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The coexistence of superconductivity and ferromagnetism is a long-standing issue in superconductivity due to the antagonistic nature of these two ordered states. Experimentally identifying and characterizing novel heterointerface superconductors that coexist with magnetism presents significant challenges. Here, we report the observation of two-dimensional long-range ferromagnetic order in a KTaO3 heterointerface superconductor, showing the coexistence of superconductivity and ferromagnetism. Remarkably, our direct current superconducting quantum interference device measurements reveal an in-plane magnetization hysteresis loop persisting above room temperature. Moreover, first-principles calculations and X-ray magnetic circular dichroism measurements provide decisive insights into the origin of the observed robust ferromagnetism, attributing it to oxygen vacancies that localize electrons in nearby Ta 5d states. Our findings suggest KTaO3 heterointerfaces as time-reversal symmetry breaking superconductors, injecting fresh momentum into the exploration of the intricate interplay between superconductivity and magnetism enhanced by the strong spin-orbit coupling inherent to the heavy Ta in 5d orbitals.
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[This corrects the article DOI: 10.1371/journal.ppat.1010665.].
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The lumen of the endoplasmic reticulum (ER) is the subcellular site where secretory protein folding, glycosylation and sulfation of membrane-bound proteins, proteoglycans, and lipids occur. The protein folding and degradation in the lumen of the ER require high levels of energy in the form of ATP. Biochemical and genetic approaches show that ATP must first be translocated across ER membrane by particular transporters before serving as substrates and energy sources in the lumenal reactions. Here we describe an ATP/ADP transporter residing in the ER membranes of T.gondii. Immunofluorescence (IFA) assay in transgenic TgANT1-HA tag revealed that TgANT1 is a protein specifically expressed in the ER. In vitro assays, functional integration of TgANT in the cytoplasmic membrane of intact E. coli cells reveals high specificity for an ATP/ADP antiport. The depletion of TgANT leads to fatal growth defects in T.gondii, including a significant slowdown in replication, no visible plaque formation, and reduced ability to invade. We also found that the amino acid mutations in two domains of TgANT lead to the complete loss of its function. Since these two domains are conserved in multiple species, they may share the same transport mechanism. Our results indicate that TgANT is the only ATP/ADP transporter in the ER of T. gondii, and the lack of ATP in the ER is the cause of the death of T. gondii.
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Toxoplasma , Adenosina Difosfato/metabolismo , Adenosina Trifosfato/metabolismo , Retículo Endoplásmico/metabolismo , Escherichia coli/metabolismo , Proteínas de la Membrana/metabolismo , Proteínas de Transporte de Membrana/metabolismo , Toxoplasma/genética , Toxoplasma/metabolismoRESUMEN
Iridoid glycosides extract, which is the main active extract of Ajuga decumbens Thunb, has been proved to have anti-breast cancer activity in previous studies. However, it is still unknown whether 8-O-acetylharpagide, a main active compound in the extract, has anti-breast cancer activity. In this study, 4 T1 breast cancer mice model was first successfully established. Then the anti-breast cancer effect of 8-O-acetylharpagide was systematically investigated. Feces were collected for metabolomics and 16S rRNA analysis to assess the potential mechanism. The results showed that 8-O-acetylharpagide was effective in reducing 4 T1 mouse tumor volume and weight compared with the model group. Metabolome analysis revealed 12 potential metabolite biomarkers in feces, mainly involved in primary bile acid biosynthesis and arachidonic acid metabolism. The 16S rRNA sequencing results demonstrated that 8-O-acetylharpagide modulated the abundance of the intestinal flora in 4 T1 mice. Spearman correlation analysis showed that calcitriol and prostaglandin G2 strongly correlated with Akkermansia, Firmicutes and Muribaculum. Overall, the active compound 8-O-acetylharpagide could inhibit significantly breast cancer growth in 4 T1 breast cancer model mice. The mechanism of the anti-breast cancer effect of 8-O-acetylharpagide may be related to the regulation of primary bile acid biosynthesis and arachidonic acid metabolism and modulation of the abundance of Akkermansia and Firmicutes.
