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While the cross-sectional relationship between internet gaming disorder (IGD) and depression is well-established, whether IGD predicts future depression remains debated, and the underlying mechanisms are not fully understood. This large-scale, three-wave longitudinal study aimed to clarify the predictive role of IGD in depression and explore the mediating effects of resilience and sleep distress.
Methods
A cohort of 41,215 middle school students from Zigong City was assessed at three time points: November 2021 (T1), November 2022 (T2) and November 2023 (T3). IGD, depression, sleep distress and resilience were measured using standardized questionnaires. Multiple logistic regression was used to examine the associations between baseline IGD and both concurrent and subsequent depression. Mediation analyses were conducted with T1 IGD as the predictor, T2 sleep distress and resilience as serial mediators and T3 depression as the outcome. To test the robustness of the findings, a series of sensitivity analyses were performed. Additionally, sex differences in the mediation pathways were explored.
Results
(1) IGD was independently associated with depression at baseline (T1: adjusted odds ratio [AOR] = 4.76, 95% confidence interval [CI]: 3.79–5.98, p < 0.001), 1 year later (T2: AOR = 1.42, 95% CI: 1.16–1.74, p < 0.001) and 2 years later (T3: AOR = 1.24, 95% CI: 1.01–1.53, p = 0.042); (2) A serial multiple mediation effect of sleep distress and resilience was identified in the relationship between IGD and depression. The mediation ratio was 60.7% in the unadjusted model and 33.3% in the fully adjusted model, accounting for baseline depression, sleep distress, resilience and other covariates. The robustness of our findings was supported by various sensitivity analyses; and (3) Sex differences were observed in the mediating roles of sleep distress and resilience, with the mediation ratio being higher in boys compared to girls.
Conclusions
IGD is a significant predictor of depression in adolescents, with resilience and sleep distress serving as key mediators. Early identification and targeted interventions for IGD may help prevent depression. Intervention strategies should prioritize enhancing resilience and improving sleep quality, particularly among boys at risk.
The emotion regulation network (ERN) in the brain provides a framework for understanding the neuropathology of affective disorders. Although previous neuroimaging studies have investigated the neurobiological correlates of the ERN in major depressive disorder (MDD), whether patients with MDD exhibit abnormal functional connectivity (FC) patterns in the ERN and whether the abnormal FC in the ERN can serve as a therapeutic response signature remain unclear.
Methods
A large functional magnetic resonance imaging dataset comprising 709 patients with MDD and 725 healthy controls (HCs) recruited across five sites was analyzed. Using a seed-based FC approach, we first investigated the group differences in whole-brain resting-state FC of the 14 ERN seeds between participants with and without MDD. Furthermore, an independent sample (45 MDD patients) was used to evaluate the relationship between the aforementioned abnormal FC in the ERN and symptom improvement after 8 weeks of antidepressant monotherapy.
Results
Compared to the HCs, patients with MDD exhibited aberrant FC between 7 ERN seeds and several cortical and subcortical areas, including the bilateral middle temporal gyrus, bilateral occipital gyrus, right thalamus, calcarine cortex, middle frontal gyrus, and the bilateral superior temporal gyrus. In an independent sample, these aberrant FCs in the ERN were negatively correlated with the reduction rate of the HAMD17 score among MDD patients.
Conclusions
These results might extend our understanding of the neurobiological underpinnings underlying unadaptable or inflexible emotional processing in MDD patients and help to elucidate the mechanisms of therapeutic response.
In contemporary neuroimaging studies, it has been observed that patients with major depressive disorder (MDD) exhibit aberrant spontaneous neural activity, commonly quantified through the amplitude of low-frequency fluctuations (ALFF). However, the substantial individual heterogeneity among patients poses a challenge to reaching a unified conclusion.
