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Childhood and adolescence are vulnerable periods for mental disorders, and the COVID-19 pandemic has exacerbated mental health challenges in this population. We aimed to estimate changes in the global burden of mental disorders among children and adolescents before and during the pandemic.
Methods
Using data from the Global Burden of Diseases Study 2021, we analyzed incidence, prevalence, and years lived with disability (YLDs) for mental disorders in individuals aged 5–24. Annual percent changes in age-standardized rates were calculated, and a Bayesian age–period–cohort model estimated the expected and additional burden based on pre-pandemic trends.
Results
In 2021, an estimated 123.0 million new cases of mental disorders were reported among children and adolescents, with an 11.8% average annual increase in the age-standardized incidence rate during the pandemic. Anxiety disorders, which previously ranked third, became the leading cause of nonfatal disability (12.9 million [8.0–19.3] YLDs), while depressive disorders rose to fourth place (10.9 million [6.8–16.5] YLDs). The burden grew in most regions, especially among females, those aged 15–24, and in high sociodemographic index (SDI) areas. Based on pre-pandemic data, we estimated an additional burden of 795.0, 165.9, and 622.8 new cases per 100,000 population for total mental disorders, anxiety disorders, and depressive disorders globally in 2021, respectively. Spearman correlation analysis showed a significant positive correlation between additional burden and SDI levels.
Conclusions
These findings highlight the increased burden of mental disorders among children and adolescents during the pandemic, emphasizing the need for targeted post-pandemic mental health support.
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.
Prehistoric humans seem to have preferred inhabiting small river basins, which were closer in distance to most settlements compared to larger rivers. The Holocene landscape evolution is considered to have played a pivotal role in shaping the spatiotemporal patterns of these settlements. In this study, we conducted comprehensive research on the relationship between landscape evolution and settlement distribution within the Huangshui River basin, which is a representative small river in Central China with numerous early settlements, including a prehistoric city known as the Wangjinglou site (WJL). Using geoarchaeological investigations, optically stimulated luminescence dating, pollen analysis, and grain-size analysis, we analyzed the characteristics of the Holocene environment. The results indicate the presence of two distinct geomorphic systems, namely the red clay hills and the river valley. The red clay hills, formed in the Neogene, represent remnants of the Songshan piedmont alluvial fan that was eroded by rivers. There are three grades of terraces within the river valley. T3 is a strath terrace and formed around 8.0 ka. Both T2 and T1 are fill terraces, which were developed around 4.0 ka and during the historical period, respectively. The sedimentary features and pollen analysis indicate the existence of an ancient lake-swamp on the platform during 11.0–9.0 ka. This waterbody gradually shrank during 9.0–8.0 ka, and ultimately disappeared after 8.0 ka. Since then, the development of large-scale areas of water ceased on the higher geomorphic units. River floods also cannot reach the top of these high geomorphic units, where numerous prehistoric settlements are located, including the Xia–Shang cities of the WJL site. Our research demonstrates that landscape stability supported the long-term and sustainable development of ancient cultures and facilitated the establishment of the WJL ancient cities in the region.
Head-up tilt test (HUTT) is an important tool in the diagnosis of pediatric vasovagal syncope. This research will explore the relationship between syncopal symptoms and HUTT modes in pediatric vasovagal syncope.
Methods:
A retrospective analysis was performed on the clinical data of 2513 children aged 3–18 years, who were diagnosed with vasovagal syncope, from Jan. 2001 to Dec. 2021 due to unexplained syncope or pre-syncope. The average age was 11.76 ± 2.83 years, including 1124 males and 1389 females. The patients were divided into the basic head-up tilt test (BHUT) group (596 patients) and the sublingual nitroglycerine head-up tilt test (SNHUT) group (1917 patients) according to the mode of positive HUTT at the time of confirmed pediatric vasovagal syncope.
Results:
(1) Baseline characteristics: Age, height, weight, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and composition ratio of syncope at baseline status were higher in the BHUT group than in the SNHUT group (all P < 0.05). (2) Univariate analysis: Age, height, weight, HR, SBP, DBP, and syncope were potential risk factors for BHUT positive (all P < 0.05). (3) Multivariate analysis: syncope was an independent risk factor for BHUT positive, with a probability increase of 121% compared to pre-syncope (P<0.001).
Conclusion:
The probability of BHUT positivity was significantly higher than SNHUT in pediatric vasovagal syncope with previous syncopal episodes.
In recent years, obesity is a growing pandemic in the world and has likely contributed to increasing the incidence of obesity-related diseases. Fat mass and obesity-associated gene (FTO) is the first gene discovered which has a close connection with fat. Recent studies suggested that FTO gene has played an important role in the molecular mechanisms of many diseases. Obesity is considered to be a hereditary disease and can evoke many kinds of diseases, including polycystic ovary syndrome (PCOS), type 2 diabetes mellitus (T2DM), cancer, etc., whose exact possible molecular mechanisms responsible for the effect of FTO on obesity and obesity-related diseases remain largely unknown. In this review, we comprehensively discuss the correlation between FTO gene and obesity, cancer, PCOS, T2DM, as well as the molecular mechanism involved in these diseases.