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Neoplasias de la Mama , Metaboloma , Animales , Ratones , Femenino , Metaboloma/efectos de los fármacos , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/metabolismo , Heces/microbiología , Heces/química , Glicósidos Iridoides/farmacología , Glicósidos Iridoides/química , Microbioma Gastrointestinal/efectos de los fármacos , Metabolómica/métodos , Línea Celular Tumoral , Modelos Animales de Enfermedad , Ratones Endogámicos BALB CRESUMEN
Using linked public health data from Australia to measure uptake of COVID-19 vaccination by infection status, we found coverage considerably lower among infected than uninfected persons for all ages. Increasing uptake of scheduled doses, including among previously infected persons after the recommended postinfection delay, is needed to reduce COVID-19 illness rates.
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Vacunas contra la COVID-19 , COVID-19 , Humanos , Nueva Gales del Sur/epidemiología , COVID-19/epidemiología , COVID-19/prevención & control , Australia/epidemiología , Salud Pública , VacunaciónRESUMEN
BACKGROUND: Little is known about what impact the use of different spatial methodological approaches may have on understanding the relationship between area-level socio-economic factors and suicide. METHODS: In this systematic review, we searched PubMed, Embase, CINAHL and PsycInfo for original empirical studies examining the relationship between socio-economic factors and suicide with a spatial lens, published up to January 22, 2022. Data on applied spatial methods, indicators of socio-economic factors, and risk of suicide related to socio-economic factors were extracted. The protocol for this systematic review was registered with PROSPERO (CRD42021251387). RESULTS: A systematic search yielded 6290 potentially relevant results; 58 studies met the inclusion criteria for review. Of the 58 included studies, more than half of the studies (n = 34; 58.6%) used methods that accounted for spatial effects in analyses of the association between socio-economic factors and suicide or examined spatial autocorrelation, while 24 (41.4%) studies applied univariate and multivariate models without considering spatial effects. Bayesian hierarchical models and spatial regression models were commonly used approaches to correct for spatial effects. The risk of suicide relating to socio-economic factors varied greatly by local areas and between studies using various socio-economic indicators. Areas with higher deprivation, higher unemployment, lower income, and lower education level were more likely to have higher suicide risk. There was no significant difference in results between studies using conventional versus spatial statistic methods. CONCLUSION: An increasing number of studies have applied spatial methods, including Bayesian spatial models and spatial regression models, to explore the relationship between area-level socio-economic factors and suicide. This review of spatial studies provided further evidence that area-level socio-economic factors are generally inversely associated with suicide risk, with or without accounting for spatial autocorrelation.
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Suicidio , Humanos , Teorema de Bayes , Renta , Factores Económicos , Análisis Espacial , Factores SocioeconómicosRESUMEN
Means restriction interventions are recognised as highly effective for the deterrence of suicide attempts by jumping. While such interventions can lead to significant reductions in suicide, it is unclear whether these reductions represent a displacement effect, whereby individuals are instead choosing to attempt suicide at other nearby locations which offer the same means. The potential displacement of suicides as an unintended consequence of means restriction has been relatively unexplored to date. The only studies exploring displacement effects have focused on bridges, which are relatively easily contained sites; no studies have yet explored displacement effects at cliff-based high risk suicide locations (hotspots). Using Australian coronial data for the period of 2006-2019, we undertook joinpoint and kernel density analysis of suicides by jumping at a well-known cliff-based hotspot in Sydney, Australia, to determine whether there was evidence of displacement to local and broader surrounding cliffs following the installation of a multi-component harm minimization intervention (the Gap Park Masterplan). While slight decreases were noted in the immediate area subject to the structural intervention in the post-implementation period, alongside slight increases in the surrounding cliffs, there was no evidence for statistically significant changes. While kernel density analyses did not identify the emergence of any new hotspot locations in the post-implementation period, three existing hotspot sites of concern were found in our total area of interest, with greater than expected growth in the density of one of the hotspots. While we found no persuasive evidence of displacement, ongoing monitoring of the cliff-based location where the structural interventions were implemented is needed to ensure the ongoing safety of the area.
