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Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used due to their profound efficacy in glycemic control and weight management. Real-world observations have revealed potential neuropsychiatric adverse events (AEs) associated with GLP-1RAs. This study aimed to comprehensively investigate and characterize these neuropsychiatric AEs with GLP-1RAs.
Methods
We analyzed GLP-1RA adverse reaction reports using the FDA Adverse Event Reporting System database. Disproportionality analysis using reporting odds ratio (ROR) identified eight categories of neuropsychiatric AEs associated with GLP-1RAs. We conducted descriptive and time-to-onset (TTO) analyses and explored neuropsychiatric AE signals among individual GLP-1RAs for weight loss and diabetes mellitus (DM) indications.
Results
We identified 25,110 cases of GLP-1RA-related neuropsychiatric AEs. GLP-1RAs showed an association with headache (ROR 1.74, 95% confidence interval [CI] 1.65–1.84), migraine (ROR 1.28, 95%CI 1.06–1.55), and olfactory and sensory nerve abnormalities (ROR 2.44, 95%CI 1.83–3.25; ROR 1.69, 95%CI 1.54–1.85). Semaglutide showed a moderate suicide-related AEs signal in the weight loss population (ROR 2.55, 95%CI 1.97–3.31). The median TTO was 16 days (interquartile range: 3–66 days).
Conclusions
In this study, we identified eight potential neuropsychiatric adverse events (AEs) associated with GLP-1RAs and, for the first time, detected positive signals for migraine, olfactory abnormalities, and sensory abnormalities. We also observed positive suicide-related signals of semaglutide, in weight loss population. This study provides a reliable basis for further investigation of GLP-1RA-related neuropsychiatric AEs. However, as an exploratory study, our findings require confirmation through large-scale prospective studies.
This study examined the sour grapes/sweet lemons rationalization through 2 conditions: ‘attainable’ (sweet lemons) and ‘unattainable’ (sour grapes), reflecting China’s 2019-nCoV vaccination strategy. The aim was to find ways to change people’s beliefs and preferences regarding vaccines by easing their safety concerns and encouraging more willingness to get vaccinated. An online survey was conducted from January 22 to 27, 2021, with 3,123 residents across 30 provinces and municipalities in the Chinese mainland. The direction of belief and preference changed in line with the sour grapes/sweet lemons rationalization. Using hypothetical and real contrasts, we compared those for whom the vaccine was relatively unattainable (‘sour grapes’ condition) with those who could get the vaccine easily (‘sweet lemons’). Whether the vaccine was attainable was determined in the early stage of the vaccine roll-out by membership in a select group of workers that was supposed to be vaccinated to the greatest extent possible, or, by being in the second stage when the vaccine was available to all. The attainable conditions demonstrated higher evaluation in vaccine safety, higher willingness to be vaccinated, and lower willingness to wait and see. Hence, we propose that the manipulation of vaccine attainability, which formed the basis of the application of sour grapes/sweet lemons rationalization, can be utilized as a means to manipulate the choice architecture to nudge individuals to ease vaccine safety concerns, reducing wait-and-see tendencies, and enhancing vaccination willingness. This approach can expedite universal vaccination and its associated benefits in future scenarios resembling the 2019-nCoV vaccine rollout.
We report a numerical investigation of a previously noticed but less explored flow state transition in two-dimensional turbulent Rayleigh–Bénard convection. The simulations are performed in a square domain over a Rayleigh number range of $10^7 \leq Ra \leq 2 \times 10^{11}$ and a Prandtl number range of $0.25 \leq Pr \leq 20$. The transition is characterized by the emergence of multiple satellite eddies with increasing $Ra$, which orbit around and interact with the main vortex roll in the system. Consequently, the main roll is squeezed to a smaller size compared with the domain and wanders around in the bulk region irregularly and extensively. This is in sharp contrast to the flow state before the transition, which is featured by a domain-sized circulatory roll with its vortex centre ‘condensed’ near the domain's centre. Detailed velocity field analysis reveals that there exists an abrupt increase in the energy fluctuations of the Fourier modes during the transition. Based on this phase-transition-like signal, the critical condition for the transition is found to follow a scaling relation as $Ra_t \sim Pr^{1.41}$ where $Ra_t$ is the critical Rayleigh number for the transition. This scaling relation is quantitatively explained by a phenomenological model grounded on the bistability behaviour (i.e. spontaneous and stochastic switching between the two flow states) observed at the edge of the transition. The model can also account for the effects of aspect ratio on the transition reported in the literature (van der Poel et al., Phys. Fluids, vol. 24, 2012).
