Global trends and regional differences in the burden of anxiety disorders and major depressive disorder attributed to bullying victimisation in 204 countries and territories, 1999-2019: an analysis of the Global Burden of Disease Study.

AIM: This study aimed to analyse the temporal and spatial trends in the burden of anxiety disorders and major depressive disorder related to bullying victimisation on global, regional and country scales. METHODS: Data were from the 2019 Global Burden of Disease (GBD) Study. We assessed the global disability-adjusted life years (DALYs, per 100 000 population) of anxiety disorders and major depressive disorder attributable to bullying victimisation by age, sex and geographical location. The percentage changes in age-standardised rates of DALYs were used to quantify temporal trends, and the annual rate changes across 204 countries and territories were used to present spatial trends. Furthermore, we examined the relationship between the sociodemographic index (SDI) and the burden of anxiety disorders as well as major depressive disorder attributable to bullying victimisation and its spatial and temporal characteristics globally. RESULTS: From 1990 to 2019, the global DALY rates of anxiety disorders and major depressive disorder attributable to bullying victimisation increased by 23.31 and 26.60%, respectively, with 27.27 and 29.07% for females and 18.88 and 23.84% for males. Across the 21 GBD regions, the highest age-standardised rates of bullying victimisation-related DALYs for anxiety disorders were in North Africa and the Middle East and for major depressive disorder in High-income North America. From 1990 to 2019, the region with the largest percentage increase in the rates of DALYs was High-income North America (54.66% for anxiety disorders and 105.88% for major depressive disorder), whereas the region with the slowest growth rate or largest percentage decline was East Asia (1.71% for anxiety disorders and -25.37% for major depressive disorder). In terms of SDI, this study found overall upward trends of bullying-related mental disorders in areas regardless of the SDI levels, although there were temporary downward trends in some stages of certain areas. CONCLUSIONS: The number and rates of DALYs of anxiety disorders and major depressive disorder attributable to bullying victimisation increased from 1990 to 2019. Effective strategies to eliminate bullying victimisation in children and adolescents are needed to reduce the burden of anxiety disorders and major depressive disorder. Considering the large variations in the burden by SDI and geographic location, future protective actions should be developed based on the specific cultural contexts, development status and regional characteristics of each country.

[COVID-19 vaccines primary features and research progress on possible trigger of liver injury post-vaccination].

The COVID-19 outbreak is a global pandemic that has had caused a profound impact on social stability, economic development and national security, and has further evolved into a major public health crisis. The rapid research and development and efficient deployment of vaccines is one of the effective means to prevent and control the epidemic. This article reviews the primary features of current COVID-19 vaccines, simultaneously focus the clinical features of liver injury post-vaccination and explore its possible pathogenesis.

[Quality assessment of global guidelines on colorectal cancer screening].

OBJECTIVE: To systematically review and assess the quality of guidelines on colorectal cancer screening worldwide to provide guidance for the development of high-quality colorectal cancer screening guidelines in mainland China. METHODS: CNKI, WanFang Data, VIP, SinoMed, PubMed, Embase, and Web of Science were systematically searched to identify guidelines on colorectal cancer screening from inception to Jun. 20th, 2018, and so were some websites and major search engines about the development of the guidelines from the existing literature (search date: Aug. 3rd, 2018). Two experienced reviewers independently examined these abstracts and then extracted information, and the Appraisal of Guidelines for Research and Evaluation II (AGREE II) were used to evaluate the methodological quality of these guidelines by four well trained reviewers. RESULTS: In this study, 46 guidelines published from 1994 to 2018 were finally included in our analysis from 10 countries and 5 regions, among which 5 were from mainland China. The quality of these guidelines was relatively high in domain 1 (scope and purpose) and domain 4 (clarity of presentation), and medium in domain 2 (stakeholder involvement). While in the other three domains (domain 3: rigour of development; domain 5: applicability; domain 6: editorial independence), the results were quite different among these guidelines. The quality of evidence-based guidelines (defined by the criteria based on World Health Organization guideline development handbook) was generally higher than that of the common guidelines. Existing guidelines from mainland China were not evidence-based guidelines, which were of low quality. CONCLUSION: The colorectal cancer screening guidelines all over the world are generally large in number, low in quality, different in statements, and so are the guidelines in China. There are no evidence-based guidelines in mainland China, which cannot provide effective guidance for colorectal cancer screening, so we need to pay more attention to the establishment of guidelines with high quality and high credibility for colorectal cancer screening as well as for cancer screening based on the national condition, in order to provide reasonable guidance for practice in public health and improve the health conditions in our society.

