Medication non-adherence and self-inflicted violence behaviors among 185,800 patients with schizophrenia in the community: a 12-year cohort study.

BACKGROUND: Despite the importance of medication adherence in treatment effectiveness, little is known about the association between medication non-adherence and self-inflicted violence behaviors. We aimed to assess whether medication non-adherence increased the risk of self-inflicted violence behaviors among schizophrenics in communities (hypothesis 1) and whether the dose-response relationship existed (hypothesis 2). METHODS: This 12-year cohort study in western China recruited 292,667 community-dwelling schizophrenics. The proportion of regular medication (PRM) was calculated by dividing the time of "regular adherence" by the total time of antipsychotic treatment during follow-up period as an indicator of medication adherence. For hypothesis 1, medication adherence was designated as a binary variable with a threshold of 0.8 (PRM); for hypothesis 2, medication adherence was specified as five-category and continuous variables, respectively. Inverse probability weighting and mixed effects Cox proportional hazards models were conducted for confounders control and survival analyses. RESULTS: One hundred eighty-five thousand eight hundred participants were eligible for the final analyses, with a mean age of 47.49 years (SD 14.55 years), of whom 53.6% were female. For hypothesis 1, the medication non-adherence group (PRM < 0.8) had a lower risk of suicide (HR, 0.527, 95% CI, 0.447-0.620), an increased risk of NSSI (HR, 1.229, 95% CI, 1.088-1.388), and non-significant risk of attempted suicide compared with adherence group (PRM ≥ 0.8). For hypothesis 2, the lowest medication adherence (PRM < 0.2) was associated with increased risks of suicide attempt (HR, 1.614, 95% CI, 1.412-1.845), NSSI (HR, 1.873, 95% CI, 1.649-2.126), and a decreased risk of suicide (HR, 0.593, 95% CI, 0.490-0.719). The other non-adherence groups had lower risks for all three self-inflicted violence behaviors. The associations between medication adherence in continuous-variable and three outcomes were consistent with the categorical medication adherence results. CONCLUSIONS: Almost no medication taken as prescribed was associated with an increased risk of suicide attempt and NSSI. However, medication adherence did not appear to prevent completed suicide. Besides, patients with moderate adherence had a lower incidence of suicide attempt and NSSI. These findings highlight the need for a more detailed portrayal of medication adherence and the need to be vigilant for suicide intent in schizophrenics with good medication adherence who may be overlooked previously.

Quality of life and its influencing factors in patients with schizophrenia. / ç²¾ç¥žåˆ†è£‚ç—‡æ‚£è€ ç”Ÿæ´»è´¨é‡åŠå ¶å½±å“å› ç´ .

Schizophrenia is a chronic mental disease. With the change of medical model, quality of life has gradually become an important prognostic indicator for patients with schizophrenia. People with schizophrenia have a lower quality of life than the general population or people with other chronic diseases, Sociodemographic factors such as age, gender, employment, education level, income and living situation; clinical factors such as psychiatric symptoms, medication compliance and insight; and psychosocial factors such as social support, cognition, stigma, self-esteem and needs are the main influencing factors for schizophrenia patients. Medication and psychological interventions such as social skills training, family intervention, cognitive correction and cognitive behavioral therapy can be used to improve the quality of life of patients with schizophrenia. Understanding the factors affecting the quality of life of schizophrenia patients and the improvement measures helps to provide reference for improving their quality of life.

[Quality of Life and Its Influencing Factors Among Schizophrenia Patients Living in Urban and Rural Areas].

