We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
CD33 has been implicated in the pathogenesis of Alzheimer’s disease primarily through its role in inhibiting the clearance of beta-amyloid (Aβ). However, genetic studies yield mixed results and it is unclear whether the impact of CD33 is specific to Alzheimer’s disease or related to broader neurodegenerative processes. Interestingly, CD33 has also been shown to interact with the hepatitis B (HBV) and C viruses (HCV).
Aims
This study aims to investigate the effects of CD33 single-nucleotide polymorphisms (SNPs) on cognitive functions across diverse populations, including healthy controls, individuals with chronic HBV or HCV and those diagnosed with Parkinson’s disease.
Method
We genotyped CD33 SNPs in 563 participants using the Affymetrix platform. Participants’ cognitive functions were cross-sectionally assessed using a neuropsychological test battery spanning six domains.
Results
Our analysis revealed that CD33 SNP variations had no significant cognitive impact on healthy individuals or Parkinson’s disease patients. However, chronic HBV and HCV patients exhibited significant cognitive differences, particularly in memory, related to CD33 SNP genotypes. Moderation analysis indicated a heightened influence of CD33 SNPs on cognitive functions in chronic HBV and HCV individuals. Our data also suggest that inflammation severity may modulate the cognitive effects in hepatitis patients with specific CD33 SNPs.
Conclusions
This study highlights the importance of CD33 SNPs in cognitive outcomes, emphasising their role in the context of chronic viral hepatitis. It contributes to understanding the cognitive profiles influenced by CD33 SNPs and posits CD33’s potential contribution to neurodegenerative disease progression, potentially intensified by HBV/HCV-induced inflammation.
Women remain underrepresented in National Institutes of Health (NIH) study sections, panels of scientists who review grant applications to inform national research priorities and funding allocations. This longitudinal, retrospective study examined the representation of women on study sections before and during the COVID-19 pandemic. Overall, 16,902 reviewers served on 1,045 study sections across 2019, 2020, and 2021, of which 40.1% (n = 6,786) were women. The likelihood of reviewers being women significantly increased from 2019 to 2021, except among chairpersons. Understanding the representation of scientists influencing NIH grant decisions is important to ensuring scientific discovery that meets the nation’s pluralistic needs.
History effects play a significant role in determining the velocity in boundary layers with pressure gradients, complicating the identification of a velocity scaling. This work pivots away from traditional velocity analysis to focus on fluid acceleration in boundary layers with strong adverse pressure gradients. We draw parallels between the transport equation of the velocity in an equilibrium spatially evolving boundary layer and the transport equation of the fluid acceleration in temporally evolving boundary layers with pressure gradients, establishing an analogy between the two. To validate our analogy, we show that the laminar Stokes solution, which describes the flow immediately after the application of a pressure gradient force, is consistent with the present analogy. Furthermore, fluid acceleration exhibits a linear scaling in the wall layer and transitions to logarithmic scaling away from the wall after the initial period, mirroring the velocity in an equilibrium boundary layer, lending further support to the analogy. Finally, by integrating fluid acceleration, a velocity scaling is derived, which compares favourably with data as well.
A primary objective of integral methods, such as the momentum integral method, is to discern the physical processes contributing to skin friction. These methods encompass the momentum, kinetic energy and angular momentum integrals. This paper reformulates existing integrals based on the double-averaged Navier–Stokes equations, and extends their application to flows over rough walls. Our derivation yields distinct decompositions for the bottom-wall viscous friction coefficient, denoted as $C_S$, and the roughness element drag coefficient $C_R$. The decompositions comprise three terms: a viscous term, a turbulent term and a roughness (dispersive) term – regardless of the flow configuration, be it channel or boundary layer. Notably, when these integrals are evaluated for laminar flow scenarios, only the viscous term remains significant. In addition, we elucidate the spatial distributions of the terms within these decompositions. To demonstrate the practicality of our formulations, we apply them to analyse data from direct numerical simulations of turbulent half-channel flows. These flows feature aligned and staggered cubical roughness at various packing densities. Our analyses, based on kinetic-energy-oriented decompositions, reveal that when the surface coverage density $\lambda _p$ is small, the dominant terms within the decompositions are the viscous and turbulent terms. With increasing $\lambda _p$, the viscous dissipation term decreases, while the turbulent production term increases and then decreases. These variations arise from a subdued near-wall cycle and the development of a shear layer at the height of the cubes.
