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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 *** 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 *** Participants were 621 pregnant Pakistani women with mild *** the Pregnancy Experience Scale-Brief Version,six scores were created to assess positive and negative *** 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 *** effect of the intervention on this relationship was examined by adding an interaction term to the regression *** 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 *** experiences at baseline during early pregnancy to mid-pregnancy were not associated with mental health *** Stressors in the third trimester but not earlier in pregnancy were associated with postpartum symptoms

关键词： postpartum stress behaviour

Cost effectiveness of nonpharmacological prevention programs for diabetes:A systematic review of trial-based studies

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Chronic Diseases and Translational Medicine 2024年第1期10卷 12-21页

作者： Yongyi Xiong Zhaohua Huo Samuel Y.S.Wong Benjamin H.K.Yip Jockey Club School of public health and primary care Prince of Wales HospitalThe Chinese University of Hong KongShatinHong KongChina

Trial-based economic value of prevention programs for diabetes is *** aimed to review the cost-effectiveness of nonpharmacological interventions to prevent type-2 diabetes mellitus(T2DM)for high-risk *** electronic databases were searched up to March *** assessing both the cost and health outcomes of nonpharmacological interventions for people at high-risk of T2DM were *** quality of the study was assessed by the Consolidated health Economic Evaluation Reporting Standards 2022 *** primary outcome for synthesis was incremental cost-effectiveness ratios(ICER)for quality-adjusted life years(QALYs),and costs were standardized in 2022 US *** synthesis was performed,considering different types and delivery methods of *** studies included five based on the US diabetes prevention program(DPP),six on non-DPP-based lifestyle interventions,four on health education,and one on screening plus lifestyle *** with usual care,lifestyle interventions showed higher potential of cost-effectiveness than educational *** lifestyle interventions,DPP-based programs were less cost-effective(median of ICERs:$27,077/QALY)than non-DPP-based programs(median of ICERs:$1395/QALY)from healthcare perspectives,but with larger decreases in diabetes ***,the cost-effectiveness of interventions was more possibly realized through the combination of different delivery *** interventions to prevent T2DM in high-risk populations are both cost-effective and feasible in various ***,economic evidence from low-and middle-income countries is still lacking,and interventions delivered by trained laypersons and combined with peer support sessions or mobile technologies could be potentially a cost-effective solution in such settings with limited resources.

关键词： economic evaluation nonpharmacological interventions pre-diabetes prevention

Association of the INSR gene variants with the long-term response to a lifestyle intervention for preventing childhood obesity in Beijing

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中华医学杂志(英文版) 2024年第18期137卷 2024 Jul 8页

作者： Chen Jing Shan Rui Song Jieyun Wang Hui Xiao Wucai Zhou Shuang Gao Aiyu Zhang Fang Liu Zheng Department of Maternal and Child health School of Public Health Peking University Beijing China Institute of Child and Adolescent health School of Public Health Peking University Beijing China Dongcheng primary and Secondary School health care Center Beijing China Mentougou primary and Secondary School health care Center Beijing China

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 *** increasing number of studies are now being conducted on the role of exosome-mediated cell-cell communication in disease ***,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 *** 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 ***,the exosomal lncRNA expression profiles derived from PM_(2.5)-treated HBE cells and nontreated HBE cells were investigated using an Agilent Human LncRNA *** coculture assays and direct exosome treatment,we found that HBE cell-derived exosomal HOTAIRM1 facilitated the myofibroblast differentiation of ***,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 ***,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 *** 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

Introducing the Hong Kong Medical Journal and its important role in the timely dissemination of COVID-19 related knowledge

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Chinese Medical Journal 2024年第3期137卷 253-254页

作者： Rashid N Lui Kenneth KW Li Martin CS Wong Hong Kong Medical Journal Hong Kong SARChina The JC School of public health and primary care Faculty of MedicineThe Chinese University of Hong KongHong Kong SARChina

Hong Kong Medical Journal(HKMJ)is the flagship general medical journal in the Hong Kong Special Administrative Region,China,with an international *** are committed to publishing and promoting high-quality *** by our Editor-in-Chief,Professor Martin CS Wong,our Editorial Board is pleased to collaborate with *** Wang,the Editor-in-Chief of the Chinese Medical Journal(CMJ),as well as the editors of CMJ to enhance the visibility of our respective journals and foster a collaborate environment that brings forth ideas and knowledge to our readers.

