Translation and validation of the Chinese version of the menstrual distress questionnaire.

BACKGROUND: The Menstrual Distress Questionnaire (MDQ) is a commonly used questionnaire that assesses various symptoms and distress associated with the menstrual cycle in women. However, the questionnaire has not been completely translated into Chinese with rigorous reliability and validity testing. METHODS: This study translated the Menstrual Distress Questionnaire Form Cycle (MDQC) from English into Chinese: MDQCC in two stages. First, it was translated forward and backward using Jones' model; second, to test the validity and reliability, 210 Chinese-speaking women were recruited through online announcements and posters posted between June 2019 and May 2020. Expert validity, construct validity, convergent validity, and factorial validity were determined using content validity index (CVI), intraclass correlation coefficient (ICC), composite reliability (CR), and exploratory factor analysis, respectively. For concurrent criterion validity, MDQCC score was compared with three existing pain scales. Reliability was evaluated using internal consistency across items and two-week test-retest reliability over time. RESULTS: The CVI for content validity was .92. Item-CVI for expert validities among the 46 items ranged from .50 - 1; scale-CVI for the eight subscales, from .87 - 1; ICC, from .650 - .897; and CRs, from .303 - .881. Pearson correlation coefficients between MDQCC and short-form McGill pain questionnaire, present pain intensity, and visual analog scale scores were .640, .519, and .575, respectively. Cronbach's α for internal consistency was satisfactory (.932). ICC for test-retest reliability was .852 for the entire MDQCC. CONCLUSION: MDQCC was valid and reliable for Mandarin Chinese-speaking women. It can be used to evaluate female psychiatric symptoms related to the menstrual cycle in future work.

The Menstrual Distress Questionnaire has been used to evaluate menstrual distress, including dysmenorrhoea and premenstrual syndrome. This questionnaire has been translated into Persian, Korean, Japanese, and Cantonese, rendering it to be used more and more widely all over the world. The study translated all 46 items of the Menstrual Distress Questionnaire from English to Mandarin Chinese using a two-stage strategy. The Chinese version of this questionnaire developed by the present study was found to be a valid and reliable tool in Chinese Mandarin-speaking female populations. It could be used to evaluate women's physical and psychiatric symptoms related to the menstrual cycle in future works.

Research on Alternating Current Field Measurement Method for Buried Defects of Titanium Alloy Aircraft Skin.

Titanium alloys are extensively used in the manufacturing of key components in aerospace engines and aircraft structures due to their excellent properties. However, aircraft skins in harsh operating environments are subjected to long-term corrosion and pressure concentrations, which can lead to the formation of cracks and other defects. In this paper, a detection probe is designed based on the principle of alternating current field measurement, which can effectively detect both surface and buried defects in thin-walled titanium alloy plates. A finite element simulation model of alternating current field measurement detection for buried defects in thin-walled TC4 titanium alloy plates is established using COMSOL 5.6 software. The influence of defect length, depth, and excitation frequency on the characteristic signals is investigated, and the detection probe is optimized. Simulation and experimental results demonstrate that the proposed detection probe exhibits high detection sensitivity to varying lengths and depths of buried defects, and can detect small cracks with a length of 3 mm and a burial depth of 2 mm, as well as deep defects with a length of 10 mm and a burial depth of 4 mm. The feasibility of this probe for detecting buried defects in titanium alloy aircraft skin is confirmed.

Stroke and suicide among people with severe mental illnesses.

The associations between people with severe mental illnesses (SMI) and the risks of stroke, suicide, and death remain unclear. We examined healthcare service usage among adults with and without SMI and explored the risk of stroke, suicide, and death. We divided 18-80-year-old adults with SMI into catastrophic and non-catastrophic illness groups. These groups were subjected to a 1:5:5 propensity score matching with people without SMI. Data on demographic characteristics, economic factors, environmental factors, comorbid conditions, self-injury behavior, the number of outpatients and ED visits, and hospitalization were collected. The primary outcomes were risks of stroke, suicide, and death. We included 19,570 people with catastrophic SMI, 97,850 with non-catastrophic SMI, and 97,850 controls. Patients with SMI, especially those with catastrophic illnesses, had higher stroke risk, suicide, and death than those without SMI. People with SMI used health services more frequently than those without SMI. Patients with a history of hospitalization or ED access had a higher risk of stroke, suicide, and death. Our data indicate that special attention should be given to patients with SMI, particularly those with a history of healthcare service utilization, such as through more extended hospital stays with high-intensity interventions.

