Microbiome Signature of Endophytes in Wheat Seed Response to Wheat Dwarf Bunt Caused by Tilletia controversa Kühn.

Wheat dwarf bunt leads to the replacement of seeds with fungal galls containing millions of teliospores of the pathogen Tilletia controversa Kühn. As one of the most devastating internationally quarantined wheat diseases, wheat dwarf bunt spreads to cause distant outbreaks by seeds containing teliospores. In this study, based on a combination of amplicon sequencing and isolation approaches, we analyzed the seed microbiome signatures of endophytes between resistant and susceptible cultivars after infection with T. controversa. Among 310 bacterial species obtained only by amplicon sequencing and 51 species obtained only by isolation, we found 14 overlapping species by both methods; we detected 128 fungal species only by amplicon sequencing, 56 only by isolation, and 5 species by both methods. The results indicated that resistant uninfected cultivars hosted endophytic communities that were much more stable and beneficial to plant health than those in susceptible infected cultivars. The susceptible group showed higher diversity than the resistant group, the infected group showed more diversity than the uninfected group, and the microbial communities in seeds were related to infection or resistance to the pathogen. Some antagonistic microbes significantly suppressed the germination rate of the pathogen's teliospores, providing clues for future studies aimed at developing strategies against wheat dwarf bunt. Collectively, this research advances the understanding of the microbial assembly of wheat seeds upon exposure to fungal pathogen (T. controversa) infection. IMPORTANCE This is the first study on the microbiome signature of endophytes in wheat seed response to wheat dwarf bunt caused by Tilletia controversa Kühn. Some antagonistic microbes suppressed the germination of teliospores of the pathogen significantly, which will provide clues for future studies against wheat dwarf bunt. Collectively, this research first advances the understanding of the microbial assembly of wheat seed upon exposure to the fungal pathogen (T. controversa) infection.

Characterization of Rhizosphere Microbial Communities for Disease Incidence and Optimized Concentration of Difenoconazole Fungicide for Controlling of Wheat Dwarf Bunt.

Rhizosphere soil microorganisms have great agricultural importance. To explore the relationship between rhizosphere microorganisms and the disease incidence, and to optimize the concentration of difenoconazole fungicide for the control of wheat dwarf bunt, caused by Tilletia controversa Kühn, the rhizosphere microorganisms were characterized based on sequencing methods. We found that the disease incidence correlated with the relative abundance of some microbial communities, such as Acidobacteria, Nocardioides, Roseiflexaceae, Pyrinomonadaceae, and Gemmatimonadaceae. Actinobacteria showed significant differences in the infected soils when compared to the control soils, and the relative abundance of Acidobacteria, Pyrinomonadaceae, Gemmatimonadaceae, and Saccharimonadales populations was distinctly higher in the T. controversa-inoculated group than in the control group. The members of Dehalococcoidia, Nitrosomonadaceae, and Thermomicrobiales were found only in T. controversa-inoculated soils, and these taxa may have potential effects against the pathogen and contribute to disease control of wheat dwarf bunt. In addition, for T. controversa-infected plants, the soil treated with difenoconazole showed a high relative abundance of Proteobacteria, Actinobacteria, Ascomycota, Basidiomycota, Mortierellomycota, and Olpidiomycota based on the heatmap analysis and ANOVA. Our findings suggest that the optimized concentration of fungicide (5% recommended difenoconazole) exhibits better control efficiency and constant diversity in the rhizosphere soil.

Development of an Agrobacterium tumefaciens-mediated transformation system for Tilletia controversa Kühn.

Dwarf bunt of wheat caused by Tilletia controversa Kühn has been identified an international quarantine disease, which replace the grain material into millions of teliospores. Agrobacterium tumefaciens-mediated transformation (ATMT) system is a powerful tool for fungi transformation with significant advantages of simple operation, high efficiency, and genetic stability of transformants. In this study, we constructed ATMT system for T. controversa. All the transformants were tested using Acetosyringone (AS) concentration at 150 µmol/l, hygromycin B at 25 µg/ml, 1 × 106 T. controversa hypha cells/ml, A. tumefaciens with OD600 of 0.5 co-cultivation at 16 °C for 48 h and culture was incubated at 16 °C for 20 days. Using the ATMT method, we cultivated 8 generations of transformants on complete medium (CM) containing hygromycin B antibiotic and validated by PCR, which indicate that T-DNA had been successfully inserted into each of T. controversa transformants. In addition, thermal asymmetric interlaced PCR (TAIL-PCR) evaluated the Ti element inserts were at random sites in the fungal genome. Thus, ATMT approach is an efficient tool for insertional mutagenesis of T. controversa.

