Repetitive Transcranial magnetic stimulation (rTMS) combined with antidepressants benefited adults with depression while its efficacy and safety in children and adolescents with depression remain controversial. We searched PubMed, Embase, the Cochrane Library, Web of Science, CINAHL, LILACS, PsycINFO, CNKI, Wanfang Data Knowledge Service Platform, a Chinese Biology Medical disc database, and relevant clinical registration databases for randomized controlled trials from their inception to October 18, 2022. The efficacy of the treatment was assessed by changes in depression rating scale scores. Safety was assessed by the incidence of adverse events. Heterogeneity was determined using the Cochrane Q statistics and I² statistics. Publication bias was assessed by Egger's test. Eighteen studies from 10 datasets (1396 patients, 64.7 % female, age range from 8 to 24 years old). The pooled mean-endpoint scores of the depression scale for rTMS combined with the antidepressant group were significantly lower than those of sham combined with the antidepressant group both in two weeks (MD = -4.68, 95 % CI: [-6.66, -2.69]; I² = 91 %; P < 0.05) and four weeks (MD = -5.53, 95 % CI: [-9.90, -1.16]; I² = 98 %; P < 0.05). There were no differences in safety (OR = 0.64, 95 % CI: [0.20, 2.04]; I² = 64 %; P = 0.45) and acceptability between the two groups (3/70 vs 3/70). Heterogeneity was found in this study due to the limited number of original studies included. rTMS combined with antidepressants enhanced the efficacy of the antidepressant medication. The safety and acceptability of the two groups were comparable. These findings may help guide future research and clinical practice.

Background: Echinococcosis is a global enzootic disease influenced by different biological and environmental factors and causes a heavy financial burden on sick families and governments. Currently, government subsidies for the treatment of patients with echinococcosis are only a fixed number despite patients’ finical income or cost of treatment, and health authorities are demanded to supply an annual summary of only endemic data. The risk to people in urban areas or non-endemic is increasing with climate, landscape, and lifestyle changes. Methods: We conducted retrospective descriptive research on inpatients with human echinococcosis (HE) in Lanzhou hospitals and analyzed the healthcare expenditure on inpatient treatment and examined the financial inequalities relating to different levels of gross domestic product. The livestock losses were also estimated by infection ratio. The occurrence records of Echinococcus spp. composed of hospitalized patients and dogs infected in the Gansu province were collected for Ecological niche modeling (ENM) to estimate the current suitable spatial distribution for the parasite in Gansu province. Then, we imported the resulting current niche model into future global Shared Socioeconomic Pathways scenarios for estimation of future suitable habitat areas. Results: Between 2000 to 2020, 625 hospitalized HE patients (51% men and 49% women) were identified, and 48.32 ± 15.62 years old. The average cost of hospitalization expenses per case of HE in Gansu Province was ￥24,370.2 with an increasing trend during the study period and was negative with different counties’ corresponding gross domestic product (GDP). The trend of livestock losses was similar to the average cost of hospitalization expenses from 2015 to 2017. The three factors with the strongest correlation to echinococcosis infection probability were (1) global land cover (GLC, 56.6%), (2) annual precipitation (Bio12, 21.2%), and (3) mean temperature of the Wettest Quarter (Bio12, 8.5% of variations). We obtained a robust model that provides detail on the distribution of suitable areas for Echinococcus spp. including areas that have not been reported for the parasite. An increasing tendency was observed in the highly suitable areas of Echinococcus spp. indicating that environmental changes would affect the distributions. Conclusion: This study may help in the development of policies for at-risk populations in geographically defined areas and monitor improvements in HE control strategies by allowing targeted allocation of resources, including spatial analyses of expenditure and the identification of non-endemic areas or risk for these parasites, and a better comprehension of the role of the environment in clarifying the transmission dynamics of Echinococcus spp. Raising healthcare workers’ and travelers’ disease awareness and preventive health habits is an urgent agenda. Due to unpredictable future land cover types, prediction of the future with only climatic variables involved needs to be treated cautiously.

Prebiotics interventions to restore microbiome homeostasis may have long-lasting benefits for mental health especially in adolescence. However, the anti-depressants of prebiotics, particularly in prebiotics chronotherapy, orchestrated remain unknown. We aimed to elucidate the underlying mechanisms of prebiotics in light of maximum antidepressant effects by appropriate dosing timing. Adolescent depression mouse model was made by fecal microbiota transplantation (FMT) from major depressive disorder (MDD) adolescent patients. Sodium Butyrate (SB), one of SCFAs, was intragastrically administrated to mice at Zeitgeber time 4 (ZT4: the highest short-chain fatty acids (SCFAs) receptor-activated timing) or ZT16 (the lowest SCFA receptor-activated timing) for the last 2 weeks within 4-week-FMT exposure. The success of modeling and antidepressant effects of SB chronotherapy were determined by changes in depression-like behaviors, inflammation, neurotrophy, neuron functions, circadian rhythm, and barrier systems. SB alleviated depressive symptoms at ZT4 with better efficacy over ZT16. SB decreased inflammation, upregulated neurotrophy, restored functions, and re-established circadian rhythm. Notably, SB increased the expressions of SCFAs receptors to repair the intestinal barrier and blood-brain barrier, thereby alleviating depressive symptoms. Only one prebiotic with one disease was involved. SB supplementation could be a promising therapeutic tactic for restoring the integrity of barrier systems by enhancing the intestinal SCFAs receptors. Alignment SB supplementation with circadian clocks might help to obtain better antidepressant efficacy, which may generate novel insights into diseases related to diseases with barrier system impairment and optimize interventions to improve health and human well-being.

Comprehension of whether human and livestock presence affects wildlife activity is a prerequisite for the planning and management of humans and livestock in protected areas. Xinglong Mountain Nature Reserve (XMNNR) in northwest China, as a green island in a semi-arid mountain ecosystem, is one of the scattered and isolated areas for Alpine musk deer (AMD), an endangered species. AMD cohabits their latent habitat area with foraging livestock and humans. Hence, habitat management within and outside the distribution areas is crucial for the effective conservation of AMD. We applied camera traps to a dataset of 2 years (September 2018–August 2020) to explore seasonal activity patterns and habitat use and assess the impacts of AMD habits in XMNNR. We investigated AMD responses to livestock grazing and human activities and provided effective strategies for AMD conservation. We applied MaxENT modeling to predict the distribution size under current conditions. The activity patterns of the AMD vary among seasons. The optimum habitat average distance to cultivated land ranges of AMD (150~3300 m during grass period/100~3200 m during withered grass period), distances to the residential area ranges (500~5700 m during the grass period/1000~5300 m during the withered grass period), elevation ranges (2350~3400 m during the grass period/2360~3170 m during the withered grass period), aspect ranges (0~50° and 270~360°), normalized vegetation index ranges (0.64~0.72 during the grass period/0.14~0.60 during the withered grass period), and land cover types (forest, shrub, and grassland). Results present that the predicted distributions of AMD were not confined to the areas reported but also covered other potential areas. The results provide evidence of strong spatial-temporal avoidance of AMD in livestock, but gradually adjusting to human activities. These camera trap datasets may open new opportunities for species conservation in much wider tracts, such as human-dominated landscapes, and may offer guidance and mitigate impacts from livestock, as well as increase artificial forest planting and strengthen the investigation of the potential population resources of AMD.