关键词： journal knowledge visibility

Development of a Proof-of-Concept Multi-Method Computer Simulation to Support Rural healthcare Disaster Preparedness Planning

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International Journal of Disaster Risk Science 2024年第3期15卷 346-358页

作者： Thomas A.Berg Kristina W.Kintziger Julie Suzuki Crumly Scott A.Lawson Carole R.Myers Tracey T.Stansberry College of Nursing University of Tennessee Knoxville Department of Environmental Agricultural and Occupational Health University of Nebraska Medical Center public health and healthcare Oak Ridge Associated Universities

Due to a lack of resources, rural communities often face challenges when planning catastrophic events. This project involved applying systems thinking and model-based systems engineering to develop a proof-of-concept, multi-method computer simulation and then determining whether the simulation could be used to assess the efficacy of disaster planning approaches on health outcomes in rural communities, as a function of primary healthcare. The project focus was a rural or non-urban healthcare system experiencing a natural hazard. Both system dynamics and discrete event models were incorporated to represent subsystem operations, crucial disaster responses, as well as three key response systems: public health, emergency management, and healthcare. The subsystem models included several components: policies/procedures, communications,resources, exercises/drills/training, healthcare space and staff, and the flow of affected people into and through the *** combined simulation can serve as a first step to a more comprehensive approach to helping rural communities achieve more efficient and effective healthcare planning for disaster responses.

关键词： Computer simulation Disaster preparedness Model-based systems engineering Rural healthcare System dynamics model Systems thinking

Twin studies as an innovative approach to address research questions in cancer care within primary care settings

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Family Medicine and Community health 2024年第S2期12卷 58-62页

作者： Monalisha Sahu Department of Occupational health All India Institute of Hygiene and Public HealthKolkataIndia Department of Preventive&Social Medicine All India Institute of Hygiene and Public HealthKolkataIndia

This paper proposes the utilisation of twin studies as a novel and powerful methodological approach to investigate critical research questions pertaining to cancer prevention,screening,diagnosis,treatment and survivorship within primary care *** inherent genetic similarity between monozygotic(MZ)(identical)twins provides a unique opportunity to disentangle genetic and environmental influences on cancer-related *** twins share virtually identical genetic makeup,offering a unique opportunity to discern the relative contributions of genetic and environmental factors to cancer-related *** contrast,dizygotic(DZ)twins,also known as fraternal twins,develop from two separate eggs fertilised by two different sperm and share on average 50%of their genetic material,the same level of genetic similarity found in non-twin *** between MZ and DZ twins enable researchers to disentangle hereditary factors from shared environmental *** methodology has the potential to advance our understanding of the multifaceted interplay between genetic predisposition,lifestyle factors and healthcare interventions in the context of cancer *** paper outlines the rationale,design considerations and potential applications of twin studies in primary care-based cancer research.

关键词： prevention identical similarity

Trial characteristics and treatment effect estimates in randomized controlled trials of Chinese herbal medicine: A meta-epidemiological study

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Journal of Integrative Medicine 2024年第3期22卷 223-234页

作者： Betty H.Wang Ya-li Lin Yin-yan Gao Jin-lu Song Lang Qin Ling-qi Li Wen-qi Liu Claire C.W.Zhong Mary Y.Jiang Chen Mao Xiao-bo Yang Vincent C.H.Chung Irene X.Y.Wu Jockey Club School of public health and primary care the Chinese University of Hong KongHong Kong 999077China Xiangya School of public health Central South UniversityChangsha 410006Hunan ProvinceChina School of Chinese Medicine the Chinese University of Hong KongHong Kong 999077China School of public health Southern Medical UniversityGuangzhou 510080Guangdong ProvinceChina State Key Laboratory of Dampness Syndrome of Chinese Medicine the Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510120Guangdong ProvinceChina Chinese Medicine Syndrome Research Team the Second Affiliated HospitalGuangzhou University of Chinese MedicineGuangzhou 510120Guangdong ProvinceChina Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome Guangzhou 510120Guangdong ProvinceChina Hunan Provincial Key Laboratory of Clinical Epidemiology Central South UniversityChangsha 410006Hunan ProvinceChina