Objective: To investigate the status quo of the quality of life of schizophrenia patients in a city in Sichuan Province and to explore, thereof, the urban-rural differences in the factors influencing their quality of life. Methods: A total of 824 schizophrenia patients were selected for the study through multistage stratified cluster random sampling method. All the subjects were selected from a pool of patients covered by the Sichuan Provincial Information System for the Comprehensive Management of Severe Mental Disorders. Questionnaire surveys were conducted with the Schizophrenia Quality of Life Scale (SQLS), the Social Support Rating Scale (SSRS), the general circumstance questionnaire, and the lifestyle questionnaire. In addition, univariate and multiple linear regression models were used to analyze the influencing factors of quality of life among schizophrenia patients living in urban areas and those in rural areas. Results: Rural patients had poorer quality of life than urban patients did in all measurement domains ( P<0.05). Marital status, vocational skills, physical exercise, and social support were influencing factors of the quality of life among urban patients ( P<0.05). Age, marital status, annual household income, vocational skills, participation in community rehabilitation activities, and the time required to walk to the nearest medical institution were influencing factors of the quality of life among rural patients ( P<0.05). Conclusion: Targeted measures for the enhancement of the quality of life of schizophrenia patients should be formulated on the basis of urban and rural characteristics in terms of economic support, vocational skills training, input in mental health services, community rehabilitation services, and social support.

Medication Nonadherence and Risk of Violence to Others Among Patients With Schizophrenia in Western China.

Importance: Reducing violence to others in community-based patients with schizophrenia has important implications for public health. Increasing medication adherence is often used to reduce the risk of violence, yet little is known about the association between medication nonadherence and violence to others in this population. Objective: To examine the association between medication nonadherence and violence to others among community-based patients with schizophrenia. Design, Setting, and Participants: This large, naturalistic, prospective cohort study was performed in western China from May 1, 2006, to December 31, 2018. The data set was from the integrated management information platform for severe mental disorders. As of December 31, 2018, 292 667 patients with schizophrenia were registered in the platform. During follow-up, patients could enter or leave the cohort at any time. Maximum follow-up was 12.8 years, with a mean (SD) of 4.2 (2.3) years. Data analysis was conducted from July 1, 2021, to September 30, 2022. Exposures: Medication nonadherence. Main Outcomes and Measures: Violence to others throughout the follow-up period was the outcome, including minor nuisances, violating the Law of the People's Republic of China on Penalties for Administration of Public Security (APS law), and violating criminal law. Information about these behaviors was provided by the public security department. Directed acyclic graphs were used to identify and control confounders. Propensity score matching and generalized linear mixed-effects models were used for analysis. Results: The final study sample included 207 569 patients with schizophrenia. The mean (SD) age was 51.3 (14.5) years, and 107 271 (51.7%) were women; 27 698 (13.3%) perpetrated violence to others, including 22 312 of 142 394 with medication nonadherence (15.7%) and 5386 of 65 175 with adherence (8.3%). In 112 710 propensity score-matched cases, risks of minor nuisances (odds ratio [OR], 1.82 [95% CI, 1.75-1.90]; P < .001), violating APS law (OR, 1.91 [95% CI, 1.78-2.05]; P < .001), and violating criminal law (OR, 1.50 [95% CI, 1.33-1.71]; P < .001) were higher in patients with nonadherence. However, the risk did not increase with higher medication nonadherence. There were differences in risk of violating APS law between urban and rural areas. Conclusions and Relevance: Medication nonadherence was associated with a higher risk of violence to others among community-based patients with schizophrenia, but the risk did not increase as medication nonadherence increased.

Risk factors for mortality due to natural causes and suicide among people with severe mental illness in western China.

Excess mortality in people with severe mental illness (SMI) has been extensively reported. However, little is known about mortality due to natural causes and suicide and their risk factors among people with SMI in western China. The study was conducted to determine the risk factors of natural death and suicide among people with SMI in western China. A totoal of 20,195 SMI patients in western China derived from severe mental illness information system in Sichuan province (January 1, 2006, through July 31, 2018) were included in the cohort study. Mortality rates per 10,000 person-years of natural causes and suicide for patients were calculated with different characteristics. Fine-Gray competing risk model was used to identify risk factors of natural death and suicide. The mortality was 132.8 per 10,000 person-years for natural death and 13.6 per 10,000 person-years for suicide. Males, older age, divorced/widowed, poverty and no anti-psychotic treatment were significantly associated with natural death. Higher education and suicide attempt were strong risk factors of suicide. Risk factors were not shared across natural death and suicide among people with SMI in western China. Risk management and interventions for people with SMI should be tailored for specific causes of death.