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Prevención del Suicidio , Humanos , Australia , Análisis EspacialRESUMEN
BACKGROUND: The study aimed to compare the predictive values of three widely used nutritional assessment methods, body mass index (BMI), Nutritional Risk Screening 2002 (NRS 2002), and the prognostic nutritional index (PNI), for different clinical prognostic indicators of ovarian cancer patients. METHODS: Patients diagnosed with ovarian cancer treated in our hospital between January 2017 and March 2019 were retrospectively included. The three nutritional assessment methods were assessed, and multivariable analysis was conducted to explore predictive factors for clinical prognoses. Receiver operating characteristic (ROC) curves and the area under the ROC curve (AUROC) were generated to evaluate the discriminative abilities of the three nutritional assessment tools. RESULTS: A total of 442 patients were recruited. Multivariable analysis revealed that the PNI value predicted 1-year death and 1-year recurrence and that both the NRS 2002 score and the PNI value predicted 30-day readmission (P < 0.05). For PNI, AUROCs were 0.834 for predicting 1-year death and 0.719 for 1-year recurrence prediction; for NRS, the AUROC was 0.820 2002 for predicting 30-day readmission. The optimal cutoff values that maximized the prognostic prediction ability were PNI values of 47.75 g/L and 50.40 g/L for 1-year death and 1-year recurrence, respectively, and an NRS 2002 score of 3 points for 30-day readmission following discharge. CONCLUSION: For ovarian cancer patients, the PNI is better at predicting 1-year death and 30-day readmission after discharge, and the NRS 2002 is superior for predicting 1-year recurrence.
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Evaluación Nutricional , Neoplasias Ováricas , Femenino , Humanos , Estado Nutricional , Neoplasias Ováricas/diagnóstico , Pronóstico , Estudios RetrospectivosRESUMEN
Silybin, an active component in the plant Silybum marianum (L.) Gaertn., is commonly used to protect against liver disease. We investigated silybin's protective potential in rat liver against emodin-induced liver injury 4 weeks. It was found that aspartate aminotransferase and direct bilirubin serum biomarkers for liver toxicity significantly increased, and liver histopathology revealed cholestasis and necrosis in rats administered emodin alone, whereas aspartate aminotransferase and total bile acid levels in rats administered emodin and silybin simultaneously were changed compared to rats administered emodin alone. Liver mRNA and protein levels of Cyp7a1-which plays roles in cholesterol metabolism and bile acid synthesis-and Abcb11 (Bsep)-which facilitates bile salt secretion in hepatocyte canaliculi-were significantly altered with emodin, whereas cotreatment with silybin attenuated emodin's adverse effect. Metabolomic analysis using ultra-performance liquid chromatography-quadrupole-time-of-flight-mass spectrometry determined eight potential metabolite biomarkers in serum, urine, and liver tissue. Network analysis was conducted to conceptualize the interplay of genes, metabolites, and metabolic pathways for cholesterol metabolism and bile acid synthesis for liver injury. Overall, rats administered only emodin were shown to be a sound model to investigate fat-associated drug-induced hepatoxicity or liver injury and cotreatment of emodin with silybin prevents fatty liver injury. This metabolomic study revealed that emodin-induced fatty liver injury disrupted bile acid synthesis, vitamin B6 , and glycerophospholipid metabolism pathways and that silybin ameliorates liver injury on these compromised pathways.