Smectite growth is of importance across various fields due to its abundance on the surface of both Earth and Mars. However, the impact of the crystallinity of initial materials on smectite growth processes remains poorly understood. In this study, the kinetic processes of smectite growth were examined via experimental synthesis of trioctahedral Mg-Ni saponites. Mg-Ni saponites were synthesized using mixed precursors, specifically end-member Mg-saponite and Ni-saponite, which exhibit different crystallinities. The crystal chemistry and morphology of samples were analyzed using X-ray diffraction, Fourier-transform infrared spectroscopy, and high-angle annular dark-field scanning transmission electron microscopy. The experimental results converge towards these main conclusions: (i) the formation of Mg-Ni saponite solid solutions are promoted when the precursors are small particles, whereas large-particle precursors limit their own dissolution and do not yield Mg-Ni saponite solid solutions under the experimental conditions; (ii) because Ni exhibits a greater stability within the saponite structure compared to Mg, the Mg-Ni-saponite solid solutions formed more easily from the mixture of Ni-saponite germs and well-crystallized Mg-saponite precursors than from the mixture of Mg-saponite germs and well-crystallized Ni-saponite precursors; (iii) the dissolution extent (DE) of precursor mixtures increases with longer synthesis time, higher synthesis temperature, and larger gap between synthesis temperature of precursors and of samples, and stabilizes once it reaches a certain value. Thus DE can be used to estimate the kinetics of Mg-Ni saponite crystallization from precursor mixtures. These results obtained from the experimental Mg-Ni saponite system are useful for predicting the evolution processes of smectite in natural systems.
Trauma is a significant health issue that not only leads to immediate death in many cases but also causes severe complications, such as sepsis, thrombosis, haemorrhage, acute respiratory distress syndrome and traumatic brain injury, among trauma patients. Target protein identification technology is a vital technique in the field of biomedical research, enabling the study of biomolecular interactions, drug discovery and disease treatment. It plays a crucial role in identifying key protein targets associated with specific diseases or biological processes, facilitating further research, drug design and the development of treatment strategies. The application of target protein technology in biomarker detection enables the timely identification of newly emerging infections and complications in trauma patients, facilitating expeditious medical interventions and leading to reduced post-trauma mortality rates and improved patient prognoses. This review provides an overview of the current applications of target protein identification technology in trauma-related complications and provides a brief overview of the current target protein identification technology, with the aim of reducing post-trauma mortality, improving diagnostic efficiency and prognostic outcomes for patients.
The burden of mental disorders is increasing worldwide, thus, affecting society and healthcare systems. This study investigated the independent influences of age, period and cohort on the global prevalence of mental disorders from 1990 to 2019; compared them by sex; and predicted the future burden of mental disorders in the next 25 years.
Methods
The age-specific and sex-specific incidence of mental disorders worldwide was analysed according to the general analysis strategy used in the Global Burden of Disease Study in 2019. The incidence and mortality trends of mental disorders from 1990 to 2019 were evaluated through joinpoint regression analysis. The influences of age, period and cohort on the incidence of mental disorders were evaluated with an age–period–cohort model.
Results
From 1990 to 2019, the sex-specific age-standardized incidence and disability-adjusted life years (DALY) rate decreased slightly. Joinpoint regression analysis from 1990 to 2019 indicated four turning points in the male DALY rate and five turning points in the female DALY rate. In analysis of age effects, the relative risk (RR) of incidence and the DALY rate in mental disorders in men and women generally showed an inverted U-shaped pattern with increasing age. In analysis of period effects, the incidence of mental disorders increased gradually over time, and showed a sub-peak in 2004 (RR, 1.006 for males; 95% CI, 1.000–1.012; 1.002 for women, 0.997–1.008). Analysis of cohort effects showed that the incidence and DALY rate decreased in successive birth cohorts. The incidence of mental disorders is expected to decline slightly over the next 25 years, but the number of cases is expected to increase.
