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Pregnancy stressors and postpartum symptoms of depression and anxiety:the moderating role of a cognitivebehavioural therapy(CBT)intervention

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General Psychiatry 2024年第1期37卷 112-121页

作者： Yunxiang Sun Soim Park Abid Malik Najia Atif Ahmed Zaidi Atif Rahman Pamela J Surkan department of International health Johns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA department of public mental health Health Services AcademyIslamabadPakistan Human Development Research Foundation RawalpindiPakistan department of Primary Care and mental health Institute of Population HealthUniversity of LiverpoolLiverpoolUK

Background Little is known about the association between stressors(especially positive stressors)during pregnancy and postpartum depression and anxiety.Aims We investigated the association between positive and negative stress events during different stages of pregnancy and postpartum mental health outcomes among low-income pregnant women with symptoms of anxiety in Pakistan and evaluated whether an intervention based on cognitive behavioural therapy(CBT)had a regulatory effect.Methods Participants were 621 pregnant Pakistani women with mild anxiety.Using the Pregnancy Experience Scale-Brief Version,six scores were created to assess positive and negative stressors.We performed a multivariate linear regression to examine whether these six scores,measured both at baseline and in the third trimester,were associated with postpartum anxiety and depressive symptoms.The effect of the intervention on this relationship was examined by adding an interaction term to the regression model.Results Hassles frequency measured in the third trimester was positively associated with depression(B=0.22,95%confidence interval(Cl):0.09 to 0.36)and anxiety(B=0.19,95%Cl:0.08to 0.30).At the same timepoint,uplifts intensity was negatively associated with symptoms of depression(B=-0.82,95%Cl:1.46 to-0.18)and anxiety(B=-0.70,95%Cl:-1.25 to-0.15),whereas hassles intensity was positively related to symptoms of depression(B=1.02,95%Cl:0.36 to 1.67)and anxiety(B=0.90,95%Cl:0.34 to 1.47).The intensity ratio of hassles to uplifts reported in the third trimester was positively related to both depression(B=1.40,95%Cl:0.59 to 2.20)and anxiety(B=1.26,95%Cl:0.57 to 1.96).The intervention strengthened the overall positive effects of uplfts and the negative effects of hassles.Pregnancy experiences at baseline during early pregnancy to mid-pregnancy were not associated with mental health outcomes.Conclusions Stressors in the third trimester but not earlier in pregnancy were associated with postpartum symptoms of anxiety and depression.The CBT intervention m

关键词： postpartum stress behaviour

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Associations of daily sedentary behavior,physical activity,and sleep with irritable bowel syndrome:A prospective analysis of 362,193 participants

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Journal of Sport and health Science 2024年第1期13卷 72-80页

作者： Xu Gao Sifan Tian Ninghao Huang Gang Sun Tao Huang department of Occupational and Environmental health Sciences School of Public HealthPeking UniversityBeijing 100191China department of Epidemiology and Biostatistics School of Public HealthPeking UniversityBeijing 100191China department of Gastroenterology and Hepatology First Medical Center of People's Liberation Army General HospitalBeijing 100853China

Background:Irritable bowel syndrome(IBS)substantially affects quality of life and requires early prevention.This study aimed to elucidate the relationships between IBS and daily behaviors,including sedentary behavior(SB),physical activity(PA),and sleep.In particular,it seeks to identify healthy behaviors to reduce IBS risk,which previous studies have rarely addressed.Methods:Daily behaviors were retrieved from self-reported data of 362,193 eligible UK Biobank participants.Incident cases were determined by self-report or health care data according to RomeⅣcriteria.Results:A total of 345,388 participants were IBS-free at baseline,during a median follow-up of 8.45 years,19,885 incident IBS cases were recorded.When examined individually,SB and shorter(≤7 h/day)or longer(>7 h/day)sleep duration were each positively associated with increased IBS risk,and PA was associated with lower IBS risk.The isotemporal substitution model suggested that replacing SB with other activities could provide further protective effects against IBS risk.Among people sleeping≤7 h/day,replacing 1 h of SB with equivalent light PA,vigorous PA,or sleep was associated with 8.1%(95%confidence interval(95%CI):0.901-0.937),5.8%(95%CI:0.896-0.991),and 9.2%(95%CI:0.885-0.932)reduced IBS risk,respectively.For people sleeping>7 h/day,light and vigorous PA were associated with a 4.8%(95%CI:0.926-0.978)and a 12.0%(95%CI:0.815-0.949)lower IBS risk,respectively.These benefits were mostly independent of genetic risk for IBS.Conclusion:SB and unhealthy sleep duration are risk factors for IBS.A promising way to mitigate IBS risk for individuals sleeping≤7 h/day and for those sleeping>7 h/day appears to be by replacing SB with adequate sleep or vigorous PA,respectively,regardless of the genetic predisposition of IBS.