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Enfermedad Hepática Inducida por Sustancias y Drogas , Emodina , Hígado Graso , Miembro 11 de la Subfamilia B de Transportador de Casetes de Unión al ATP , Animales , Aspartato Aminotransferasas , Ácidos y Sales Biliares/metabolismo , Bilirrubina/metabolismo , Bilirrubina/farmacología , Biomarcadores/metabolismo , Enfermedad Hepática Inducida por Sustancias y Drogas/metabolismo , Colesterol , Cromatografía Liquida , Emodina/metabolismo , Hígado Graso/metabolismo , Hígado Graso/patología , Glicerofosfolípidos/metabolismo , Hígado/metabolismo , Espectrometría de Masas , ARN Mensajero/metabolismo , ARN Mensajero/farmacología , Ratas , Silibina/metabolismo , Silibina/farmacología , Vitaminas/metabolismo , Vitaminas/farmacologíaRESUMEN
OBJECTIVES: To examine the association between DMARD use and subsequent risk of herpes zoster in a large, heterogeneous and prospective population-based cohort. METHODS: Using data from a cohort of adults (45 and Up Study) recruited between 2006 and 2009 and linked to pharmaceutical, hospital and death data (2004-2015), the effect of DMARD use on zoster risk was analysed using Cox proportional hazards models, adjusting for sociodemographic characteristics, comorbidities and corticosteroid use. RESULTS: Among 254 065 eligible participants, over 1 826 311 person-years follow-up, there were 6295 new DMARD users and 17 024 incident herpes zoster events. Compared with non-users, the risk of zoster was higher in those who used biologic (b)DMARDs, either alone or in combination with conventional synthetic (cs)DMARDs than in those who only used csDMARDs (adjusted hazard ratio [aHR] 2.53 [95% CI: 2.03, 3.16]) for bDMARDs vs 1.48 [95% CI: 1.33, 1.66] for csDMARDs, P-heterogeneity < 0.001; reference: non-users). Among users of csDMARDs, compared with non-users, zoster risks were highest in those using exclusively cyclophosphamide (aHR 2.69 [95% CI: 1.89, 3.83]), more moderate in those using azathioprine (aHR 1.57 [95% CI: 1.07, 2.30]) and hydroxychloroquine (aHR 1.43 [95%CI: 1.11, 1.83]) and not elevated in users of methotrexate (aHR 1.24 [95% CI: 0.98, 1.57]), sulfasalazine (aHR 1.00 [95% CI: 0.71, 1.42]) and leflunomide (aHR 0.41 [95% CI: 0.06, 2.88]). CONCLUSIONS: The risk of zoster was high among bDMARD and cyclophosphamide users. Also, the risk was increased in those using hydroxychloroquine alone and in combination with methotrexate but not methotrexate alone. Preventative strategies such as zoster vaccination or antiviral therapies should be considered in these populations if not contraindicated.
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Antirreumáticos/efectos adversos , Herpes Zóster/inducido químicamente , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
BACKGROUND: There are limited data on zoster recurrence. OBJECTIVE: To examine in detail zoster recurrence in a population-based cohort. METHODS: Using data from a large cohort (The 45 and Up Study) with linked medical data (2004-2015), the incidences of first and recurrent zoster were examined by using survival analysis methods. RESULTS: Over 1,846,572 person-years of follow-up, of 17,413 participants who had a first zoster episode (incidence, 9.43 per 1000 person-years; 95% confidence interval, 9.29-9.57), 675 (3.9%) experienced a recurrence. The mean time between first and recurrent zoster was 2 years for those aged 45-54 years and 3 years for those aged 55 years and older. Among those with a first zoster, the incidence of recurrence was 11.05 (95% confidence interval, 10.24-11.91) per 1000 person-years, and higher recurrence incidence occurred in women compared to men, in younger compared to older participants, and in immunosuppressed compared to nonimmunosuppressed participants. Recurrence appeared lower in the 12 months after zoster onset but then remained consistent at approximately 12.00 per 1000 person-years in the following 8 years. LIMITATIONS: Recurrence may be underestimated because of the use of administrative data for case ascertainment. Potential misclassification of nonimmunosuppressed participants. CONCLUSIONS: Our results support the vaccination of people who have already experienced zoster and underpin the need for additional studies on immunogenicity and vaccine efficacy in these populations.
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Herpes Zóster , Estudios de Cohortes , Femenino , Herpes Zóster/epidemiología , Vacuna contra el Herpes Zóster , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Eficacia de las VacunasRESUMEN
BACKGROUND: Information on the risks of herpes zoster (zoster) preceding a cancer diagnosis and the role of cancer treatment on risk is limited. METHODS: This was a prospective cohort of 241497 adults, with mean age 62.0 years at recruitment (2006-2009), linked to health datasets from 2006 to 2015. The relation between cancer diagnosis, treatment, and zoster risk was analyzed using time-varying proportional hazards models. RESULTS: Over 1760 481 person-years of follow-up, 20286 new cancer diagnoses and 16350 zoster events occurred. Participants with hematological and solid cancer had higher relative risks of zoster than those without cancer (adjusted hazard ratio [aHR], 3.74 [95% confidence interval {CI}, 3.11-4.51] and 1.30 [95% CI, 1.21-1.40], respectively). Compared to those without cancer, zoster risk was also elevated prior to a hematological cancer diagnosis (aHR for 1-2 years prior, 2.01 [95% CI, 1.31-3.09]), but this was not the case for solid cancers (aHR for 1-2 years prior, 0.90 [95% CI, .75-1.07]). Compared to those without cancer, zoster risk among participants with solid cancers receiving chemotherapy was greater than in those without a chemotherapy record (aHR, 1.83 [95% CI, 1.60-2.09] and 1.16 [95% CI, 1.06-1.26], respectively). CONCLUSIONS: For hematological cancer, increases in zoster risk are apparent in the 2 years preceding diagnosis and treatment; for solid organ cancers, the increased risk appears to be largely associated with receipt of chemotherapy.