Oral health in patients with dementia: A meta-analysis of comparative and observational studies.

OBJECTIVE: Poor oral health is common in dementia, but findings of epidemiological studies have been inconsistent. This meta-analysis examined oral health in patients with dementia diagnosed according to standardized diagnostic criteria. METHODS: Six international databases (PubMed, EMBASE, PsycINFO, Medline, Cochrane Library, and Web of Science) were searched from their commencement date until 8 November 2018. Oral health was measured by the Remaining Teeth (RT) and Decayed, Missing, and Filled Teeth (DMFT) Index. The mean differences (MD) and 95% confidence intervals (CI) of DMFT Index total and component scores were calculated using a random-effect model. RESULTS: Twenty-four studies were included for analyses. The pooled DMFT Index was 23.48 (95% CI: 22.34, 24.62), while the pooled score for each component was 2.38 (95% CI: 1.56, 3.20) in decayed teeth (DT), 18.39 (95% CI: 15.92, 20.87) in missing teeth (MT), 2.29 (95% CI: 0.62, 3.95) in filled teeth (FT), and 11.59 (95% CI: 9.14, 14.05) in RT. Compared to controls, people with dementia had significantly a higher DMFT Index total score (MD = 3.80, 95% CI: 2.21, 5.39, p < 0.00,001), and significantly lower number of RT (MD = -3.15, 95% CI: -4.23, -2.06, p < 0.00,001). Subgroup analyses revealed that higher DMFT Index score was significantly associated with year of survey (>2010), study design (case-control study), percentage of females (≤54.3), and the Mini Mental State Examination score (≤18.2). Higher MT score was significantly associated with study design (cross-sectional study), and lower FT score was significantly associated with year of survey (>2010). CONCLUSIONS: Oral health was significantly poorer in people with dementia compared with controls. Regular screening and effective treatment should be implemented for this population.

Gender Difference in the Prevalence of Insomnia: A Meta-Analysis of Observational Studies.

Objective: Insomnia is a major health challenge in the general population, but the results of the gender differences in the epidemiology of insomnia have been mixed. This is a meta-analysis to examine the gender difference in the prevalence of insomnia among the general population. Methods:Two reviewers independently searched relevant publications in PubMed, EMBASE, PsycINFO, Web of Science from their inception to 16 April 2019. Studies that reported the gender-based prevalence of insomnia according to the international diagnostic criteria were included for analyses using the random-effects model. Results:Eventually 13 articles were included in the meta-analysis. The pooled prevalence of insomnia in the general population was 22.0% [n = 22,980, 95% confidence interval (CI): 17.0-28.0%], and females had a significantly higher prevalence of insomnia compared with males (OR = 1.58, 95% CI: 1.35, 1.85, Z = 5.63, p < 0.0001). Subgroup analyses showed that greater gender difference was associated with the use of case-control study design and consecutive sampling method. Meta-regression analyses also revealed that higher proportion of females and better study quality were significantly associated with greater gender difference. Conclusions:This meta-analysis found that the prevalence of insomnia in females was significantly higher than males in the included studies. Due to the negative effects of insomnia on health, regular screening, and effective interventions should be implemented in the general population particularly for females.

Worldwide prevalence of smoking cessation in schizophrenia patients: A meta-analysis of comparative and observational studies.