关键词： Irritable bowel syndrome Isotemporal substitution model Physical activity Sedentary behavior Sleep

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health benefits from the rapid reduction in ambient exposure to air pollutants after China's clean air actions:progress in efficacy and geographic equality

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National Science Review 2024年第2期11卷 103-113页

作者： Tao Xue Ruohan Wang Meng Wang Yanying Wang Dan Tong Xia Meng Conghong Huang Siqi Ai Fangzhou Li Jingyuan Cao Mingkun Tong Xueqiu Ni Hengyi Liu Jianyu Deng Hong Lu Wei Wan Jicheng Gong Shiqiu Zhang Tong Zhu Clean Air Asia Institute of Reproductive and Child health National Health Commission Key Laboratory of Reproductive Health/Department of Epidemiology and Biostatistics Ministry of Education Key Laboratory of Epidemiology of Major Diseases(PKU) School of Public Health Peking University Health Science Centre State Environmental Protection Key Laboratory of Atmospheric Exposure and Health Risk Management and Center for Environment and Health Peking University Advanced Institute of Information Technology Peking University department of Epidemiology and Environmental health School of Public Health and Health ProfessionsUniversity at Buffalo State Key Joint Laboratory of Environment Simulation and Pollution Control College of Environmental Sciences and EngineeringPeking University department of Earth System Science Tsinghua University School of public health Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of HealthFudan University College of Land Management Nanjing Agricultural University National&Local Joint Engineering Research Center for Rural Land Resources Use and Consolidation

Clean air actions （CAAs） in China have been linked to considerable benefits in public health.However,whether the beneficial effects of CAAs are equally distributed geographically is unknown.Using high-resolution maps of the distributions of major air pollutants (fine particulate matter[PM2.5]and ozone[O3]) and population,we aimed to track spatiotemporal changes in health impacts from,and geographic inequality embedded in,the reduced exposures to PM2.5and O3from 2013 to 2020.We used a method established by the Global Burden of Diseases Study.By analyzing the changes in loss of life expectancy（LLE） attributable to PM2.5and O3,we calculated the gain of life expectancy （GLE） to quantify the health benefits of the air-quality improvement.Finally,we assessed the geographic inequality embedded in the GLE using the Gini index （GI）.Based on risk assessments of PM2.5and O3,during the first stage of CAAs（2013 to 2017）,the mean GLE was 1.87 months.Half of the sum of the GLE was disproportionally distributed in about one quarter of the population exposed （GI 0.44）.During the second stage of CAAs（2017 to 2020）,the mean GLE increased to 3.94 months and geographic inequality decreased （GI 0.18）.According to our assessments,CAAs were enhanced,from the first to second stages,in terms of not only preventing premature mortality but also ameliorating health inequalities.The enhancements were related to increased sensitivity to the health effects of air pollution and synergic control of PM2.5and O3levels.Our findings will contribute to optimizing future CAAs.

关键词： clean air action public health inequality fine particulate matter ozone

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Independent and Combined Associations of Sleep Duration, Bedtime, and Polygenic Risk Score with the Risk of Hearing Loss among Middle-Aged and Old Chinese: The Dongfeng–Tongji Cohort Study

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Research 2024年第1期2023卷 721-733页

作者： Miao Liu Haiqing Zhang Zhichao Wang Tingting Mo Xuefeng Lai Yaling He Minghui Jiang Meian He Weijia Kong Tangchun Wu Xiaomin Zhang department of Occupational and Environmental health Ministry of Education Key Laboratory of Environment and Healthand State Key Laboratory of Environmental Health(Incubating)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina department of Otorhinolaryngology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina department of Epidemiology and Biostatistics School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina

Evidence available on the independent and combined associations of sleep duration,bedtime,and genetic predisposition with hearing loss was lacking.The present study included 15,827 participants from the Dongfeng–Tongji cohort study.Genetic risk was characterized by polygenic risk score(PRS)based on 37 genetic loci related to hearing loss.We conducted multivariate logistic regression models to assess the odds ratio(OR)for hearing loss with sleep duration and bedtime,as well as the joint association and interaction with PRS.Results showed that hearing loss was independently associated with sleeping≥9 h/night compared to the recommended 7 to9:00 p.***.to 10:00 p.***.compared to those with bedtime>10:00 p.***.to 11:00 p.m.,with estimated ORs of 1.25,1.27,and 1.16,respectively.

