Efficacy of cognitive behavioral therapy for insomnia in the perinatal period: a meta-analysis of randomized controlled trials.

The meta-analysis aims to explore the effect of cognitive behavioral therapy for insomnia (CBT-I) in the perinatal period. Randomized controlled trials (RCTs) assessed the effects of CBT-I in perinatal women with insomnia, published in English, were eligible. Electronic searches were performed using PubMed, Embase (Elsevier), PsycINFO (Ebsco), and Web of Science (Clarivate Analytics). Insomnia Severity Index (ISI) as the primary outcome was used to estimate the pooled effects and durable efficacy of CBT-I. The secondary outcome measures were Edinburgh Postnatal Depression Scale (EPDS) and Pittsburgh Sleep Quality Index (PSQI). Of 46 studies reviewed, seven studies met the inclusion criteria. The meta-analysis indicated significant improvement in insomnia as measured with the ISI (standardized mean difference (SMD) = - 0.62, 95% confidence intervals (CI) - 0.77, - 0.47, I2 = 28%). At the follow-up time point, the meta-analysis indicated the durable efficacy of CBT-I (SMD = - 0.47, 95% CI - 0.90, - 0.03, I2 = 73%). Definite improvement of CBT-I on EPDS (SMD = -0.31, 95% CI - 0.55, - 0.06, I2 = 33%) and PSQI (SMD = - 0.82, 95% CI - 1.27, - 0.38, I2 = 68%) score change post-intervention were found. In sub-analyses, CBT-I had similar effect sizes, independent of possible modifiers (study population, comparison group, delivery format, etc.). This meta-analysis demonstrates that CBT-I is effective in alleviating insomnia, depression, and sleep quality among perinatal women. It is equally important to find that CBT-I has a durable efficacy on insomnia in the perinatal period. However, it is necessary to include larger samples and conduct rigorous RCTs to further explore this issue. Supplementary Information: The online version contains supplementary material available at 10.1007/s41105-023-00502-z.

Weight change across adulthood in relation to the risk of depression.

Background: Studies examining weight change patterns and depression are scarce and report inconsistent findings. This study-aimed to elucidate the association between weight change patterns and the risk of depression in a large, representative sample of US adults. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 was analyzed. Five weight change groups were categorized: stable normal, weight loss, weight gain, maximum overweight, and stable obesity. Depression was ascertained using the validated Patient Health Questionnaire (PHQ-9) and depression was defined as PHQ score ≥ 10. Results: A total of 17,556 participants were included. Compared with participants who maintained normal weight, stable obesity participants had increased risks of depression across adulthood from age 25 years to 10 years before the survey (OR = 1.61, 95% CI =1.23 to 2.11), in the 10 years period before the survey (OR = 2.15, 95% CI =1.71 to 2.70), and from age 25 years to survey (OR = 1.88, 95% CI =1.44 to 2.44). Weight gain was associated with an increased risk of depression from age 25 years to 10 years before the survey (OR = 1.71, 95% CI = 1.41 to 2.04), in the 10 years period before the survey (OR = 1.73, 95% CI = 1.35 to 2.21), and for the period from age 25 years to survey (OR = 1.83, 95% CI = 1.49 to 2.24). In the stratified analyses, we found statistically significant interactions with sex. Conclusion: Our study suggested that stable obesity and weight gain across adulthood were associated with increased risks of depression.

The association between extreme temperature and pulmonary tuberculosis in Shandong Province, China, 2005-2016: a mixed method evaluation.

BACKGROUND: The effects of extreme temperature on infectious diseases are complex and far-reaching. There are few studies to access the relationship of pulmonary tuberculosis (PTB) with extreme temperature. The study aimed to identify whether there was association between extreme temperature and the reported morbidity of PTB in Shandong Province, China, from 2005 to 2016. METHODS: A generalized additive model (GAM) was firstly conducted to evaluate the relationship between daily reported incidence rate of PTB and extreme temperature events in the prefecture-level cities. Then, the effect estimates were pooled using meta-analysis at the provincial level. The fixed-effect model or random-effect model was selected based on the result of heterogeneity test. RESULTS: Among the 446,016 PTB reported cases, the majority of reported cases occurred in spring. The higher reported incidence rate areas were located in Liaocheng, Taian, Linyi and Heze. Extreme low temperature had an impact on the reported incidence of PTB in only one prefecture-level city, i.e., Binzhou (RR = 0.903, 95% CI: 0.817-0.999). While, extreme high temperature was found to have a positive effect on reported morbidity of PTB in Binzhou (RR = 0.924, 95% CI: 0.856-0.997) and Weihai (RR = 0.910, 95% CI: 0.843-0.982). Meta-analysis showed that extreme high temperature was associated with a decreased risk of PTB (RR = 0.982, 95% CI: 0.966-0.998). However, extreme low temperature was no relationship with the reported incidence of PTB. CONCLUSION: Our findings are suggested that extreme high temperature has significantly decreased the risk of PTB at the provincial levels. The findings have implications for developing strategies to response to climate change.