Methods
To address this variability, our study adopts a novel framework to parse individualized ALFF abnormalities. We hypothesize that individualized ALFF abnormalities can be portrayed as a unique linear combination of shared differential factors. Our study involved two large multi-center datasets, comprising 2424 patients with MDD and 2183 healthy controls. In patients, individualized ALFF abnormalities were derived through normative modeling and further deconstructed into differential factors using non-negative matrix factorization.
Results
Two positive and two negative factors were identified. These factors were closely linked to clinical characteristics and explained group-level ALFF abnormalities in the two datasets. Moreover, these factors exhibited distinct associations with the distribution of neurotransmitter receptors/transporters, transcriptional profiles of inflammation-related genes, and connectome-informed epicenters, underscoring their neurobiological relevance. Additionally, factor compositions facilitated the identification of four distinct depressive subtypes, each characterized by unique abnormal ALFF patterns and clinical features. Importantly, these findings were successfully replicated in another dataset with different acquisition equipment, protocols, preprocessing strategies, and medication statuses, validating their robustness and generalizability.
Conclusions
This research identifies shared differential factors underlying individual spontaneous neural activity abnormalities in MDD and contributes novel insights into the heterogeneity of spontaneous neural activity abnormalities in MDD.
Folate metabolism is involved in the development and progression of various cancers. We investigated the association of single nucleotide polymorphisms (SNP) in folate-metabolising genes and their interactions with serum folate concentrations with overall survival (OS) and liver cancer-specific survival (LCSS) of newly diagnosed hepatocellular carcinoma (HCC) patients. We detected the genotypes of six SNP in three genes related to folate metabolism: methylenetetrahydrofolate reductase (MTHFR), 5-methyltetrahydrofolate-homocysteine methyltransferase reductase (MTRR) and 5-methyltetrahydrofolate-homocysteine methyltransferase (MTR). Cox proportional hazard models were used to calculate multivariable-adjusted hazard ratios (HR) and 95 % CI. This analysis included 970 HCC patients with genotypes of six SNP, and 864 of them had serum folate measurements. During a median follow-up of 722 d, 393 deaths occurred, with 360 attributed to HCC. In the fully-adjusted models, the MTRR rs1801394 polymorphism was significantly associated with OS in additive (per G allele: HR = 0·84, 95 % CI: 0·71, 0·99), co-dominant (AG v. AA: HR = 0·77; 95 % CI: 0·62, 0·96) and dominant (AG + GG v. AA: HR = 0·78; 95 % CI: 0·63, 0·96) models. Carrying increasing numbers of protective alleles was linked to better LCSS (HR10–12 v. 2–6 = 0·70; 95 % CI: 0·49, 1·00) and OS (HR10–12 v. 2–6 = 0·67; 95 % CI: 0·47, 0·95). Furthermore, we observed significant interactions on both multiplicative and additive scales between serum folate levels and MTRR rs1801394 polymorphism. Carrying the variant G allele of the MTRR rs1801394 is associated with better HCC prognosis and may enhance the favourable association between higher serum folate levels and improved survival among HCC patients.
This study aimed to explore the combined association between the dietary antioxidant quality score (DAQS) and leisure-time physical activity on sleep patterns in cancer survivors. Data of cancer survivors were extracted from the National Health and Nutrition Examination Surveys database in 2007–2014 in this cross-sectional study. Weighted multivariable logistic regression models were used to estimate OR and 95 % CI for the association of DAQS and leisure-time physical activity on sleep patterns. The combined association was also assessed in subgroups of participants based on age and use of painkillers and antidepressants. Among the eligible participants, 1133 had unhealthy sleep patterns. After adjusting for covariates, compared with low DAQS level combined with leisure-time physical activity level < 600 MET·min/week, high DAQS level combined with leisure-time physical activity ≥ 600 MET·min/week was associated with lower odds of unhealthy sleep patterns (OR = 0·41, 95 % CI: 0·23, 0·72). Additionally, the association of high DAQS level combined with high leisure-time physical activity with low odds of unhealthy sleep patterns was also significant in < 65 years old (OR = 0·30, 95 % CI: 0·13, 0·70), non-painkiller (OR = 0·39, 95 % CI: 0·22, 0·71), non-antidepressant (OR = 0·49, 95 % CI: 0·26, 0·91) and antidepressant (OR = 0·11, 95 % CI: 0·02, 0·50) subgroups. DAQS and leisure-time physical activity had a combined association on sleep patterns in cancer survivors. However, the causal associations of dietary nutrient intake and physical activity with sleep patterns in cancer survivors need further clarification.