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.
Thrombocytopenia occasionally occurs following the closure of some giant patent ductus arteriosus cases. Unfortunately, there is no associated research describing the associated risk factors for thrombocytopenia post-procedure.
Methods:
We reviewed all patients who received occluders with sizes ≥10/12 mm between January 2013 and June 2019. All the data and information on the characteristics of the patients and their follow-up were recorded. Univariate analysis, receiver operating characteristic curves, and linear regression were used to analyse the risk factors for thrombocytopenia and the predictors of hospitalisation stay.
Results:
Finally, 32 patients (17.5%) suffered from thrombocytopenia. Univariate analysis revealed the ratio between occluder disc size (mm) and body weight (kg) (1.71 ± 0.51 versus 1.35 ± 0.53) as an independent predictive factor for thrombocytopenia, and the area under the curve of the ratio of occluder size and body weight for predicting thrombocytopenia post-closure was 0.691 (95% confidence interval: 0.589–0.792, p = 0.001). The best cut-off value for the ratio of occluder size and weight was 1.5895, with a sensitivity and specificity of 68.8 and 66.9%, respectively. Each unit of the ratio of occluder size and body weight predicted an average hospitalisation stay of 2.856 days (95% confidence interval: 1.380–4.332). Treatment with medication did not reduce the hospitalisation stay or benefit platelet restoration.
Conclusion:
Once the ratio of occluder size and body weight is greater than 1.6, thrombocytopenia always exists. Every unit of the ratio of occluder size and body weight represents an additional 3 days of hospitalisation. Treatment does not reduce the duration of hospitalisation.
To assess the prevalence and to identify the associated factors of malnutrition among elderly Chinese with physical functional dependency.
Design:
Face-to-face interviews using standardised questionnaires were conducted to collect demographic information, health-related issues and psychosocial status. Physical function was measured by the Barthel Index (BI), and nutrition status was assessed by the Mini Nutritional Assessment–Short Form. Multivariate binary logistic regression was used to assess associated factors of malnutrition.
Setting:
China.
Participants:
A total of 2323 participants (aged ≥ 60 years) with physical functional dependency in five provinces in China were enrolled using a multistage cluster sampling scheme.
Results:
The prevalence of malnutrition was 17·9 % (95 % CI 16·3, 19·4). Multivariable binary logistic regression revealed the independent risk factors of poor nutrition status were being female, older age, lower educational status, poor hearing, poor physical functional status, lack of hobbies, low religious participation, poor social support, lack of social participation and changes in social participation. The study found that the most significant independent risk factor for malnutrition was complete physical functional dependence (OR 4·46, 95 % CI 2·92, 6·82).
Conclusions:
The findings of the study confirm that malnutrition and the risk of malnutrition are prevalent in Chinese older adults with physical functional dependency. In addition to demographic and physical health-related factors, psychosocial factors, which are often overlooked, are independently associated with nutrition status in Chinese older adults with physical functional dependency. A holistic approach should be adopted to screen for malnutrition and develop health promotion interventions in this vulnerable population.
Discounting rate refers to people’s tendency to reduce the rate of subjective value from delayed benefit over time. The current study investigates the relationship among belief in a just world (BJW), sense of control, and discounting rate, especially the mediating effect of sense of control between BJW and discounting rate. The study recruited 412 undergraduates to complete a BJW scale, Sense of Control scale, and the Monetary Choice Questionnaire. The results show that (1) BJW positively predicted sense of control, (2) BJW and sense of control were negatively correlated with discounting rate, and (3) sense of control completely mediated the associations between BJW and discounting rate. These findings extend those of prior studies and indicate that a sense of control underlies the association between BJW and discounting rate.
The aim of this study was to investigate the in vivo degradation mechanism and the mechanical properties of poly(lactide-co-glycolide)/beta-tricalcium phosphate (PLGA/β-TCP) composite anchors. Anchors composed of PLGA and β-TCP were implanted in the dorsal subcutaneous tissue of beagle dogs for 6, 12, 16, and 26 weeks. The degradation of the materials was evaluated by measuring the changes in thermal behavior, crystallinity, and mechanical properties. Scanning electron microscope (SEM) was used to observe the surface and longitudinal section of the material. The evaluation of mechanical strength retention and degradation properties suggest that the addition of β-TCP particles efficiently enhances their mechanical properties and thermal characteristics and delays their degradation rate. By analyzing the results of SEM, X-ray diffraction, and differential scanning calorimetry, we can infer that after 12 weeks, the connection between β-TCP and PLGA becomes less compact, which accelerates the decline of mechanical strength.