[Factors Influencing Suicide Deaths in Patients With Schizophrenia Based on Cohort Data: An Empirical Study of a Sample of 170006 Patients in Sichuan Province].

Objective: To prospectively explore the risk factors of suicide in patients with schizophrenia. Methods: Data on schizophrenia patients in Sichuan Province between 2006 and 2018 were obtained from the National Severe Mental Disorders Information System, and the Cox proportional hazards regression model was used to explore for risk factors for suicide in schizophrenia patients. Result: A total of 170006 patients with schizophrenia were included in the study. At the end of the follow-up period, 160570 patients were alive and 9436 died from various causes, 929 of which being suicide deaths, resulting in a suicide rate of 223.61/100, 000 person-years. The Cox proportional hazards regression model suggested that risk factors for suicide in patients with schizophrenia included poverty ( HR=1.20, 95% CI: 1.02-1.41), higher education level (primary school [ HR=1.32, 95% CI: 1.09-1.60], middle school [ HR=1.40, 95% CI: 1.14-1.73], high school and above [ HR=1.93, 95% CI: 1.49-2.52]) in comparison with illiteracy and semi-literacy, suicide attempts ( HR=2.70, 95% CI: 1.70-4.29), strict medication compliance ( HR=1.91, 95% CI: 1.66-2.20), history of antipsychotic drug therapy ( HR=1.42, 95% CI: 1.06-1.90), younger age group of patients of 46-60 ( HR=1.95, 95% CI: 1.60-2.39), 31-45 ( HR=3.61, 95% CI: 2.92-4.47), and 15-30 ( HR=12.37, 95% CI: 9.69-15.78) compared with the 61-90 age group, and doing agriculture jobs ( HR=1.36, 95% CI: 1.13-1.65). Conclusion: Young and middle-aged schizophrenia patients with higher education levels, especially those with a history of suicide attempts, are at high risk for suicide. Focused interventions should be directed at high-risk groups to reduce suicide deaths in patients with schizophrenia.

Childhood experiences and needs of offspring living with paternal and maternal severe mental illness: A retrospective study in China.

OBJECTIVE: Parental mental illness is considered one of the strongest risk factors for the development of children. This study aimed to describe the adverse childhood experiences and needs of offspring living with parental severe mental illness (SMI) in China and to compare the differences in needs between offspring living with maternal SMI and those living with paternal SMI. METHOD: Overall, 381 participants, including 76 living with paternal SMI, 104 living with maternal SMI, and 201 living without parental mental illness, were enrolled. Data were collected using questionnaires from five sites in China. Differences among the three groups were compared using analysis of variance and chi-square test. Factors were extracted using exploratory factor analysis, and differences in factor scores between the paternal and maternal SMI groups were compared using the rank sum test. RESULTS: The percentages of poverty, family care, and housework were significantly higher in the paternal SMI group and maternal SMI group, compared with the control group, and those of school dropout and relationship with friends were significantly higher in the maternal SMI group (p < 0.0167). The need for stigma reduction in the maternal SMI group was significantly higher than that in the paternal SMI group (p = 0.015). CONCLUSION: Our findings highlight the importance of considering the impact of maternal and paternal SMI on child development. There is an urgent need to develop a national program to assist families with mentally ill parents to provide services for children living with parental SMI.

Adverse childhood experiences in offspring living with parental mental illness: a controlled study from China.