Conclusions
Although the age-standardized burden of mental disorders has declined in the past 30 years, the number of new cases and deaths of mental disorders worldwide has increased, and will continue to increase in the near future. Therefore, relevant policies should be used to promote the prevention and management of known risk factors and strengthen the understanding of risk profiles and incidence modes of mental disorders, to help guide future research on control and prevention strategies.
Prostrate water primrose is a troublesome weed in rice paddy fields. A study was conducted to determine the influence of environmental and agronomic factors on its emergence. The efficacy of herbicides on this species was also examined. The germination percentage of mature seeds remained above 90% within 180 d after harvest, indicating a low primary dormancy of this species. Light stimulated seed germination. Seeds buried deeper than 0.5 cm did not form seedlings. These results suggest that stale seedbed practices and deep tillage operations can mitigate the occurrence of this species in paddy fields. The optimum temperature for germination varied from 25/15 C to 35/25 C. The osmotic potential and salt concentration needed to inhibit 50% of maximum germination were −0.4 MPa and 197 mM, respectively. Seeds were tolerant to flooding and did not germinate at pH 8 to 10. The preemergence herbicides oxadiazon, oxadiargyl, and butachlor had excellent control efficacy on prostrate water primrose, with a 95.4% to 100% reduction in seedling number and a 99.2% to 100% reduction in biomass, respectively. The postemergence herbicides MCPA-Na + bentazone, bentazone, MCPA-Na, and fluroxypyr applied at the 2- to 3-leaf stage of prostrate water primrose provided a 90.6% to 100% reduction in seedling number and a 99.3% to 100% reduction in biomass. The results of this study can help in developing sustainable and effective integrated weed management strategies for controlling prostrate water primrose in paddy fields.
The relationships between childhood weight self-misperception and obesity-related factors particularly health markers have not been extensively discussed. This study aims to examine the associations between weight self-misperception and obesity-related knowledge, attitudes, lifestyles and cardio-metabolic markers among Chinese paediatric population.
Design:
Cross-sectional study.
Setting:
Data sourced from a national survey in Chinese seven provinces in 2013.
Participants:
Children and adolescents aged 5–19 years.
Results:
Of the total 14 079 participants, there were 14·5 % and 2·2 % participants over-estimated and under-perceived their weight, respectively. Multi-variable logistic regression was applied to calculate OR and 95 % CI (95 % Cl) of obesity-related behaviours and cardio-metabolic markers by actual and perceived weight status. Individuals who perceived themselves as overweight/obese were more likely to have prolonged screen time, insufficient dairy intake and over sugar-sweetened beverages consumption (all P < 0·05), regardless of their weight. Furthermore, actual overweight/obese individuals had higher odds of abnormal cardio-metabolic markers, but a smaller magnitude of association was found among weight under-estimators. Among non-overweight/obese individuals, weight over-estimation was positively associated with abdominal obesity (OR: 10·49, 95 % CI: 7·45, 14·76), elevated blood pressure (OR: 1·30, 95 % CI: 1·12, 1·51) and dyslipidemia (OR: 1·43, 95 % CI: 1·29, 1·58).
Conclusions:
Weight over-perception was more prevalent than under-estimation, particularly in girls. Weight over-estimators tended to master better knowledge but behave more unhealthily; both weight over-perception and actual overweight/obesity status were associated with poorer cardio-metabolic markers. Future obesity intervention programmes should additionally pay attention to the population with inaccurate estimation of weight who were easily overlooked.
Dynamic interpersonal therapy (DIT) is a brief, structured psychodynamic psychotherapy with demonstrated efficacy in treating major depressive disorder (MDD). The aim of the study was to determine whether DIT is an acceptable and efficacious treatment for MDD patients in China.