Although the rate of cigarette smoking is high in schizophrenia patients, the prevalence of smoking cessation in this group is reportedly low. This meta-analysis aimed to examine the prevalence of cessation among schizophrenia patients worldwide. A systematic literature search in PubMed, PsycINFO, Medline, EMBASE, Cochrane Library and Web of Science was performed from their inception date until 15 November 2018. Studies that reported prevalence of smoking cessation were synthesized using a random-effects model. Fourteen studies were included. The pooled prevalence of smoking cessation among schizophrenia patients was 14.0 % (95 % CI: 9.2-18.8 %; I2 = 97.3 %). Compared with schizophrenia patients, both healthy controls (OR = 0.45, 95 % CI:0.38-0.54, p < 0.001) and controls with other psychiatric disorders (OR = 0.79, 95 % CI:0.63-0.99, p = 0.004) had significantly higher prevalence of cessation. Subgroup and meta-regression analyses found that year of survey (after 2005), duration of smoking cessation (<6 months), outpatient setting and poor study quality were significantly associated with higher prevalence of smoking cessation. This meta-analysis found that the prevalence of smoking cessation was significantly lower among schizophrenia patients compared to healthy control and those with other psychiatric disorders. Better understanding of the barriers to smoking cessation and more effective measures for quitting smoking should be developed for patients with schizophrenia.

Prevalence of burnout in mental health nurses in China: A meta-analysis of observational studies.

OBJECTIVE: Burnout is common in mental health nurses because of work-related stress. Burnout has a negative impact on nurses' health and work performance. The prevalence of high burnout in mental health nurses has been inconclusive across studies. This meta-analysis aimed to estimate the pooled prevalence of high burnout in mental health nurses in China. METHODS: Electronic databases (PubMed, EMBASE, PsycINFO, Web of Science, CNKI, WanFang and SinoMed) were independently and systematically searched from their commencement date up to 14 May 2018. Studies that reported the prevalence of any of the 3 burnout dimensions (high Emotional Exhaustion (EE), Depersonalization (DP), and low Personal Accomplishment (PA)) as measured by the Maslach Burnout Inventory (MBI) were included and analyzed using the random-effects model. RESULTS: A total of 19 studies were included in this meta-analysis. The pooled prevalence of high EE was 28.1% (95% CI: 20.4-35.8%), DP was 25.4% (18.1-32.6%) and low PA was 39.7% (28.3-51.1%). Subgroup analyses found that short working experience, use of MBI-Human Services Survey (HSS), and younger age had moderating effects on prevalence of high burnout. CONCLUSIONS: Burnout is common in mental health nurses in China. Considering its negative impact on health and work performance, regular screening, preventive measures and effective interventions should be implemented.

Treatment Rate of Schizophrenia in China: a Meta-Analysis of Epidemiological Studies.

Effective and prompt medication treatment is essential for schizophrenia patients to alleviate psychotic symptoms and improve prognosis. The treatment rate of schizophrenia usually varies greatly across studies. This is a meta-analysis that examined the overall treatment rate of schizophrenia in China. Both international (PubMed, EMBASE, PsycINFO, Web of Science) and Chinese (CNKI, WanFang and Sinomed) databases were searched. The random effects model was used to analyze the data. Fifteen studies with 1,219,472 patients were included. This meta-analysis found that 73% (95%CI: 66%, 80%) of schizophrenia patients received treatment in any type of medical institutions, while 31.0% (95%CI = 21.0%, 41.0%) received treatment in psychiatric institutions. Studies conducted in middle region of China (76.8% for any type of medical institutions; 42.6% for psychiatric institutions) and those published before 2007 (74.6% for any type of medical institutions; 31.3% for psychiatric institutions) reported significantly higher treatment rates. Studies using combined diagnostic instruments had a higher treatment rate of schizophrenia (72.0%) in any type of medical institutions, while using the Chinese classification of Mental Disorders (47.7%) and including both rural and urban areas (35.7%) had higher treatment rates of schizophrenia in psychiatric institutions. The treatment rate of schizophrenia was relatively high in China, but most treatments were delivered in non-psychiatric medical institutions. Greater efforts should be made to improve the provision of accessible mental health services for schizophrenia patients in this part of the world.

Knowledge and attitudes of adolescents with psychiatric disorders and their caregivers towards electroconvulsive therapy in China.