关键词： Middle hearing fen

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Disease Burden and Costs Associated with Multiple Sclerosis in China:A Cross-sectional Analysis of Nationwide Survey Data

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Neuroscience Bulletin 2024年第4期40卷 533-538页

作者： Yusheng Jia Xuanqi Qiao Jin Zhao Hainan Li Shanlian Hu Min Hu department of health Economics School of Public HealthFudan UniversityShanghai200032China National health Commission Key Laboratory of health Technology Assessment Fudan UniversityShanghai200032China

DearEditors,Multiple sclerosis(MS)is a chronic,autoimmune neurological disorder characterized by inflammatory demyelination of the central nervous system;it is associated with reduced mobility,cognitive impairment,and numerous comorbidities[1].Global MS incidence(2.1 per 100,000 person-years)and prevalence(30.1 per 100,000)have increased in recent years,and its prevalence is notably higher in Western countries,ranging from~30 to 200 cases per 100,000[2].In China,recent epidemiological research has shown that the crude prevalence was 2.44 per 100,000 in 2016[3],and the age-and sex-adjusted incidence was 0.235 per 100,000 person-years[4].Despite the relatively low prevalence compared with the global average,China has extensively addressed the well-being of over 30,000 MS patients,enrolling MS in China's First National List of Rare Diseases in 2018.

关键词： prevalence impairment autoimmune

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Associations between parental adherence to healthy lifestyles and cognitive performance in offspring:A prospective cohort study in China

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Chinese Medical Journal 2024年第6期137卷 683-693页

作者： Rongxia Lv Yuhui Huang Siyi Huang Shiyi Wu Siwen Wang Guangyu Hu Yanan Ma Peige Song Jorge E.Chavarro S.V.Subramanian Chunling Lu Zhihui Li Changzheng Yuan School of public health the Second Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiang 310058China department of Nutrition Harvard T.H.Chan School of Public HealthBostonMA 02115USA Institute of Medical Information/Center for health Policy and Management Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China department of Biostatistics and Epidemiology School of Public HealthChina Medical UniversityShenyangLiaoning 110122China department of Social and Behavioral Sciences Harvard T.H.Chan School of Public HealthBostonMA 02115USA Division of Global health Equity Brigham and Women’s HospitalHarvard Medical SchoolBostonMA 02115USA department of Global health and Social Medicine Harvard Medical SchoolBostonMA 02115USA Vanke School of public health Tsinghua UniversityBeijing 100084China department of Global health and Population Harvard T.H.Chan School of Public HealthBostonMA 02115USA

Background:Previous studies have reported associations of specific maternal and paternal lifestyle factors with offspring’s cognitive development during early childhood.This study aimed to investigate the prospective associations between overall parental lifestyle and offspring’s cognitive performance during adolescence and young adulthood in China.Methods:We included 2531 adolescents aged 10-15 years at baseline in 2010 from the China Family Panel Studies.A healthy parental lifestyle score(ranged 0-5)was constructed based on the following five modifiable lifestyle factors:Smoking,drinking,exercise,sleep,and diet.Generalized estimating equation models were used to examine the association between baseline parental healthy lifestyle scores and offspring’s fluid and crystallized intelligence in subsequent years(2012,2014,2016,and 2018).Results:Offspring in the top tertile of parental healthy lifestyle scores performed better in overall fluid intelligence(multivariable-adjusted β=0.53,95%confidence interval[CI]:0.29-0.77)and overall crystallized intelligence(multivariable-adjusted β=0.35,95%CI:0.16-0.54)than those in the bottom tertile of parental healthy lifestyle scores.The results were similar after further adjustment for the offspring’s healthy lifestyle scores and persisted across the subgroups of parental socioeconomic status.Additionally,maternal and paternal healthy lifestyle scores were independently associated with better offspring’s cognitive performance,with significant contribution observed for paternal never-smoking,weekly exercise,and diversified diet.When both parents and offspring adhered to a healthier lifestyle,we observed the highest level of the offspring’s overall crystallized intelligence.Conclusions:Our study indicates that parental adherence to a healthier lifestyle is associated with significantly better offspring’s cognitive performance during adolescence and early adulthood,regardless of socioeconomic status.These findings highlight the potential cognitive benefits of promoting healthy lif

关键词： Cohort study Parental healthy lifestyle Offspring Cognitive performance Intelligence Adolescence

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Intertwined depressive and cognitive trajectories and the risk of dementia and death in older adults:a competing risk analysis

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General Psychiatry 2024年第2期37卷 207-215页