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Herpes Zóster , Neoplasias , Anciano , Antineoplásicos/uso terapéutico , Femenino , Herpes Zóster/complicaciones , Herpes Zóster/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/complicaciones , Neoplasias/diagnóstico , Neoplasias/tratamiento farmacológico , Neoplasias/epidemiología , Estudios Prospectivos , Factores de RiesgoRESUMEN
OBJECTIVES: To investigate the perceptions and attitudes of Chengdu residents toward "medical and aged care" integrated models and associated factors. METHODS: A cross-sectional questionnaire survey was conducted in 935 residents who were 45 years or older in 8 communities in Chengdu. Descriptive analyses and logistic binary regression analyses were performed. RESULTS: About 91.1% of respondents preferred self-care and family support, and only 8.9% preferred community and institutional care. About 84.9% of respondents reported no knowledge about the "medical and aged care" integrated models, and 15.1% had some basic understanding of the integrated care models. Middle-aged respondents were more likely to understand the integrated care models than their older counterparts, with 21.7% willing to endorse the integrated care models. The logistic regression analyses showed that age, educational attainment, marital status, chronic illness, available financial support, and knowledge and awareness were associated with the choice. CONCLUSIONS: Chengdu residents have low level of knowledge and awareness of the "medical and aged care" integrated models. Public education is needed to promote the new aged care models.
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Envejecimiento , Prestación Integrada de Atención de Salud/organización & administración , Conocimientos, Actitudes y Práctica en Salud , Estudios Transversales , Humanos , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
OBJECTIVES: To investigate social support for elderly in urban and rural settings, and determine its role in physical and psychological health of the elderly populations. METHODS: Data were extracted from the 2013 China Health and Retirement Longitudinal Study (CHARLS). Physical health was measured by the ADL/IADL scale. Mental health was measured by the CES-D scale. Family support included financial support, daily care and emotional care. Binary logistic models were established to test the associations between family support and physical and mental health. RESULTS: For the rural elderly people, financial support from children was positively associated with physical health (P <0.05); whereas, emotional comfort from children was associated with better mental health (P <0.01). Daily care from children was associated with physical and mental health of the elderly in both urban and rural settings (P <0.01). CONCLUSION: An urban-rural difference exists in the role of family support in physical and mental health of the elderly. Rural elderly people are more dependent on family support than their urban counterparts. Social support needs to be strengthened to reduce the urban-rural gap. Meanwhile, family support will continue to play a role in improving the health of elderly populations.
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Salud Mental , Población Rural , Apoyo Social , Población Urbana , Anciano , Niño , China , Familia , Humanos , Estudios LongitudinalesRESUMEN
OBJECTIVES: To determine the prevalence of arthritis in middle- and old-aged populations in China and associated factors. METHODS: Data were drawn from the 2013 China Health and Retirement Longitudinal Study (CHARLS). Binary logistic regression analyses were performed to examine the associations of arthritis with social economic status (age, gender, areas, education), comorbidity (hypertension, dyslipidaemia, diabetes, cancer, chronic lung disease, liver disease, heart disease, stroke, kidney disease, digestive disease, asthma), lifestyle (smoking, drinking, sleeping) and mental health (depression symptoms). RESULTS: About 30.8% of respondents reported arthritis. Those who resided in rural areas, drank regularly, and had depression symptoms, hypertension, chronic lung disease, liver disease, heart disease, stroke, kidney disease, digestive disease and asthma had higher prevalence of arthritis than others. CONCLUSION: The prevalence of arthritis is high in middle- and old-aged populations in China, which deserves increasing attention.