Genes involved in melanin production directly impact insect pigmentation and can affect diverse physiology and behaviours. The role these genes have on sex behaviour, however, is unclear. In the present study, the crucial melanin pigment gene black was functionally characterised in an urban pest, the German cockroach, Blattella germanica. RNAi knockdown of B. germanica black (Bgblack) had no effect on survival, but did result in black pigmentation of the thoraxes, abdomens, heads, wings, legs, antennae, and cerci due to cuticular accumulation of melanin. Sex-specific variation in the pigmentation pattern was apparent, with females exhibiting darker coloration on the abdomen and thorax than males. Bgblack knockdown also resulted in wing deformation and negatively impacted the contact sex pheromone-based courtship behaviour of males. This study provides evidence for black function in multiple aspects of B. germanica biology and opens new avenues of exploration for novel pest control strategies.
This study presents the interplay of flow and acoustics within tandem deep cavities, focusing on the resonance mechanism occurring between turbulent shear layers and acoustic eigenmodes. The arrangement inside the tandem deep cavities includes both close and remote configurations. A combined fully coupled and decoupled aeroacoustic simulation strategy was devised. Employing an advanced high-order spectral/hp element method in conjunction with implicit large eddy simulation, the nonlinear compressible Navier–Stokes equations were solved to acquire internal flow–acoustic resonant field. In parallel, the linearized Navier–Stokes equations were tackled to determine coherent shear layer perturbations with external acoustic forcing. Based on acoustic measurements, the mainstream Reynolds number approaches approximately $R{e_{in}} = {O}({10^5})$, where we identified the presence of frequency lock-in and a resonance range. Aeroacoustic noise sources were examined by implementing spectral proper orthogonal decomposition to decompose the pressure fields into hydrodynamic and acoustic components. As feedback intensified, the flow characteristics by the acoustic forcing effect and the flow-interactive effect were categorized according to the development of concurrent turbulent shear layers. Subsequently, the alternating and synchronous behaviours of concurrent shear layers resonated with the out-of-phase and in-phase acoustic eigenmodes were identified, and the corresponding large-scale counter-rotating vortex pairs and co-rotating vortex structures at the cavity entrances were extracted. The acoustic power generated by the Coriolis force was calculated using Howe's vortex-sound analogy, and the aeroacoustic energy transfer mechanism between large-scale shear layer vortices with acoustic eigenmodes was further explored. Finally, a linear response of coherent perturbations of the concurrent shear layers by external acoustic forcing was established. The amplification of flow in the streamwise direction toward the main duct led to the formation of coherent vortex structures, accompanied by separation bubbles into the main duct.
The super-temporal-resolution (STR) reconstruction of turbulent flows is an important data augmentation application for increasing the data reach in measurement techniques and understanding turbulence dynamics. This paper proposes a data assimilation (DA) strategy based on weak-constraint four-dimensional variation to conduct an STR reconstruction in a turbulent jet beyond the Nyquist limit from given low-sampling-rate observations. Highly resolved large-eddy simulation (LES) data are used to produce synthetic measurements, which are used as observations and for validation. A segregated assimilation procedure is realised to assimilate the initial condition, inflow boundary condition and model error separately. Different types of observational data are tested. The first type is down-sampled LES data containing many small-scale turbulence structures with or without synthetic noise. The DA results show that the temporal variation of the small-scale structures is well recovered even with noise in the observations. The spectra are resolved to a frequency approximately one order of magnitude higher than what can be captured within the Nyquist limit. The second type of observation is low-sampling-rate tomographic particle image velocimetry (tomo-PIV) data with or without the injection of small-scale structures. The modulation between the large-scale structures contained in the tomo-PIV fields and the small scales injected from the observations is improved. The resultant small scales in the STR reconstruction have the characteristics of authentic turbulence to a considerable extent. Additionally, DA yields much smaller errors in the prediction of particle positions when compared with the Wiener filter, demonstrating the great potential for Lagrangian particle tracking in measurement techniques.
