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The relationship between emotional symptoms and cognitive impairments in major depressive disorder (MDD) is key to understanding cognitive dysfunction and optimizing recovery strategies. This study investigates the relationship between subjective and objective cognitive functions and emotional symptoms in MDD and evaluates their contributions to social functioning recovery.
Methods
The Prospective Cohort Study of Depression in China (PROUD) involved 1,376 MDD patients, who underwent 8 weeks of antidepressant monotherapy with assessments at baseline, week 8, and week 52. Measures included the Hamilton Depression Rating Scale (HAMD-17), Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16), Chinese Brief Cognitive Test (C-BCT), Perceived Deficits Questionnaire for Depression-5 (PDQ-D5), and Sheehan Disability Scale (SDS). Cross-lagged panel modeling (CLPM) was used to analyze temporal relationships.
Results
Depressive symptoms and cognitive measures demonstrated significant improvement over 8 weeks (p < 0.001). Baseline subjective cognitive dysfunction predicted depressive symptoms at week 8 (HAMD-17: β = 0.190, 95% CI: 0.108–0.271; QIDS-SR16: β = 0.217, 95% CI: 0.126–0.308). Meanwhile, baseline depressive symptoms (QIDS-SR16) also predicted subsequent subjective cognitive dysfunction (β = 0.090, 95% CI: 0.003-0.177). Recovery of social functioning was driven by improvements in depressive symptoms (β = 0.384, p < 0.0001) and subjective cognition (β = 0.551, p < 0.0001), with subjective cognition contributing more substantially (R2 = 0.196 vs. 0.075).
Conclusions
Subjective cognitive dysfunction is more strongly associated with depressive symptoms and plays a significant role in social functioning recovery, highlighting the need for targeted interventions addressing subjective cognitive deficits in MDD.
Parkinson’s disease (PD) diagnosis mostly relies on (late) clinical (parkinsonism) symptoms, whereas we need early diagnostic markers in order to initiate and monitor the effects of forthcoming disease-modifying drugs in the earliest phase of this disease. Therefore, reliable diagnostic and prognostic biomarkers are urgently needed. Evidence suggests the potential (differential) diagnostic and prognostic value of clinical, genetic, neuroimaging, and biochemical markers (e.g., in saliva, urine, blood and cerebrospinal fluid). Such biomarkers may include α-synuclein species, lysosomal enzymes, markers of amyloid and tau pathology, and neurofilament light chain, closely reflecting the pathophysiology of PD. Here, we provide an overview of these markers with practical guidelines for facilitating early PD diagnosis.
Retropharyngeal lymphadenectomy is challenging. This study investigated a minimally invasive approach to salvage retropharyngeal lymphadenectomy in patients with nasopharyngeal carcinoma.
Methods
An anatomical study of four fresh cadaveric heads was conducted to demonstrate the relevant details of retropharyngeal lymphadenectomy using the endoscopic transoral medial pterygomandibular fold approach. Six patients with nasopharyngeal cancer with retropharyngeal lymph node recurrence, who underwent retropharyngeal lymphadenectomy with the endoscopic transoral medial pterygomandibular fold technique at the Eye and ENT Hospital of Fudan University from July to December 2021, were included in this study.
Results
The anatomical study demonstrated that the endoscopic transoral medial pterygomandibular fold approach offers a short path and minimally invasive approach to the retropharyngeal space. The surgical procedure was well tolerated by all patients, with no significant post-operative complications.
Conclusion
The endoscopic transoral medial pterygomandibular fold approach is safe and efficient for retropharyngeal lymphadenectomy.