Carbon disulfide exposure at peri-implantation disrupts embryo implantation by decreasing integrin ß3 expression in the uterine tissue of pregnant mice.

Carbon disulfide (CS2) exposure might disrupt embryo implantation in females during pregnancy but the relevant mechanism remains unclear. Since integrin ß3 has shown to be one of the cell adhesion molecules involved in embryo implantation, the current study examined the effect of CS2 exposure during the peri-implantation period on the protein and mRNA expression of integrin ß3 and its DNA methylation degree in the uterine tissue of gestational mice. Exposure was on the 3rd day of gestation (GD3), GD4, GD5 and GD6, respectively, one time administration (631.4 mg/kg). The number of implanted embryos on GD9 was observed and compared with the control, it was decreased by 32.92%, 56.11%, 56.11% and 51.21%, respectively, which revealed that GD4 and GD5 were the most sensitive time for embryotoxicity. The protein and mRNA expression of integrin ß3 were detected each day after exposure till the GD7 endpoint. It down-regulated the protein and mRNA expression of integrin ß3 in uterine tissue and there was a positive correlation between the number of embryos and the expression of protein on the first and second day after exposure. However, the degree of integrin ß3 DNA methylation was not affected, which was detected by bisulfite sequencing polymerase chain reaction (BSP) method. These findings suggest that the decreased protein and mRNA level of integrin ß3 in the uterine tissue after mice exposure to CS2 might be relevant to the underlying mechanism of embryo implantation disorders, but DNA methylation of integrin ß3 does not contribute to this action.

The polymorphism for endothelial nitric oxide synthase gene, the level of nitric oxide and the risk for pre-eclampsia: a meta-analysis.

Endothelial NO, which is synthesized by endothelial nitric oxide synthase (eNOS), has been reported to be related with the occurrence of pre-eclampsia (PE). However, the polymorphisms of eNOS (-786 T>C, 4b/a and G894T), the level of nitric oxide and the risk of PE remain unclear. Thus we performed this meta-analysis to determine the associations between them in order to predict the risk for PE and interference with PE development in the early period of antenatal care. All studies investigating the associations between PE risk and polymorphisms of eNOS, or PE risk and serum concentration of NO were reviewed. Finally, 29 studies were included, involving 11 for -786 T>C, 11 for 4b/a, and 22 for G894T polymorphisms and PE risk. In the overall analysis, -786 T>C polymorphism was found to be related with increased PE risk in the dominant model (OR=1.17, 95% CI=1.02-1.35). a allele for 4b/a suffers the high risk of PE (OR=1.46, 95% CI=1.01-2.10). In the subgroup analysis, significantly increased risk was detected among Europeans for -786 T>C polymorphism (OR=1.40, 95%CI=1.14-1.73).However, no significant association was detected for G894T polymorphism in the overall and subgroup analysis. The comprehensive evaluation of 9 available studies indicated that serum NO level was significantly decreased in case group (SMD=-0.96 umol/mL, 95%CI=-1.80, -0.12 umol/mL).Hence, we concluded that eNOS gene -786 T>C and 4b/a except for G894T polymorphisms were contributed significantly to PE risk, especially for Europeans, and a low NO concentration in serum increased the risk for PE.

[Effects of carbon disulfide exposure during peri-implantation on estrogen receptor-α expression in uterus and serum level of estrogen in pregnant mice].

OBJECTIVE: To evaluate the effects of carbon disulfide (CS(2)) exposure during peri-implantation on the estrogen receptor-α (ER-α) expression in the uterus and serum level of estradiol (E(2)) in pregnant mice, and to explore the mechanism of embryotoxicity of CS(2). METHODS: Healthy female mice were exposed to a single dose of CS(2) (631.4 mg/kg) or olive oil (solvent control) on gestational day (GD)3, GD4, GD5, or GD6. At different time points after exposure, the serum E(2) levels of the pregnant mice were measured by enzyme-linked immunosorbent assay, and the expression levels of ER-α in the uterus were measured by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot. RESULTS: Compared with the control group, the GD3, GD4, GD5, and GD6 exposure groups showed significantly decreased serum E(2) levels on day 7 of gestation (P < 0.05); the GD3 and GD5 exposure groups showed significantly decreased serum E(2) levels on day 6 of gestation (P < 0.05). The expression level of ER-α in the GD 4 exposure group was 23.6% lower than that in the control group on day 5 of gestation, and the expression level of ER-α in the GD 5 exposure group was 72.9% lower than that in the control group on day 6 of gestation (P < 0.05); the GD 3 and GD 6 exposure groups showed lower expression levels of ER-α than the control group at any time point, but no significant difference was found (P > 0.05). CONCLUSION: CS(2) exposure during peri-implantation can reduce the ER-α expression in the uterus and the serum level of E(2) in pregnant mice, which may be one of the mechanisms of embryotoxicity of CS(2).