Hinge-like paper-based dual-channel enzyme-free ratiometric fluorescent microfluidic platform for simultaneous visual detection of carbaryl and glyphosate.

On-site multi-pesticide residues detection is particularly urgent and challenging. Here, we fabricated an enzyme-free ratiometric fluorescent detection system in combination with a hinge-like dual-channel 3D microfluidic paper analytical device (3D µPAD) for simultaneous visual detection of carbaryl and glyphosate. Blue-emission 1-naphthol (Em. 470 nm) was hydrolyzed from carbaryl, while yellow-emission 2,3-diaminophenazine (Em. 570 nm) was produced with the aid of Cu2+ for glyphosate sensing. Inner-filter effect between 1-naphthol or 2,3-diaminophenazine and green-emission carbon dots (Em. 510 nm) realized two ratiometric fluorescent detection systems. Remarkable color variation of green-blue for carbaryl (50.00-1100 µΜ) and yellow-green for glyphosate (5.00-600 µΜ) were observed on a dual-channel 3D µPAD without crosstalk. Their detection limits were 1.11 and 0.63 µΜ, respectively. The strategy realized simultaneous visual detection of carbaryl and glyphosate in food/herbal with excellent accuracy (spiked recoveries, 91.00-107.2%), high precision (RSD ≤ 8.43%), and superior selectivity.

Dopamine Receptor 1 Impedes ILC2-Mediated Antitumor Immunity.

Ever-growing evidence has revealed that group 2 innate lymphoid cells (ILC2s) exhibit pleiotropic effects in antihelminth immunity, allergy, tissue protection, and cancer. Currently, the role of ILC2s in cancer is highly controversial regarding the intricate tumor microenvironment (TME), and the tumor-promoting or antitumor immunological mechanisms of ILC2s remain largely unknown. In this study, we report that dopamine receptor 1 (DRD1) restrains ILC2 activity in the TME. DRD1 deficiency promotes ILC2 activation, which irritates eosinophil recruitment and cytotoxic CD8+ T cell expansion during ongoing malignancy. Consequently, DRD1-deficient mice exhibit delayed tumor growth and reduced tumor progression. Furthermore, fenoldopam, a selective DRD1 agonist, restrains the ILC2 response in the TME and aggravates tumor burden in mice. Taken together, our data elaborate that the DRD1 signal acts as an excitatory rheostat in regulating ILC2-dependent antitumor immunity.

Regulation of endothelial cells on the osteogenic ability of bone marrow mesenchymal stem cells in peri-implantitis.

OBJECTIVES: The relationship between bone resorption and angiogenesis in peri-implantitis remains to be studied. We constructed a Beagle dog model of peri-implantitis, and extracted bone marrow mesenchymal stem cells (BMSCs) and endothelial cells (ECs) for culture. The osteogenic ability of BMSCs in the presence of ECs was investigated through an in vitro osteogenic induction model, and its mechanism was initially explored. SUBJECTS AND METHODS: The peri-implantitis model was verified by ligation, bone loss was observed by micro-CT, and cytokines were detected by ELISA. The isolated BMSCs and ECs were cultured to detect the expression of angiogenesis, osteogenesis-related proteins, and NF-κB signaling pathway-related proteins. RESULTS: 8 weeks after surgery, the peri-implant gums were swollen, and micro-CT showed bone resorption. Compared with the control group, IL-1ß, TNF-α, ANGII and VEGF were markedly increased in the peri-implantitis group. In vitro studies found that the osteogenic differentiation ability of BMSCs co-cultured with IECs was decreased, and the expression of NF-κB signaling pathway-related cytokines was increased. CONCLUSION: Endothelial cells inhibit the osteogenic differentiation of bone marrow mesenchymal stem cells through NF-κB signaling in the environment of peri-implantitis, which may become a new target for the treatment of peri-implantitis.

Design and Performance Research of a New Dual-Excitation Uniform Eddy Current Probe.