BACKGROUND: Adverse childhood experiences (ACEs) affect children's development, and their harm to health is pervasive throughout the life course. AIMS: To identify ACEs and their risk factors in Chinese household with or without parental mental illness. METHODS: A controlled study was conducted among 181 young adults with parental mental illness (positive group) and 201 demographically matched individuals without parental mental illness (negative group). Univariate and multivariate analyses were performed to study the correlation between ACEs and their risk factors. RESULTS: The positive group suffered emotional abuse, domestic violence, bullying, and cumulative ACEs more frequently than the negative group. In the positive group, living in rural areas and having a low household economic status during childhood were identified as risk factors for cumulative ACEs, whereas a higher education level of the mother was a protective factor for cumulative ACEs in univariate analyses. Low household economic status remained an independent risk factor for cumulative ACEs in the positive group in multivariate analyses. CONCLUSIONS: Children living with parental mental illness are more vulnerable to ACEs, and our findings highlight the importance of socioeconomic factors in increasing the risk of ACEs. To alleviate the deleterious impact of parental mental illness on offspring, multidimensional supports are needed.

Effects of azadirachtin on detoxification-related gene expression in the fat bodies of the fall armyworm, Spodoptera frugiperda.

The fall armyworm, Spodoptera frugiperda, has become a worldwide pest and threatens world food production. A previous study indicated that azadirachtin, the most effective botanical insecticide for S. frugiperda, inhibits larval growth of the insect. The effect of azadirachtin on the tissues of the larvae, however, remains to be determined. In this study, the effects of azadirachtin on the structure of fat bodies were analyzed. Comparative transcriptomic analysis was conducted between controls and samples treated with 0.1 µg/g azadirachtin for 7 days to explore potential relevant mechanisms. The expression of 5356 genes was significantly affected after azadirachtin treatment, with 3020 up-regulated and 2336 down-regulated. Among them, 137 encode detoxification enzymes, including 53 P450s, 20 GSTs, 27 CarEs, 16 UGTs, and 12 ABC transporters. Our results indicated that azadirachtin could destroy fat body structure and change the mRNA levels of detoxification-related genes. The up-regulated genes encoding detoxification enzymes might be related to detoxifying azadirachtin. Our results elucidate a preliminary mechanism of azadirachtin detoxification in the fat bodies of S. frugiperda larvae.

[Association Between Medication Compliance and Various Risky Behaviors in Patients With Schizophrenia]. / ç²¾ç¥žåˆ†è£‚ç—‡æ‚£è€ æœè¯ä¾ä»Žæ€§ä¸Žä¸åŒç±»åž‹å±é™©è¡Œä¸ºçš„å ³è”ç ”ç©¶.

Objective: To investigate the status of medication adherence and various types of risky behaviors of schizophrenia patients in a certain area of western China and to explore accordingly the correlation between the two. Methods: A total of 292 667 patients with schizophrenia were enrolled in a follow-up survey between 2006 and 2018. In addition, based on the outcome-wide analysis strategy, a multivariate Cox proportional risk regression model was used to estimate and compare the impact of medication adherence on different types of risky behaviors in schizophrenia patients. Results: In this 13-year prospective cohort, 65 175 patients (31.4%) showed good medication adherence, while 142 394 patients (68.6%) showed poor medication adherence. The incidence rates of various risky behaviors during the follow-up period were as follows, minor nuisances, 12.25%, violation of the Law of the People's Republic of China on Penalties for Administration of Public Security (APS law), 3.82%, violation of criminal law, 0.94%, suicide completed, 0.28%, self-harm, 1.42%, and attempted suicide, 0.82%. Schizophrenia patients who had poor medication adherence had higher risks of committing violence against others and self-inflicted injury compared to patients with good medication adherence did, with the associated effects being minor nuisances (hazard ratio [HR]=1.31, 95% confidence interval [CI]: 1.27-1.35), violation of APS law (HR=1.47, 95% CI: 1.38-1.56), violation of criminal law (HR=1.17, 95% CI: 1.05-1.31), and self-harm (HR=1.43, 95% CI: 1.32-1.56), respectively, while the risk of suicide completed is lower in schizophrenia patients with poor medication adherence than that in patients with good medication adherence (HR=0.56, 95% CI: 0.47-0.66). There was no statistically significant association between attempted suicide and medication adherence. Conclusion: There are variations in the direction and strength of the association between medication adherence and different types of risky behaviors and further research is needed to elucidate the mechanisms of the association.