[Etiology analysis and vestibular assessment of bilateral vestibular vestibulopathy].

Objective:To define clinical and laboratory characteristics of bilateral vestibulopathy(BVP) and to propose diagnostic criteria of this disorder based on clinical and laboratory vestibular function test findings.Method:Forty-two case series with a clinical suspicion of BVP were retrospectively analyzed, in an attempt to determine etiology. Presenting auditory-vestibular symptoms, bedside dynamic visual acuity tests and laboratory test were reviewed, including bithermal caloric test, rotatory chair tests, video head impulse test (vHIT), vestibular-evoked myogenic potentials (VEMP).Result:Among these 42 patients, dizziness was seen in 42 cases(100%), oscillopsia was seen in 21 cases(50%), hearing loss was seen in 30(71.4%). Eight cases(19%) had tinnitus. Twenty-five cases showed vestibular loss in dynamic visual acuity test (69.4%). Definite diagnosis of complete BVP was made in 36 patients when the patients showed abnormal findings on caloric test, rotatory chair test and vHIT in addition to the symptoms. Whereas probable diagnosis of partial BVP was obtained in 6 patients with abnormal caloric test and rotatory chair test but no pathological vHIT. VEMP (ocular or cervical) could be recorded in 20 patients. Fourteen cases were caused by ototoxic drugs while no causes could be determined in 6 cases among these 42 cases.Conclusion:The diagnosis of BVP is a challenge. Vestibular laboratory test battery which reflect full frequency function of VOR has great value to confirming the diagnosis and differentiate complete BVP to partial BVP. Diagnosis standard shall be made combining clinical history, characteristic symptoms and the results of auditory-vestibular function testing. Ototoxic drugs contribute most considering etiology.

[Series of risk of bias assessment (5): Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I)].

This paper summaries the Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I), a tool for evaluating risk of bias about Non-randomized Studies-of Interventions (NRSI), and introduces the application of ROBINS-I in a published NRSI. According to the characteristics of NRSI, evaluation field and signaling question were designed in ROBINS-I to provide essential information about risk of bias for NRSI included in systematic reviews. ROBINS-I is the tool in assessment of risk of bias in observational studies and quasi-randomised studies. Although the tool has been used in practice to some extent, but it still needs further improvement. Attention should be paid to its update and progress.

[Assessment of the validity and utility of the Beijing questionnaire as atool to evaluate for obstructive sleep apnea hypopnea syndrome].

Objective:To test the Beijing questionnaire as a means of identifying patients with obstructive sleep apnea hypopnea syndrome（OSAHS）.Method: The Beijing questionnaire is designed as an explorative tool consist of 11 questions for patients with obstructive sleep apnea hypopnea, and is targeted toward key symptoms include snoring, apneas, daytime sleepiness, hypertension and overweight. 1 336 female participants living in communities of age≥40 years and 198 male adult subjects visting clinics were given questionnaires. Finally, 59 female and 198 male subjects underwent sleep studies after factor analysis,reliability check,internal consistency study. The correlation analysis was performed between the scores from the Beijing questionnaire and the apnea-hypopnea index from inlaboratory polysomnography.Receiver operating characteristics were constructed to determine optimal sensitivity and specificity. Twenty-four male subjects were recorded in the sleep laberatory again after operative.Result: Factor analysis reduced 11 questions of scale to four common factors as we have designed: snoring,apneas,other symptoms,risk factors. Cronbach's α coefficient of scale reached 0.7.There were an acceptable level of testretest reliability(r=0.619,P<0.01).The apnea hypopnea indices were significantly correlated with their Beijing questionnaire scores(P<0.01).For wemen,an Beijing questionnaire scroe of 19.5 provided a sensitivity of 74.3% and a specificity of 62.5%.For men,an Beijing questionnaire scroe of 22.5 provided a sensitivity of 90.9% and a specificity of 54.5%. And the postoperative Beijing questionnaire scroes changed with the apnea hypopnea indices.Conclusion:This questionnaire has a good validity and reliability and appears to be valid and sensitive to clinical change.