A dual-excitation uniform eddy current probe, composed of two excitation coils placed tangentially and one detection coil placed horizontally, is developed to solve the difficulties of detection rate and direction recognition of crack defect. Firstly, a probe simulation model is established using COMSOL Multiphysics, and the differences of eddy current distribution between the dual-excitation probe and the traditional probe are investigated. Then, the influence of the distance between excitation coils on sensitivity and the test capability for crack defects with different depths and directions are investigated. Besides, the sensitivity of the dual-excitation probe is compared to that of the traditional probe made of the same coils. Finally, a physical probe and an experimental system are developed, and the performance of the dual-excitation probe is tested. The experimental results show that the probe developed in this paper exhibits a slightly higher sensitivity than the traditional probe for crack defects with different depths in the range of 0.5 mm-4.0 mm; the measurement accuracy of crack length is about 3.0 mm and can avoid missing detection of crack defects with different directions. In testing, the detection signal can be compensated to achieve precision measurement by identifying the angle of crack defects. This dual-excitation uniform eddy current probe can be used for precise quantification and direction identification of crack defect in eddy current testing.

Anxiety and depression risk in Taiwan women with breast cancer and cervical cancer.

Background: Studies comparing mental disorder risks between women with breast cancer and cervical cancer are lacking. This study compared risks of developing anxiety and depression between women with breast cancer (BC cohort) and women with cervical cancer (CC cohort) using insurance claims data of Taiwan. Methods: From the 2000 to 2016 data, we identified a BC cohort and BC controls (N = 96,862) and a CC cohort and CC controls (N = 26,703), matched by propensity scores. Incident mental disorders and the Cox method estimated the related cancer cohort to control cohort hazard ratios (HRs), and 95% confidence intervals (CIs) were estimated by the end of 2016. Results: Compared to the CC cohort, the BC cohort had slightly higher incident anxiety (15.9 versus 15.5 per 1,000 person-years) and depression (6.92 vs. 6.28 per 1,000 person-years). These mental disorders were higher in respective cancer cohorts than controls. The BC cohort to BC control adjusted HRs of anxiety and depression were 1.29 (95% CI = 1.25-1.33) and 1.78 (95% CI = 1.69-1.87), respectively. The corresponding adjusted HRs for the CC cohort were 1.12 (95% CI = 1.06-1.18) and 1.29 (95% CI = 1.18-1.41). The combined incidence rates of both disorders were 1.4-fold greater in the BC cohort than in BC controls (22.8 vs. 15.8 per 1,000 person-years), and 1.2-fold greater in the CC cohort than in the CC controls (21.7 vs. 18.3 per 1,000 person-years). Conclusion: Women with breast cancer or cervical cancer are at an elevated likelihood of developing anxiety and depression disorders. These incident disorders are slightly higher in those with breast cancer.

Thermal sensation, sick building syndrome symptoms, and physiological responses of occupants in environments with vertical air temperature differences.

Vertical air temperature differences (VTDs) can have important influences on thermal comfort and the evaluation of air distributions. The air distributions might create either positive or negative VTDs. However, no research has clearly revealed the effect of different directions of VTDs on human comfort. To create environments with positive and negative VTDs in this study, the air temperature of half of the body was maintained at an air temperature of 25 °C, whereas the other half of the body (the upper or lower body part, respectively) was exposed to air temperatures of 22 °C, 25 °C, 28 °C, and 31 °C, respectively. That is two series of experiments with the same VTD value but different directions were compared, based on 16 subjects seated in a climatic box in a climate chamber. The thermal sensations, sick building syndrome (SBS) symptoms, and physiological responses of occupants were studied. The results showed that subjects were more sensitive to the VTD at the upper body part in warm environments with respect to thermal sensations, perceived air quality, and sweat intensity. The analysis indicated that there were more discomfort and heat stress for positive VTDs than negative VTDs. Thus, the criterion for acceptable negative VTDs should be different with the positive VTDs incorporated in current standards. Overall, the directions of the VTDs were suggested to be considered for evaluating the thermally stratified air distributions based on both of thermal comfort and energy efficiency in buildings.

A New Design of the Dual-Mode and Pure Longitudinal EMAT by Using a Radial-Flux-Focusing Magnet.

An electromagnetic acoustic transducer (EMAT) is suitable for measuring the propagation time more accurately without causing abrasion to the transducer during testing due to the principle of its excitation. This work designs a flux-concentrating EMAT with a radial-flux-focusing permanent magnet to significantly enhance static magnetic field strength. Through theoretical analysis and finite element simulation, two kinds of coils are designed according to the concentration areas of the horizontal and vertical components of the magnetic field. One is used to generate pure longitudinal waves, and the other is used to generate both longitudinal waves and shear waves. The experimental comparison shows that the amplitudes of the pure longitudinal wave and the dual-mode wave excited by the two kinds of coils with the radial-flux-focusing magnet are more than two times higher than those with the ordinary magnet. Therefore, the flux-concentrating EMAT with the appropriate coil provides an insight into realizing more accurate detection where longitudinal wave detection is required.