A series of organoclays with monolayers, bilayers, pseudotrilayers, paraffin monolayers and paraffin bilayers were prepared from montmorillonite by ion exchange with hexadecyltrimethylammonium bromide (HDTMAB). The HDTMAB concentrations used for preparing the organoclays were 0.5, 0.7, 1.0, 1.5, 2.0 and 2.5 times the montmorillonite cation exchange capacity (CEC). The microstructural parameters, including the BET-N2 surface area, pore volume, pore size, and surfactant loading and distribution, were determined by X-ray diffraction, N2 adsorption-desorption and high-resolution thermogravimetric analysis (HRTG). The BET-N2 surface area decreased from 55 to 1 m2/g and the pore volume decreased from 0.11 to 0.01 cm3/g as surfactant loading was increased from Na-Mt to 2.5CEC-Mt. The average pore diameter increased from 6.8 to 16.3 nm as surfactant loading was increased. After modifying montmorillonite with HDTMAB, two basic organoclay models were proposed on the basis of HRTG results: (1) the surfactant mainly occupied the clay interlayer space (0.5CEC-Mt, 0.7CEC-Mt, 1.0CEC-Mt); and (2) both the clay interlayer space and external surface (1.5CEC-Mt, 2.0CEC-Mt, 2.5CEC-Mt) were modified by surfactant. In model 1, the sorption mechanism of p-nitrophenol to the organoclay at a relatively low concentration involved both surface adsorption and partitioning, whereas, in model 2 it mainly involved only partitioning. This study demonstrates that the distribution of adsorbed surfactant and the arrangement of adsorbed HDTMA+ within the clay interlayer space control the efficiency and mechanism of sorption by the organoclay rather than BET-N2 surface area, pore volume, and pore diameter.
Heterostructures formed by nanoparticles hybridized with porous hosts are of great potential in many practical applications such as catalysis, adsorption, and environmental remediation, based on their intrinsic properties. The objectives of this study were to synthesize zerovalent iron nanoparticles/montmorillonite heterostructures and to investigate their textural evolution under different Fe loadings. Iron nanoparticles were hybridized with montmorillonite by impregnation of montmorillonite by ferric ions followed by chemical reduction with sodium borohydride in solution. These hybridized Fe nanoparticles were well dispersed on the montmorillonite surface, size adjustable, and resistant to oxidation under the protection of native Fe-oxide shells. The textural evolution of these heterostructures under various Fe loadings was investigated using nitrogen physisorption, X-ray diffraction, electron microscopy, and elemental analyses. As the Fe loadings increased, the total pore and mesopore volumes were almost unchanged; the total, micropore, and external surface areas as well as the micropore volume decreased; and the average pore diameter increased. These textural changes could be attributed to the filling of the interparticle pores of montmorillonite by a variable amount of Fe nanoparticles. In addition, with increasing Fe loadings, the mesoporous character was enhanced for these heterostructures. These fundamental results are important in understanding the structure of these heterostructures as well as in developing some novel applications in related fields.
