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ImportanceWomen and gender-diverse individuals have faced disproportionate socioeconomic burden during COVID-19. There have been reports that this has translated into greater negative changes in mental health, but this has been based on cross-sectional research that has not accounted for pre-COVID-19 differences. ObjectiveTo compare mental health symptom changes since pre-COVID-19 by sex or gender. Data SourcesMEDLINE, PsycINFO, CINAHL, EMBASE, Web of Science, China National Knowledge Infrastructure, Wanfang, medRxiv, and Open Science Framework (December 31, 2019 to August 30, 2021). Study SelectionEligible studies compared mental health symptom changes from pre-COVID-19 to COVID-19 by sex or gender. Data Extraction and SynthesisData was extracted by a single reviewer with validation by a second reviewer. Adequacy of study methods and reporting was assessed using an adapted version of the Joanna Briggs Institute Checklist for Prevalence Studies. A restricted maximum-likelihood random-effects meta-analyses was conducted. Main Outcomes and MeasuresAnxiety symptoms, depression symptoms, general mental health, and stress measured continuously or dichotomously. Results12 studies (10 unique cohorts) were included. All compared females or women to males or men; none included gender-diverse individuals. Continuous symptom change differences were not statistically significant for depression (standardized mean difference [SMD]= 0.12, 95% CI -0.09 to 0.33; 4 studies, 4,475 participants; I2=69.0%) and stress (SMD= - 0.10, 95% CI -0.21 to 0.01; 4 studies, 1,533 participants; I2=0.0%), but anxiety (SMD= 0.15, 95% CI 0.07 to 0.22; 4 studies, 4,344 participants; I2=3.0%) and general mental health (SMD= 0.15, 95% CI 0.12 to 0.18; 3 studies, 15,692 participants; I2=0.0%) worsened more among females or women than males or men during COVID-19. There were no significant differences in changes in proportion above a cut-off: anxiety (difference= -0.05, 95% CI -0.20 to 0.11; 1 study, 217 participants), depression (difference= 0.12, 95% CI -0.03 to 0.28; 1 study, 217 participants), general mental health (difference= -0.03, 95% CI -0.09 to 0.04; 3 studies, 18,985 participants; I2=94.0%), stress (difference= 0.04, 95% CI -0.10 to 0.17; 1 study, 217 participants). Conclusion and RelevanceMental health outcomes did not differ or were worse by amounts below thresholds for clinical significance for women compared to men. RegistrationPROSPERO (CRD42020179703). KEY MESSAGESO_ST_ABSQuestionC_ST_ABSDid mental health symptoms worsen more for females or women than males or men in COVID-19? FindingsWe reviewed almost 65,000 citations and identified 12 studies that provided data to directly compare mental health symptom changes from pre-COVID-19 to during COVID-19 for females or women versus males or men. Statistically significant, but small, sex- or gender-based differences were found in 2 of 8 mental health outcomes. MeaningMental health changes among females or women were not significantly different from males or men for most outcomes, and differences that were identified were small and less than minimally important difference thresholds.
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ObjectivesThe rapid pace, high volume, and limited quality of mental health evidence that has been generated during COVID-19 poses a barrier to understanding mental health outcomes. We sought to summarize results from studies that compared mental health outcomes during COVID-19 to outcomes assessed prior to COVID-19 in the same cohort in the general population and in other groups for which data have been reported. DesignLiving systematic review. Data SourcesMEDLINE (Ovid), PsycINFO (Ovid), CINAHL (EBSCO), EMBASE (Ovid), Web of Science Core Collection: Citation Indexes, China National Knowledge Infrastructure, Wanfang, medRxiv (preprints), and Open Science Framework Preprints (preprint server aggregator). Eligibility criteria for selecting studiesFor this report, we included studies that compared general mental health, anxiety symptoms, or depression symptoms, assessed January 1, 2020 or later, to the same outcomes collected between January 1, 2018 and December 31, 2019. Any population was eligible. We required [≥] 90% of participants pre-COVID-19 and during COVID-19 to be the same or the use of statistical methods to address missing data. For population groups with continuous outcomes for at least two studies in an outcome domain, we conducted restricted maximum-likelihood random-effects meta-analyses. Worse COVID-19 mental health outcomes are reported as positive. Risk of bias of included studies was assessed using an adapted version of the Joanna Briggs Institute Checklist for Prevalence Studies. ResultsAs of April 11, 2022, we had reviewed 94,411 unique titles and abstracts and identified 137 unique eligible studies with data from 134 cohorts. Almost all studies were from high-income (105, 77%) or upper-middle income (28, 20%) countries. Among