Constraining the timing and extent of Quaternary glaciations in the Tibetan Plateau (TP) is significant for the reconstruction of paleoclimatic environment and understanding the interrelationships among climate, tectonics, and glacial systems. We investigated the late Quaternary glacial history of the Qinggulong and Juequ valleys in the Taniantaweng Mountains, southeastern TP, using cosmogenic 10Be surface exposure dating. Four major glacial events were identified based on 26 10Be ages. The exposure ages of the oldest late Quaternary glaciation correspond to Marine Oxygen Isotope Stage (MIS) 6. The maximum glacial extent was dated to 48.5–41.1 ka (MIS 3), during the last glaciation, and was more advanced than that of the last glacial maximum (LGM). Geochronology and geomorphological evidence indicate that multiple glacial fluctuations occurred in the study area during the Early–Middle Holocene. These glacial fluctuations likely were driven by the North Atlantic climate oscillations, summer solar insolation variability, Asian summer monsoon intensity, and CO2 concentration.
Slowed information processing speed (IPS) is the core contributor to cognitive impairment in patients with late-life depression (LLD). The hippocampus is an important link between depression and dementia, and it may be involved in IPS slowing in LLD. However, the relationship between a slowed IPS and the dynamic activity and connectivity of hippocampal subregions in patients with LLD remains unclear.
Methods
One hundred thirty-four patients with LLD and 89 healthy controls were recruited. Sliding-window analysis was used to assess whole-brain dynamic functional connectivity (dFC), dynamic fractional amplitude of low-frequency fluctuations (dfALFF) and dynamic regional homogeneity (dReHo) for each hippocampal subregion seed.
Results
Cognitive impairment (global cognition, verbal memory, language, visual–spatial skill, executive function and working memory) in patients with LLD was mediated by their slowed IPS. Compared with the controls, patients with LLD exhibited decreased dFC between various hippocampal subregions and the frontal cortex and decreased dReho in the left rostral hippocampus. Additionally, most of the dFCs were negatively associated with the severity of depressive symptoms and were positively associated with various domains of cognitive function. Moreover, the dFC between the left rostral hippocampus and middle frontal gyrus exhibited a partial mediation effect on the relationships between the scores of depressive symptoms and IPS.
Conclusions
Patients with LLD exhibited decreased dFC between the hippocampus and frontal cortex, and the decreased dFC between the left rostral hippocampus and right middle frontal gyrus was involved in the underlying neural substrate of the slowed IPS.
The Welfare of Farmed Animals (England) Regulations (2007) make it an offence to allow unnecessary suffering to animals, highlighting that farmers have a duty of care for their livestock. Despite this, the current global mean prevalence of lameness in sheep in England is 5%; ie ~750,000 lame adult sheep at any time. To investigate farmers’ attitudes to sanctions and rewards as drivers to reduce the prevalence of lameness in sheep, farmers’ attitudes to external inspections, acceptable prevalence of lameness and attitudes on outcomes from inspections were investigated using a self-administered questionnaire. A total of 43/102 convenience-selected English sheep farmers responded to the questionnaire. Their median flock size was 500 ewes with a geometric mean prevalence of lameness of 2.8%. Few farmers selected correct descriptions of the legislation for treatment and transport of lame sheep. Participants considered 5-7.5% prevalence of lameness acceptable and were least tolerant of farmers who rarely treated lameness and most tolerant of farmers experiencing an incident out of their control, eg disease outbreak. Participants consider sanctions and rewards would help to control lameness on sheep farms in England. Sanctions (prosecution, reduction in payment from the single [basic] payment scheme or suspension from a farm assurance scheme) were considered ‘fair’ when lameness was ≥ 10% and rewards ‘fair’ when lameness was ≤ 2%. If these farmers’ attitudes are applied to 1,300 randomly selected flocks with a mean prevalence of lameness of 3.5%, 24.6% of flocks that had ≥ 10% lameness would be sanctioned and 32.5% of flocks that had ≤ 2% lameness would be rewarded.
COVID-19 has long-term impacts on public mental health, while few research studies incorporate multidimensional methods to thoroughly characterise the psychological profile of general population and little detailed guidance exists for mental health management during the pandemic. This research aims to capture long-term psychological profile of general population following COVID-19 by integrating trajectory modelling approaches, latent trajectory pattern identification and network analyses.