The mean flow behaviour of a turbulent boundary layer over rough walls is expected to exhibit symmetries that govern the flow dynamics. In particular, when roughness elements are arranged in a spanwise symmetric manner, the mean flow above them should also exhibit spanwise symmetry. This symmetrical consideration has garnered substantial empirical support. We conduct direct numerical simulations (DNS) of flow over aligned cube arrays to test such symmetry considerations further. We vary the surface coverage density from 0.25 % to 6.25 %, and employ an averaging time of about 100 large-eddy turnover times, which is longer than the typical averaging time in prior DNS studies of rough-wall boundary layers. The results suggest the presence of spanwise asymmetry in the mean flow. Specifically, we observe the development of a prominent secondary vortex on one side of the cubical roughness, accompanied by a relatively smaller secondary vortex on the other side. This asymmetry becomes most pronounced when the surface coverage density is approximately 0.59 %, and diminishes as the coverage density approaches either a low or a high value. We also establish that this mean flow asymmetry is robust across variations in the domain size, the initial condition, and the placement of the cubes in the spanwise direction.
The mixing-layer analogy is due to Raupach, Finnigan & Brunet (Boundary-Layer Meteorol., vol. 25, 1996, pp. 351–382). In the analogy, the flow in the roughness sublayer of a homogeneous deep vegetation canopy boundary layer is analogous to a plane mixing layer rather than a surface layer. Evidence for the analogy includes the inflected velocity profile, which resembles the velocity profile in a plane mixing layer, and, most notably, the following estimate as a result of the Kelvin–Helmholtz instability: $\varLambda _x=8.1L_s$, where $\varLambda _x$ is the spacing of the large-scale eddies, and $L_s$ is the shear length. The mixing-layer analogy has been very successful in vegetation canopy flow research, but has received only limited support in urban-canopy flow research. This work revisits Raupach et al.'s mixing-layer analogy, and we present the evidence for the mixing-layer analogy in urban-canopy flows: the exponential velocity profile in the canopy layer, i.e. $(U-U_c)/(U_h-U_c)=\exp (z/L_m)$, and $L_m\sim [(U_h/U_c-1)(U_h/U_c+3)]^{-1}$. Here, $z$ is the vertical coordinate, $L_m$ is the attenuation length and is a measure of the largest eddy in the canopy layer, $U_h$ is the wind speed at the canopy crest and $U_c$ is the velocity in the inactive layer. We conduct direct numerical simulations of various deep homogeneous urban-canopy flows and test the above two scalings. We also discuss why Raupach et al.'s analogy has not seen as many successes in urban-canopy flows as in vegetation canopy flows.
There is a lack of evidence related to the prevalence of mental health symptoms as well as their heterogeneities during the coronavirus disease 2019 (COVID-19) pandemic in Latin America, a large area spanning the equator. The current study aims to provide meta-analytical evidence on mental health symptoms during COVID-19 among frontline healthcare workers, general healthcare workers, the general population and university students in Latin America.
Methods
Bibliographical databases, such as PubMed, Embase, Web of Science, PsycINFO and medRxiv, were systematically searched to identify pertinent studies up to August 13, 2021. Two coders performed the screening using predefined eligibility criteria. Studies were assigned quality scores using the Mixed Methods Appraisal Tool. The double data extraction method was used to minimise data entry errors.
Results
A total of 62 studies with 196 950 participants in Latin America were identified. The pooled prevalence of anxiety, depression, distress and insomnia was 35%, 35%, 32% and 35%, respectively. There was a higher prevalence of mental health symptoms in South America compared to Central America (36% v. 28%, p < 0.001), in countries speaking Portuguese (40%) v. Spanish (30%). The pooled prevalence of mental health symptoms in the general population, general healthcare workers, frontline healthcare workers and students in Latin America was 37%, 34%, 33% and 45%, respectively.
Conclusions
The high yet heterogenous level of prevalence of mental health symptoms emphasises the need for appropriate identification of psychological interventions in Latin America.