Effects of customized resin base on bonding strength of spherical self-ligating brackets.

PURPOSE: Fabricating resin bases has become an easy and economical method to achieve the customization of brackets. This study aimed to assess the effect of the resin base on bonding strength of spherical self-ligating brackets. METHODS: A defined amount of adhesive was bonded to the bracket base and constituted the new resin base. The thickness of the adhesive was measured and controlled at 0.5, 1.0, 1.5 and 2.0 mm, and a group without a resin base was used as a control. Sixty extracted human premolars were randomly divided into five groups. The brackets in each group were bonded to the specimen, and debonding tests were conducted. The shear bond strength (SBS) was calculated according to the measured debonding force in relation to the base area. The adhesive remnant index (ARI) score and the residual location of the fractured resin base were recorded. Enamel damage was also analyzed by scanning electron microscopy. After assessing for data normality and homogeneity, statistical comparisons between the groups and correlations among parameters were determined. P < 0.05 was regarded as significant. RESULTS: The correlation analysis revealed an inverse correlation between the resin base thickness and the SBS (Coeff = -0.719, P < 0.01). The highest SBS was 9.33 MPa, in the control group, which was significantly greater than the lowest SBS (6.03 MPa), in the 2.0-mm group (P < 0.05). Multiple comparisons analysis revealed no differences in SBS between the 1.0-, 1.5- and 2.0-mm groups. Nonparametric analysis found that only the ARI score in the 0.5-mm group (2.92) was significantly different (P < 0.05) from that in the control group (1.25). As the thickness of the resin base increased, the fractured resin base tended to remain at the bracket base, and the risk of enamel damage decreased. CONCLUSIONS: As the thickness of the resin base increased, the bonding strength of the spherical bracket decreased. However, the required clinical bonding strength was still satisfied when the thickness was less than 2.0 mm. The existence of a resin base could protect the enamel surface from damage caused by debonding. The customization of spherical brackets by tailoring a resin base can be applied in clinical practice because of the clinically acceptable bonding strength.

LINC00968 promotes osteogenic differentiation in vitro and bone formation in vivo via regulation of miR-3658/RUNX2.

Osteogenic differentiation of dental pulp stem cells (DPSCs) is considered as a promising strategy in posterior maxilla tooth implantation. Information on the function and mechanisms of long non-coding RNAs (lncRNAs) in osteogenic differentiation of DPSCs is growing, however, the mechanism of LINC00968 and miR-3658 in regulating osteogenic differentiation of DPSCs still needs to be explored. In this study, the LINC00968 and miR-3658 expression level was upregulated and downregulated in DPSCs and peri-implantitis DPSCs (pDPSCs) treated with bone morphogenic protein (BMP)2, respectively. Moreover, the effects of LINC00968 and miR-3658 on BMP2-induced osteogenic differentiation of DPSCs in vitro using Alizarin Red S staining, alkaline phosphatase (ALP) activity, quantitative real time PCR and Western blot assays showed that overexpression of LINC00968 significantly promoted mineralized bone matrix, alkaline phosphatase (ALP), runt-related transcription factor 2 (RUNX2), and osterix (OSX) expression levels for osteogenic differentiation of DPSCs and pDPSCs; and overexpression of miR-3658 showed an opposite result that inhibited osteogenic differentiation of DPSCs and pDPSCs. Luciferase reporter assay showed that luciferase activities of LINC00968-WT reporter and RUNX2-WT reporter were strongly suppressed by miR-3658 overexpression. In addition, the miR-3658 upregulation interfered ectopic bone formation in vivo stimulated by LINC00968. In general, we had identified a novel molecular pathway involving LINC00968/miR-3658/RUNX2 during DPSCs and pDPSCs differentiation into osteoblasts, which might facilitate bone anabolism.

Research on Detection Mechanism of Weld Defects of Carbon Steel Plate Based on Orthogonal Axial Eddy Current Probe.