Normothermic ex vivo perfusion provides superior organ preservation and enables viability assessment of hearts from DCD donors.

The shortage of donors in cardiac transplantation may be alleviated by the use of allografts from donation after circulatory death (DCD) donors. We have previously shown that hearts exposed to 30 min warm ischemic time and then flushed with Celsior supplemented with agents that activate ischemic postconditioning pathways, show complete recovery on a blood-perfused ex vivo working heart apparatus. In this study, these findings were assessed in a porcine orthotopic heart transplant model. DCD hearts were preserved with either normothermic ex vivo perfusion (NEVP) using a clinically approved device, or with standard cold storage (CS) for 4 h. Orthotopic transplantation into recipient animals was subsequently undertaken. Five of six hearts preserved with NEVP demonstrated favorable lactate profiles during NEVP and all five could be weaned off cardiopulmonary bypass posttransplant, compared with 0 of 3 hearts preserved with CS (p < 0.05, Fisher's exact test). In conclusion, DCD hearts flushed with supplemented Celsior solution and preserved with NEVP display viability before and after transplantation. Viability studies of human DCD hearts using NEVP are warranted.

Improving pressure ulcer risk assessment and management using the Waterlow scale at a London teaching hospital.

OBJECTIVE: Pressure ulcers (PUs) cost the National Health Service (NHS) up to 4% of its health care expenditure. Arising from this are also clinical negligence claims, where inadequate risk assessment has been cited as one of the principal drawbacks in the prevention of PUs. This two-cycle audit aims to examine the consistency and accuracy of risk assessment of patients, and demonstrates how simple focused interventions can improve the quality of care provided. METHOD: The Waterlow pressure ulcer risk assessment tool was employed to assess inpatients during a 6-month period at a London teaching hospital. Patients were risk assessed, and examined to detect PUs and to determine the type of mattress. We compared our findings with clinical (nursing and medical) documentation. Interventions were made through questionnaires given to staff, educational sessions, presentations and posters addressing where improvements could be made in risk stratifying patients. A repeat audit was carried out 24 months later and the results from both cycles were compared. Statistical analysis was carried out using Fisher's exact and the Student's T-test. RESULTS: In total 100 in-patients were assessed in each cycle with a mean age of 71.4 years in cycle 1 and 70.1 years in cycle 2. A nursing Waterlow score was recorded for 81% of patients in cycle 1 and 100% in cycle 2 (p<0.05). In cycle 1, the average nursing score was significantly lower than that from the study (mean 13.7 versus 17.1, median 14.0 versus 18.0; p<0.05), but after intervention this had reduced to a minimal difference (mean 8.5 versus 9.0, median 8.0 versus 9.0, p=0.08). CONCLUSION: Nursing scores recorded in the notes were lower than the study scores in cycle 1, primarily from a failure to appropriately assess certain categories of the Waterlow scale. These differences reduced after focused education of staff. Our results suggest that targeted interventions tailored towards nursing and medical staff can result in improvements in the risk assessment for prevention and subsequent management of PUs. However, it also highlights the need for increased input from the entire multidisciplinary team in order to reduce the morbidity caused by PUs. DECLARATION OF INTEREST: The authors have no conflict of interest. No funding was received for this study.

Complete genome sequence of an isolate of papaya leaf distortion mosaic virus from commercialized PRSV-resistant transgenic papaya in China.