Cysticercosis caused by the metacestode larval stage of Taenia hydatigena formerly referred to as Cysticercus tenuicollis is a disease of veterinary importance that constitutes a significant threat to livestock production worldwide, especially in endemic regions due to condemnation of visceral organs and mortality rate of infected young animals. While the genetic diversity among parasites is found to be potentially useful in many areas of research including molecular diagnostics, epidemiology and control, that of T. hydatigena across the globe remains poorly understood. In this study, analysis of the mitochondrial DNA (mtDNA) of adult worms and larval stages of T. hydatigena isolated from dogs, sheep and a wild boar in China showed that the population structure consists of two major haplogroups with very high nucleotide substitutions involving synonymous and non-synonymous changes. Compared with other cestodes such as Echinococcus spp., the genetic variation observed between the haplogroups is sufficient for the assignment of major haplotype or genotype division as both groups showed a total of 166 point-mutation differences between the 12 mitochondrial protein-coding gene sequences. Preliminary analysis of a nuclear protein-coding gene (pepck) did not reveal any peculiar changes between both groups which suggests that these variants may only differ in their mitochondrial makeup.
The present study aimed to evaluate the status of iodine nutrition and thyroid function in adults, to understand the distribution of thyroid disease in people with autoimmune thyroid disease (AITD) in different water iodine areas and to explore the relationship between serum iodine, urine iodine and thyroid function in people with AITD. A cross-sectional survey was conducted in areas of Shandong Province with different water iodine levels, and subsequently 1225 adults were enrolled from iodine-deficient (ID), iodine-adequate (IA) and iodine-excess (IE) areas. Urinary iodine, water iodine, salt iodine, serum iodine and thyroid function were measured. According to the urine iodine concentration, the ID and IA areas were defined as iodine sufficient and the IE area as iodine excessive. Urine iodine, serum iodine, free thyroxine (FT4) and thyroid-stimulating hormone (TSH) levels were comparatively higher in the IE area. The positive rate of thyroglobulin antibody (19·1 %) and the prevalence of AITD (21·8 %) were higher in the ID areas; the prevalence of subclinical hypothyroidism was lowest in the ID areas (7·3 %) and highest in the IE area (16·3 %). Among the AITD population, urinary iodine concentration, free triiodothyronine, FT4 and TSH had a non-linear correlation with serum iodine; abnormal TSH level, serum iodine concentration > 110 µg/l and goitre were risk factors for AITD in adults, especially females. Our data collectively suggest that universal salt iodisation has improved the iodine nutritional status of the population in ID areas in China. Non-step-by-step iodine fortification may induce the transformation of thyroid autoimmune diseases from recessive-to-dominant in susceptible people. Moreover, enhanced monitoring of thyroid function in people with AITD is important.
Executive dysfunction is one of the main cognitive theories of autism spectrum disorder (ASD). Despite evidence of deficits in executive functions in individuals with ASD, little is known about executive dysfunctions as candidate cognitive endophenotypes for ASD. In this study, we investigated executive functions in youths with ASD, their unaffected siblings and typically developing controls (TDC).
Methods
We recruited 240 youths with a clinical diagnosis of ASD (aged 6–18 years), 147 unaffected siblings of ASD youths, and 240 TDC youths. TDC youths were recruited based on the age and sex distribution of the ASD youths. Participants were assessed using the verbal Digit Span test and four executive function tasks from the Cambridge Neuropsychological Test Automated Battery, including Intra-dimensional/Extra-dimensional Shift (I/ED), Spatial Span (SSP), Spatial Working Memory (SWM), and Stocking of Cambridge (SoC).
Results
ASD youths, relative to TDC, performed significantly worse in executive function tasks assessing verbal working memory (forward and backward digit span), set-shifting (I/ED), visuospatial working memory (SSP, SWM), and planning/problem solving (SoC). Furthermore, unaffected siblings, relative to TDC, performed worse in forward and backward digit recalls and made more errors in SWM. These results were independent of the effects of age, sex, IQ, and symptoms of attention-deficit/hyperactivity disorder.
Conclusions
Our findings support impaired executive functions in youths with ASD. However, unaffected siblings were mostly unimpaired except in the areas of verbal and spatial working memory, which may be potential cognitive endophenotypes for ASD.