adult general population studies, we did not find changes in general mental health (standardized mean difference of change [SMDchange = 0.11, 95% CI -0.00 to 0.22) or anxiety symptoms (SMDchange = 0.05, 95% CI -0.04 to 0.13), but depression symptoms worsened minimally (SMDchange = 0.12, 95% CI 0.01 to 0.24). Among women or females, mental health symptoms worsened by minimal to small amounts in general mental health (SMDchange = 0.22, 95% CI 0.08 to 0.35), anxiety symptoms (SMDchange = 0.20, 95% CI 0.12 to 0.29), and depression symptoms (SMDchange = 0.22, 95% CI 0.05 to 0.40). Of 27 other analyses across outcome domains, among subgroups other than women or females, 5 analyses suggested minimal or small amounts of symptom worsening, and 2 suggested minimal or small symptom improvements. No other subgroup experienced statistically significant changes across outcome domains. In the 3 studies with data from March to April 2020 and later in 2020, symptoms either were unchanged from pre-COVID-19 at both time points or increased initially then returned to pre-COVID-19 levels. Heterogeneity measured by the I2 statistic was high (e.g., > 80%) for most analyses, and there was concerning risk of bias in most studies. ConclusionsHigh risk of bias in many studies and substantial heterogeneity suggest that point estimates should be interpreted cautiously. Nonetheless, there was general consistency across analyses in that most symptom change estimates were close to zero and not statistically significant, and changes that were identified were of minimal to small magnitudes. There were, however, small negative changes for women or females in all domains. It is possible that gaps in data have not allowed identification of changes in some vulnerable groups. Continued updating is needed as evidence accrues. Funding: Canadian Institutes of Health Research (CMS-171703; MS1-173070; GA4-177758; WI2-179944); McGill Interdisciplinary Initiative in Infection and Immunity Emergency COVID-19 Research Fund (R2-42). Registration: PROSPERO (CRD42020179703); registered on April 17, 2020.
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BackgroundScalable interventions to address COVID-19 mental health are needed. Our objective was to assess effects of mental health interventions for community-based children, adolescents, and adults. MethodsWe searched 9 databases (2 Chinese-language) from December 31, 2019 to March 22, 2021. We included randomised controlled trials with non-hospitalised, non-quarantined participants of interventions to address COVID-19 mental health challenges. We synthesized results descriptively but did not pool quantitatively due to substantial heterogeneity of populations and interventions and concerns about risk of bias. FindingsWe identified 9 eligible trials, including 3 well-conducted, well-reported trials that tested interventions designed specifically for COVID-19 mental health challenges, plus 6 trials of standard interventions (e.g., individual or group therapy, expressive writing, mindfulness recordings) minimally adapted for COVID-19, all with risk of bias concerns. Among the 3 COVID-19-specific intervention trials, one (N = 670) found that a self-guided, internet-based cognitive-behavioural intervention targeting dysfunctional COVID-19 worry significantly reduced COVID-19 anxiety (standardized mean difference [SMD] 0.74, 95% CI 0.58 to 0.90) and depression symptoms (SMD 0.38, 95% CI 0.22 to 0.55) in Swedish general population participants. A lay-delivered telephone intervention for homebound older adults in the United States (N = 240) and a peer-moderated education and support intervention for people with a rare autoimmune condition from 12 countries (N = 172) significantly improved anxiety (SMD 0.35, 95% CI 0.09 to 0.60; SMD 0.31, 95% CI 0.03 to 0.58) and depressive symptoms (SMD 0.31, 95% CI 0.05 to 0.56; SMD 0.31, 95% CI 0.07 to 0.55) 6-weeks post-intervention, but these were not significant immediately post-intervention. No trials in children or adolescents were identified. InterpretationInternet-based programs for the general population and lay-or peer-delivered interventions for vulnerable groups may be effective, scalable options for public mental health in COVID-19. More well-conducted trials, including for children and adolescents, are needed. FundingCanadian Institutes of Health Research (CMS-171703; MS1-173070); McGill Interdisciplinary Initiative in Infection and Immunity Emergency COVID-19 Research Fund (R2-42). RegistrationPROSPERO (CRD42020179703); registered on April 17, 2020. RESEARCH IN CONTEXTO_ST_ABSEvidence before this studyC_ST_ABSWe searched for systematic reviews of randomised controlled trials of interventions to address mental health challenges in COVID-19. We used searches from our living systematic review, which were not limited by study design and reviewed citations through April 29, 2021 from MEDLINE, PsycINFO, CINAHL, EMBASE, Web of Science, China National Knowledge Infrastructure, Wanfang, medRxiv (preprints), and Open Science Framework Preprints (preprint server aggregator). We identified 4 systematic reviews of interventions for COVID-19 mental health with search dates between April and September 2020. None, however, included evidence from any completed randomised controlled trials on mental health interventions for community-based children, adolescents, or adults during COVID-19. Added value of this studyOur systematic review is the only living systematic review on COVID-19 community-based mental health interventions registered in PROSPERO and, to the best of our knowledge, the first systematic review to synthesize evidence on completed randomised controlled trials of COVID-19 mental health interventions. The sheer volume of evidence being published in COVID-19 poses a barrier to effective synthesis and policy response. We reviewed over 45,000 citations in any language and distilled this to 9 verified eligible community-based trials. Of these, there were 3 well-conducted trials of interventions designed specifically to be scalable to address challenges of public mental health in COVID-19. One trial showed that internet-based cognitive behavioural therapy in the Swedish general population (N = 670) reduced COVID-19 anxiety and symptoms of depression. Trials that tested a lay-delivered telephone support intervention for homebound older adults in the United States (N = 240) and a peer-moderated group intervention for people with a rare autoimmune condition from 12 countries (N = 172) also found that they improved mental health outcomes, although not all outcomes were statistically significant. Implications of all the available evidenceEffective, scalable, and feasibly delivered mental health interventions are needed for the general public and vulnerable groups as lockdown restrictions continue, even intermittently, and because COVID-19 mental health implications will likely persist beyond the pandemic. Although we identified only 3 high-quality trials, they demonstrated approaches that can be feasibly adopted to meet the needs of adults in the general public and vulnerable groups. The successful internet-based cognitive behavioural therapy intervention was made available to the Swedish general public free-of-charge following testing and suggests that online tools tailored for specific concerns in COVID-19 may represent an efficient way of addressing public mental health. Two lay-and peer-delivered interventions, consistent with pre-COVID-19 evidence, suggest that low-intensity, non-professionally delivered, support-oriented approaches can be leveraged among vulnerable groups. The absence of trials of interventions for children and adolescents underlines the need for evidence on scalable strategies for this population, including school-based approaches.
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BackgroundIn 2020, the current outbreak of Coronavirus Disease 2019(COVID-19) has constituted a global pandemic. But the question about the immune mechanism of patients with COVID-19 is unclear and cause particular concern to the world. Here, we launched a follow-up analysis of antibodies against SARS-CoV-2 of 192 COVID-19 patients, aiming to depict a kinetics profile of antibodies against SARS-CoV-2 and explore the related factors of antibodies expression against SARS-CoV-2 in COVID-19 patient. MethodsA total of 192 COVID-19 patients enrolled in the designated hospital of Guangzhou, Guangzhou Eighth Peoples Hospital, from January to February 2020 were selected as the study cohort. A cohort of 130 COVID-19 suspects who had been excluded from SARS-CoV-2 infected by negative RT-PCR result and 209 healthy people were enrolled in this study. Detection of IgM and IgG against SARS-CoV-2 were performed by Chemiluminescence immunoassay in different groups. ResultsIt has been found that the seroconversion time of IgM against SARS-CoV-2 in most patients was 5-10 days after the symptoms onset, and then rose rapidly, reaching a peak around 2 to 3 weeks, and the median peak concentration was 2.705 AU / mL. The peak of IgM maintained within one week, and then enters the descending channel. IgG seroconverted later than or synchronously with IgM, reaching peaks around 3 to 4 weeks.The median peak concentration was 33.998AU / ml,which was higher than that of IgM. IgM titers begins to gradually decrease after reaching the peak in the 4th week, after the 8th week, a majority of IgM in patients serum started to turn negative. On the contrary, titers of IgG began to decline slightly after the fifth week, and more than 90% of results of patients were positive after 8 weeks. Additionally, the concentration of antibodies positively correlated with the severity of the disease and the duration of virus exist in host. ConclusionWe depict a kinetics profile of antibodies against SARS-CoV-2 in COVID-19 patients and found out that the levels of antibodies were related to the disease severity, age, gender and virus clearance or continuous proliferation of COVID-19 patients.
