The rising antimicrobial resistance (AMR) and the difficulty in developing new antibiotics are causing a global public health problem. This analysis aims to better understand the clinical and economic value of new antibiotic treatment strategies, in order to inform clinical and antibiotic formulary decisions.

We applied a published and validated dynamic disease transmission and cost-effectiveness model of AMR with a 10-year time horizon and discount rate of five percent to evaluate the clinical and economic outcomes of introducing a new antibiotic, namely, Ceftazidime/Avibactam (CAZ-AVI) for treating AMR infections in Zhejiang Province, China. Together with piperacillin-tazobactam (pip/taz) and meropenem, we explored the impact of six treatment strategies across three common infections (complicated intra-abdominal infection (cIAI), hospital-acquired/ventilator-associated pneumonia (HAP/VAP) and infections with limited treatment options (LTO)), and pathogens (Escherichia coli, Klebsiella spp., and Pseudomonas aeruginosa). These treatment strategies included (i) current treatment strategy (pip/taz and meropenem, no CAZ-AVI), (ii) CAZ-AVI at the third line, (iii) CAZ-AVI at the second line, (iv) CAZ-AVI at the first line, (v) first line diversity (i.e., equal pip/taz and CAZ-AVI at the first line; meropenem at the last line) and (vi) all-lines diversity (pip/taz, meropenem and CAZ-AVI used randomly and only once). The data with a total of 10,905 patients were collected from a tier-3 hospital from 2018 to 2021.

Under the current treatment strategy, the hospital length of stay (LOS) and costs over ten years were estimated to be 1,588,763 days and CNY3,898,198,802 (USD559,781,348), respectively, associated with 142,999 quality-adjusted life-years (QALYs) lost, resulting in the resistance of pip/taz and meropenem being 42.0 percent and 49.9 percent respectively. In contrast, the other five treatment strategies all have shown improved outcomes, among which the “all-lines diversity” carried the greatest benefit, saving CNY1,646.04 (USD236.37) for each additional QALY gained, with the net monetary benefit being CNY24,727,102,215 (USD3,550,811,878).

Introducing CAZ-AVI had positive impact on clinical and economic outcomes for treating AMR, and diversifying early the antibiotics might yield the best benefits.

The age-related heterogeneity in major depressive disorder (MDD) has received significant attention. However, the neural mechanisms underlying such heterogeneity still need further investigation. This study aimed to explore the common and distinct functional brain abnormalities across different age groups of MDD patients from a large-sample, multicenter analysis.

The analyzed sample consisted of a total of 1238 individuals including 617 MDD patients (108 adolescents, 12–17 years old; 411 early-middle adults, 18–54 years old; and 98 late adults, > = 55 years old) and 621 demographically matched healthy controls (60 adolescents, 449 early-middle adults, and 112 late adults). MDD-related abnormalities in brain functional connectivity (FC) patterns were investigated in each age group separately and using the whole pooled sample, respectively.

We found shared FC reductions among the sensorimotor, visual, and auditory networks across all three age groups of MDD patients. Furthermore, adolescent patients uniquely exhibited increased sensorimotor-subcortical FC; early-middle adult patients uniquely exhibited decreased visual-subcortical FC; and late adult patients uniquely exhibited wide FC reductions within the subcortical, default-mode, cingulo-opercular, and attention networks. Analysis of covariance models using the whole pooled sample further revealed: (1) significant main effects of age group on FCs within most brain networks, suggesting that they are decreased with aging; and (2) a significant age group × MDD diagnosis interaction on FC within the default-mode network, which may be reflective of an accelerated aging-related decline in default-mode FCs.

To summarize, these findings may deepen our understanding of the age-related biological and clinical heterogeneity in MDD.

Alienation towards parents often occurs when parents divorce; however, it can also occur when one or both parents leave for work for more than 6 months. Our previous investigation has confirmed a high level of feelings of alienation towards parents among Chinese left-behind children. However, the longitudinal prediction of alienation on children's mental health outcomes remains largely unknown. This study aims to observe the prediction of alienation towards parents on children's depression 12 months later and potential mediators and moderators.

A total of 1090 Chinese left-behind children took part in this 12-month follow-up investigation, using the Chinese version of the Inventory of Alienation towards Parents (IAP), the Children's Depression Inventory (CDI), the Adolescent Self-Rating Life-events Checklist (ASLEC), and the Adolescent Resilience Scale.

Alienation towards parents was high (16.42 ± 7.27 for mother, 15.63 ± 7.17 for father) in left-behind children, and 21.01% of children reported depression. Alienation towards parents predicted current depression of children directly and later depression indirectly; children's alienation toward their mothers was a stronger predictor of depression than alienation towards fathers. In models, stressful life-events acted as a risk mediator. Previous depression was the strongest risk predictor, resilience was the strongest protective factor, and duration of fathers’ absence and parents’ marital status moderated the predictive effects.

This study is among the first to longitudinally confirm that alienation towards parents is a predictor of children's later depression. The results provide important suggestions for families and schools; i.e. to prevent depression in left-behind children, parent−child bonds especially alienation towards mothers, should be carefully considered, and individuals with more negative life-events and weaker resilience need further attention.

Late-life depression issues in developing countries are challenging because of understaffing in mental health. Cognitive behavioural therapy (CBT) is effective for treating depression.

This pilot trial examined the adherence and effectiveness of an eight-session adapted CBT delivered by trained lay health workers for older adults with depressive symptoms living in rural areas of China, compared with the usual care.

Fifty with screen-positive depression were randomly assigned to the CBT arm or the care as usual (CAU) arm. The primary outcomes were the session completion of older adults and changes in depressive symptoms, assessed using the Geriatric Depression Scale (GDS).

The majority (19/24) of participants in the CBT arm completed all sessions. Mixed-effect linear regression showed that the CBT reduced more GDS scores over time compared with CAU.

Lay-delivered culturally adapted CBT is potentially effective for screen-positive late-life depression.