Ca2+-sensing receptor (CaSR) represents a potential therapeutic target for inflammatory bowel diseases and strongly prefers aromatic amino acid ligands. We investigated the regulatory effects of dietary supplementation with aromatic amino acids – tryptophan, phenylalanine and tyrosine (TPT) – on the CaSR signalling pathway and intestinal inflammatory response. The in vivo study was conducted with weanling piglets using a 2 × 2 factorial arrangement in a randomised complete block design. Piglets were fed a basal diet or a basal diet supplemented with TPT and with or without inflammatory challenge. The in vitro study was performed in porcine intestinal epithelial cell line to investigate the effects of TPT on inflammatory response using NPS-2143 to inhibit CaSR. Dietary supplementation of TPT alleviated histopathological injury and decreased myeloperoxidase activity in intestine challenged with lipopolysaccharide. Dietary supplementation of TPT decreased serum concentration of pro-inflammatory cytokines (IL-1β, IL-6, IL-8, IL-12, granulocyte-macrophage colony-stimulating factor, TNF-α), as well as the mRNA abundances of pro-inflammatory cytokines in intestine but enhanced anti-inflammatory cytokines IL-4 and transforming growth factor-β mRNA levels compared with pigs fed control diet and infected by lipopolysaccharide. Supplementation of TPT increased CaSR and phospholipase Cβ2 protein levels, but decreased inhibitor of NF-κB kinase α/β and inhibitor of NF-κB (IκB) protein levels in the lipopolysaccharide-challenged piglets. When the CaSR signalling pathway was blocked by NPS-2143, supplementation of TPT decreased the CaSR protein level, but enhanced phosphorylated NF-κB and IκB levels in IPEC-J2 cells. To conclude, supplementation of aromatic amino acids alleviated intestinal inflammation as mediated through the CaSR signalling pathway.
This paper describes an experimental investigation of steady-state resonant waves. Several co-propagating short-crested wave trains are generated in a basin at the State Key Laboratory of Ocean Engineering (SKLOE) in Shanghai, and the wavefields are measured and analysed both along and normal to the direction of propagation. These steady-state resonant waves are first calculated theoretically under the exact resonance criterion with sufficiently high nonlinearity, and then are generated in the basin by means of the main wave components that contain at least 95 % of the wave energy. The steady-state wave spectra are quantitatively observed within the inherent system error of the basin and identified by means of a contrasting experiment. Both symmetrical and anti-symmetrical steady-state resonant waves are observed and the experimental and theoretical results show excellent agreement. These results offer the first experimental evidence of the existence of steady-state resonant waves with multiple solutions.
Mouse strain differences in immobility and in sensitivity to antidepressants have been observed in the forced swimming test (FST) and the tail suspension test (TST). However, the neurotransmitter systems and neural substrates that contribute to these differences remain unknown. To investigate the role of the hippocampal serotonin transporter (5-HTT), we measured baseline immobility and the immobility responses to fluoxetine (FLX) in the FST and the TST in male CD-1, C57BL/6, DBA and BALB/c mice. We observed strain differences in baseline immobility time, with CD-1 mice showing the longest and DBA mice showing the shortest. In contrast, DBA and BALB/c mice showed the highest sensitivity to FLX, whereas CD-1 and C57BL/6 mice showed the lowest sensitivity. Also we found strain differences in both the total 5-HTT protein level and the membrane-bound 5-HTT level (estimated by Vmax) as follows: DBA > BALB/c > CD-1 = C57BL/6. The uptake efficiency of the membrane-bound 5-HTT (estimated by 1/Km) was highest in DBA and BALB/c mice and lowest in CD-1 and C57BL/6 mice. A correlation analysis of subregions within the hippocampus revealed that immobility time was negatively correlated with Vmax and positively correlated with Km in the hippocampus. Therefore a higher uptake capacity of the membrane-bound 5-HTT in the hippocampus was associated with lower baseline immobility and greater sensitivity to FLX. These results suggest that alterations in hippocampal 5-HTT activity may contribute to mouse strain differences in the FST and the TST.
We discuss tail behaviors, subexponentiality, and the extreme value distribution of logarithmic skew-normal random variables. With optimal normalized constants, the asymptotic expansion of the distribution of the normalized maximum of logarithmic skew-normal random variables is derived. We show that the convergence rate of the distribution of the normalized maximum to the Gumbel extreme value distribution is proportional to 1/(log n)1/2.
Cryphodera sinensis n. sp. is described from ramie (Boehmeria nivea) based on the morphology and molecular analyses of rRNA small subunit (SSU), D2D3 expansion domains of large subunit (LSU D2D3) and internal transcribed spacer (ITS). This new species is characterized by oval females with a distinct subcrystalline layer and pronounced and protruding vulval lip, distinctly concave vulva–anus profile and a vulva–anus distance of 29.5–35.8 μm. Males possess two annuli in the lip region, a stylet 27–32.5 μm in length with round knobs sloping slightly posteriorly, lateral fields with three lines, spicules 20–28 μm long and the presence of a short cloacal tube. Second-stage juveniles possess three lip annuli, a stylet 28–31 μm in length with well-developed knobs projected anteriorly and three lines along the lateral field. The pointed tail, 52–65 μm long, possesses a mucro-like tip and a hyaline region, 24.5–35 μm long. Large phasmids with a lens-like structure are located 2–6 annuli posterior to the anus. Phylogenetic analysis shows that the species has unique SSU, LSU D2D3 and ITS rRNA sequences. Phylogenetic relationships of the three rDNA sequences of C. sinensis n. sp. and other cystoid/cyst nematodes are analysed together with a comparison of other species within the genus Cryphodera.
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