We describe an ultra-wide-bandwidth, low-frequency receiver recently installed on the Parkes radio telescope. The receiver system provides continuous frequency coverage from 704 to 4032 MHz. For much of the band (${\sim}60\%$), the system temperature is approximately 22 K and the receiver system remains in a linear regime even in the presence of strong mobile phone transmissions. We discuss the scientific and technical aspects of the new receiver, including its astronomical objectives, as well as the feed, receiver, digitiser, and signal processor design. We describe the pipeline routines that form the archive-ready data products and how those data files can be accessed from the archives. The system performance is quantified, including the system noise and linearity, beam shape, antenna efficiency, polarisation calibration, and timing stability.
Consumption of a high-fat diet increases fat accumulation and may further lead to inflammation and hepatic injuries. The aim of the study was to investigate the effects of Camellia oleifera seed extract (CSE) on non-alcoholic fatty liver disease (NAFLD). After a 16-week NAFLD-inducing period, rats were assigned to experimental groups fed an NAFLD diet with or without CSE. At the end of the study, we found that consuming CSE decreased the abdominal fat weight and hepatic fat accumulation and modulated circulating adipokine levels. We also found that CSE groups had lower hepatic cytochrome P450 2E1 and transforming growth factor (TGF)-β protein expressions. In addition, we found that CSE consumption may have affected the gut microbiota and reduced toll-like receptor (TLR)-4, myeloid differentiation primary response gene 88, toll/IL-1 receptor domain-containing adaptor-inducing interferon-β (TRIF) expression and proinflammatory cytokine concentrations in the liver. Our results suggest that CSE may alleviate the progression of NAFLD in rats with diet-induced steatosis through reducing fat accumulation and improving lipid metabolism and hepatic inflammation.
The condition of caregivers is important to the quality of care received by people with Parkinson’s disease (PD), especially at the late disease stages. This study addresses the distress placed on caregivers by participants’ neuropsychiatric symptoms at different stages of PD in Taiwan
Methods:
This prospective study enrolled 108 people with PD. All participants were examined with the Unified Parkinson’s Disease Rating Scale (UPDRS), Neuropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), and Clinical Dementia Rating (CDR) scale. Caregiver distress was measured using the Neuropsychiatric Inventory Caregiver Distress Scale (NPI-D). Statistical analysis was used to explore the PD-related factors that contribute to caregiver distress.
Results:
The mean follow-up interval in the 108 PD participants were 24.0 ± 10.2 months with no participant lost to follow-up due to death. NPI-distress (the sum of NPI caregiver distress scale across the 12 domains of the NPI) was positively correlated with NPI-sum (the total score across the 12 domains of the NPI) (r = 0.787, p < 0.001), CDR (r = 0.403, p < 0.001), UPRDS (r = 0.276, p = 0.004), and disease duration (r = 0.246, p = 0.002), but negatively correlated with CASI (r = −0.237, p = 0.043) and MMSE (r = −0.281, p < 0.001). Multiple linear regression analysis showed that only NPI-sum and disease duration were independently correlated with NPI-distress.
Conclusion:
The disease duration and NPI-sum are independent predictors of caregiver distress in Taiwanese populations with PD. Early detection and reduction of neuropsychiatric symptoms in people with PD can help decrease caregiver distress.
Altered heart rate variability (HRV), an index of autonomic nervous system function, has been reported in generalized anxiety disorder (GAD), but the results have been mixed. Thus, the present study, using a large sample size and better methodology, aims to examine whether GAD is associated with impaired HRV, both at rest and in response to posture challenges.
Methods
In total, 1832 participants were recruited in this study, consisting of 682 patients with GAD (including 326 drug- and comorbidity-free GAD patients) and 1150 healthy controls. Short-term HRV was measured during the supine-standing-supine test (5-min per position). Propensity score matching (PSM), a relatively novel method, was used to control for potential confounders.