The uneven surface of the weld seam makes eddy current testing more susceptible to the lift-off effect of the probe. Therefore, the defect of carbon steel plate welds has always been a difficult problem in eddy current testing. This study aimed to design a new type of eddy current orthogonal axial probe and establish the finite element simulation model of the probe. The effect of the probe structure, coil turns, and coil size on the detection sensitivity was simulated. Further, a designed orthogonal axial probe was used to conduct a systematic experiment on the weld of carbon steel specimens, and the 0.2 mm width and 1 mm depth of weld defects of carbon steel plates were effectively detected. The experimental results showed that the new orthogonal axial eddy current probe effectively suppressed the unevenness effect of the weld surface on the lift-off effect during the detection process.

The regulatory mechanisms of IGF1 in the osteogenic differentiation of canine MSMSCs via BMP2⁃Smad 1/5 signaling pathway / 口腔疾病防治

Objective@#To investigate the role of the bone morphogenetic protein 2 (BMP2)⁃Smad1/5 and p38MAPK signaling pathways in the osteogenic differentiation of MSMSCs by insulin⁃like growth factor 1 (IGF1).@* Methods @#A re⁃ combinant adenovirus (RAD) and IGF1 expressing IGF1 gene were constructed. After osteogenic induction, qRT⁃PCR and Western blot were used to detect the phosphorylation level of Smad1/5 and the expression of the BMP⁃2 protein in the BMP⁃Smad signaling pathway; immunohistochemistry was used to observe the nuclear translocation of Smad1/5; qRT⁃PCR and Western blot were used to detect IGF with Noggin and SB203580, inhibitors of the p38MAPK signaling path⁃ way 1⁃mediated osteogenic differentiation of MSMSCs@* Results@#The recombinant IGF1 adenovirus was constructed suc⁃ cessfully. MSMSCs were cultured in inductive medium after infection with different concentrations of Ad⁃IGF1, and then, the protein levels of BMP2 and p⁃Smad1/5 increased. IGF1 can also induce nuclear translocation of Smad1/5. In addition, Noggin significantly reduced the phosphorylation level of Smad1/5 and the formation of mineralized nodules in the MSMSCs. The mRNA levels of Runx2, OPN and ALP also decreased. In contrast, SB203580 decreased neither the phosphorylation level of p38 nor the mRNA expression of Runx2, OPN and ALP in the Ad⁃IGF1 MSMSCs@* Conclu⁃sion@#IGF1 can promote the osteogenic differentiation of MSMSCs via the BMP2⁃Smad1/5 signaling pathway. In con⁃ trast, IGF1 may not promote the osteogenic differentiation of MSMSCs via the p38MAPK signaling pathway.

Patients with Cerebral Stroke Have an Increased Risk of Gastroesophageal Reflux Disease: A Population-Based Cohort Study.

BACKGROUND: Medical complications following stroke often result in significant morbidity. This study was designed to investigate the prevalence and risk of gastroesophageal reflux disease (GERD) between patients with stroke and those without stroke in Taiwan. METHODS AND RESULTS: This retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database. The study included 18,412 patients newly diagnosed as having stroke during 2000-2006 and 18,412 patients without stroke frequency-matched by sex, age, and index year. All patients were followed from the index date to December 31, 2011. The Cox proportional hazards regression model was used to estimate the GERD risk. The GERD risk was approximately 1.51-times higher in the stroke group than in the nonstroke group, after adjustment for age, sex, and the cumulative incidence of some comorbidities. GERD was positively associated with stroke; the male sex (adjusted hazard ratio [HR] = 1.31); an age of 65 years or older (adjusted HR = 1.11); hyperlipidemia (adjusted HR = 1.14); ischemic heart disease (adjusted HR = 1.27); renal disease (adjusted HR = 1.45); and use of aspirin (adjusted HR = 2.34), clopidogrel (adjusted HR = 1.41), and dipyridamole (adjusted HR = 1.30). CONCLUSIONS: This study indicates a significantly higher GERD risk in patients with stroke than in the nonstroke group. In clinical practice, neurologists should focus on the risk of GERD symptoms.

Severe hypertriglyceridemia secondary to venlafaxine use in an older adult on dialysis -case report.