Method
Patients were randomized to 16-week treatments with either DIT plus antidepressant medication (DIT + ADM; n = 66), general supportive therapy plus antidepressant medication (GST + ADM; n = 75) or antidepressant medication alone (ADM; n = 70). The Hamilton Depression Rating Scale (HAMD) administered by blind raters was the primary efficacy measure. Assessments were completed during the acute 16-week treatment and up to 12-month posttreatment.
Results
The group × time interaction was significant for the primary outcome HAMD (F = 2.900, df1 = 10, df2 = 774.72, p = 0.001) in the acute treatment phase. Pairwise comparisons showed a benefit of DIT + ADM over ADM at weeks 12 [least-squares (LS) mean difference = −3.161, p = 0.007] and 16 (LS mean difference = −3.237, p = 0.004). Because of the unexpected high attrition during the posttreatment follow-up phase, analyses of follow-up data were considered exploratory. Differences between DIT + ADM and ADM remained significant at the 1-, 6-, and 12-month follow-up (ps range from 0.001 to 0.027). DIT + ADM had no advantage over GST + ADM during the acute treatment phase. However, at the 12-month follow-up, patients who received DIT remained less depressed.
Conclusions
Acute treatment with DIT or GST in combination with ADM was similarly efficacious in reducing depressive symptoms and yielded a better outcome than ADM alone. DIT may provide MDD patients with long-term benefits in symptom improvement but results must be viewed with caution.
Suppose you need to complete a task of 5 steps, each of which has equal difficulty and pass rate. You somehow have a privilege that can ensure you pass one of the steps, but you need to decide which step to be privileged before you start the task. Which step do you want to privilege? Mathematically speaking, the effect of each step on the final outcome is identical, and so there seems to be no prima facie reason for a preference. Five studies were conducted to explore this issue. In Study 1, participants could place the privilege on any of steps 1–5. Participants were most inclined to privilege step 5. In Study 2, participants needed to pay some money to purchase the privilege for steps 1–5, respectively. Participants would pay most money for step 5. Study 3 directly reminded participants that the probability of success of the whole task is mathematically the same, no matter on which step the privilege is placed, but most of the participants still prefer to privilege the final step. Study 4 supposed that the outcomes of all steps were not announced until all steps were finished, and asked how painful participants would feel if they passed all steps but one. People thought they would feel most painful when they failed at the final step. In Study 5, an implicit association test showed that people associated the first step with easy and the final step with hard. These results demonstrated the phenomenon of the final step effect and suggested that both anticipated painfulness and stereotype may play a role in this phenomenon.
Parametric interaction allows both forward and backward energy transfers among the three interacting waves. The back-conversion effect is usually detrimental when unidirectional energy transfer is desired. In this theoretical work, we manifest that the back-conversion effect underpins the direct generation of the picosecond pulse train without the need for a laser resonator. The research scenario is an optical parametric amplification (OPA) that consists of a second-order nonlinear medium, a quasi-continuous pump laser and a sinusoidal amplitude-modulated seed signal. The back-conversion of OPA can transfer the modulation peaks (valleys) of the incident signal into output valleys (peaks), which inherently induces spectral sidebands. The generation of each sideband is naturally accompanied with a phase shift of ±π. In the regime of full-back-conversion, the amount and amplitude of the sidebands reach the maximum simultaneously, and their phase constitutes an arithmetic sequence, leading to the production of a picosecond pulse train. The generated picosecond pulse train can have an ultrahigh repetition rate of 40 GHz or higher, which may facilitate ultrafast applications with ultrahigh speed.
The mumps resurgence has frequently been reported around the world in recent years, especially in many counties mumps vaccines have been widely used. This study aimed to describe the spatial epidemiological characteristics of mumps in Jiangsu, and provide a scientific basis for the implementation and adjustment of strategies to prevent and control mumps. The epidemiological characteristics were described with ratio or proportion. Spatial autocorrelation, Tango's flexible spatial scan statistics, and Kulldorff's elliptic spatiotemporal scan statistics were applied to identify the spatial autocorrelation, detect hot and cold spots of mumps incidence, and aggregation areas. A total of 172 775 cases were reported from 2004 to 2020 in Jiangsu. The general trend of mumps incidence is declining with a bimodal seasonal distribution identified mainly in summer and winter, respectively. Children aged 5–10 years old are the main risk group. A migration trend of hot spots from southeast to northwest over time was found. Similar high-risk aggregations were detected in the northwestern parts through spatial-temporal analysis with the most likely cluster time frame around 2019. Local medical and health administrations should formulate and implement targeted health care policies and allocate health resources more appropriately corresponding to the epidemiological characteristics of mumps.
