Towards Universal Screening for Postpartum Depression in China: Lessons Learned from a Comprehensive Prevention Programme in Shenzhen.

PURPOSE: This study was conducted to assess the real-world efficacy of a universal programme for the prevention of postpartum depression (PPD) in Shenzhen. Given the lack of evidence on routine PPD screening and intervention in China, it sought to provide insights for programme planning and implementation, particularly in relation to achievement of the targets set by the first national guidelines for PPD prevention and treatment. METHODS: Using routine health information system data, the PPD screening, referral and intervention rates for 2015-2019 were calculated and compared to the programmes targets. Trends of variables were tested by using trend χ2. RESULTS: The programme screened 137,761 to 178,857 women for PPD every year with the coverage among all postpartum women increased steadily from 71.1% to 82. 5% (χ2 = 10145.251, p < 0.001). The PPD-positive rate maintained between 4.06% and 4.89%. However, although referral messages were given to an increased percentage of PPD-positive women (χ2 = 1090.908, p < 0.001), the intervention rate (i.e., referral uptake) were far lower than the programme target of 80%. CONCLUSIONS: This study demonstrated high efficacy of Shenzhen's comprehensive PPD prevention programme initiated in 2013. The resultant rise in the screening rate among all postpartum women, together with a high referral rate of those screened positive, have contributed to the city's relatively low PPD prevalence. PPD screening and intervention should be included as part of basic public health services to ensure universal coverage and specific strategies should be adopted to ensure referral uptake.

Additional evidence on prevalence and predictors of postpartum depression in China: A study of 300,000 puerperal women covered by a community-based routine screening programme.

BACKGROUND: Previous studies on the prevalence and predictors of postpartum depression (PPD) in China were mostly hospital-based with relatively small study samples. Basing on a routine screening programme, this study assessed the prevalence and factors associated with PPD at community level. METHODS: A cross-sectional study was conducted with all the women who delivered in a hospital and were screened for depression during routine postpartum home visits in Shenzhen between 2015 August and 2017 April. The Edinburgh Postnatal Depression Scale was used as the screening tool with a cut-off score of 10. Predictors of PPD were determined by Chi-square test and stepwise logistic regression. RESULTS: Approximately 300,000 puerperal women were included in the study with a PPD prevalence of 4.3%. Prenatal anxiety and depression were associated with 4.55 and 3.80 times of PPD risk, respectively. Stressful life events, family history of mental illness, poor economic status, low Apgar scores and birth defects of the infants, bottle and mixed feeding, as well as living with parents-in-low after childbirth were related to moderate risk. Higher gravidity and parity, larger gestation age, prenatal education, and living with the women's own parents were associated with lower risk. LIMITATIONS: The large sample size might have suggested statistically significant differences which were not practical. CONCLUSIONS: The prevalence of PPD at community level is significantly lower than the rates detected within hospitals. Prenatal anxiety and depression are the most important predictors of PPD. Integrating depression screening into routine postpartum home visits facilitates achievement of universal coverage.

Live birth rate of twin pregnancies after frozen embryo transfer: natural cycle versus ovulation induction regimens.

PURPOSE: Ovulation induction (OI) using letrozole or human menopausal hormone (hMG) is recently developed for endometrium preparation in frozen embryo transfer (FET) cycles. The purpose of this study is to compare the live birth rate of twin pregnancies between modified natural and OI regimens for endometrium preparation in FET cycles. STUDY DESIGN: This study included all consecutive twin pregnancies following FET with modified natural cycle (mNC-FET) or OI (OI-FET) regimen for endometrium preparation between January 2015 to June 2019. Primary outcome was the live birth of at least one twin per pregnancy. Multivariable logistic regression analysis was used to evaluate the potential association of endometrium preparation regimen and live birth. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. RESULTS: During the study period, 269 twin pregnancies after mNC-FET and 177 twin pregnancies after OI-FET were included. The live birth rate of at least one twin per pregnancy was not significantly different between mNC-FET and OI-FET groups, 92.2% vs 90.4%; aOR 0.65; 95%CI 0.32-1.34. The multivariable regression analysis showed that twin pregnancies after OI-FET had decreased odds for gestational diabetes mellitus (aOR 0.37; 95% CI 0.16-0.87) in comparison to twin pregnancies after mNC-FET. In subgroup analysis, we found that the rate of live birth of at least one twin per pregnancy was significantly higher in OI-FET cycles using letrozole compared to those using hMG (94% vs 83.3%; aOR 3.45; 95%CI 1.24-9.57). CONCLUSION: The live birth rate in twin pregnancies after FET is comparable between mNC or OI regimens for endometrium preparation.

There is a Strong Association between Early Preeclampsia and Congenital Heart Defects: A Large Population-Based, Retrospective Study.

OBJECTIVE: The aim of this study was to determine the prevalence of congenital heart defects and examine their association with preeclampsia (PE). METHODS: A clinical-based, retrospective study was conducted in Shenzhen between 2004 and 2017. Data were collected from Shenzhen Maternal and Child Health Hospital Medical Record Database. This study included all infants who were born at the hospital with or without heart defects and their mothers (N = 177,434 newborns). Data processing and analysis were performed by SPSS23.0 (Chicago, IL, USA). RESULTS: 6,852 women (3.9%) were diagnosed as PE and 1,289 newborns (7.30 per 1,000) have congenital heart disease (CHD). Prevalence of CHD in newborns of women with PE is 15.8 per 1,000 significantly higher than the overall prevalence (7.30 per 1,000). CHD in newborns has strong association with PE, especially early-onset PE (adjusted OR 3.29 and 95% CI 2.15-5.03) and severe PE (adjusted OR 2.75 and 95% CI 2.13-3.56). Among those with CHD, infants of preeclamptic women had higher prevalence of tetralogy of Fallot (43.78 vs. 28.14 per 100,000), atrial septal defect (335.67 vs. 53.93 per 100,000), ventricular dysplasia (102.16 vs. 89.69 per 100,000), and ventricular septal defect (525.39 vs. 212.22 per 100,000) than pregnant women with non-PE. CONCLUSION: PE, especially early-onset PE and severe PE, is strongly associated with offspring CHD. Our results help advance the current understanding of the association between PE and offspring CHD. So preventing PE and reducing PE may have a beneficial effect on the offspring CHD.

