cellular ultrastructure of microorganisms by transmission electron microscopy (TEM). Here, we propose a new ultra-low lead staining (ULLS) technique for preparing the ultrathin sections for TEM analysis. Sections of Enterobacter sp. (bacteria), Aspergillus niger (filamentous fungi), Rhodotorula mucilaginosa (fungi), and Chlamydomonas reinhardtii (microalgae) were tested. Compared with the sections prepared by the typical double-staining technique, ULLS-based sections showed evident advantages: (i) the staining process only required the addition of Pb(NO3)2; (ii) the Pb level during incubation was set as low as 1 mg/L, which had negligible toxicity to most microbial cells; (iii) the Pb cations were added during microbial culture, which avoided complicated sample preparation as in typical double staining. Taking C. reinhardtii as an example, the ULLS technique allowed fine investigation of microbial ultrastructure, e.g., starch granule, mitochondrion, Golgi apparatus, vacuole, and vesicle. Meanwhile, the physiological processes of the cells such as cell lysis and exocytosis were successfully captured, with relatively high contrast. This study hence shows a bright future on preparation of the high-quality ultrathin sections of microbial cells by the ULLS technique.
Using a sample of 21,628 firm-year observations from the Chinese stock market during the period of 2008–2017, this study finds that the divorce–marriage ratio, the proxy for marital demography, is significantly positively associated with corporate greenwashing. This finding suggests that higher divorce–marriage ratio is associated with stronger individualistic social atmosphere, lower conformity to social norms, and more unfavorable attitude towards environmental conservation, abets firms to talk the talk rather than walk the walk, and foments corporate greenwashing. Moreover, China's Environmental Protection Law attenuates above positive relation. Lastly, our conclusions are robust to sensitivity tests using the divorce rate, alternative proxies for greenwashing, and individual-level divorce data, and further our findings are also valid after addressing the endogeneity issue.
The aim of this study was to present the clinical characteristics and dynamic changes in laboratory parameters of the coronavirus disease 2019 (COVID-19) in Guangzhou, and explore the probable early warning indicators of disease progression.
Method:
We enrolled all the patients diagnosed with COVID-19 in the Guangzhou No. 8 People’s Hospital. The patients’ demographic and epidemiologic data were collected, including chief complaints, lab results, and imaging examination findings.
Results:
The characteristics of the patients in Guangzhou are different from those in Wuhan. The patients were younger in age, predominately female, and their condition was not commonly combined with other diseases. A total of 75% of patients suffered fever on admission, followed by cough occurring in 62% patients. Comparing the mild/normal and severe/critical patients, being male, of older age, combined with hypertension, abnormal blood routine test results, raised creatine kinase, glutamic oxaloacetic transaminase, lactate dehydrogenase, C-reactive protein, procalcitonin, D-dimer, fibrinogen, activated partial thromboplastin time, and positive proteinuria were early warning indicators of severe disease.
Conclusion:
The patients outside epidemic areas showed different characteristics from those in Wuhan. The abnormal laboratory parameters were markedly changed 4 weeks after admission, and also were different between the mild and severe patients. More evidence is needed to confirm highly specific and sensitive potential early warning indicators of severe disease.
We have previously bred Chinese local dairy sheep through grading up with local Small-Tailed Han (STH) sheep as female parent and DairyMeade (DM) sheep as male parent. In this research communication we characterize the whey protein profile of STH sheep and their offspring (F1, F2) to reveal physiological differences and variation in milk traits. A total of 1032 whey proteins were identified through tandem mass tag labeling (TMT) proteome profiling. Three proteins were significantly differentially abundant between F1 and STH milk, six between F2 and STH milk and five between F1 and F2 milk. In terms of differential changes between generations, WASHC4 and CUTA of F1 and Ig-like domain-containing protein of F2 milk were dominant whey proteins. Overall, the results showed that the whey protein profiles of different generations varied little. The crossbreeds of STH and DM sheep would be suitable for the development of the Chinese local sheep milk industry, and the F2 may be a better population for sheep milk production.