Effects of perinatal exposure to low doses of tributyltin chloride on pregnancy outcome and postnatal development in mouse offspring.

Tributyltin (TBT), an endocrine-disrupting chemical, is well known to induce imposex in female gastropods. In this study, we assessed the effects of low doses of tributyltin chloride (TBTCl) on dams and their offspring. Pregnant mice were administered by gavage with 0, 1, 10, or 100 µg TBTCl/kg body weight/day from day 6 of pregnancy through the period of lactation. There were no TBT treatment-related deaths or clinical signs of toxicity for dams, and no treatment-related effects on body weight, litter sizes, gestational length of dams, and sex ratio, lactational body weight, postnatal survival, age at eruption of incisors, and eye opening of pups. However, at 100 µg/kg, TBTCl retarded the testes descent of male offspring. Behavioral tests showed a significant delay in cliff-drop aversion response in offspring of 10 and 100 µg/kg groups, but no significant difference in the righting reflex between control and TBT-exposed offspring was detectable. These results indicate that neurobehavioral toxicity seems to be one sensitive indicator to assess the risk of low doses of TBT.

Vascular endothelial growth factor and recurrent spontaneous abortion: a meta-analysis.

To evaluate the association between vascular endothelial growth factor (VEGF) gene polymorphisms and the risk of recurrent spontaneous abortion (RSA), a meta-analysis of published case-control studies for the VEGF gene polymorphisms (gene polymorphisms reported more than three times were selected) and the risk of RSA. Odds ratios (ORs) and 95% confidence intervals (CIs) for codominant, dominant and recessive genetic models were assessed by RevMan software. Eight studies with 2813 cases and 2830 controls were included in this meta-analysis. The pooled analysis showed that -2578C/A, -1154G/A polymorphisms of VEGF were not significantly associated with the risk of RSA neither under codominant model nor under dominant model, nor under recessive model. Whereas, for -634G/C polymorphism, the pooled OR and 95% CI were 1.23 (1.01-1.49) under recessive model; and for 936C/T polymorphism, the pooled OR and 95% CI were 1.34 (1.07-1.67) and 1.40 (1.09-1.80) under codominant and dominant models, respectively. This meta-analysis suggested that VEGF gene -2578C/A, -1154G/A polymorphisms were not significantly associated with the risk of RSA, whereas, -634G/C and +936C/T polymorphisms were associated with the risk of RSA under specific genetic models.

Vitamin A and risk of cervical cancer: a meta-analysis.

OBJECTIVE: To conduct a systematic review with meta-analysis of studies assessing the association of vitamin A (retinol, carotene and other carotenoids) intake or blood (serum or plasma) levels of vitamin A (retinol and carotene) with risk of cervical cancer. METHODS: We evaluated the studies published in English and Chinese on diet or blood vitamin A for the risk of cervical cancer. We also reviewed reference lists from retrieved articles. Meta-analysis was applied to calculate the combined effect values and their 95% confidence intervals. The risk of bias was assessed by the Egger regression asymmetry test. RESULTS: As many as 11 articles on dietary vitamin A and 4 articles on blood vitamin A were selected according to the eligibility criteria and were included in the meta-analysis, for a total of 12,136 participants. The pooled odds ratios (ORs) of cervical cancer were 0.59 (95% CI, 0.49-0.72) for total vitamin A intake and 0.60 (95% CI, 0.41-0.89) for blood vitamin A levels. The combined ORs of cervical cancer were 0.80 (95% CI, 0.64-1.00), 0.51 (95% CI, 0.35-0.73) and 0.60 (95% CI, 0.43-0.84) for retinol, carotene and other carotenoid intake, and 1.14 (95% CI, 0.83-1.56) and 0.48 (95% CI, 0.30-0.77) for blood retinol and carotene. CONCLUSIONS: Vitamin A intake and blood vitamin A levels were inversely associated with the risk of cervical cancer in this meta-analysis.