Can scope-of-practice transfer psychiatrists be up for their job? A cross-sectional study of clinical competence status and related factors.

BACKGROUND: The great economic and social changes have resulted in the prevalence of mental disorder increasing year by year in China. Mental health medical service resources of China are significantly insufficient. The program of Transfer Training for psychiatrist was launched in China in October 2015. Thousands of physicians completed the transfer training and obtained certificates. To date, there is little evidence to identify the status and related factors of clinical competence among scope-of-practice transfer psychiatrists in China. PURPOSE: This study aimed to investigate the status and related factors of clinical competence among scope-of-practice transfer psychiatrists of Sichuan Province, China. PATIENTS AND METHODS: The sample was composed of 291 physicians who certificated the transfer training. Data were collected between September and November 2021, using self-made questionnaire with a total of 22 items to record demographic characteristics, practice status and workplace of participants. Descriptive statistics analysis, independent sample T-test, one-way ANOVA, Spearman rank correlation, and multiple regression analysis were used to analyze the data. RESULTS: The clinical competence of participants score was (8.02 ± 1.48). Significant differences were found in clinical competence scores among: the subgroups of practice category, reasons for attending in the transfer training for psychiatrists, whether transfer to/ add mental health practice registration, whether engage in mental / psychological work after training, whether the level of transfer training meeting participants' job needs, whether the level of transfer training meeting their theoretical learning needs, whether the level of transfer training meeting their clinical practice needs, salary change compared with pre-training, whether join in continuing education after training, whether wanted to join in continuing education after training, whether the workplace before training has mental / psychological department, whether the workplace after training has mental / psychological department, institutional nature, institutional level and institutional affiliation. Multiple regression analysis identified that level of transfer training meeting participants' job needs, level of transfer training meeting their clinical practice needs, Whether the workplace before training has mental / psychological department, whether wanted to join in continuing education after training, institutional nature were the contributors of clinical competence. CONCLUSION: The study demonstrated that clinical competence of scope-of-practice transfer psychiatrists needed to be improved. Whether workplace has mental/psychological departments was an important factor of clinical competence. Besides, interest of physicians is another crucial factor for their clinical competence. The continuing education of those psychiatrists may be one effective measure considering their factual working conditions.

Prevalence of violence to others among individuals with schizophrenia in China: A systematic review and meta-analysis.

Background: Violence to others (hereinafter referred to as "violence-TO") is common in individuals with schizophrenia. The reported prevalence of violence-TO among schizophrenics ranges widely in existing studies. Improved prevalence estimates and identification of moderators are needed to guide future management and research. Methods: We searched EBSCO, EMBASE, Medline, PubMed, Science Direct, Web of Science, CNKI, VIP, WANFANG data, and CBM for relevant articles published before June 5, 2022. Meanwhile, violence-TO was summarized into four categories: (a) violence-TO on the reviews of official criminal or psychiatric records (type I); (b) less serious forms of violence-TO (type II); (c) physical acts causing demonstrable harm to victims (type III); (d) homicide (type IV). We did meta-analysis for the above types of violence-TO, respectively, and applied subgroup analyses and meta-regression analyses to investigate the source of heterogeneity. Results: A total of 56 studies were eligible in this study and 34 of them were high-quality. The prevalence of type I to type IV in individuals with schizophrenia in China was 23.83% (95% CI: 18.38-29.75%), 23.16% (95% CI: 8.04-42.97%), 17.19% (95%CI: 8.52-28.04%), and 0.62% (95% CI: 0.08-1.54%) respectively. The results of the subgroup analysis showed that the prevalence of type I was higher among subjects in the inland than in the coastal non-economic zone, while the prevalence of type III was the highest in the coastal economic zone, followed by the inland region and the lowest in the coastal non-economic zone. The results of multivariate meta-regression analyses showed that: patient source in type I (ß = 0.15, P < 0.01), patient source (ß = 0.47, P < 0.01), and proportion of male (ß = 0.19, P < 0.01) in type II, age (ß = 0.25, P < 0.01), and GDP per capita (ß = 0.05, P = 0.01) in type III were statistically significant. Conclusion: The prevalence of different types of violence-TO and their influencing factors varied. Therefore, the authorities should take different management measures. In addition to individual factors, regional factors may also affect violence-TO, which suggests the need for a multi-sectorial approach to prevention and treatment for subjects in different regions and adopting targeted control strategies. Systematic Review Registration: [www.ClinicalTrials.gov], identifier [CRD42021269767].