Background:Previously published meta-epidemiological studies focused on Western medicine have identified some trial characteristics that impact the treatment effect of randomized controlled trials(RCTs).Nevertheless,it remains unclear if similar associations exist in RCTs on Chinese herbal medicine(CHM).Further,Chinese medicine-related characteristics have not been explored ***:To investigate trial characteristics related to treatment effect estimates on CHM *** strategy:This meta-epidemiological study searched 5 databases for systematic reviews on CHM treatment published between January 2011 and July *** criteria:An eligible systematic review should only include RCTs of CHM and conduct at least one *** extraction and analysis:Two reviewers independently conducted data extraction on general characteristics of systematic reviews,meta-analyses and included *** also assessed the risk of bias of RCTs using the Cochrane risk of bias tool.A two-step approach was used for data *** ratio of odds ratios(ROR) and difference in standardized mean differences (dSMD) with 95%confidence interval (CI) were applied to present the difference in effect estimates for binary and continuous outcomes,***:Ninety-one systematic reviews,comprising 1338 RCTs were *** binary outcomes,RCTs incorporated with syndrome differentiation (ROR:1.23;95%CI:[1.07,1.39]),adopting Chinese medicine formula (ROR:1.19;95%CI:[1.03,1.34]),with low risk of bias on incomplete outcome data (ROR:1.29;95%CI:[1.06,1.52]) and selective outcome reporting (ROR:1.12;95%CI:[1.01,1.24]),as well as a trial size≥100 (ROR:1.23;95%CI:[1.04,1.42]) preferred to show larger effect *** for continuous outcomes,RCTs with Chinese medicine diagnostic criteria (dSMD:0.23;95%CI:[0.06,0.41]),judged as high/unclear risk of bias on allocation concealment (dSMD:-0.70;95%CI:[-0.99,-0.42]),with low risk of bias on incomplete outcome data (dSMD:0.30

关键词： Chinese herbal medicine Randomized controlled trial Risk of bias Meta-epidemiological study Effect estimates

Metabolic disorders and hepatitis: Insights from a Mendelian randomization study

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1775-1790页

作者： Ling-Bo Liang Xiang-Ping Liu Ting-Rui Mao Qiao-Li Su General Practice Ward General Practice Medical CenterWest China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of primary health care The Fourth People’s Hospital of Dazhu CountyDazhou 635100Sichuan ProvinceChina

BACKGROUND Hepatitis is a systemic disease that often results in various ***-bolic disorders,the most common comorbidities in clinical practice,were selected for this *** To investigate the causal relationship between comorbidities and hepatitis trea-tment *** A total of 23583378 single nucleotide polymorphisms from 1248743 cases and related summaries of genome-wide association studies were obtained from online public databases.A two-sample Mendelian randomization(MR)was performed to investigate causality between exposure[type 2 diabetes mellitus(T2D),hyperlipidemia,and hypertension]and outcome(chronic hepatitis B or C in-fections).RESULTS The data supported the causal relationship between comorbidities and hepatitis infections,which will affect the severity of hepatitis progression and will also provide a reference for clinical *** three exposures showed a link with progression of both hepatitis B(T2D,P=0.851;hyperlipidemia,P=0.596;and hypertension,P=0.346)and hepatitis C(T2D,P=0.298;hyperlipidemia,P=0.141;and hypertension,P=0.035).CONCLUSION The results of MR support a possible causal relationship between different ex-posures(T2D,hyperlipidemia,and hypertension)and chronic hepatitis progression;however,the potential mechanisms still need to be elucidated.

关键词： Hepatitis Comorbidity Type 2 diabetes mellitus Hyperlipidemia Hypertension