Results
After PSM algorithm, drug- and comorbidity-free GAD patients had reductions in resting (baseline) high-frequency power (HF), an index for parasympathetic modulation, and increases in the low-frequency/HF ratio (LF/HF), an index for sympathovagal balance as compared to matched controls. Furthermore, the responses of HF and LF/HF to posture changes were all attenuated when compared with matched controls. Effect sizes, given by Cohen's d, for resting HF and HF reactivity were 0.42 and 0.36–0.42, respectively.
Conclusions
GAD is associated with altered sympathovagal balance, characterized by attenuation in both resting vagal modulation and vagal reactivity, with an almost medium effect size (Cohen's d ≈ 0.4), regardless of medication use or comorbidity status.
This paper is concerned with the global dynamics and spreading speeds of a partially degenerate non-local dispersal system with monostable nonlinearity in periodic habitats. We first obtain the existence of the principal eigenvalue for a periodic eigenvalue problem with partially degenerate non-local dispersal. Then we study the coexistence and extinction dynamics. Finally, the existence and characterization of spreading speeds are considered. In particular, we show that the spreading speed is linearly determinate. Overall, we extend the existing results on global dynamics and spreading speeds for the degenerate reaction–diffusion system to the degenerate non-local dispersal case. The extension is non-trivial and meaningful.
Barium-rich silicates were recently found in the lower Cambrian black shale sequence of Anhui Province, South China. The Ba silicates can be divided into Ba-poor K-feldspar, Ba-rich K-feldspar and cymrite, on the basis of occurrence and composition. The Ba-poor K-feldspar have low BaO contents (<1.00 wt.%) and occur as sporadic grains in mudstone. In contrast, the Ba-rich K-feldspar have higher BaO contents (1.36–20.51 wt.%) and occur mainly as rims around grains of Ba-poor K-feldspar in mudstone, as void fillings in dolostone, and as grains dispersed in chert. The cymrite is observed only in chert and occurs as dispersed euhedral tabular crystals. Analyses of the Ba-poor K-feldspar and Ba-rich K-feldspar provide compositions that total <100 wt.% and show non-stoichiometry characterized by (Na + K + Ba + Ca)apfu less than 1.00 and (Al + Si)apfu slightly higher than 4.00. Raman and infrared (IR) spectroscopy has revealed the presence of ${\rm NH}_{\rm 4}^{\rm +} $ and H2O in the Ba-rich K-feldspar, which accounts for the unusual composition of these feldspars. We suggest that the formation processes of the Ba-poor K-feldspar, Ba-rich K-feldspar and cymrite were closely associated with multi-stage hydrothermal fluids enriched in Ba and NH4, consistent with an extensional tectonic setting during the early Cambrian. The Ba-poor K-feldspars might have formed through interactions between pre-existing K-feldspars and hydrothermal fluids. The Ba-rich K-feldspars in mudstone and dolostone formed mainly by precipitation from hydrothermal fluids that infiltrated the sediments, and we suggest the Ba-rich K-feldspars and cymrite in the chert are of exhalative hydrothermal origin.
Salt, promoting oxidative stress, contributes to insulin resistance, whereas K, inhibiting oxidative stress, improves insulin sensitivity. Oxidative stress activation of NLRP3 inflammasome is a central player in the induction of insulin resistance. Therefore, we hypothesised that NLRP3 inflammasome may mediate the effects of salt and K on insulin resistance. In all, fifty normotensive subjects were recruited from a rural community of Northern China. The protocol included a low-salt diet for 7 d, then a high-salt diet for 7 d and a high-salt diet with K supplementation for another 7 d. In addition, THP-1 cells were cultured in different levels of Na with and without K. The results showed that salt loading elevated fasting blood glucose, insulin and C-peptide levels, as well as insulin resistance, whereas K supplementation reversed them. Meanwhile, additional K reversed the active effects of high salt on NLRP3 inflammasome in both the subjects and THP-1 cells, and the change of insulin resistance index notably related with the alteration of plasma IL-1β, the index of NLRP3 inflammasome activation, during intervention in the subjects. Additional K ameliorated oxidative stress induced by high salt in both the subjects and cultured THP-1 cells, and the change of oxidative stress related with the alteration of plasma IL-1β during intervention in the subjects. In vitro, antioxidant N-acetyl-l-cysteine significantly prevented the active effects of high Na or oxidant Rosup on NLRP3 inflammasome, so did K. Our study indicates that oxidative stress modulation of NLRP3 inflammasome may be involved in the impacts of Na and K on insulin resistance.
