Comparing Screening Abilities of the 33-Item Hypomania Checklist (HCL-33) and the 33-Item Hypomania Checklist External Assessment (HCL-33-EA) for the Detection of Bipolar Disorder.

Background: Bipolar disorder (BD) is a severe psychiatric disorder that is often misdiagnosed and under-diagnosed in clinical settings. The 33-item Hypomania Checklist (HCL-33) is a newly developed self-administered scale for BD detection, while the 33-item Hypomania Checklist-external assessment (HCL-33-EA) is a version of the HCL-33 for external rating used by patient's carer (e.g., family member or friend). We aimed to compare the screening abilities between the HCL-33 and the HCL-33-EA, and evaluate the screening consistency between the two scales. Methods: The data were collected from 269 patients with diagnosed BD (n = 84) or major depressive disorder (MDD) (n = 185). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) between the HCL-33 and the HCL-33-EA for BD were compared against clinician diagnosis as the gold standard. Results: Using Youden's index, the optimal cut-off value of the HCL-33 is 20, while the corresponding figure for HCL-33-EA is 11. Using Youden's index, the HCL-33-EA showed a better performance than the HCL-33 (0.51 vs.0.41). The HCL-33-EA was more sensitive in correctly identifying BD patients from MDD patients than the HCL-33 (0.83 vs. 0.59), while the HCL-33 presented better specificity than the HCL-33-EA (0.82 vs. 0.68). There was significant screening consistency between the two scales (p < 0.001). Conclusions: Both scales have acceptable psychometric properties in detection BD from MDD. Use of the two scales should be considered based on the assessment purpose in clinical research or daily practice (i.e., prefer sensitivity or specificity). Noticeably, the current sample size is insufficient and future studies are recommended to further evaluate the scales.

Representation of Diverse Populations in Couple and Family Therapy Intervention Studies: A Systematic Review of Race/Ethnicity, Sexual Orientation, Age, and Income in the United States from 2014 to 2019.

Disparities in mental health care among marginalized populations have been well-documented. Without research designed to study interventions for diverse populations, disparities in the quality of services will persist. A systematic review of articles evaluating couple and family therapy (CFT) interventions was conducted to evaluate the representation of diverse populations. More specifically, researchers sought to examine race/ethnicity, sexual orientation, income level, and age of sample participants. One hundred ninety-six studies evaluating CFT interventions in the United States in ten journals were included in the analysis. Findings indicate that family therapy research is more representative of racial minority and low-income participants compared with studies of couple interventions. Couple therapy research is often still conducted with predominately white, middle- to high-income samples. Following whites, African Americans and Hispanic/Latinos were the most common racial/ethnic groups included in both couple therapy research and family therapy research. Participants in same-sex relationships were absent from family intervention research and under-researched in couple intervention studies. Only one couple therapy study recruited a sample in which the average age was late adulthood. These findings are cause for concern given the widening mental health disparities in the United States.

Las desigualdades en la atención para la salud mental entre poblaciones marginadas están muy bien documentadas. Si no se diseñan investigaciones para estudiar intervenciones orientadas a poblaciones diversas, las desigualdades en la calidad de los servicios y en los resultados de los tratamientos seguirán existiendo. Se realizó un análisis sistemático de artículos que evaluaban las intervenciones de la terapia familiar y de pareja para evaluar la representación de poblaciones diversas. Más específicamente, los investigadores intentaron analizar la raza/etnia, la orientación sexual, el nivel de ingresos y la edad de los participantes de la muestra. Se incluyeron en el análisis ciento noventa y seis estudios que evaluaban las intervenciones de la terapia familiar y de pareja en los Estados Unidos en diez revistas médicas. Los resultados indican que la investigación sobre terapia familiar es más representativa de la minoría racial y de los participantes de bajos recursos en comparación con los estudios de intervenciones para las parejas. La investigación sobre terapia de pareja generalmente se sigue realizando con muestras predominantemente blancas, de ingresos medios y altos. Después de los blancos, los afroestadounidenses y los hispanos/latinos fueron los grupos raciales/étnicos más comunes incluidos tanto en la investigación sobre terapia familiar como en la de pareja. Los participantes de relaciones del mismo sexo estuvieron ausentes en las investigaciones sobre intervenciones familiares y se investigaron poco en los estudios sobre intervenciones para parejas. Solo un estudio sobre terapia de pareja reunió una muestra en la cual la edad promedio fue la edad adulta tardía. Estos resultados son motivo de preocupación teniendo en cuenta las desigualdades crecientes en el ámbito de la salud mental en los Estados Unidos.