Methods
Longitudinal data were collected from a nationwide sample of 18 804 adults in 12 months after COVID-19 outbreak in China. Patient Health Questionnaire-9, Generalised Anxiety Disorder-7 and Insomnia Severity Index were used to measure depression, anxiety and insomnia, respectively. The unconditional and conditional latent growth curve models were fitted to investigate trajectories and long-term predictors for psychological symptoms. We employed latent growth mixture model to identify the major psychological symptom trajectory patterns, and ran sparse Gaussian graphical models with graphical lasso to explore the evolution of psychopathological network.
Results
At 12 months after COVID-19 outbreak, psychological symptoms generally alleviated, and five psychological symptom trajectories with different demographics were identified: normal stable (63.4%), mild stable (15.3%), mild-increase to decrease (11.7%), mild-decrease to increase (4.0%) and moderate/severe stable (5.5%). The finding indicated that there were still about 5% individuals showing consistently severe distress and approximately 16% following fluctuating psychological trajectories, who should be continuously monitored. For individuals with persistently severe trajectories and those with fluctuating trajectories, central or bridge symptoms in the network were mainly ‘motor abnormality’ and ‘sad mood’, respectively. Compared with initial peak and late COVID-19 phase, aftermath of initial peak might be a psychologically vulnerable period with highest network connectivity. The central and bridge symptoms for aftermath of initial peak (‘appetite change’ and ‘trouble of relaxing’) were totally different from those at other pandemic phases (‘sad mood’).
Conclusions
This research identified the overall growing trend, long-term predictors, trajectory classes and evolutionary pattern of psychopathological network of psychological symptoms in 12 months after COVID-19 outbreak. It provides a multidimensional long-term psychological profile of the general population after COVID-19 outbreak, and accentuates the essentiality of continuous psychological monitoring, as well as population- and time-specific psychological management after COVID-19. We believe our findings can offer reference for long-term psychological management after pandemics.
Mechanistic studies have suggested that antioxidants have beneficial effects on age-related macular degeneration (AMD). This study aimed to investigate the association between the types and sources of dietary vitamin and carotenoid intakes and AMD risk in China. A matched case–control study of 260 AMD cases and 260 matched controls was performed. The participants were interviewed for dietary information and potential confounders, and comprehensive ophthalmic examinations were performed. Conditional logistic models were used to estimate the odds ratio (OR) and 95 % confidence interval (CI) of specific vitamins and carotenoids and their main sources. When comparing the extreme quartiles, the ORs (95 % CI) were 0·30 (0·10, 0·88) for lutein and 0·28 (0·11, 0·74) for β-cryptoxanthin. The associations for other dietary vitamin and carotenoid intakes were generally weaker and non-significant. Higher intakes of spinach and egg, which are important sources of lutein, were associated with a reduced odds of AMD. ORs (95% CIs) comparing extreme categories were 0·42 (0·20, 0·88) for spinach and 0·52 (95% CI: 0·27, 0·98) for egg. Participants who were in the highest category of both egg intake and spinach intake had a much greater reduced odds of having AMD (OR: 0·23; 95% CI: 0·08, 0·71) than those in the lowest category of egg intake and spinach intake. In conclusion, a higher intake of lutein and lutein-rich foods was associated with a significantly decreased odds of AMD. These findings provide further evidence of the benefits of lutein and lutein-rich foods in the prevention of AMD.
The 4.2 ka event is widely presumed to be a globally widespread aridity event and has been linked to several episodes of societal changes across the globe. Whether this climate event impacted the cultural development in south-central China remains uncertain due to a lack of regional paleorainfall records. We present here stalagmite stable carbon isotope and trace element–based reconstruction of hydroclimatic conditions from south-central China. Our data reveal a sub–millennial scale (~5.6 to 4.3 ka) drying trend in the region followed by a gradual transition to wetter conditions during the 4.2 ka event (4.3–3.9 ka). Together with the existing archaeological evidence, our data suggest that the drier climate before 4.3 ka may have promoted the Shijiahe culture, while the pluvial conditions during the 4.2 ka event may have adversely affected its settlements in low-lying areas. While military conflicts with the Wangwan III culture may have accelerated the collapse of Shijiahe culture, we suggest that the joint effects of climate and the region's topography also played important causal roles in its demise.
Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.
Four of China’s six wintering populations of “grey” geese Anser spp. declined during the last decade. In contrast, the Bar-headed Goose A. indicus wintering population in China’s Tibet Autonomous Region more than doubled. During six surveys in Tibet over a 27-year period (1991/92 to 2017/18 winters) we documented an annual growth rate of 6.8% in the Bar-headed Goose population – an increase from approximately 10,100 to 68,100 birds. We propose that in addition to the cessation of hunting, the population growth of Bar-headed Goose is being driven by changes in agricultural land use patterns in Tibet, the establishment of protected areas on the wintering and breeding grounds, and the impacts of climate change across the Tibetan Plateau. Consistent with this hypothesis, the sown area of winter wheat in Tibet has increased and geese have shifted from primarily feeding in crop stubble to planted winter wheat fields. We also found that the most rapid population growth coincided with a 1998 climate regime shift across the Tibetan Plateau resulting in warmer temperatures, an increase in net precipitation, the appearance of new lakes and changes in the water levels and surface area of historical lakes. We suggest that warmer temperatures and high-quality forage on the south-central Tibet wintering grounds may be enhancing over-winter survival, while on the breeding grounds the expansion of lakes and wet meadows is augmenting breeding and brood-rearing habitat.
Over the past few decades, the number of liquefied natural gas (LNG) ships and terminals has been increasing, playing an important role in global clean energy transportation. However, the traffic capacity of LNG shipping in port areas is limited because of its high safety requirements. In view of this problem, a novel model is proposed to study the ship traffic in a port area by combining cellular automaton (CA) and multi-agent methods. Taking the CNOOC Tianjin LNG Terminal as an example, the ship traffic in Tianjin Port is simulated. Based on the simulation results, the LNG ship traffic capacity and its impact on the general shipping traffic flow under different special traffic rules are obtained. This model can provide theoretical support for optimising the port traffic organisation for LNG ships.
Chronic tubulointerstitial nephropathy (CTIN) is one of the most common kidney diseases. However, treatment for CTIN has multiple limits. Adjuvant therapy through nutritional regulation has become a hot research topic at present. Icariin (ICA), an extraction of Chinese herbal medicine epimedium, has many pharmacological functions including anti-inflammation and tonifying kidney. Selenomethionine (SeMet) possesses the effects of antioxidant and lightening nephrotoxicity. However, little is known about the combined nephroprotection of them. This study was investigated to evaluate the joint effects of ICA and SeMet on CTIN and explore the mechanism. Based on a novel CTIN model developed in our previous study, mice were randomly divided into five groups (a: control; b: model; c: model + ICA; d: model + SeMet; e: model + ICA + SeMet). Renal tubule epithelial cells were treated with cyclosporine A and ochratoxin A without/with ICA or/and SeMet. The results showed that ICA or/and SeMet ameliorated CTIN by inhibiting the uptrends of blood urine nitrogen, serum creatinine, urine protein, urine gravity, histopathological damage degree and collagen I deposition. ICA or/and SeMet also increased cell proliferation and decreased apoptosis and the expression of transforming growth factor-beta 1 and α-smooth muscle actin. Emphatically, ICA and SeMet joint had better nephroprotection than alone in most indexes including fibrosis. Furthermore, ICA and SeMet joint decreased the activation of toll-like receptor 4 (TLR4)/NFκB pathway induced by CTIN. TLR4 overexpression counteracted the joint protection of ICA and SeMet. Therefore, ICA and SeMet in combination could protect against CTIN through blocking TLR4/NFκB pathway. The study will provide novel insights to explore an adjuvant therapeutic orientation.
The coronavirus disease 2019 (COVID-19) pandemic is a major threat to the public. However, the comprehensive profile of suicidal ideation among the general population has not been systematically investigated in a large sample in the age of COVID-19.