BACKGROUND: Electroconvulsive therapy (ECT) is effective in treating adolescents with severe psychiatric disorders. This study examined the knowledge, experiences and attitudes of adolescents with severe psychiatric disorders and their caregivers towards ECT in China. METHODS: A total of 158 participants, including 79 adolescents who received ECT and their caregivers (n = 79), were enrolled in this study. Their knowledge and experiences about and attitudes towards ECT were evaluated with self-administered data collection forms. RESULTS: Only around half of patients and caregivers reported that they received sufficient information about the process, the therapeutic and side effects, and the risks of ECT, although most believed that ECT is beneficial, and around half believed that ECT is safe. Around one third of patients and caregivers reported that only critically ill patients should receive ECT. More than half of patients experienced side effects, such as memory impairment, headache and short-term confusion. CONCLUSIONS: Sufficient information about ECT should be provided to adolescents with severe psychiatric disorders and their caregivers prior to treatment, with particular focus on the treatment process and possible side effects.

Obesity increases the risk of depression in children and adolescents: Results from a systematic review and meta-analysis.

BACKGROUND: Clinical depression (including major depression, dysthymia, and unspecified depression) is common in children and adolescents with obesity and overweight. The objective of this systematic review and meta-analysis was to examine prevalence of clinical depression among overweight and obese children. METHODS: PubMed, EMBASE, Web of Science, Medline, Cochrane library, and PsycINFO databases were systematically and independently searched by three researchers from the inception dates to April 01, 2019. The fixed-effects model was used to perform meta-analysis. Data analyses were performed with STATA Version 12.0. RESULTS: Eleven studies with 69,893 subjects were included; 5 studies examined major depressive disorder (MDD), while the remaining 6 studies examined other types of clinical depression. In the overweight and obese group, the prevalence of clinical depression ranged from 1.7% to 26.7% in obese subjects and from 4.0% to 16.9% in overweight subjects. In studies on MDD, prevalence ranged from 10.1% to 26.7% in obese subjects and from 9.0% to 16.9% in overweight subjects. The odd ratios (ORs) of clinical depression ranged from 0.92 to 4.39 between obese subjects and healthy controls (i.e., normal-weight controls), and ranged from 0.96 to 1.67 between overweight subjects and controls. Compared to healthy controls, obese (OR = 1.851, 95% CI: 1.410-2.429) but not overweight (OR = 1.068, 95% CI: 0.889-1.283) children and adolescents were more likely to have MDD. CONCLUSION: Obese children and adolescents had a significantly higher risk for MDD compared with healthy controls. Considering the negative health outcomes of depression, regular screening and effective treatments should be implemented for obese children and adolescents.

Prevalence of prenatal and postpartum depression in fathers: A comprehensive meta-analysis of observational surveys.

BACKGROUND: Increasing attention has been paid to maternal prenatal and postpartum depressive symptoms (depression thereafter), but little is known about the prevalence of paternal prenatal and postpartum depression. To fill this gap, the current study meta-analyzed the worldwide prevalence of prenatal and postpartum depression in fathers. METHODS: Studies that reported paternal depression occurring between the first trimester and the first postpartum year were identified by searching both international (PubMed, PsycINFO, Web of Science and EMBASE) and Chinese (WanFang and CNKI) databases between their inception date and July 1, 2018. A random-effects model was used to calculate pooled estimates and 95% confidence intervals. RESULTS: Forty-seven studies with 20,728 subjects were included in the meta-analysis. The prevalence of prenatal depression in fathers was 9.76% in all three trimesters, 13.59% in the first, 11.31% in the second and 10.12% in the third trimester. The prevalence of postpartum depression was 8.75% within a whole year, 8.98% within one-month, 7.82% between one- and three months, 9.23% between three months and six months and 8.40% between six months to twelve months after child-birth. The prevalence of paternal postpartum depression was moderated by year of publication, study area, age of fathers of ≥18 years, quality assessment score and mean age (all P<0.05). CONCLUSIONS: This meta-analysis found that the prevalence of prenatal and postpartum depression in fathers was relatively common. Regular screening, effective prevention and appropriate treatment need to be implemented in this population.

Prevalence of smoking in nursing students worldwide: A meta-analysis of observational studies.