Papaya leaf distortion mosaic virus is highly destructive to commercial papaya production. Here, the complete genome sequence was determined for an isolate of papaya leaf distortion mosaic virus, designated PLDMV-DF, infecting the commercialized papaya ringspot virus (PRSV)-resistant transgenic papaya from China. Excluding the 3'-poly (A) tail, the sequence shares high sequence identity to several PLDMV isolates from Taiwan and Japan and is phylogenetically most closely related to the isolate from Japan. Infection of PLDMV-DF in transgenic PRSV-resistant papaya may indicate emergence of this disease in genetically engineered plants. The reported sequence for this isolate may help generate bi-transgenic papaya resistant to PRSV and PLDMV.

Preliminary assessment of the quantitative relationships between testicular tissue composition and ultrasonographic image attributes in the ram.

This study examined the relationships between gross chemical composition and ultrasonographic characteristics of the ram testes. Ten testes from sexually mature Karakul rams were scanned ex situ with an 8-MHz linear-array transducer, in a transverse and longitudinal plane. All ultrasonograms were saved as digital images and subjected to computerized analyses. Crude protein content was determined by the Kjeldahl method, moisture was determined with an oven-drying method, and fat was measured by the Soxhlet extraction of dried samples. Mean pixel values (r=-0.64, P=0.04), pixel heterogeneity (standard deviation of pixel values; r=-0.64, P=0.04) and maximum pixel intensity (r=-0.76, P=0.01) were all negatively correlated with parenchymal protein content. Pixel heterogeneity correlated directly with extractable lipids (r=0.66, P=0.02). The quantitative correlations between echotextural and biochemical parameters found in the present experiment confirm the utility of ultrasonographic imaging combined with computer-assisted image analysis for determining changes in testicular histophysiology.

An economical and practical method for whole-mount in situ hybridization for mouse embryos and organs.

Whole-mount in situ hybridization (WISH) is a useful method for detecting specific gene expression patterns at their site of action during embryonic development. Traditional WISH methods are costly and suitable only for mouse embryos younger than 11.5 days. We present here an economical and practical in situ hybridization method using DIG-labeled RNA probes. We changed the conditions in several steps to make the WISH method suitable for whole mouse embryos from embryonic days 9.5 to 12.5 and for older stage mouse embryonic organs. We performed all steps in one microcentrifuge tube up to the staining steps to avoid losing or damaging the mouse embryos. We re-used the solutions and materials to make the method more economical and suitable for less sophisticated laboratories. We also performed ß-galactosidase staining on Tb × 18 Cre/Rosa26/LacZ mouse embryos; the results agreed with the in situ hybridization results. Finally, we sectioned the specimens after hybridization and ß-galactosidase staining; the results agreed with the literature.

Screening men for abdominal aortic aneurysm: 10 year mortality and cost effectiveness results from the randomised Multicentre Aneurysm Screening Study.

OBJECTIVES: To assess whether the mortality benefit from screening men aged 65-74 for abdominal aortic aneurysm decreases over time, and to estimate the long term cost effectiveness of screening. DESIGN: Randomised trial with 10 years of follow-up. SETTING: Four centres in the UK. Screening and surveillance was delivered mainly in primary care settings, with follow-up and surgery offered in hospitals. PARTICIPANTS: Population based sample of 67 770 men aged 65-74. INTERVENTIONS: Participants were individually allocated to invitation to ultrasound screening (invited group) or to a control group not offered screening. Patients with an abdominal aortic aneurysm detected at screening underwent surveillance and were offered surgery if they met predefined criteria. MAIN OUTCOME MEASURES: Mortality and costs related to abdominal aortic aneurysm, and cost per life year gained. RESULTS: Over 10 years 155 deaths related to abdominal aortic aneurysm (absolute risk 0.46%) occurred in the invited group and 296 (0.87%) in the control group (relative risk reduction 48%, 95% confidence interval 37% to 57%). The degree of benefit seen in earlier years of follow-up was maintained in later years. Based on the 10 year trial data, the incremental cost per man invited to screening was pound100 (95% confidence interval pound82 to pound118), leading to an incremental cost effectiveness ratio of pound7600 ( pound5100 to pound13,000) per life year gained. However, the incidence of ruptured abdominal aortic aneurysms in those originally screened as normal increased noticeably after eight years. CONCLUSIONS: The mortality benefit of screening men aged 65-74 for abdominal aortic aneurysm is maintained up to 10 years and cost effectiveness becomes more favourable over time. To maximise the benefit from a screening programme, emphasis should be placed on achieving a high initial rate of attendance and good adherence to clinical follow-up, preventing delays in undertaking surgery, and maintaining a low operative mortality after elective surgery. On the basis of current evidence, rescreening of those originally screened as normal is not justified. Trial registration Current Controlled Trials ISRCTN37381646.