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Artritis/epidemiología , Anciano , China/epidemiología , Comorbilidad , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Prevalencia , Factores de RiesgoRESUMEN
OBJECTIVE: To determine the relationship between sleep duration and abdominal obesity in elderly in china. METHODS: Data were drawn from the 2013 China Health and Retirement National Investigation (China Health and Retirement Longitudinal Study, CHARLS). The prevalence of abdominal obesity in the elderly who had a normal range of sleep duration was compared with those who had a shorter or longer sleep duration using Chi-square tests and binary logistic regression models. RESULTS: Higher odds of abdominal obesity were found in the elderly male with a shorter (OR=1.627, 95%CI: 1.286-2.060, P<0.05) or longer (OR=1.499, 95%CI: 1.009-2.228, P<0.001) sleep duration, compared with those with a normal range of sleep duration. Statistical significances were found in the prevalence of abdominal obesity among those with different characteristics in education, smoking, chronic conditions, and social participation. CONCLUSION: Both long and short sleep durations are associated with increased risk of obesity, which is more evident in older men. Bad living habits and mental state will increase the risk of abdominal obesity.
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Obesidad Abdominal , Sueño , Anciano , China , Humanos , Estudios Longitudinales , Masculino , Factores de TiempoRESUMEN
OBJECTIVE: To determine differences of self-rated health in elderly people across geographic regions of China, and to identify factors influencing self-rated health of elderly. METHODS: Ordered logistic modeling was performed using the China Health and Retirement Longitudinal Study (CHARLS) data in 2013. RESULTS: Elderly people resided in Eastern China had better self-rated health than their counterparts residing in Middle (partial regression coefficient 0.252, P < 0.01) and Western (partial regression coefficient 0.338, P < 0.001) China. Sex, residency, education, per capita consumption expenditure, smoking and drinking, social participation, chronic diseases, and life satisfaction were identified as associated with self-rated health of elderly. CONCLUSION: There are regional differences in self-rated health of elderly. Policy priorities should be given to Middle and Western China, with more health resources being allocated to those regions. Regional economic and educational inequalities need to be addressed. Healthy lifestyle should be promoted.
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Autoevaluación Diagnóstica , Estado de Salud , Anciano , China , Geografía , Humanos , Modelos Logísticos , Estudios LongitudinalesRESUMEN
In this article, we report a general protocol for the direct decarboxylative chlorination, iodination, and bromination of aliphatic carboxylic acids catalyzed by iron salts under visible light. This method enjoys a broad substrate scope with good functional group compatibility, including complex natural products. Benzylic and allylic C(sp3)-H bonds can be retained under the oxidative halogenation conditions. This method also shows application potential for late-stage functionalization.
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OBJECTIVE: To evaluate clinical effect and safety on the basis of detecting the specific response of jing-well point in treatment of intractable insomnia with acupuncture by meridian differentiation. METHODS: Sixty-four patients with intractable insomnia were randomized into an observation group (32 cases, 1 case dropped out and 1 case was eliminated) and a control group (32 cases, 1 case was eliminated). In the observation group, the meridian imbalance value detected at the jing-well point was taken as the evidence so that the corresponding yuan-source and back-shu points were stimulated with acupuncture. In the control group, the routine acupuncture was operated at Baihui (GV 20), Sishencong (EX-HN 1), and bilateral Shenmen (HT 7), Sanyinjiao (SP 6), Shenmai (BL 62) and Zhaohai (KI 6). Besides, the detection at jing-well point was performed for blindness in the control group. In the two groups, the interventions were delivered once daily, 5 times a weeks and for consecutive 4 weeks. In the two groups, the scores of Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI) and the TCM symptom scale were observed before treatment and after 2 and 4 weeks of treatment; the clinical effect and safety were evaluated after treatment; the changes of meridian imbalance value were observed before and after treatment and the correlation analysis with the total score of PSQI was conducted. RESULTS: After 2 and 4 weeks of treatment, except the scores for hypnotic drug in the two groups and sleep disorder after 2 weeks of treatment in the control group, the