Exploration of the psychometric properties of the 33-item Hypomania Checklist - external assessment (HCL-33-EA).

BACKGROUND: Misdiagnosis of bipolar disorder (BD) is common in clinical practice, leading to inappropriate treatment and detrimental consequences. The 33-item Hypomania Checklist (HCL-33) is a newly developed screening instrument for hypomanic symptoms in patients with BD. The 33-item Hypomania Checklist-external assessment (HCL-33-EA) is a version of the HCL-33 for carers of patients with mood disorders. In this study, the psychometric properties of the HCL-33-EA in a Chinese population were explored. METHOD: A total of 182 inpatients and 240 carers were recruited in this study. Patients were diagnosed with bipolar depression or major depressive disorder (MDD) according to the International Classification of Diseases (ICD-10). The patients completed the HCL-33, while their carers filled out the HCL-33-EA. RESULTS: The HCL-33-EA showed high internal consistency (Cronbach's alpha = 0.876) with two-factorial dimensions. Paired samples t-test revealed that the mean score of the HCL-33-EA was significantly lower than that of the HCL-33 (t = 10.1, p < 0.001). Spearman's rho showed that the two instruments were significantly and positively correlated (r = 0.46, p < 0.001). CONCLUSION: The HCL-33-EA has acceptable psychometric properties and could be an effective screening tool for patients' carers, enabling identification of the symptoms of hypomania.

N-glycosylation of serum proteins for the assessment of patients with IgD multiple myeloma.

BACKGROUND: Because glycosylation is one of the most common post-translational modifications of proteins and because changes in glycosylation have been shown to have a significant correlation with the development of many cancer types, we investigated the serum N-glycome used to diagnose, stage and evaluate the pathological outcomes in IgD multiple myeloma. METHODS: Serum samples were available for 20 patients with IgD multiple myeloma, 41 patients with light chain multiple myeloma and 42 healthy control subjects. Serum N-glycans were released and analysed using DNA sequencer-assisted fluorophore-assisted capillary electrophoresis. RESULTS: Characteristic changes were revealed in the serum N-glycome of IgD myeloma. In particular, three N-glycans (NG1(6)A2F, Peak3; NG1(3)A2F, Peak4; NA2FB, Peak7) showed increased clinical value. The best area under the ROC curve of NG1(6)A2F to diagnose IgD myeloma was 0.981, with a 95.0% sensitivity and 95.2% specificity, and that of NG1(3)A2F was 0.936, with a 95.0% sensitivity and 78.6% specificity. The best area under the ROC curve of NA2FB/NG1(3)A2F to differentially diagnose IgD myeloma versus light chain myeloma was 0.744, with a 95.3% sensitivity and 50.0% specificity. The level of NG1(3)A2F was correlated with the international staging system, while the higher abundance of NA2FB presented in IgD myeloma was predictive of a shorter progression-free survival. CONCLUSIONS: The advent of serum N-glycan signatures may play a role in the diagnosis, staging and prognosis of IgD myeloma and will serve as the foundation for a precision medicine approach to this rare subtype of multiple myeloma.

Source apportionment and risk assessment of emerging contaminants: an approach of pharmaco-signature in water systems.

This paper presents a methodology based on multivariate data analysis for characterizing potential source contributions of emerging contaminants (ECs) detected in 26 river water samples across multi-scape regions during dry and wet seasons. Based on this methodology, we unveil an approach toward potential source contributions of ECs, a concept we refer to as the "Pharmaco-signature." Exploratory analysis of data points has been carried out by unsupervised pattern recognition (hierarchical cluster analysis, HCA) and receptor model (principal component analysis-multiple linear regression, PCA-MLR) in an attempt to demonstrate significant source contributions of ECs in different land-use zone. Robust cluster solutions grouped the database according to different EC profiles. PCA-MLR identified that 58.9% of the mean summed ECs were contributed by domestic impact, 9.7% by antibiotics application, and 31.4% by drug abuse. Diclofenac, ibuprofen, codeine, ampicillin, tetracycline, and erythromycin-H2O have significant pollution risk quotients (RQ>1), indicating potentially high risk to aquatic organisms in Taiwan.

Identification and assessment of new biomarkers for colorectal cancer with serum N-glycan profiling.