作者： Ziyang Ren Lirong Nie Yushan Du Jufen Liu Institute of Reproductive and Child health/National health Commission Key Laboratory of Reproductive health Peking UniversityBeijingChina department of Epidemiology and Biostatistics School of Public HealthPeking UniversityBeijingChina

Background Depressive symptoms and cognitive impairment often interact,rendering their associations controversial.To date,their joint trajectories and associations with dementia and death remain underexplored.Aims To explore the interactions between depressive symptoms and cognitive function,their developmental trajectories and the associations with all-cause dementia,Alzheimer’s disease(AD)and all-cause death in older adults.Methods Data were from the health and Retirement Study.Depressive symptoms and cognitive function were measured using the 8-item Centre for Epidemiologic Studies Depression Scale and the Telephone Interview of Cognitive Status,respectively.All-cause dementia and AD were defined by self-reported or proxy-reported physician diagnoses.All-cause death was determined by interviews.The restricted cubic spline,group-based trajectory modelling and subdistribution hazard regression were used.Results Significant interactions between depressive symptoms and cognitive function in 2010 in their association with new-onset all-cause dementia and AD from 2010 to 2020 were found,especially in women(p for interaction<0.05).Independent trajectory analysis showed that emerging or high(vs no)depressive trajectories and poor or rapidly decreased cognitive trajectories(vs very good)from 1996 to 2010 were at significantly higher risk of subsequent all-cause dementia,AD and all-cause death.15 joint trajectories of depressive symptoms and cognitive function from 1996 to 2010 were determined,where rapidly decreased cognitive function was more common in those with no depressive symptoms.Compared with older adults with the trajectory of no depressive symptoms and very good cognitive function,those with the trajectory of no depressive symptoms but rapidly decreased cognitive function were much more likely to develop new-onset all-cause dementia and death,with subdistribution hazard ratios(95%confidence intervals)of 4.47(2.99 to 6.67)and 1.84(1.43 to 2.36),especially in women.Conclusions To effectively mitigate the risk o

关键词： death analysis rendering

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Social-ecological perspective on the suicidal behaviour factors of early adolescents in China:a network analysis

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General Psychiatry 2024年第1期37卷 143-150页

作者： Yuan Li Peiying Li Mengyuan Yuan Yonghan Li Xueying Zhang Juan Chen Gengfu Wang Puyu Su department of Maternal Child and Adolescent HealthSchool of Public HealthKey Laboratory of Population Health Across Life Cycle(Anhui Medical University)Ministry of Education of the People's Republic of ChinaAnhui Medical UniversityKey Laboratory of Population Health Across Life Cycle(Anhui Medical University)HefeiAnhuiChina Tianjin Anding Hospital Mental Health Center of Tianjin Medical UniversityTianjin Medical UniversityTianjinChina department of Environmental Medicine and public health Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA Afiliated Psychological Hospital of Anhui Medical University Anhui Mental Health CenterFourth People's Hospital of HefeiHefeiAnhuiChina

Background In early adolescence,youth are highly prone to suicidal behaviours.Identifying modifiable risk factors during this critical phase is a priority to inform effective suicide prevention strategies.Aims To explore the risk and protective factors of suicidal behaviours(ie,suicidal ideation,plans and attempts)in early adolescence in China using a social-ecological perspective.Methods Using data from the cross-sectional project‘healthy and Risky Behaviours Among Middle School Students in Anhui Province,China',stratified random cluster sampling was used to select 5724 middle school students who had completed self-report questionnaires in November 2020.Network analysis was employed to examine the correlates of suicidal ideation,plans and attempts at four levels,namely individual(sex,academic performance,serious physical llness/disability,history of self-harm,depression,impulsivity,sleep problems,resilience),family(family economic status,relationship with mother,relationship with father,family violence,childhood abuse,parental mental illness),school(relationship with teachers,relationship with classmates,school-bullying victimisation and perpetration)and social(social support,satisfaction with society).Results In total,37.9%,19.0%and 5.5%of the students reported suicidal ideation,plans and attempts in the past 6 months,respectively.The estimated network revealed that suicidal ideation,plans and attempts were collectively associated with a history of self-harm,sleep problems,childhood abuse,school bullying and victimisation.Centrality analysis indicated that the most influential nodes in the network were history of self-harm and childhood abuse.Notably,the network also showed unique correlates of suicidal ideation(sex,weight=0.60;impulsivity,weight=0.24;family violence,weight=0.17;relationship with teachers,weight=-0.03;school-bullying perpetration,weight=0.22),suicidal plans(social support,weight=-0.15)and suicidal attempts(relationship with mother,weight=-0.10;parental mental llness,weight=0.61).Conclusions Thi

关键词： network analysis prevention

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Applying Machine Learning Approach to Explore Childhood Circumstances and Self-Rated health in Old Age-China and the US,2020-2021

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China CDC weekly 2024年第11期6卷 213-218,I0008-I0013页

作者： Shutong Huo Derek Feng Thomas M.Gill Xi Chen department of health Society&BehaviorPublic HealthUniversity of CaliforniaIrvineCAUSA department of Statistics and Data Science Yale UniversityNew HavenCTUS department of Internal Medicine Yale School of MedicineNew HavenCTUS department of health Policy and Management Yale School of Public HealthNew HavenCTUS department of Economics Yale UniversityNew HavenCTUS.