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BACKGROUND: Hydrogen sulfide signaling has been proved to promote distraction osteogenesis; however,the underlying mechanism remains unclear.OBJECTIVE: To evaluate the relationship between hydrogen sulfide and hypoxia-inducible factor-1α (HIF-1α)during the osteogenesis of rat bone marrow mesenchymal cells under tensile stress.METHODS: 2000 μ strain was loaded on the in vitro cultured rat bone marrow mesenchymal cells by a four-point bending apparatus, and hydrogen sulfide donor or HIF-1α inhibitor was adopted in the tensile unit. Subsequently, the levels of osteogenic markers were detected.RESULTS AND CONCLUSION: Exogenous hydrogen sulfide signaling could promote the osteogenesis of rat bone marrow mesenchymal cells under tensile stress. However, this promotion was obviously eliminated when the endogenous HIF-1α expression was inhibited.These results show that hydrogen sulfide signaling system promotes the osteogenesis of rat bone marrow mesenchymal cells under tensile stress probably through HIF-1α.
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Objective To evaluate the impact of hydrogen sulfide signal system during the process of rat bone marrow-derived mesenchymal cells osteogenesis under tensile stress. Methods After the H2S signal system of cell rooms regulated by tool drugs (Group A with propargylglycine;Goup B with PBS;Group C with GYY3147), 4 000 μ strain tensile stress were applied on rat BMMCs by four-point bending apparatus for 60 minutes. Four hours later, the H2S signal system and cystathionine-γ-lyase were detected. Meanwhile, the change of the alkaline phosphate, osteocalcin, procollagen typeⅠN-terminal propeptide, and runt-related transcription factor 2 mRNA level were also examined to evaluate the osteogenic ability. Results With the increase of H2S expression, the osteogenic capacity gradually increased, while the osteogenic capacity was compromised after the endogenous cystathionine-γ-lyase was inhibited. Conclusion The H2S signal system plays an important role during BMMCs osteogensis under tensile stress. The up-regulation expression of H2S may promote osteogenesis during distraction osteogenesis.
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Objective To investigate fingerprint analysis and quantification of Rhizoma Drynaria. Methods HPLC fingerprints were carried out at 30℃on a Zirchrom C18 column (4.6 mm×200 mm, 5μm). The mobile phase was methanol (A) and phosphoric acid aqueous solution (pH3.6, B). Gradient programmer was performed in linear gradient. The chromatogram was monitored at a wavelength of 283 nm throughout the experiment and the chromatographic peaks were obtained, ranging from 200 nm to 400 nm. The injection volume was 10μl. Then quantitative analyses were carried out at 30℃on a Kromasil C18 column (250 mm×4.6 mm,5μm). Results In fingerprint analysis, plant materials from 16 regions were analyzed under the optimized HPLC conditions and 12 peaks were selected as characteristic peaks. Compared with the reference standards, 6 major chromatographic peaks were characterized and identified, with sum of peaks area over 70% according to area normalization method. Additionally, the similarity analysis and HCA analysis were performed and the results got mutual authentication. In quantitative analysis, the four compounds showed good regression(r>0.9995) within test ranges and the recovery of the method was in the range of 97.9%-103.7%. Conclusion The results revealed that the method of reference chromatographic fingerprints combined with multiple compounds determination could be used as an efficient strategy for systematic quality evaluation of Rhizoma Drynariae.
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BACKGROUND:Long course of treatment and complications limit the extensive application of distraction osteogenesis, which cannot meet the clinical requirements. OBJECTIVE:To investigate the effect of general administration of eucommia alcohol extract on new bone regeneration based on the rabbit model of mandibular distraction osteogenesis. METHODS:Twenty-four New Zealand white rabbits were randomly divided into experimental group and control group. Unilateral mandibular distraction osteogenesis model was established by 1 mm/12 h distraction protocol. During the distraction period, the rabbits in the experimental group were intragastricaly administered with eucommia alcohol extract and the control animals received the same amount of physiological saline, respectively. Six weeks later, the animals were sacrificed for osteogenic testing. RESULTS AND CONCLUSION: New bone formation was observed in the distracted gap in both groups. However, the amount, mineralization and biomechanical strength of new regenerated bone in the experimental group were obviously greater than those in the control group by histological observation, dual energy X-ray absorptiometry, micro-CT and biomechanical test. General administration of eucommia alcohol extract can markedly promote distraction osteogensis in rabbit mandibular osteodistraction.