Increasing evidence supports sarcopenia as an important parameter for predicting cardiometabolic risks. The objective of this study was to investigate the relationship between muscle mass, muscle strength, and physical performance, and cardiovascular risk among older community-dwelling adults.
Design:
The associations between dynapenia, sarcopenia, and Framingham risk score (FRS) were estimated by multivariate regression models.
Setting:
Muscle mass is estimated by skeletal muscle mass index using a bioelectrical impedance analysis. Muscle strength is measured by handgrip strength using an analogue isometric dynamometer. Physical performance is measured by gait speed using a 6-m walking distance. Dynapenia was defined as low muscle strength and/or slow gait speed presents with normal muscle mass. The diagnosis of presarcopenia and sarcopenia was based on criteria proposed by the Asian Working Group for Sarcopenia in 2014. The FRS was used for evaluating 10-year coronary heart disease (CHD) risk.
Participants:
Adults aged 65 years and older who attended health examinations from 2015 to 2017 were recruited.
Results:
There were totally 709 subjects enrolled in this study. Dynapenic men (n 47) had 17·70 ± 5·08 % FRS and sarcopenic women (n 74) had 7·74 ± 6·06 % FRS. Participants with presarcopenia had the lowest FRS (men: 15·41 ± 5·35 %; women: 5·25 ± 3·70 %). Men with dynapenia had higher FRS than the presarcopenia group with odds ratio (OR) of 2·52 (95 % confidence interval (CI): 1·03, 6·14). Women with sarcopenia had significantly higher FRS than the presarcopenia group with OR of 2·81 (95 % CI: 1·09, 7·27).
Conclusion:
Older dynapenic men and older sarcopenic women had higher risks of 10-year CHD. Presarcopenic older adults had the lowest CHD risk in both genders.
High-Mg andesites (HMAs) are crucial for the reconstruction of plate tectonics, continental margin formation and lithospheric evolution. In this study, we present new fossil age, whole-rock geochemical and Sr–Nd isotope data on the newly discovered Dundunshan Group HMAs in the Dundunshan area of the Beishan orogen (central-southern Central Asian Orogenic Belt). The Dundunshan HMA samples are characterized by high MgO (6.47–7.02 wt%) contents and high Mg# values (67.27–68.77), with SiO2 (58.57–62.13 wt%), Al2O3 (14.49–16.07 wt%) and CaO (5.05–6.24 wt%) resembling typical HMAs. The Dundunshan HMA samples are calc-alkaline and strongly enriched in light rare earth elements (LREEs) and large-ion lithophile elements (LILEs), with slightly negative Eu anomaly and high-field-strength element (HFSE) depletions. Their (87Sr/86Sr)i ratios (0.7041–0.7057) and ϵNd(t) (3.73–5.59) indicate that the Dundunshan HMAs were mainly formed by the interactions between subducted oceanic sediment-derived melts and mantle peridotites. Fossil evidence and published radiometric age data constrain the formation of the Dundunshan HMAs to early Late Devonian time. Sedimentological features of the Middle Devonian Sangejing Formation and regional tectonic correlation suggest that the Hongliuhe–Niujuanzi–Xichangjing Ocean in the Dundunshan area was likely closed during late Middle Devonian time, and that the Dundunshan HMAs were formed in a post-collision extensional setting.
To examine the association between sleep duration in different stages of life and amnestic mild cognitive impairment (aMCI).
Design, setting, and participants:
A total of 2472 healthy elderly and 505 patients with aMCI in China were included in this study. The study analyzed the association between aMCI and sleep duration in different stages of life.
Measurements:
We compared sleep duration in different stages of life and analyzed the association between Montreal Cognitive Assessment scores and sleep duration by curve estimation. Logistic regression was used to evaluate the association between aMCI and sleep duration.