A Course-Based Undergraduate Research Experience Improves Outcomes in Mentored Research.

Infusing undergraduate curricula with authentic research training is an important contemporary challenge. Such exposure typically occurs through mentored research (MR) or course-based undergraduate research experiences (CUREs). In Asian contexts, CURE implementation is rare, while MR is often a graduation requirement. In this study, mentor interviews and mentee focus groups were used to characterize the learning challenges associated with this requirement at a Chinese university. An intensive 6-week CURE was then implemented as an MR preparatory program to help mitigate the identified challenges. This program contained seven site-specific features not typically included in other CUREs, each designed to improve different aspects of student readiness for MR. Post-CURE surveys, focus groups, and interviews demonstrated CURE enrollment significantly improved subsequent MR outcomes. Almost 90% of all enrollees, for example, began their first MR experience in their second year, more than twice the rate of non-enrollees. Enrollees also reported greater confidence in their research skills and more frequent experiences working in multiple labs. This study reports both immediate CURE and downstream MR outcomes, using the former to help explain the latter. A comprehensive CURE implementation process is described, offering a potential model for the design of other programs with similar research enhancement goals.

Investigation of the In Vivo, In Vitro, and In Silico Wound Healing Potential of Pinctada martensii Purified Peptides.

Previous studies found that both oral and topical administration of enzymatic digestion products < 3 K Da ultrafiltration fractions of Pinctada martensii mantle (PMPs) had pro-healing effects. Thus, we further purified them by Sephadex-G25 and screened them by cellular assays to obtain Pinctada martensii purified peptides (PMPPs). In this study, we explored the mechanism of PMPPs on wound healing by in vivo, in vitro, and in silico experiments. LC-MS/MS results showed that PMPPs consisted of 33 peptides with molecular weights ranging from 758.43 to 2014.04 Da, and the characteristic peptide was Leu-Asp. The results of cellular assays showed that PMPPs promoted the proliferation of human skin fibroblasts (HSF) (135%) and human immortalized keratinocyte (HaCaT) cells (125%) very significantly at 12.5 µg/mL. The in vivo results showed that PMPPs could achieve scarless healing by inhibiting the inflammatory response, accelerating the epithelialization process, and regulating collagen I/III ratio. The optimal peptide sequence FAFQAEIAQLMS of PMPPs was screened for key protein receptors in wound healing (EGFR1, FGFR1, and MMP-1) with the help of molecular docking technique, which also showed to be the key pro-healing active peptide sequence. Therefore, it may provide a therapeutic strategy with great potential for wound healing.

Life expectancy and potential years of life lost for schizophrenia in western China.