BACKGROUND: Although the prescribing information for Venlafaxine extended release includes a discussion about possible increases in total cholesterol and triglycerides (TG) seen in healthier adult patients during premarketing clinical trials, no post-marketing studies or case reports, that discuss the effects of venlafaxine on TG in elderly patients with chronic kidney disease. CASE PRESENTATION: We report a 71 year-old male patient with end-stage renal disease on hemodialysis, with a history of coronary artery disease, mild hyperlipidemia, and hypertension. This patient twice demonstrated the severe rises in triglycerides while taking the antidepressant, i.e., venlafaxine, and discontinuing the long-term use of fenofirate. The adverse drug reaction sub-committee at the hospital rated the second event as a "probable reaction" using the Naranjo nomogram, accordingly. CONCLUSIONS: This case demonstrates the risk of changes in lipid profiles while taking venlafaxine and receiving on and off fenofibrate therapy in the older adult patient with chronic kidney disease and under hemodialysis. Regular monitoring for lipid changes after starting venlafaxine is strongly advised for patients with existing risk factors.

Increased risk of concurrent gastroesophageal reflux disease among patients with Sjögren's syndrome: A nationwide population-based study.

BACKGROUND: Little data is available on the risk of gastroesophageal reflux disease in patients diagnosed with Sjögren's syndrome. METHODS: We identified 4650 Sjögren's syndrome patients between 2000 and 2011 from the National Health Insurance Research Database. Each Sjögren's syndrome patient was matched to 4 controls based on age, sex, and index year, and all subjects were followed up from the index date to December 31, 2011. Cox proportional hazards regression model was used to estimate the risk of gastroesophageal reflux disease. RESULTS: The risk of gastroesophageal reflux disease for Sjögren's syndrome patients was 2.41-fold greater than that for the comparison cohort after adjusting for age, sex, and comorbidities. In age stratified analyses, the youngest Sjögren's syndrome cohort (age: 20-44years old) had the highest risk (HR=3.02; 95% CI=2.48-3.69) and the lowest risk at age ≥65years (HR=1.95; 95% CI=1.61-2.36). Regardless of in subjects with and without comorbidity, Sjögren's syndrome patients had a higher risk than the controls. Sjögren's syndrome subjects with ischemic heart disease, hyperlipidemia and renal disease had the highest risk for gastroesophageal reflux disease compared with the comparison cohort without those diseases (HR=7.67; 95% CI=5.32-11.1). CONCLUSION: Patients with Sjögren's syndrome have a significantly greater risk of developing subsequent gastroesophageal reflux disease than the general population.

Type 2 Diabetes Mellitus in Youth Exposed to Antipsychotics: A Systematic Review and Meta-analysis.

IMPORTANCE: Antipsychotics are used increasingly in youth for nonpsychotic and off-label indications, but cardiometabolic adverse effects and (especially) type 2 diabetes mellitus (T2DM) risk have raised additional concern. OBJECTIVE: To assess T2DM risk associated with antipsychotic treatment in youth. DATA SOURCES: Systematic literature search of PubMed and PsycINFO without language restrictions from database inception until May 4, 2015. Data analyses were performed in July 2015, and additional analyses were added in November 2015. STUDY SELECTION: Longitudinal studies reporting on T2DM incidence in youth 2 to 24 years old exposed to antipsychotics for at least 3 months. DATA EXTRACTION AND SYNTHESIS: Two independent investigators extracted study-level data for a random-effects meta-analysis and meta-regression of T2DM risk. MAIN OUTCOMES AND MEASURES: The coprimary outcomes were study-defined T2DM, expressed as cumulative T2DM risk or as T2DM incidence rate per patient-years. Secondary outcomes included the comparison of the coprimary outcomes in antipsychotic-treated youth with psychiatric controls not receiving antipsychotics or with healthy controls. RESULTS: Thirteen studies were included in the meta-analysis, including 185,105 youth exposed to antipsychotics and 310,438 patient-years. The mean (SD) age of patients was 14.1 (2.1) years, and 59.5% were male. The mean (SD) follow-up was 1.7 (2.3) years. Among them, 7 studies included psychiatric controls (1,342,121 patients and 2,071,135 patient-years), and 8 studies included healthy controls (298,803 patients and 463,084 patient-years). Antipsychotic-exposed youth had a cumulative T2DM risk of 5.72 (95% CI, 3.45-9.48; P < .001) per 1000 patients. The incidence rate was 3.09 (95% CI, 2.35-3.82; P < .001) cases per 1000 patient-years. Compared with healthy controls, cumulative T2DM risk (odds ratio [OR], 2.58; 95% CI, 1.56-4.24; P < .0001) and incidence rate ratio (IRR) (IRR, 3.02; 95% CI, 1.71-5.35; P < .0001) were significantly greater in antipsychotic-exposed youth. Similarly, compared with psychiatric controls, antipsychotic-exposed youth had significantly higher cumulative T2DM risk (OR, 2.09; 95% CI, 1.50-52.90; P < .0001) and IRR (IRR, 1.79; 95% CI, 1.31-2.44; P < .0001). In multivariable meta-regression analyses of 10 studies, greater cumulative T2DM risk was associated with longer follow-up (P < .001), olanzapine prescription (P < .001), and male sex (P = .002) (r(2) = 1.00, P < .001). Greater T2DM incidence was associated with second-generation antipsychotic prescription (P ≤ .050) and less autism spectrum disorder diagnosis (P = .048) (r(2) = 0.21, P = .044). CONCLUSIONS AND RELEVANCE: Although T2DM seems rare in antipsychotic-exposed youth, cumulative risk and exposure-adjusted incidences and IRRs were significantly higher than in healthy controls and psychiatric controls. Olanzapine treatment and antipsychotic exposure time were the main modifiable risk factors for T2DM development in antipsychotic-exposed youth. Antipsychotics should be used judiciously and for the shortest necessary duration, and their efficacy and safety should be monitored proactively.

