The risk of depression in the menopausal stages: A systematic review and meta-analysis.

INTRODUCTION: For many women, menopause transition can be a period of emotional and physical changes, with different menopausal stages associated with varied risk for depressive symptoms and diagnosis. This review aimed to conduct a systematic review and meta-analyses to provide an estimate for the risk of developing a) clinical depression and b) depressive symptoms at different menopausal stages. METHODS: We searched Medline, PsycInfo, Embase and Web of Science from inception to July 2023. Seventeen prospective cohort studies with a total of 16061 women were included in the review, and risk of bias was assessed using the Quality in Prognosis Studies tool (QUIPS). Seven papers with a total of 9141 participants were included in meta-analyses, using random effects models and pooled odds ratios (OR) calculated for depressive symptoms and diagnoses. RESULTS: Perimenopausal women were found to be at a significantly higher risk for depressive symptoms and diagnoses, compared to premenopausal women (OR = 1.40; 95 % CI: 1.21; 1.61, p < .001). We did not find a significantly increased risk for depressive symptoms or diagnoses in post-menopausal, compared to pre-menopausal women. LIMITATIONS: Studies used different criteria to classify the menopausal stages and different measures for depression, which may have contributed to the heterogeneity seen in some models. We were unable to include a model that compared peri to post-menopause, due to a lack of longitudinal studies comparing the two stages. CONCLUSIONS: The risk of depression in perimenopause, shown in an ethnically diverse sample; highlights the clinical need for screening and support in this potentially vulnerable group.

The effectiveness of psychosocial interventions on non-physiological symptoms of menopause: A systematic review and meta-analysis.

BACKGROUND: Menopause, a crucial transitioning stage for women, can significantly impact mood and wellbeing. We aimed to evaluate the effectiveness of psychosocial interventions on non-physiological symptoms of menopause (depression, anxiety, cognition, and quality of life) through systematic review and meta-analysis. METHODS: Five databases were searched from inception to August 2023 for randomized controlled trials. Pre- and post-test means and standard deviations for groups were extracted and used to calculate effect sizes. The effectiveness of Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Interventions (MBI) on depression and anxiety were examined by subgroup analysis. RESULTS: Thirty studies comprising 3501 women were included. From meta-analysis, mood symptoms significantly benefited from CBT (anxiety: d = -0.22, 95 % CI = -0.35, -0.10; depression: d = -0.33, 95 % CI = -0.45, -0.21) and MBI (anxiety: d = -0.56, 95 % CI = -0.74, -0.39; depression: d = -0.27, 95 % CI = -0.45, -0.09). Psychosocial interventions were also found to significantly improve cognition (d = -0.23, 95 % CI = -0.40, -0.06) and quality of life (d = -0.78, 95 % CI = -0.93, -0.63). Mean total therapy hours ('dose') was lower for CBT (11.3) than MBI (18.6), indicating reduced costs and burden for women. LIMITATIONS: Data regarding menopausal status were not collected, limiting our ability to identify the optimal timing of interventions. Potential longer-term, effects of interventions were not investigated. CONCLUSION: Our review highlighted the value of psychosocial interventions in improving non-physiological symptoms (particularly depression and anxiety) during menopause, noting the heterogeneity of findings and importance of implementing effective interventions.

Organic-inorganic composite modifiers enhance restoration potential of Nerium oleander L. to lead-zinc tailing: application of phytoremediation.

Lead-zinc tailings are complex heavy metal solid wastes produced in the mining process. In this study, two kinds of organic-inorganic mixed improvers mushroom residue + calcium carbonate (M + C) and peat soil + calcium carbonate (N + C) were selected. Then, the effect of two improvers and a woody plant, Nerium oleander L., on the combined remediation of lead-zinc tailings was compared, respectively. The results showed that two combined improvers can slightly improve the pH of tailing, significantly increase the activity of phosphatase and catalase, effectively reduce the contents of DTPA-extractable Pb and Zn, and significantly improve the structure of tailing. However, the improvement effect of M + C was better than that of N + C on tailings' physical and chemical properties. Two improvers can reduce the enrichment and the stress degree of Pb and Zn on the N. oleander and increase the accumulation of Pb and Zn while promoting the growth of the N. oleander. The content of Pb and Zn showed the trend of root > stem > leaf under the two improvers, and the content of Zn was basically higher than that of Pb. To sum up, the combination of two modifiers and N. oleander has a good effect on the remediation of lead-zinc tailings, and the remediation effect of M + C was better than N + C.

Metronidazole Degradation by UV and UV/H2O2 Advanced Oxidation Processes: Kinetics, Mechanisms, and Effects of Natural Water Matrices.

Advanced oxidation technology represented by hydroxyl radicals has great potential to remove residual antibiotics. In this study, we systematically compared the metronidazole (MTZ) degradation behavior and mechanism in the UV and UV/H2O2 systems at pH 3.00 condition. The results show that the initial reaction rates were 0.147 and 1.47 µM min-1 in the UV and UV/H2O2 systems, respectively. The main reason for the slow direct photolysis of MTZ is the relatively low molar absorption coefficient (2645.44 M-1 cm-1) and quantum yield (5.9 × 10-3 mol Einstein-1). Then, we measured kMTZ,OH â€¢ as 2.79 (±0.12) × 109 M-1 s-1 by competitive kinetics, and calculated kMTZ,OH â€¢ and [OH â€¢]SS as 2.43 (±0.11) × 109 M-1 s-1 and 2.36 × 10-13 M by establishing a kinetic model based on the steady-state hypothesis in our UV/H2O2 system. The contribution of direct photolysis and •OH to the MTZ degradation was 9.9% and 90.1%. •OH plays a major role in the MTZ degradation, and •OH was the main active material in the UV/H2O2 system. This result was also confirmed by MTZ degradation and radicals' identification experiments. MTZ degradation increases with H2O2 dosage, but excessive H2O2 had the opposite effect. A complex matrix has influence on MTZ degradation. Organic matter could inhibit the degradation of MTZ, and the quenching of the radical was the main reason. NO3- promoted the MTZ degradation, while SO42- and Cl- had no effect. These results are of fundamental and practical importance in understanding the MTZ degradation, and to help select preferred processes for the optimal removal of antibiotics in natural water bodies, such as rivers, lakes, and groundwater.