Assessment of population genetic structure in common wild rice Oryza rufipogon Griff. using microsatellite and allozyme markers.

The genetic structure of five natural populations of common wild rice Oryza rufipogon Griff. from China, was investigated with 21 microsatellite loci and compared to estimates of genetic diversity and genetic differentiation detected by 22 allozyme loci. Microsatellite loci, as expected, have much higher levels of genetic diversity (mean values of A = 3.1, P = 73.3%, Ho = 0.358 and He = 0.345) than allozyme loci (mean values of A = 1.2, P = 12.7%, Ho = 0.020 and He = 0.030). Genetic differentiation detected by microsatellite loci ( FST = 0.468, mean I = 0.472) was higher than that for allozyme loci ( FST =0.388, mean I = 0.976). However, microsatellite markers showed less deviation from Hardy-Weinberg expectation (Wright's inbreeding coefficient FIS = -0.069) than do allozymes ( FIS = 0.337). These results suggest that microsatellite markers are powerful high-resolution tools for the accurate assessment of important parameters in population biology and conservation genetics of O. rufipogon, and offer advantages over allozyme markers.

Sex ratio at birth in China: features and influences.

The gradual increase in the sex ratio at birth (SRB) that has been recorded in China since 1980 is examined, and an attempt is made to identify the reasons for this increase. The author concludes that "such demographic variables as child-bearing age, parity and the sex of children have not determined the rising SRB since the 1980s in China. Rather, the traditional bias towards giving birth and reporting male offspring was responsible for the high SRB score and for the disparities in SRB between different socio-economic groups." The extent to which the birth of female babies is not reported is assessed, as is the extent of sex-selective abortion.

A study on the mortality differential for occupation-specific populations in China.

PIP: One caveat of this study of differential mortality in China by occupational group is that mortality among retired persons is recorded as "usual occupation" rather than "not currently employed." This artificially decreases the mortality rate among the unemployed. Data for this study were obtained from the 1990 Chinese census. Census records indicate that 79.2% of total population aged 15 years and older were employed in occupations, of which most were in agriculture, forestry, animal husbandry, sideline production, and fishery (agricultural workers). 90% were employed in agriculture and manufacturing, commercial, and service industries. 88.63% of the deceased were in the labor force and 121.37% were unemployed. The highest crude death rates were found among laborers in agriculture, forestry, animal husbandry, sideline production, and fishery. The lowest crude death rates were among technicians and specialists, secretarial staff, manufacturing industry workers, commercial workers, and government officials, who were ranked from lower to higher crude death rates. Findings from standardized death rates indicate that commercial workers, service industry workers, and secretarial staff had the lowest death rates. The lowest standardized death rates among people aged 15-54 years were among secretarial staff, technicians and specialists, and government workers. Among people over 55 years of age, death rates rose among government officials and varied by gender among other occupations. Women's death rates at over 50 years of age were higher than men's in all occupations, which is interpreted as discrepancies in reporting and not due to occupational factors. When data for female government officials aged 15-17 years were removed, the ranking of deaths by occupations showed the lowest rates among those 15-54 years old who were secretarial staff, government officials, and technicians. The highest death rates were among manufacturing industry workers, agricultural workers, and the unemployed. These differences reflect socioeconomic differences.^ieng