High prevalence of herpes zoster in patients with depression.

OBJECTIVE: Patients diagnosed with depression are at an elevated risk of physical illness. Researchers have noted that depression negatively affects immune function and leads to increased susceptibility to infection, including herpes zoster. Few epidemiologic studies have been conducted on whether patients with depression are at a higher risk of herpes zoster. We conducted a retrospective population-based cohort study to investigate whether depression is associated with an increased risk of herpes zoster. METHOD: We identified 22,886 patients with depression (ICD-9: 296.2, 296.3, 300.4, and 311) in 2000-2005 from National Health Insurance (Taiwan) claims and selected 91,542 controls, frequency matched by sex, age, and index year. We calculated the risk of herpes zoster (ICD-9: 053) between the 2 cohorts in Cox proportional hazards regression. RESULTS: Incidence of herpes zoster was 1.3 times higher in patients with depression than in controls (4.58 vs 3.54 per 1,000 person-years, respectively), with an adjusted hazard ratio (HR) of 1.11 (95% CI, 1.01-1.21). In subjects aged 45-54 years, those with depression had a significantly higher risk than controls (HR = 1.44; 95% CI, 1.19-1.73). In multivariable analysis, malignant conditions (HR = 1.41; 95% CI, 1.15-1.72), rheumatic diseases (HR = 1.28; 95% CI, 1.14-1.44), hyperlipidemia (HR = 1.24; 95% CI, 1.14-1.36), renal diseases (HR = 1.21; 95% CI, 1.08-1.36), anxiety (HR = 1.21; 95% CI, 1.07-1.38), sleep disorder (HR = 1.20; 95% CI, 1.09-1.31), and hypertension (HR = 1.11; 95% CI, 1.02-1.21) were potential risk factors for herpes zoster. CONCLUSIONS: Patients diagnosed with depression are at an elevated risk of herpes zoster, particularly those aged 45 to 54 years and those with comorbidities, including renal diseases, hyperlipidemia, malignant conditions, rheumatic diseases, hypertension, anxiety, and sleep disorder.

The Association Between Behavior Restrictions in Doing-the-Month Practice and Mental Health Status Among Postpartum Women.

OBJECTIVES: Doing-the-month practice has been commonly observed by women during the first month after delivery for hundreds of years in several countries of Asia. This retrospective study examined the correlation between these restricted behaviors and mental status in postpartum women. MATERIALS AND METHODS: The frequencies of seven restricted behaviors during the first month after delivery and levels of depression, anxiety, and sleep quality were measured in 341 women 4-6 weeks after delivery through self-reported questionnaires. The multivariate linear regression model was used to determine independent behavioral predictors for depression, anxiety, and sleep quality. RESULTS: Bathing or showering was an independent predictor of low depression status, low anxiety status (p<0.05), and good sleep quality (p<0.001). Behaviors related to high depression status were touching cold water and squatting (both p<0.05). Squatting was also related to high anxiety status (p<0.01), while exposing oneself to drafts was related to poor sleep quality (p<0.05). CONCLUSION: The results indicate that the restrictions on squatting, touching cold water, and exposure to drafts are positively associated with good mental health in postpartum women and are worth preserving; however, the restriction on bathing or showering might negatively impact the mental health of postpartum women and needs further evaluation.