Excess mortality in people with schizophrenia has been extensively reported. However, little is known about the life expectancy and potential years of life lost (PYLL) in western China. This study aimed to estimated life expectancy and PYLL for people with schizophrenia in western China. A total of 228,572 people with schizophrenia were included from National Information System for Psychosis in one province of western China. Life-expectancy was calculated by using Chiang's method. One-way ANOVA was used to compare the age-sex standardized PYLL for different causes of death among different demographic characteristics groups. Life expectancy for men and women with schizophrenia was 52.8 years and 59.0 years respectively. The overall PYLL of people with schizophrenia was 18.4 years, and suicide had the largest PYLL (31.2 years) among all causes of mortality. The PYLL due to suicide was significantly higher among men, high school and above, non-poverty, non-farmer and divorced people with schizophrenia. The PYLL due to diseases and medical conditions was higher among men, illiteracy, farmer and unmarried people with schizophrenia. Strategies to prevent causes of premature death in schizophrenia are urgently required in western China, particularly in the promotion of physical health and prevention of suicide.

Effects of camptothecin on histological structures and gene expression profiles of fat bodies in Spodoptera frugiperda.

Spodoptera frugiperda is a serious threat to global food production. Our previous study demonstrated that Camptothecin (CPT), a bioactive secondary metabolite from Camptotheca acuminata (Decne: Nyssaceae), exhibits adverse impact on the larval midgut of S. frugiperda and inhibits insect growth. However, effects of CPT on fat bodies of S. frugiperda larvae have not been examined yet. In the present study, we found that histological structures of fat bodies of S. frugiperda larvae were damaged in insects treated with CPT. Comparative transcriptomic analyses among different fat body samples from controls and insects treated with 1.0 and 5.0 µg/g CPT were performed. A total of 4212 and 5044 differentially expressed genes (DEGs) were identified in the samples treated with 1.0 and 5.0 µg/g CPT, respectively. Our data indicated that the pathways of detoxification, immune response, fatty acids, chitin, and hormone biosynthesis in fat bodies were affected by CPT treatments based on DEGs. These results provided a comprehensive view of the damage and gene expression changes in fat bodies of S. frugiperda after CPT exposure, which shall be useful to reveal the mechanism of CPT toxicity against S. frugiperda in future.

Children of parents with mental illness in the COVID-19pandemic: A cross-sectional survey in China.

OBJECTIVE: Children of parents with mental illness (COPMI) are vulnerable during the COVID-19 pandemic. The study aimed to assess the psychosocial impacts of the pandemic and identify potential factors influencing their mental health. METHOD: 665 COPMI from six sites including Wuhan in China were enrolled. COPMI's mental health and the impacts of COVID-19 were assessed by an online survey. Univariate and multivariate analyses were performed to examine the association between impact factors and participants' mental health. RESULTS: 16.1 % of participants were in abnormal range of mental health, with interpersonal relationship being the most common problem. 48.6 % of participants reported quite worried about the epidemic. All aspects of adverse effects of COVID-19 were more prevalent among COPMI in Wuhan than in other sites. Concerns about COVID-19 (OR = 1.7, p = 0.02), decreased family income (OR = 2.0, p = 0.02), being physically abused (OR = 2.1, p = 0.04), witnessing family members being physically abused (OR = 2.0, p = 0.03), and needs for promoting family members' mental health (OR = 2.2, p < 0.01) were independent risk factors for participants' mental health. CONCLUSION: The findings raise our awareness of the impacts of COVID-19 pandemic on the wellbeing of COPMI. Multifaceted psychosocial support for COPMI is urgently needed to support them live through the pandemic.

Posttraumatic stress disorder and professional burnout among local government staff seven years after the Wenchuan earthquake in China: A longitudinal study.