Introduction:Childhood circumstances impact senior health,prompting the introduction of machine learning methods to assess their individual and collective contributions to senior health.Methods:Using health and retirement study(HRS)and China health and Retirement Longitudinal Study(CHARLS),we analyzed 2,434 American and 5,612 Chinese participants aged 60 and above.Conditional inference trees and forests were employed to estimate the influence of childhood circumstances on self-rated health(SRH).Results:The conventional method estimated higher inequality of opportunity(IOP)values in both China(0.039,accounting for 22.67%of the total Gini coefficient 0.172)and the US(0.067,accounting for 35.08%of the total Gini coefficient 0.191).In contrast,the conditional inference tree yielded lower estimates(China:0.022,accounting for 12.79%of 0.172;US:0.044,accounting for 23.04%of 0.191),as did the forest(China:0.035,accounting for 20.35%of 0.172;US:0.054,accounting for 28.27%of 0.191).Childhood health,financial status,and regional differences were key determinants of senior health.The conditional inference forest consistently outperformed others in predictive accuracy,as demonstrated by lower out-of-sample mean squared error(MSE).Discussion:The findings emphasize the need for early-life interventions to promote health equity in aging populations.Machine learning showcases the potential in identifying contributing factors.

关键词： collective inequality estimates

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Exosome-encapsulated lncRNA HOTAIRM1 contributes to PM_(2.5)-aggravated COPD airway remodeling by enhancing myofibroblast differentiation

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Science China(Life Sciences) 2024年第5期67卷 970-985页

作者： Huaqi Guo Luo Fei Hengyi Yu Yan Li Yan Feng Shaowei Wu Yan Wang The Ninth People’s Hospital of Shanghai Jiao Tong University School of Medicine Shanghai 200011China School of public health Shanghai Jiao Tong University School of MedicineShanghai 200020China department of Occupational and Environmental health Sciences School of Public HealthXi’an Jiao Tong University Health Science CenterXi’an 710049China

Emphysema,myofibroblast accumulation and airway remodeling can occur in the lungs due to exposure to atmospheric pollution,especially fine particulate matter(PM_(2.5)),leading to chronic obstructive pulmonary disease(COPD).Specifically,bronchial epithelium-fibroblast communication participates in airway remodeling,which results in COPD.An increasing number of studies are now being conducted on the role of exosome-mediated cell-cell communication in disease pathogenesis.Here,we investigated whether exosomes generated from bronchial epithelial cells could deliver information to normal stromal fibroblasts and provoke cellular responses,resulting in airway obstruction in COPD.We studied the mechanism of exosome-mediated intercellular communication between human bronchial epithelial(HBE) cells and primary lung fibroblasts(pLFs).We found that PM_(2.5)-induced HBE-derived exosomes promoted myofibroblast differentiation in pLFs.Then,the exosomal lncRNA expression profiles derived from PM_(2.5)-treated HBE cells and nontreated HBE cells were investigated using an Agilent Human LncRNA Array.Combining coculture assays and direct exosome treatment,we found that HBE cell-derived exosomal HOTAIRM1 facilitated the myofibroblast differentiation of pLFs.Surprisingly,we discovered that exosomal HOTAIRM1 enhanced p LF proliferation to secrete excessive collagen secretion,leading to airway obstruction by stimulating the TGF-β/SMAD3 signaling pathway.Significantly,PM_(2.5)reduced FEV1/FVC and FEV1 and increased the level of serum exosomal HOTAIRM1 in healthy people;moreover,serum exosomal HOTAIRM1 was associated with PM_(2.5)-related reductions in FEV1/FVC and FVC.These findings show that PM_(2.5)triggers alterations in exosome components and clarify that one of the paracrine mediators of myofibroblast differentiation is bronchial epithelial cell-derived HOTAIRM1,which has the potential to be an effective prevention and therapeutic target for PM_(2.5)-induced COPD.

关键词： PM2.5 exosomal lncRNAs HOTAIRM1 chronic obstructive pulmonary disease

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