Methods
A national online cross-sectional survey was conducted between February 28, 2020 and March 11, 2020 in a representative sample of Chinese adults aged 18 years and older. Suicidal ideation was assessed using item 9 of the Patient Health Questionnaire-9. The prevalence of suicidal ideation and its risk factors was evaluated.
Results
A total of 56,679 participants (27,149 males and 29,530 females) were included. The overall prevalence of suicidal ideation was 16.4%, including 10.9% seldom, 4.1% often, and 1.4% always suicidal ideation. The prevalence of suicidal ideation was higher in males (19.1%) and individuals aged 18–24 years (24.7%) than in females (14.0%) and those aged 45 years and older (11.9%). Suicidal ideation was more prevalent in individuals with suspected or confirmed infection (63.0%), frontline workers (19.2%), and people with pre-existing mental disorders (41.6%). Experience of quarantine, unemployed, and increased psychological stress during the pandemic were associated with an increased risk of suicidal ideation and its severity. However, paying more attention to and gaining a better understanding of COVID-19-related knowledge, especially information about psychological interventions, could reduce the risk.
Conclusions
The estimated prevalence of suicidal ideation among the general population in China during COVID-19 was significant. The findings will be important for improving suicide prevention strategies during COVID-19.
Despite the numerous challenges of ageing in a foreign land, many older immigrants are fairly resilient and report experiencing good wellbeing. The key question that the present paper addresses is how this is achieved. Drawing on frameworks from cross-cultural and social identity literatures, the present study proposes and tests a model of serial multiple mediation that identifies possible mechanisms supporting the wellbeing of older immigrants who have resided in the host country for some time. In this model, it is predicted that new group memberships acquired post-migration enable access to social support that in turn provides the basis for perceived integration, which enhances wellbeing. This model was tested in a survey study with 102 older people, whose mean age was 80.3 years and who had migrated to Australia from Asian, European, and Central and South American countries on average 36 years previously. The survey assessed cultural identity, social group memberships acquired post-migration, perceived social support, perceived integration and wellbeing. Results supported the hypothesised model, indicating that joining new heritage culture and wider groups in Australia post-migration provided a platform for social support and integration, which enhanced life satisfaction and reduced loneliness. The implications of these findings for theory and adapting successfully to both migration and ageing are discussed.
The South China Block is one of the largest continental blocks located on the East Asian continent. The early Palaeozoic Wuyi–Yunkai orogen of the South China Block (known as the Caledonian orogen in Europe) is a major orogenic belt in East Asia and represents the first episode of extensive crustal reworking since Neoproterozoic time. Although this orogen is key to deciphering the formation and evolution of the South China Block, details about the orogen remain poorly defined. The Songshutang and Wushitou ultramafic–mafic units in southern Jiangxi Province, South China, have 206Pb–238U ages of c. 437 Ma, suggesting a Silurian formation age. All the Songshutang and Wushitou ultramafic–mafic rocks show relatively flat chondrite-normalized rare earth element patterns, depletions in Nb, Ta, Zr, Hf and Ti, and low ϵNd(t) values from −9.12 to −5.49 with negative zircon ϵHf(t) values from −10.84 to −2.58, resembling a typical arc magma affinity. Geochemical and isotopic data indicate that the newly identified ultramafic–mafic rocks, along with the reported Silurian mafic rocks in South China, possibly originated from the similar partial melting of an ancient subducted slab, fluid/sediment and metasomatized lithospheric mantle with varying degrees of fractional crystallization. In conjunction with other records of magmatism and metamorphism in South China, a late-orogenic extensional event led to the melting of the sub-continental lithospheric mantle in Silurian time and generated ultramafic–mafic rocks with a limited distribution along the Wuyi–Yunkai orogen and widespread late-orogenic granitic plutons in the South China Block.