The ordering conformation of surfactant molecules in intercalated montmorillonite prepared at various concentrations was investigated by 13C MAS NMR. The 13C MAS NMR study demonstrates the coexistence of ordered and disordered chain conformations. Two main resonance peaks are associated with the backbone alkyl chains: the resonance at 33 ppm corresponds to the ordered conformation (all-trans), and the resonance at 30 ppm corresponds to the disordered conformation (mixture of trans and gauche). Deconvolution of 13C MAS NMR spectra indicates that the ordering conformation of surfactant molecules within the gallery of montmorillonite depends very much on their orientation and packing density. When amine chains are oriented parallel to the silicate layers, the amount of all-trans conformer decreases with the increase of amine concentration. However, the amount of all-trans conformer increases with the increase of amine concentration when amine chains radiate from the silicate layers. Furthermore, 13C MAS NMR spectra show that the intercalated surfactant molecules in the clay minerals never attained the complete liquidlike or solidlike behavior.
The objective of the present study was to investigate changes in the structural, textural, and surface properties of tubular halloysite under heating, which are significant in the applications of halloysite as functional materials but have received scant attention in comparison with kaolinite. Samples of a purified halloysite were heated at various temperatures up to 1400°C, and then characterized by X-ray diffraction, electron microscopy, Fourier-transform infrared spectroscopy, thermal analysis, and nitrogen adsorption. The thermal decomposition of halloysite involved three major steps. During dehydroxylation at 500–900°C, the silica and alumina originally in the tetrahedral and octahedral sheets, respectively, were increasingly separated, resulting in a loss of long-range order. Nanosized (5–40 nm) γ-Al2O3 was formed in the second step at 1000–1100°C. The third step was the formation of a mullite-like phase from 1200 to 1400°C and cristobalite at 1400°C. The rough tubular morphology and the mesoporosity of halloysite remained largely intact as long as the heating temperature was <900°C. Calcination at 1000°C led to distortion of the tubular nanoparticles. Calcination at higher temperatures caused further distortion and then destruction of the tubular structure. The formation of hydroxyl groups on the outer surfaces of the tubes during the disconnection and disordering of the original tetrahedral and octahedral sheets was revealed for the first time. These hydroxyl groups were active for grafting modification by an organosilane (γ-aminopropyltriethoxysilane), pointing to some very promising potential uses of halloysite for ceramic materials or as fillers for novel clay-polymer nanocomposites.
Direct numerical simulations are performed to explore the effects of the rotating direction of the vertically asymmetric rough wall on the transport properties of Taylor–Couette (TC) flow, up to a Taylor number of ${Ta} = 2.39\times 10^{7}$. It is shown that, compared with the smooth wall, the rough wall with vertical asymmetric strips can enhance the dimensionless torque ${Nu}_{\omega }$. More importantly, at high Ta, clockwise rotation of the inner rough wall (where the fluid is sheared by the steeper slope side of the strips) results in a significantly greater torque enhancement compared to counter-clockwise rotation (where the fluid is sheared by the smaller slope side of the strips), due to the larger convective contribution to the angular velocity flux. However, the rotating direction has a negligible effect on the torque at low Ta. The larger torque enhancement caused by the clockwise rotation of the vertically asymmetric rough wall at high Ta is then explained by the stronger coupling between the rough wall and the bulk, attributed to the larger biased azimuthal velocity towards the rough wall at the mid-gap of the TC system, the increased turbulence intensity manifested by larger Reynolds stress and a thinner boundary layer, and the more significant contribution of the pressure force on the surface of the rough wall to the torque.
Obsessive–compulsive disorder (OCD) is a classic disorder on the compulsivity spectrum, with diverse comorbidities. In the current study, we sought to understand OCD from a dimensional perspective by identifying multimodal neuroimaging patterns correlated with multiple phenotypic characteristics within the striatum-based circuits known to be affected by OCD.
Methods
Neuroimaging measurements of local functional and structural features and clinical information were collected from 110 subjects, including 51 patients with OCD and 59 healthy control subjects. Linked independent component analysis (LICA) and correlation analysis were applied to identify associations between local neuroimaging patterns across modalities (including gray matter volume, white matter integrity, and spontaneous functional activity) and clinical factors.