Rudists are a principal biotic component of Cretaceous carbonates in Tibet and in the Western Tarim Basin. Barremian to Maastrichtian carbonate units are widespread on the northern margin of the Indian Plate and in Tethyan tectonic slices that were welded onto Eurasia in successive stages during the Late Cretaceous and Paleogene. In far northwestern Tibet, Barremian-Cenomanian endemic rudists and cosmopolitan orbitolinid foraminifera occupied isolated carbonate platforms in the eastern Tethys. Rudists, corals, and stromatoporoids composed bioherms up to 10 m thick and several kilometers in lateral extent. A unique endemic requieniid rudist, Rutonia, is compared to morphologically similar but older, less derived genera. Associated specimens in this assemblage are indeterminate requieniid valves, monopleurids, and two genera with three radiolitid species that are re-described and taxonomic positions re-evaluated. In southern Tibet, mainly endemic Campanian-Maastrichtian radiolitid rudists and cosmopolitan larger benthic foraminifera contributed to carbonate shelves on the northern Indian Plate near the Cretaceous equator. In the Western Tarim Basin Cenomanian strata yield Tethyan rudist species.
Coiling morphometric analysis using the three-dimensional morphology Raup diagram shows that Requieniidae valves in contact with the substrate are convergent with the basic gastropod shell. More derived strongly coiled, younger requieniids were adapted to encrusting or semi-infaunal habits. Stratigraphic analysis confirms that Requieniidae diversity crises coincided with Cretaceous oceanic anoxic events
Two end members of valve geometry each appear to be primitive and derived characters respectively and separate the family Requieniidae into two clades that are here recognized as two new subfamilies. The end members are defined by the coiling geometry, whether the spire is close to the plane of commissure or it is translated along the coiling axis and by myophore structures. The older matheroniform clade has a low spirogyrate LV that is translated slightly from the commissure along the coiling axis; this group is composed of Matheronia (and its subgenus Monnieria), Hypelasma, Lovetchenia, Rutonia, and Kugleria. Genera in the younger clade have a tall trochospiral LV that is translated along the coiling axis and consists of Requienia, Toucasia, Pseudotoucasia, Apricardia, Bayleoidea, and Bayleia. Claditics support these relationships.
SiO2-MgF2/TiO2 double-layer films with antireflective, self-cleaning and adherent properties were prepared by spin-coating SiO2-MgF2 and TiO2 sol on glass substrate successively and subsequently being calcined at 250°C. The optical and structural properties of films have been investigated by visible spectrophotometer and field emission scanning electron microscope, respectively. At the same time, self-cleaning property generated from superhydrophilicity and photocatalysis was obtained. The results indicated that the as-prepared SiO2-MgF2/TiO2 double-layer films show a maximum increase in transmittance near 520 nm wavelength of 2.8% and photocatalytic property with the R value of 4.7(JIS R 1703–2).It has been demonstrated that high transmittance, self-cleaning and adherent composite has been obtained by a simple sol–gel route presenting good potential to be applied on photovoltaics systems.
Lithium inhibits glycogen synthase kinase-3, which is an enzyme involved in the pathogenesis of cancer.
Aims
To investigate the association between lithium and cancer risk in patients with bipolar disorder.
Method
A retrospective cohort study was designed using the National Health Insurance Research Database (NHIRD) in Taiwan. Patients using lithium comprised the index drug group and patients using anticonvulsants only comprised the control group. Time-dependent Cox regression was used to evaluate the hazard ratios (HRs) for risk of cancer.
Results
Compared with anticonvulsant-only exposure, lithium exposure was associated with significantly lower cancer risk (HR = 0.735, 95% CI 0.554–0.974). The hazard ratios for the first, second and third tertiles of the cumulative defined daily dose were 0.762 (95% CI 0.516–1.125), 0.919 (95% CI 0.640–1.318) and 0.552 (95% CI 0.367–0.831), respectively.
Conclusions
Lithium is associated with reduced overall cancer risk in patients with bipolar disorder. A dose–response relationship for cancer risk reduction was observed.