Carbonized Cellulose Nanofibril with Individualized Fibrous Morphology: toward Multifunctional Applications in Polycaprolactone Conductive Composites.

Drying cellulose nanofibril (CNF) from aqueous suspensions often leads to aggregated fibril morphology, negatively affecting its performance in ensuing applications. In this work, we introduced a new solvent drying approach to acquire dry CNF from aqueous suspensions and subsequently pyrolyzed the CNF precursor to obtain carbonized CNF (CCNF) without loss of its fibrous morphology. The fibrous CCNF was dispersed homogeneously in polycaprolactone (PCL) thermoplastic resin, greatly enhancing PCL composite tensile performance. After being further mixed with carbon black (CB), the CCNF helped to minimize CB aggregation due to formation of interconnected three-dimensional (3D) structures. The CCNF/CB/PCL composite exhibited superior electrical conductivity ascribed to electrons transporting more efficiently among CB aggregates. The composite is also suitable for applications such as 3D printed electromagnetic interference (EMI) shielding and deformation sensing. Specifically, the 3D printed EMI shielding composite efficiently absorbed EM radiation in the frequency range of 4-26 GHz, and the 3D printed deformation sensor exhibited excellent sensitivity, durability, and flexibility in monitoring mechanical distortions. Herein, this study sheds light on the development of multifunctional conductive composites embedded with fibrous CCNF from sustainable resources.

Changes in the Incidence of Retinopathy of Prematurity in Extremely Low Birth Weight Infants in South China From 2004 to 2018.

PURPOSE: To report the changes in incidence and risk factors of retinopathy of prematurity (ROP) in extremely low birth weight (ELBW) infants over a 15-year period in South China. METHODS: The medical records of ELBW infants were retrospectively reviewed through established database of Shenzhen Screening for ROP Cooperative Group. The incidence and severity of ROP were compared among three successive 5-year periods (P1: 2004-2008, P2: 2009-2013, P3: 2014-2018). Gestational age, birth weight, plurality, mode of delivery and gender were analyzed as risk factors for ROP in ELBW infants. RESULTS: Among the 1099 included ELBW infants, 557 (50.7%) had ROP, and 328 (29.9%) had severe ROP. The highest incidence of ROP (87.5%) and severe ROP (82.5%) were seen in P1. From P2 to P3, the incidence of ROP and severe ROP increased from 45.9% to 50.3% for ROP (P < .05) and from 26.4% to 28.3% for severe ROP (P < .05), respectively. Multivariate logistic regression analysis found only gestational age has a significant effect on the incidence of ROP and severe ROP. CONCLUSIONS: From 2004 to 2018, the incidence of ROP and severe ROP in ELBW infants in South China was 50.7% and 29.9%, respectively. Controlling for the other risk factors, only gestational age was statistically associated with ROP in ELBW infants.

Nitrogen-doped fullerene as a potential catalyst for hydrogen fuel cells.

We examine the possibility of nitrogen-doped C60 fullerene (N-C60) as a cathode catalyst for hydrogen fuel cells. We use first-principles spin-polarized density functional theory calculations to simulate the electrocatalytic reactions on N-C60. The first-principles results show that an O2 molecule can be adsorbed and partially reduced on the N-C complex sites (Pauling sites) of N-C60 without any activation barrier. Through a direct pathway, the partially reduced O2 can further react with H(+) and additional electrons and complete the water formation reaction (WFR) with no activation energy barrier. In the indirect pathway, reduced O2 reacts with H(+) and additional electrons to form H2O molecules through a transition state (TS) with a small activation barrier (0.22-0.37 eV). From an intermediate state to a TS, H(+) can obtain a kinetic energy of ∼0.95-3.68 eV, due to the Coulomb electric interaction, and easily overcome the activation energy barrier during the WFR. The full catalytic reaction cycles can be completed energetically, and N-C60 fullerene recovers to its original structure for the next catalytic reaction cycle. N-C60 fullerene is a potential cathode catalyst for hydrogen fuel cells.

Colossal positive Seebeck coefficient and low thermal conductivity in reduced TiO(2).

Reduced (oxygen deficient) single crystal TiO(2) exhibits a very large positive Seebeck coefficient S at low temperature. S as large as 60 000 µV K(-1) was observed near 10 K for the least reduced sample, which gives a thermoelectric power factor of 170 µW K(-2) cm(-1). This value is about four times higher than the power factor of Bi(2)Te(3)-based materials near room temperature. As the temperature increases the Seebeck coefficient becomes negative. The magnitude of the room temperature Seebeck coefficient, thermal conductivity and electrical resistivity decrease with the reduction of the samples. The thermal conductivity is as low as 0.83 W K(-1) m(-1) for the heavily reduced sample at 390 K due to phonon scattering by defect planes. The colossal Seebeck coefficient found in the materials is discussed in terms of the phonon drag of the holes.