The upsurge in the number of people affected by the COVID-19 is likely to lead to increased rates of emotional trauma and mental illnesses. This article systematically reviewed the available data on the benefits of interventions to reduce adverse mental health sequelae of infectious disease outbreaks, and to offer guidance for mental health service responses to infectious disease pandemic. PubMed, Web of Science, Embase, PsycINFO, WHO Global Research Database on infectious disease, and the preprint server medRxiv were searched. Of 4278 reports identified, 32 were included in this review. Most articles of psychological interventions were implemented to address the impact of COVID-19 pandemic, followed by Ebola, SARS, and MERS for multiple vulnerable populations. Increasing mental health literacy of the public is vital to prevent the mental health crisis under the COVID-19 pandemic. Group-based cognitive behavioral therapy, psychological first aid, community-based psychosocial arts program, and other culturally adapted interventions were reported as being effective against the mental health impacts of COVID-19, Ebola, and SARS. Culturally-adapted, cost-effective, and accessible strategies integrated into the public health emergency response and established medical systems at the local and national levels are likely to be an effective option to enhance mental health response capacity for the current and for future infectious disease outbreaks. Tele-mental healthcare services were key central components of stepped care for both infectious disease outbreak management and routine support; however, the usefulness and limitations of remote health delivery should also be recognized.
Six acidic dykes were discovered surrounding the Laiziling pluton, Xianghualing area, in the western Cathaysia Block, South China. A number of captured zircons are found in two of these acidic dykes. By detailed U–Pb dating, Lu–Hf isotopes and trace-element analysis, we find that these zircons have ages clustered at c. 2.5 Ga. Two acidic dyke samples yielded upper intersection point 206U/238Pb ages of 2505 ± 42 Ma and 2533 ± 22 Ma, and weighted mean 207Pb/206Pb ages of 2500 ± 30 Ma and 2535 ± 16 Ma. The majority of these zircons have high (Sm/La)N, Th/U and low Ce/Ce* ratios, indicating a magmatic origin, but some grains were altered by later hydrothermal fluid. Additionally, the magmatic zircons have high Y, U, heavy rare earth element, Nb and Ta contents, indicating that their host rocks were mainly mafic rocks or trondhjemite–tonalite–granodiorite rock series. Equally, their moderate Y, Yb, Th, Gd and Er contents also indicate that a mafic source formed in a continental volcanic-arc environment. These zircons have positive ϵHf(t) values (2.5–6.9) close to zircons from the depleted mantle, with TDM (2565–2741 Ma) and TDM2 (2608–2864 Ma) ages close to their formation ages, indicating that these zircons originated directly from depleted mantle magma, or juvenile crust derived from the depleted mantle in a very short period. We therefore infer that the Cathaysia Block experienced a crustal growth event at c. 2.5 Ga.
Excessive gestational weight gain (GWG) increases the risk of maternal anaemia during pregnancy, but whether it is associated with offspring anaemia has not been investigated. We aimed to prospectively investigate the association of GWG rate in the second/third trimester with infant Hb concentration and anaemia risk. The present study comprised 13 765 infants born during 2006–2009 to mothers who participated in a trial on prenatal micronutrient supplementation. The GWG was calculated by subtracting the maternal weight at enrolment from that at end-pregnancy. The GWG rate was calculated as dividing the GWG by number of weeks between the two measurements and classified into quintiles within each category of maternal BMI. Infant Hb concentrations were measured at 6 and 12 months of age, and anaemia was defined as an Hb concentration <110 g/l. Of the 13 765 infants, 949 (6·9 %) were anaemic at 6 months and 728 (5·3 %) at 12 months. The GWG rate was inversely and linearly associated with the infant Hb concentrations at both 6 and 12 months (P < 0·001 for linearity). Compared with the middle quintile of GWG rate, the highest quintile was associated with an increased risk of anaemia at 6 months (adjusted OR 1·30, 95 % CI 1·07, 1·59) and 12 months (adjusted OR 1·74, 95 % CI 1·40, 2·17). The associations were consistently mediated by maternal anaemia during pregnancy (P < 0·001). In conclusion, excessive GWG rate appears to be associated with an increased risk of infant anaemia, partly independent of maternal anaemia during pregnancy that mediates the association.