Results:
In the analysis, there were no results proving that sleep duration in youth (P = 0.719, sleep duration < 10 hours; P = 0.999, sleep duration ≥ 10 hours) or midlife (P = 0.898, sleep duration < 9 hours; P = 0.504, sleep duration ≥ 9 hours) had a significant association with aMCI. In the group sleeping less than 7 hours in late life, each hour more of sleep duration was associated with approximately 0.80 of the original risk of aMCI (P = 0.011, odds ratio = 0.80, 95% confidence interval = 0.68–0.95).
Conclusions:
Among the elderly sleeping less than 7 hours, there is a decreased risk of aMCI for every additional hour of sleep.
The most important issue for the clinical application of sarcopenic obesity (SO) is the lack of a consensus definition. The aim of the present study was to determine the best measurement for SO by estimating the association between various definitions and the risk of falls and metabolic syndrome (MS). We studied a community of 765 adults aged 65 years and older in 2015–2017. Sarcopenia obesity was measured by sarcopenia (defined by low muscle mass with either low handgrip strength or low gait speed or both) plus obesity (defined by waist circumference, body fat percentage and BMI). The MS was defined according to the National Cholesterol Education Program ATP III. Logistic regression models were constructed to examine the relationships between sarcopenia obesity and risk of fall and MS. In the analysis of the fall risk with SO defined by waist circumference, the participants with non-sarcopenia/non-obesity were treated as the reference group. The OR to fall in participants with SO was 10·16 (95 % CI 2·71, 38·13) after adjusting for confounding covariates. In the analysis of the risk of the MS between participants with individual components of sarcopenia coupled with obesity defined by waist circumference, the risk was statistically significant for low gait speed (OR: 7·19; 95 % CI 3·61, 14·30) and low grip strength (OR: 9·19; 95 % CI 5·00, 16·91). A combination of low grip strength and abdominal obesity for identifying SO may be a more precise and practical method for predicting target populations with unfavourable health risks, such as falls risk and MS.
The prediction of prognosis is an important part of management in hepatitis B virus (HBV)-related decompensated cirrhosis patients with high long-term mortality. Lactate is a known predictor of outcome in critically ill patients. The aim of this study was to assess the prognostic value of lactate in HBV-related decompensated cirrhosis patients. We performed a single-centre, observational, retrospective study of 405 HBV-related decompensated cirrhosis patients. Individuals were evaluated within 24 h after admission and the primary outcome was evaluated at 6-months. Multivariable analyses were used to determine whether lactate was independently associated with the prognosis of HBV-related decompensated cirrhosis patients. The area under the ROC (AUROC) was calculated to assess the predictive accuracy compared with existing scores. Serum lactate level was significantly higher in non-surviving patients than in surviving patients. Multivariable analyses demonstrated that lactate was an independent risk factor of 6-months mortality (odds ratio: 2.076, P < 0.001). Receiver operating characteristic (ROC) curves were drawn to evaluate the discriminative ability of lactate for 6-months mortality (AUROC: 0.716, P < 0.001). Based on our patient cohort, the new scores (Model For End-Stage Liver Disease (MELD) + lactate score, Child–Pugh + lactate score) had good accuracy for predicting 6-months mortality (AUROC = 0.769, P < 0.001; AUROC = 0.766, P < 0.001). Additionally, the performance of the new scores was superior to those of existing scores (all P < 0.001). Serum lactate at admission may be useful for predicting 6-months mortality in HBV-related decompensated cirrhosis patients, and the predictive value of the MELD score and Child–Pugh score was improved by adjusting lactate. Serum lactate should be part of the rapid diagnosis and initiation of therapy to improve clinical outcome.