Results
LICA identified eight multimodal neuroimaging patterns related to phenotypic variations, including three related to symptoms and diagnosis. One imaging pattern (IC9) that included both the amplitude of low-frequency fluctuation measure of spontaneous functional activity and white matter integrity measures correlated negatively with OCD diagnosis and diagnostic scales. Two imaging patterns (IC10 and IC27) correlated with compulsion symptoms: IC10 included primarily anatomical measures and IC27 included primarily functional measures. In addition, we identified imaging patterns associated with age, gender, and emotional expression across subjects.
Conclusions
We established that data fusion techniques can identify local multimodal neuroimaging patterns associated with OCD phenotypes. The results inform our understanding of the neurobiological underpinnings of compulsive behaviors and OCD diagnosis.
We investigate numerically the spreading dynamics of a bubble coming into contact with a smooth solid substrate in a viscous liquid. The substrate is partially wettable, and the singularity of the moving contact line is relieved by adopting the Navier-slip model. The Stokes equations are solved by employing a boundary element method coupled with adaptive mesh refinement. This allows us to realize sufficiently small slip lengths down to $O(10^{-5})$ in dimensionless form, which is crucial to resolve the local interface structures at the early stage of spreading. The results show that the early-stage spreading of the bubble is always characterized by the growth and propulsion of a dewetting liquid rim close to the contact line, while the macroscopic interface remains unchanged. The evolution of the contact line and the morphology of the rim depends on the wettability and the slip length, and a parametric investigation is performed. Based on mass conservation, a relation between the rim size and the spreading radius is established. We also propose an analytical prediction of the temporal variation in the contact line radius at the early stage of spreading, which is found to follow a logarithmically corrected linear relation rather than a pure power law. Moreover, the early stages of bubble spreading are qualitatively similar for two-dimensional and axisymmetric configurations.
The Wood Snipe Gallinago nemoricola is one of the least known shorebird species, and its habitat associations are very poorly understood. Here we provide the first assessment of the habitat use of the Wood Snipe during the breeding season. Between May and July 2021 at a 4-km2 alpine meadow in Sichuan province, China, we conducted population surveys and behavioural observations to identify sites where breeding Wood Snipe occurred and foraged. We quantified the habitat characteristics and food resource availability of these sites and compared them with randomly selected “background” sites. Comparison between 34 occurrence sites and 25 background sites indicated that during the breeding season, Wood Snipes are not distributed evenly across alpine meadow habitats, but preferred habitats in the lower part (3,378–3,624 m) of the alpine meadow with intermediate levels of soil moisture. In addition, comparison between 17 foraging sites and 24 background sites showed that the Wood Snipe tended to forage at sites with higher soil fauna abundance. We found weak evidence for denser vegetation cover at its height and no evidence for other biotic habitat variables such as vegetation composition or other abiotic habitat variables such as slope, soil penetrability, or disturbance level to influence Wood Snipe habitat associations. Our results suggest that the actual distribution range of the Wood Snipe during the breeding season may be smaller than expected from the extent of apparently suitable habitat. We advise caution in evaluating the potential habitat availability and distribution of the Wood Snipe, and call for further research to better understand the ecology of this rare species to inform its conservation.
Major depressive disorder (MDD) is a common neuropsychiatry disorder with high prevalence and recurrence rate, but the misdiagnosis rate is inevitable due to the shortage of objective laboratory-based diagnostic criteria. This study is focused on the disturbance of lipid metabolism, providing potential biomarkers for diagnosing.
Methods
Lipid metabolism-related molecules in plasma of 42 drug-naïve MDD patients and 49 healthy people were measured by liquid chromatography-mass spectrometry. Further to evaluate the diagnostic values of changed metabolites, these molecules were evaluated by the receiver operating characteristic curve. Based on the significant role of phosphatidylcholine (PC) disturbance in depression, oxidization of PCs, oxidation of 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphocholine (OxPAPC), IL-8 and caspase-3 in hippocampus, and serum of chronic lipopolysaccharide (cLPS) depression mice were detected by ELISA.