BACKGROUND: Smoking is common among nursing students worldwide, but the reported prevalence is inconsistent across epidemiological studies. This is a meta-analysis of the prevalence of smoking in nursing students worldwide. DESIGN: Meta-analysis of observational studies. SAMPLE: A total of 46 studies were included in this meta-analysis. METHOD: Electronic databases (PubMed, Medline, PsycINFO, EMBASE and Web of science) were independently and systematically searched by two investigators from their commencement date up to 12 May 2018. Studies that reported the smoking rate of nursing students were included and analyzed using random-effects model. RESULTS: The pooled prevalence of current smoking was 26.6% (95% CI: 22.9-30.4%), while pooled prevalence of previous smoking was 15.5% (95% CI: 11.8-19.3%). Subgroup analyses showed that smoking rate was higher in male compared with female students (39% vs 25.2%, P < .001), while survey time, sample size, age, study design and academic year did not moderate the smoking rate (all P > .05). CONCLUSION: This meta-analysis confirmed that smoking is common in nursing students. Considering the negative impact of smoking on health, appropriate smoking cessation measures for nursing students should be developed.

Treatment Rate for Major Depressive Disorder in China: a Meta-Analysis of Epidemiological Studies.

Major depressive disorder (MDD) is a common psychiatric disorder in China, but its reported treatment rate varies largely across different studies. The objective of this meta-analysis was to determine the pooled treatment rate for people with MDD in China and its associated factors. Both English (PubMed, Cochrane Library, PsycINFO, Web of Science) and Chinese (Chinese National Knowledge Infrastructure, WanFang and SinoMed) databases were searched from their commencement date to November 13, 2018. Epidemiological studies that reported the treatment rate of MDD were included and synthesized using a random effects model. Fifteen studies covering 609,054 participants were included. The pooled treatment rate for MDD in China was 19.5% (95% CI: 10.7%-28.4%). Among the 15 studies, 9 reported the number of patients who received treatments in psychiatric hospitals with a pooled treatment rate of 5.2% (95% CI: 2.8%-7.5%). Meta-regression found that study quality (ß = 0.131, P = 0.028) and male gender (ß = 0.006, P = 0.039) were significantly associated with a higher treatment rate for MDD. In China, the treatment rate for MDD, particularly in psychiatric hospitals, was low. Effective public education and increasing access to mental health services will probably increase the number of people seeking and receiving treatment.

Prevalence of depressive symptoms in overweight and obese children and adolescents in mainland China: A meta-analysis of comparative studies and epidemiological surveys.

BACKGROUND: Obesity is associated with a higher risk of depression in children and adolescents. This is a meta-analysis of studies examining depressive symptoms in overweight and obese children and adolescents in China. METHODS: A systematic literature search was performed independently in both English (PubMed, EMBASE, Web of Science and Medline Complete) and Chinese (China National Knowledge Internet, WANFANG Data and WeiPu VIP) databases from their commencement date to December 31, 2018. The pooled prevalence of depressive symptoms was calculated using a random-effects model. Data analyses were performed with STATA Version 12.0, R Version 3.3.0 and R Studio Version 0.99.903. RESULTS: Twenty-two epidemiological and 18 comparative studies were included in the meta-analysis. The overall prevalence of depressive symptoms was 24.02% (95% CI: 15.92%-33.16%) in obese children and adolescents and 22.61% (95% CI: 14.87%-31.34%) in overweigh children and adolescents. Obese children and adolescents were more likely to suffer from depressive symptoms (OR = 1.877, 95% CI: 1.459-2.415, P < 0.001) than their non-obese counterparts. The use of different screening scales for depressive symptoms was significantly associated with the prevalence of depressive symptoms. CONCLUSIONS: Depressive symptoms are common in overweight and obese children and adolescents in China. Obese, but not overweight children and adolescents had higher risk of depressive symptoms. In order to lessen the risk of depressive symptoms, regular screening and effective interventions should be implemented to reduce obesity and overweight in this population.

Prevalence of sexual harassment of nurses and nursing students in China: a meta-analysis of observational studies.

