The impact of depression and physical multimorbidity on health-related quality of life in China:a national longitudinal quantile regression study

Abstract The co-occurrence of mental and physical chronic conditions is a growing concern and a largely unaddressed challenge in low-and-middle-income countries. This study aimed to investigate the independent and multiplicative effects of depression and physical chronic conditions on health-related quality of life (HRQoL) in China, and how it varies by age and gender. We used two waves of the China Health and Retirement Longitudinal Study (2011, 2015), including 9227 participants aged ≥ 45 years, 12 physical chronic conditions and depressive symptoms. We used mixed-effects linear regression to assess the effects of depression and physical multimorbidity on HRQoL, which was measured using a proxy measure of Physical Component Scores (PCS) and Mental Component Scores (MCS) of the matched SF-36 measure. We found that each increased number of physical chronic conditions, and the presence of depression were independently associated with lower proxy PCS and MCS scores. There were multiplicative effects of depression and physical chronic conditions on PCS (− 0.83 points, 95% CI − 1.06, − 0.60) and MCS scores (− 0.50 points, 95% CI − 0.73, − 0.27). The results showed that HRQoL decreased markedly with multimorbidity and was exacerbated by the presence of co-existing physical and mental chronic conditions

Evaluating the Effectiveness of the Health Management Program for the Elderly on Health-Related Quality of Life among Elderly People in China: Findings from the China Health and Retirement Longitudinal Study

The world’s rapidly aging population brings serious challenges which could be addressed by changes in behaviour and policy that promote good health in older age. However, these cheap and simple interventions are not available in many countries. China is one of the fastest-ageing countries in the world. The health management programs for the elderly in basic public health services was introduced by the government to promote the health of the elderly in China and address the challenges related to ageing. However, the effectiveness of the program is uncertain. So, we use a propensity score matching difference-in-difference (PSM-DID) model to analyse the causal effect of the health management program for the elderly in basic public health services on the health-related quality of life (HRQoL) of the elderly in China. The result shows that the program has improved the physical health of the elderly but has had no significant impact on mental health. Expanding the program to cover mental health could further benefit the HRQoL of the elderly. The program is a cost-effective approach to tackle the challenges of ageing and is a good example for other developing countries facing the same ageing challenges

Microservice combination optimisation based on improved gray wolf algorithm

Microservices architecture is a new paradigm for application development. The problem of optimising the performance of microservice architectures from a non-functional perspective is a typical Nondeterministic Polynomial (NP) problem. Therefore, aiming to quantify the non-functional requirements of computing microservice systems, while solving the problem of latency in computing the best combination of services with the maximum QoS objective function value, this paper proposes a microservice combination approach based on the QoS model and a CGWO algorithm for optimisation computation for this model. The experimental results verify that the error rate of the method is only 0.528% on the non-functional combination optimisation problem, and the computational efficiency of the algorithm increases by 97.29% when the complexity of the problem search space increases, while CGWO improves 65.97% and 81.25% respectively in the accuracy of optimisation compared to the prototype of the algorithm (GWO), and has a stable optimisation performance, aspect. It proves that the research in this paper has a high advantage in automatically searching for the best QoS for the microservice combination problem

Sensitizing Tumors to Immune Checkpoint Blockage via STING Agonists Delivered by Tumor-Penetrating Neutrophil Cytopharmaceuticals

Immune checkpoint inhibitors (ICIs) have displayed potential efficacy in triple-negative breast cancer (TNBC) treatment, while only a minority of patients benefit from ICI therapy currently. Although activation of the innate immune stimulator of interferon genes (STING) pathway potentiates antitumor immunity and thus sensitizes tumors to ICIs, the efficient tumor penetration of STING agonists remains critically challenging. Herein, we prepare a tumor-penetrating neotype neutrophil cytopharmaceutical (NEs@STING-Mal-NP) with liposomal STING agonists conjugating on the surface of neutrophils, which is different from the typical neutrophil cytopharmaceutical that loads drugs inside the neutrophils. We show NEs@STING-Mal-NP that inherit the merits of neutrophils including proactive tumor vascular extravasation and tissue penetration significantly boost the tumor penetration of STING agonists. Moreover, the backpacked liposomal STING agonists can be released in response to hyaluronidase rich in the tumor environment, leading to enhanced uptake by tumor-infiltrating immune cells and tumor cells. Thus, NEs@STING-Mal-NP effectively activate the STING pathway and reinvigorate the tumor environment through converting macrophages and neutrophils to antitumor phenotypes, promoting the maturation of dendritic cells, and enhancing the infiltration and tumoricidal ability of T cells. Specifically, this cytopharmaceutical displays a significant inhibition on tumor growth and prolongs the survival of TNBC-bearing mice when combined with ICIs. We demonstrate that neutrophils serve as promising vehicles for delivering STING agonists throughout solid tumors and the developed neutrophil cytopharmaceuticals with backpacked STING agonists exhibit huge potential in boosting the immunotherapy of ICIs