Results
Compared with healthy control, MDD patients expressed higher 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (16:0-16:0 PC, DPPC), 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphocholine (16:0-20:4 PC, PAPC), 1-palmitoyl-2-stearoyl-sn-glycero-3-phosphocholine (16:0-18:0 PC), glycocholic acid, taurocholic acid, glycoursodeoxycholic acid, and chenodeoxycholic acid glycine conjugate, and lower 1-heptadecanoyl-2-hydroxy-sn-glycero-3-phosphocholine (LPC 20:0). The 16:0-20:4 PC showed the great diagnostic value for MDD with an area under the curve (AUC) of 0.9519, and combination of 16:0 PC, 16:0-18:0 PC, and 16:0-20:4 PC exhibited the highest diagnostic value with AUC of 0.9602. OxPAPC was certified increase in hippocampus and serum of cLPS depression mice, which further supported PCs disorder participated in depression.
Conclusion
This research offers 16:0-20:4 PC as the latent diagnostic indicator for MDD and hints the important role of PCs in depression.
To determine the association between after-hours consultations and the likelihood of antibiotic prescribing for self-limiting upper respiratory tract infections (URTIs) in primary care practices.
Design:
A cross-sectional analysis using Australian national primary-care practice data (MedicineInsight) between February 1, 2016 and January 31, 2019.
Setting:
Nationwide primary-care practices across Australia.
Participants:
Adult and pediatric patients who visited primary care practices for first-time URTIs.
Methods:
We estimated the proportion of first-time URTI episodes for which antibiotic prescribing occurred on the same day (immediate prescribing) using diagnoses and prescription records in the electronic primary-care database. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the likelihood of antibiotic prescribing by the time of primary care visits were calculated using generalized estimating equations.
Results:
Among 357,287 URTI episodes, antibiotics were prescribed in 172,605 episodes (48.3%). After adjusting for patients’ demographics, practice characteristics, and seasons, we detected a higher likelihood of antibiotic prescribing on weekends compared to weekdays (OR, 1.42; 95% CI, 1.39–1.45) and on national public holidays compared to nonholidays (OR, 1.23; 95% CI, 1.17–1.29). When we controlled for patient presentation and diagnosis, the association between antibiotic prescribing and after-hours consultations remained significant: weekend versus weekdays (OR, 1.37; 95% CI, 1.33–1.41) and holidays versus nonholidays (OR, 1.10; 95% CI, 1.03–1.18).
Conclusions:
Primary-care consultations on weekends and public holidays were associated with a higher likelihood of immediate antibiotic prescribing for self-limiting URTIs in primary care. This finding might be attributed to lower resourcing in after-hours health care.
There is increasing attention on the association of socioeconomic status and individual behaviors (SES/IB) with mental health. However, the impacts of SES/IB on mental disorders are still unclear. To provide evidence for establishing feasible strategies on disease screening and prevention, we implemented Mendelian randomization (MR) design to appraise causality between SES/IB and mental disorders.
Methods
We conducted a two-sample MR study to assess the causal effects of SES and IB (dietary habits, habitual physical activity, smoking behaviors, drinking behaviors, sleeping behaviors, leisure sedentary behaviors, risky behaviors, and reproductive behaviors) on three mental disorders, including bipolar disorder, major depressive disorder and schizophrenia. A series of filtering steps were taken to select eligible genetic instruments robustly associated with each of the traits. Inverse variance weighted was used for primary analysis, with alternative MR methods including MR-Egger, weighted median, and weighted mode estimate. Complementary methods were further used to detect pleiotropic bias.
Results
After Bonferroni correction and rigorous quality control, we identified that SES (educational attainment), smoking behaviors (smoking initiation, number of cigarettes per day), risky behaviors (adventurousness, number of sexual partners, automobile speeding propensity) and reproductive behavior (age at first birth) were causally associated with at least one of the mental disorders.
Conclusions
MR study provides robust evidence that SES/IB play broad impacts on mental disorders.