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Objective:To research the quality standard for Xilei San. Methods:Imdigo naturalis and calculus bovis were identi-fied by TLC and their contents were determined by HPLC, and Borneolum syntheticum was determined by GC. Results: Indirubin showed good linearity over the concentration range of 0. 043-4. 255 0 μg(r=0. 999 2) with the average recovery of 97. 9%(RSD=1.5%,n=6). Bilirubin showed good linearity over the concentration range of 9.968 ×10 -4-9.968 ×10 -2 μg(r=0.999 9) with the average recovery of 95.3%(RSD =0.55%, n =6). Borneolum syntheticum showed good linearity over the concentration range of 0. 010 3-0. 826 6 mg(r=0. 999 8) with the average recovery of 94. 9%(RSD=3. 2%,n=6). Conclusion: The method is accurate with good reproducibility,which can be used as the quality control for Xilei San.
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Tetrahydrobiopterin (BH4), an essential cofactor for nitric oxide synthase (NOS) activity, is known to play important roles in modulating both NO and superoxide production during vascular diseases such as atherosclerosis. However, the role of BH4 in functions of vascular smooth muscle cells is not fully known. In this study, we tested the effects of BH4 and dihydrobiopterin (BH2), a BH4 precursor, on migration and proliferation in response to platelet-derived growth factor-BB (PDGF-BB) in rat aortic smooth muscle cells (RASMCs). Cell migration and proliferation were measured using a Boyden chamber and a 5-bromo-2'-deoxyuridine incorporation assay, respectively, and these results were confirmed with an ex vivo aortic sprout assay. Cell viability was examined by 2,3-bis [2-methoxy-4-nitro-5-sulfophenyl]-2H-tetrazolium-5-carboxanilide assays. BH4 and BH2 decreased PDGF-BB-induced cell migration and proliferation in a dose-dependent manner. The inhibition of cell migration and proliferation by BH4 and BH2 was not affected by pretreatment with N G-nitro-L-arginine methyl ester, a NOS inhibitor. Moreover, the sprout outgrowth formation of aortic rings induced by PDGF-BB was inhibited by BH4 and BH2. Cell viability was not inhibited by BH4 and BH2 treatment. The present results suggest that BH4 and BH2 may inhibit PDGF-stimulated RASMC migration and proliferation via the NOS-independent pathway. Therefore, BH4 and its derivative could be useful for the development of a candidate molecule with an NO-independent anti-atherosclerotic function.
Subject(s)
Animals , Rats , Atherosclerosis , Biopterins , Bromodeoxyuridine , Cell Movement , Cell Survival , Muscle, Smooth , Muscle, Smooth, Vascular , Myocytes, Smooth Muscle , Nitric Oxide , Nitric Oxide Synthase , Proto-Oncogene Proteins c-sis , Superoxides , Vascular DiseasesABSTRACT
Objective To report the experience on the modified Abb? flap for correction of mild tightness of the corrected cleft lip deformity. Methods Forty-two patients with a mild or moderately tight lip deformity after primary unilateral cleft lip repair were performed a modified Abb? flap for correcting tight upper lip. The operative technique was that the pocket was creased for the vermilion tubercle by splitting the lip. The skin was incised several millimeters beyond the vermilion-skin border and was moved laterally for a distance equal to the breadth of the vermilion tubercle. The orbicularis oris muscle and the full length of the upper lip vermilion were incised. By releasing the tension, the slight concavity, expressed in profile by the slight pout which a normal upper lip had in cross section, was obtained. The Abb? flap that was taken from the central portion of the lower lip vermilion, was designed to repair the vermilion tubercle and the Cupid's bow. The flap was approximately 8 mm in width. The full length of the lower lip vermilion and the orbicularis oris muscle were incorporated. A ting portion of skin was included, which facilitated closure of the donor site, The flap, based on the labial vessels, was rotated 180?and sutured into the created defect of the upper lip. The pedicle was divided 10 days after operation. Results Forty-two patients all showed an obvious Cupid's bow, Cupid's bow peak, the median tubercle and the height and width of the upper lip. The scarring of the base of the nose was not obvious. Conclusion Use of modified Abb? flap to reconstruct the contour of the upper lip is successful in patients with cleft lip.
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This article discusses the practice of GMP in producing hospital pharmaceutical preparatioon in regard to the following points: 1. necessity and feasibility, 2. key links to be grasped, and 3. effective organizing work.