scores of the other factors and the total scores of PSQI were all reduced when compared with those before treatment in the two groups (P<0.05). After 4 weeks of treatment, except the scores for hypnotic drug in the two groups and sleep disorder in the control group, the scores of the other factors and the total scores of PSQI were lower than those after 2 weeks of treatment in the two groups (P<0.05). After 2 weeks of treatment, the scores for time to fall asleep, sleep efficiency and daytime dysfunction in the observation group were lower than those of the control group (P<0.05); and after 4 weeks of treatment, except the scores for sleep disorder and hypnotic drug, the scores of the other factors and the total score of PSQI in the observation group were all lower than those of the control group (P<0.05). After 2 and 4 weeks of treatment, ISI scores and the scores of TCM symptom scale decreased when compared with those before treatment (P<0.05), and the scores of these two scales after 4 weeks of treatment were lower than those after 2 weeks of treatment (P<0.05) in the two groups; and the scores in the observation group were lower than thoese in the control group (P<0.05). The total effective rate was 93.3% (28/30) in the observation group, higher than that (90.3% [28/31]) in the control group (P<0.05). Of 64 cases, there was only 1 case of mild hematoma in the control group; and no any other adverse events occurred. Among 64 cases, the meridians, with the imbalance frequency ≥30 times, included the pericardium meridian of hand-jueyin and the heart meridian of hand-shaoyin; those with the imbalance frequency ≥20 times, were the kidney meridian of foot-shaoyin, the triple energizers meridian of hand-shaoyang, the gallbladder meridian of foot-shaoyang, the spleen meridian of foot-taiyin and the stomach meridian of foot-yangming. Except the lung meridian of hand-taiyin in the control group, the imbalance value of each meridian was reduced after treatment (P<0.05, P<0.001, P<0.01), and the meridian imbalance value presented a linear positive correlation with the total score of PSQI in the two groups . CONCLUSION: Meridian differentiation acupuncture based on detecting the specific response of jing-well point can significantly improve the sleep quality and reduce the related symptoms in the patients with intractable insomnia. This therapy promotes the conversion of the meridians from the imbalance to the balance and is satisfactory in its safe operation.
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Puntos de Acupuntura , Terapia por Acupuntura , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Trastornos del Inicio y del Mantenimiento del Sueño/fisiopatología , Masculino , Femenino , Persona de Mediana Edad , Adulto , Resultado del Tratamiento , Anciano , Adulto Joven , Calidad del SueñoRESUMEN
BACKGROUND: Self-harm is a critical issue affecting young people which could result in adverse outcomes including repeat episodes and suicide. In this study, we aimed to estimate the short-term and long-term risk of repeat self-harm and subsequent suicide death following self-harm presentations among adolescents and young adults. METHODS: Using linked data from the New South Wales (NSW) Emergency Department Data Collection (EDDC), the NSW Admitted Patient Data Collection (APDC), and cause of death unit record file (COD-URF), we collected all self-harm presentations to emergency departments and/or hospitals and suicide deaths between 2012 and 2019 in NSW, Australia. We used survival analysis models to estimate the incidence of repeat self-harm and suicide by time since the index self-harm and relative risks by sex, type of hospital presentation and count of self-harm records. RESULTS: In total, we identified 81,133 self-harm episodes among 48,547 individuals aged 10-29 years. Of 48,547 individuals who engaged in an index self-harm during the study period, 39.5 % (19,180) were aged between 15 and 19 years. The incidence of both repeat self-harm and suicide were highest in the year following the index self-harm presentation (repeat self-harm: 188.84 per 1000 person-years; suicide: 3.30 per 1000 person-years) and declined to 14.51 and 0.28 per 1000 person-years after five years. Among individuals indexed for self-harm at 15-29 years, males and those who were admitted to hospital for the index self-harm had the highest risk of both subsequent repeat self-harm and suicide death and those with 2 or more self-harm presentation records had the higher risk for subsequent suicide death. CONCLUSION: Adolescents and young adults with self-harm presentations were at a high risk of subsequent repeat self-harm and suicide death, especially the first year after presentations. Youth-specific early intervention and long-term management should be delivered accordingly, especially for those at early adolescence .