BACKGROUND: The objectives of this study were to identify and validate the diagnostic value of N-glycan markers in colorectal cancer (CRC) and to uncover their underlying molecular mechanism. METHODS: In total, 347 individuals, including patients with CRC, patients with colorectal adenoma, and healthy controls, were divided randomly into a training group (n = 287) and retrospective validation groups (n = 60). Serum N-glycan profiling was analyzed by DNA sequencer-assisted/flurophore-assisted carbohydrate electrophoresis (DSA-FACE). Two diagnostic models were constructed based on N-glycan profiling with logistic stepwise regression. The diagnostic performance of each model was assessed further in retrospective, prospective (n = 43), and follow-up (n = 46) cohorts. Lectin blot and reverse transcriptase-polymerase chain reaction were used to analyze the total core-fucosylated residues and molecular expression involved in core-fucosylation modifications in CRC. RESULTS: Two diagnostic models designated CRCglycoA and CRCglycoB were constructed to differentiate CRC from normal and adenoma, respectively. The areas under the receiver operating characteristic curves (AUC) of both CRCglycoA and CRCglycoB were higher than the AUC of carcinoembryonic antigen (CEA) (CRCglycoA, 0.92 vs 0.81; CRCglycoB, 0.81 vs 0.73). The sensitivity and accuracy of CRCglycoA improved from 21.7% to 25% and from 11.63% to 18% in the training cohort, the retrospective cohort, and the prospective cohorts compared with the sensitivity and accuracy of CEA. The sensitivity of CRCglycoB improved from 20% to 28.23%. Both altered N-glycans, and results from the diagnostic models were reversed after curative surgery. The level of total core fucose residues and fucosyltransferase were decreased significantly in CRC. CONCLUSIONS: The current results indicated that the N-glycan markers based diagnostic models are new, valuable, noninvasive alternatives for identifying CRC. The authors concluded that decreased fucosyltransferase may be responsible for decreased levels of total core-fucosylated modification in both tissues and serum from patients with CRC.

Distribution and source differentiation of PAHs and PCBs among size and density fractions in contaminated harbor sediment particles and their implications in toxicological assessment.

Sediment samples collected from Kaohsiung Harbor (Taiwan) were analyzed for 15 priority polycyclic aromatic hydrocarbons (PAHs) and 118 individual polychlorinated biphenyl (PCB) congeners in various particle size fractions and two density fractions. The PAHs in the low density fraction were a much more sensitive and effective indicator of the PAH source than those in the sediment as a whole. Hierarchical cluster analysis of PAH analytes in the low density sediments revealed significant differences in compositional patterns between locations and among size fractions. In the sediment samples from both study sites, the low density fraction particles had up to 155 and 150 times higher concentrations of PAHs and PCBs, respectively, than those in the corresponding high density fractions. In addition, the total toxic benzo[a]pyrene and 2,3,7,8-tetrachlorodibenzodioxin (TCDD, dioxin) equivalents in the sediment low density fractions were much higher (up to 170 and 273 times, respectively) than the corresponding high density fractions.

A preliminary assessment of polycyclic aromatic hydrocarbon distribution in the kenting coral reef waters of southern Taiwan.

This distribution and variation of 45 polycyclic aromatic hydrocarbons (PAHs) in the waters of Kenting coral reefs were investigated by using sensitive research-grade sampling and analytical methods. The concentration levels of total PAHs (including particulate and dissolved PAHs) in the Kenting waters were relatively low, ranging from 2.2 to 34.4 ng/L. There was no significant spatial difference in PAH concentrations among the sampling stations, even between the surface and bottom waters. The fraction of dissolved PAHs on average was greater than that of particulate PAHs due to the small amount of total suspended particles. The partition coefficients between the particulate and dissolved phase (log K(oc)) were positively correlated with their log K(ow) values (r(2) = 0.67, n = 80), except for the more hydrophobic PAHs with log K(ow) values greater than 5.91. Results of principal component analysis indicate that the patterns of particulate PAH compositions were similar through the Kenting waters in the fall and winter, whereas there was a significant spatial difference between the spring and summer samples, which might be affected by a combination of land runoff and coastal currents. PAHs along the Kenting coasts were dominated by low-molecular PAHs, which have higher solubility than high-molecular PAHs. Based on isomer ratios, analysis of the source of PAHs in the Kenting coastal waters demonstrated that the PAHs come mostly from petroleum and, to a lesser degree, from combustion.