Sexual harassment experienced by nurses and nursing students is common and significantly associated with negative consequences. This study is a meta-analysis of the pooled prevalence of sexual harassment of nurses and nursing students in China. Electronic databases (PubMed, EMBASE, PsycINFO, Web of Science and Ovid, China National Knowledge Internet, WanFang, SinoMed and Chinese VIP Information) were independently and systematically searched by two reviewers from their commencement date to 12 March 2018. Forty-one studies that reported the prevalence of sexual harassment were analyzed using the random-effects model. The pooled prevalence of sexual harassment was 7.5% (95% CI: 5.5%-10.1%), with 7.5% (5.5%-10.2%) in nurses and 7.2% (3.0%-16.2%) in nursing students. Subgroup analyses showed that the year of survey and sample size were significantly associated with the prevalence of sexual harassment, but not the seniority of nursing staff, department, hospital, economic region, timeframe, age, working experience or subtypes of harassment. In China, sexual harassment was found to be common in nurses and nursing students. Considering the significant negative impact of sexual harassment, effective preventive and workplace measures should be developed.

Worldwide prevalence of falls in older adults with psychiatric disorders: A meta-analysis of observational studies.

Falls are common in older adults with psychiatric disorders, but the epidemiological findings have been inconsistent. This meta-analysis examined the prevalence of falls in older psychiatric patients and its moderating factors. PubMed, EMBASE, Web of Science and PsycINFO databases were independently searched by three investigators from their inception date to Nov 31, 2017. The random effects meta-analysis was used to synthesize the prevalence of falls, while meta-regression and subgroup analyses were conducted to explore the moderating factors. Sixteen of the 2061 potentially relevant papers met the entry criteria for the meta-analysis. The pooled lifetime prevalence of falls was 17.25% (95% confidence interval: 13.14%-21.35%). Neither univariate and nor multivariate meta-regression analyses revealed any moderating effects of the study region, duration, sample size, and quality on the prevalence of falls (P values > 0.05). Falls in older adults with psychiatric disorders are common.

Quality of life in Chinese patients with schizophrenia: A meta-analysis.

The impact of schizophrenia on quality of life (QOL) is significantly influenced by sociocultural factors. This meta-analysis systematically compared QOL between patients with schizophrenia and healthy controls in China. PubMed, PsycINFO, Embase, Chinese National Knowledge Infrastructure (CNKI), SinoMed and WanFang databases were searched to identify case-control studies. Standardized mean differences (SMDs) and 95% confidence interval (CI) were calculated using random effect models. Eighteen case-control studies comparing QOL between schizophrenia patients (n = 2,425) and healthy controls (n = 2,072) were included in the analyses. Compared with healthy controls, schizophrenia patients had significantly poorer overall QOL [11 studies; SMD:-1.07 (95%CI:-1.44, -0.70), P < 0.001] as well as in the physical, psychological, social and environmental QOL domains. Subgroup analyses revealed that poorer QOL was significantly associated with diagnostic criteria, study location, female gender, older age and inpatient status. Older schizophrenia patients had lower physical and psychological QOL, while inpatients had lower psychological QOL. In conclusion, compared with healthy controls, schizophrenia patients in China have significantly lower QOL.

Prevalence of falls in adult and older adult psychiatric patients in China: A systematic review and comprehensive meta-analysis of observational studies.

Falls have significant health consequences and are common in psychiatric patients. Findings on the prevalence of falls in Chinese adult and older adult psychiatric inpatients have been inconsistent. This meta-analysis examined the pooled prevalence of falls in adult and older adult psychiatric inpatients in China. Both English (PubMed, EMBASE, Web of Science, PsycINFO, Cochrane Library) and Chinese (China National Knowledge Interne, WanFang Data and SinoMed) databases were searched independently by three reviewers. The pooled prevalence of falls and its 95% confidence intervals (CIs) using the random effects model were calculated. A total of 39 studies covering 204,234 inpatients were analyzed. The pooled prevalence of falls in adult and older adult (≥60 years) patients was 3% (95% CI: 1.8%-5%) and 7.3% (95%CI: 5.0%-10.6%), respectively. Subgroup analyses revealed that the prevalence of falls was significantly associated with the psychiatric diagnostic criteria and study sample size. This meta-analysis found that the prevalence of falls among adult and older adult psychiatric patients in China was significantly high, although less than that was reported from Western psychiatric inpatient settings.