The use of a corn–earthworm coculture (CE) system is an eco-agricultural technology that has been gradually extended due to its high economic output and diverse ecological benefits for urban agriculture in China. However, the effect of CE on weed occurrence has received little attention. A 5-yr successive experiment (2015 to 2019) was conducted to compare weed occurrence in CE and a corn (Zea mays L.) monoculture (CM). The results show that CE significantly decreased weed diversity, the dominance index, total weed density, and biomass, but increased the weed evenness index. The 5-yr mean number of weed species per plot was 8.4 in CE and 10.7 in CM. Compared with those in CM, the 5-yr mean density and biomass of total weeds in CE decreased by 59.2% and 66.6%, respectively. The effect of CE on weed occurrence was species specific. The mean density of large crabgrass [Digitaria sanguinalis (L.) Scop.], green foxtail [Setaria viridis (L.) P. Beauv.], goosegrass [Eleusine indica (L.) Gaertn.], and common purslane (Portulaca oleracea L.) in CE decreased by 94.5%, 78.1%, 75.0%, and 45.8%, whereas the mean biomass decreased by 96.2%, 80.8%, 76.9%, and 41.4%, respectively. Our study suggests that the use of CE could suppress weed occurrence and reduce herbicide inputs in agriculture.
During the COVID-19 pandemic, the use of telemedicine as a way to reduce COVID-19 infections was noted and consequently deregulated. However, the degree of telemedicine regulation varies from country to country, which may alter the widespread use of telemedicine. This study aimed to clarify the telepsychiatry regulations for each collaborating country/region before and during the COVID-19 pandemic.
Methods
We used snowball sampling within a global network of international telepsychiatry experts. Thirty collaborators from 17 different countries/regions responded to a questionnaire on barriers to the use and implementation of telepsychiatric care, including policy factors such as regulations and reimbursement at the end of 2019 and as of May 2020.
Results
Thirteen of 17 regions reported a relaxation of regulations due to the pandemic; consequently, all regions surveyed stated that telepsychiatry was now possible within their public healthcare systems. In some regions, restrictions on prescription medications allowed via telepsychiatry were eased, but in 11 of the 17 regions, there were still restrictions on prescribing medications via telepsychiatry. Lower insurance reimbursement amounts for telepsychiatry consultations v. in-person consultations were reevaluated in four regions, and consequently, in 15 regions telepsychiatry services were reimbursed at the same rate (or higher) than in-person consultations during the COVID-19 pandemic.
Conclusions
Our results confirm that, due to COVID-19, the majority of countries surveyed are altering telemedicine regulations that had previously restricted the spread of telemedicine. These findings provide information that could guide future policy and regulatory decisions, which facilitate greater scale and spread of telepsychiatry globally.
The soil weed seedbank is the source of future weed infestations. Seed predation can result in a large number of seed losses, thus contributing to weed biocontrol. Earthworms are important predators of seeds and seedlings and affect seeds and seedling survival after gut passage. A study was conducted to assess the ability of Pheretima guillelmi (Kinberg) to ingest and digest the seeds and seedlings of 15 main farmland weed species. Pheretima guillelmi ingested the seeds and seedlings of each weed species tested. The percentages of seeds and seedlings ingested were 96.7% to 100% and 21.7% to 94.2%, respectively. Pheretima guillelmi showed greater ingestion of seeds than seedlings for each species and digested the seeds and seedlings of each weed species tested to varying extents. The percentages of seeds and seedlings digested were less than 15% irrespective of the weed species. Passage through the gut of P. guillelmi affected the survival of seeds and seedlings. The germination of large crabgrass [Digitaria sanguinalis (L.) Scop.], green foxtail [Setaria viridis (L.) P. Beauv.], goosegrass [Eleusine indica (L.) Gaertn.], Chinese sprangletop [Leptochloa chinensis (L.) Nees], Malabar sprangletop [Leptochloa fusca (L.) Kunth], redroot pigweed (Amaranthus retroflexus L.), common purslane (Portulaca oleracea L.), barnyardgrass [Echinochloa crus-galli (L.) P. Beauv.], and ricefield flatsedge (Cyperus iria L.) seeds egested by P. guillelmi decreased by 46%, 49%, 47%, 25%, 38%, 26%, 32%, 13%, and 15%, respectively, compared with their respective controls. In contrast to seed ingestion, ingestion of seedlings by P. guillelmi was fatal to individuals of all weed species; no seedlings survived passage through the gut. Our results indicate that predation of weed seeds and seedlings by P. guillelmi probably depletes the soil weed seedbank and that the introduction of P. guillelmi into fields is a potential strategy for weed biocontrol in farmland.