Although local government staff are crucial in post-quake reconstruction, their long-term psychological and professional consequences remain unclear. This longitudinal study investigated changes of posttraumatic stress disorder (PTSD) and professional burnout over seven years, and their underlying relationship. The study assessed 250 staff at one year (T1y) after the earthquake, and 162 (64.8 %) were followed up at seven years (T7y). PTSD and professional burnout were assessed with the Short Screening Scale for DSM-IV PTSD and the burnout subscale of Professional Quality of Life Scale (ProQOL), respectively, at both time points. Longitudinal changes in PTSD and burnout were examined and cross-lagged panel analyses were conducted to test the relationship between PTSD and burnout. The rates of positive cases of PTSD screening were 23.2 % at T1y and 11.1 % at T7y. The percentages of moderate burnout were 61.7 % at T1y and 23.5 % at T7y. Scores of PTSD (z = -5.70, p < 0.001) and burnout (t = 10.07, p < 0.001) from T1y to T7y decreased. The cross-lagged analysis indicated that burnout at T1y predicted PTSD at T7y (ß = 0.19, p = 0.025). In conclusion, the Wenchuan earthquake has long-lasting negative effects on local government staff, although they can recover over time. Interventions to reduce professional burnout after disaster may does be beneficial to decrease the risk of PTSD in the long run.

A longitudinal study on emotional distress among local government staff seven years after the 2008 Wenchuan earthquake in China.

BACKGROUND: The current study examined the change in local government staff's emotional distress over 7 years after the 2008 Wenchuan earthquake, and the influence of earthquake exposure and professional quality of life (ProQOL) on emotional distress. METHODS: This longitudinal study assessed 250 participants at 1 year after the earthquake; 162 (64.8%) were followed up at 7 years. Emotional distress was assessed with the Self-Reporting Questionnaire (SRQ) at both time points. We assessed ProQOL, including compassion satisfaction, burnout, and secondary traumatic stress, and earthquake exposure at 1 year. Wilcoxon signed-rank tests were performed to test longitudinal changes in emotional distress. Hierarchical multiple regression was conducted to examine the effect of earthquake exposure and ProQOL. RESULTS: The positive screening rate of emotional distress (SRQ ≥ 8) was 37.6 and 15.4% at one and 7 years, respectively. Emotional distress scores declined over time (p < 0.001). Earthquake exposure and ProQOL predicted one-year (ps < 0.05) but not seven-year emotional distress, whereas burnout predicted both one-year (p = 0.018) and seven-year (p = 0.047) emotional distress. CONCLUSIONS: Although emotional distress can recover over time, it persists even 7 years later. Actions to reduce burnout during the early stage of post-disaster rescue have long-term benefits to staff's psychological outcomes.

Comparative Genomic and Transcriptomic Analysis Reveals Specific Features of Gene Regulation in Kluyveromyces marxianus.

Kluyveromyces marxianus is a promising host for producing bioethanol and heterologous proteins. It displays many superior traits to a conventional industrial yeast species, Saccharomyces cerevisiae, including fast growth, thermotolerance and the capacity to assimilate a wider variety of sugars. However, little is known about the mechanisms underlying the fast-growing feature of K. marxianus. In this study, we performed a comparative genomic analysis between K. marxianus and other Saccharomycetaceae species. Genes involved in flocculation, iron transport, and biotin biosynthesis have particularly high copies in K. marxianus. In addition, 60 K. marxianus specific genes were identified, 45% of which were upregulated during cultivation in rich medium and these genes may participate in glucose transport and mitochondrion related functions. Furthermore, the transcriptomic analysis revealed that under aerobic condition, normalized levels of genes participating in TCA cycles, respiration chain and ATP biosynthesis in the lag phase were higher in K. marxianus than those in S. cerevisiae. Levels of highly copied genes, genes involved in the respiratory chain and mitochondrion assembly, were upregulated in K. marxianus, but not in S. cerevisiae, in later time points during cultivation compared with those in the lag phase. Notably, during the fast-growing phase, genes involved in the respiratory chain, ATP synthesis and glucose transport were co-upregulated in K. marxianus. A few shared motifs in upstream sequences of relevant genes might result in the co-upregulation. Specific features in the co-regulations of gene expressions might contribute to the fast-growing phenotype of K. marxianus. Our study underscores the importance of genome-wide rewiring of the transcriptional network during evolution.