Mapping the global, regional and national burden of bipolar disorder from 1990 to 2019: trend analysis on the Global Burden of Disease Study 2019.

BACKGROUND: Data on trends in the epidemiological burden of bipolar disorder are scarce. AIMS: To provide an overview of trends in bipolar disorder burden from 1990 to 2019. METHOD: Revisiting the Global Burden of Disease Study 2019, we analysed the number of cases, calculated the age-standardised rate (per 100 000 population) and estimated annual percentage change (EAPC) of incidence, prevalence and years lived with disability (YLDs) for bipolar disorder from 1990 to 2019. The independent effects of age, period and cohort were estimated by the age-period-cohort modelling. RESULTS: Globally, the bipolar disorder-related prevalent cases, incident cases and number of YLDs all increased from 1990 to 2019. Regionally, the World Health Organization Region of the Americas accounted for the highest estimated YLD number and rate, with the highest age-standardised prevalence rate in 1990 and 2019 and highest EAPC of prevalence. By sociodemographic index (SDI) quintiles, all five SDI regions saw an increase in estimated incident cases. Nationally, New Zealand reported the highest age-standardised rate of incidence, prevalence and YLDs in 1990 and 2019. The most prominent age effect on incidence rate was in those aged 15-19 years. Decreased effects of period on incidence, prevalence and YLD rates was observed overall and in females, not in males. The incidence, prevalence and YLD rates showed an unfavourable trend in the younger cohorts born after 1990, with males reporting a higher cohort risk than females. CONCLUSIONS: From 1990 to 2019, the overall trend of bipolar disorder burden presents regional and national variations and differs by age, sex, period and cohort.

Assessment of testicular volume in neonates in the tropical province of China.

BACKGROUND: Testicular volume in neonates is a potential indicator of testicular development during the fetal period, particularly the masculinization programming window. Reliable measurements of testicular volume provide an opportunity for early detection of testicular abnormalities. This study aimed to assess the testicular volume in neonates and evaluate its relationship with gestational week and birth weight in Hainan Province, China. METHODS: Data on 458 neonates who underwent ultrasonography examinations at our institution from 2018 to 2022 were collected. The neonates were categorized by gestational week, birth weight, and presence of cryptorchidism. We evaluated the testicular volume among different groups and its relationship to gestational week and birth weight. RESULTS: There was no significant difference between the right and left testicular volume in neonates without cryptorchidism. However, a significant difference was observed between normal birth weight and low birth weight neonates in terms of testicular volume. Similarly, there was a significant difference between premature and full-term neonates in testicular volume. Bilateral testicular volume showed positive and significant correlations with gestational week and birth weight. Additionally, a significant difference was noted in testicular volume between the affected side in neonates with cryptorchidism and the same side in normal birth weight full-term neonates. CONCLUSIONS: We established the normal range of testicular volume for neonates in Hainan Province and demonstrated that testicular volume is positively correlated with both birth weight and gestational week. Cryptorchidism also affects testicular volume during the neonatal period, likely due to reduced androgenic exposure in utero, particularly during the masculinization programming window. The findings of this study have significant implications for assessing testis development during fetal development.

Validation of the THINC-It Tool for Assessment of Cognitive Impairment in Patients with Bipolar Depression.

Background: Cognitive impairment is one of the core features of bipolar depression. A unified, reliable, and valid assessment tool is key to screening and assessing cognitive impairment. The THINC-Integrated Tool (THINC-it) is a simple and quick battery for screening cognitive impairment in patients with major depressive disorder. However, the use of the tool has not been validated in patients with bipolar depression. Methods: The cognitive functions of 120 patients with bipolar depression and 100 healthy controls were evaluated using the THINC-it tool including Spotter, Symbol Check, Codebreaker, Trials, and the only one subjective test (PDQ-5-D) and five corresponding standard tests. A psychometric analysis of the THINC-it tool was performed. Results: The overall Cronbach's alpha coefficient of the THINC-it tool was 0.815. The intra-group correlation coefficient (ICC) of retest reliability ranged from 0.571 to 0.854 (P<0.001), while the correlation r of parallel validity ranged from 0.291 to 0.921 (P<0.001). There were significant differences in the two groups Z-scores of THINC-it total score, Spotter, Codebreaker, Trails, and PDQ-5-D (P<0.05). Construct validity was analyzed using exploratory factor analysis (EFA). The Kaiser-Meyer-Olkin (KMO) value was 0.749. Using Bartlett's Sphericity test, the χ 2 (10) value was 198.257 (P<0.001). The factor loading coefficients of Spotter, Symbol Check, Codebreaker, and Trails on the common factor 1 were -0.724, 0.748, 0.824, and -0.717, respectively, and the factor loading coefficient of PDQ-5-D on the common factor 2 was 0.957. Results revealed that the correlation coefficient of the two common factors was 0.125. Conclusion: The THINC-it tool has good reliability and validity in assessing patients with bipolar depression.

Assessment of In-Use NOx Emissions from Heavy-Duty Diesel Vehicles Equipped with Selective Catalytic Reduction Systems.

This work evaluated the nitrogen oxide (NOx) emissions of 277 heavy-duty diesel vehicles (HDDVs) from three portable emission measurement system testing programs. HDDVs in these programs were properly maintained before emission testing, so the malfunction indicator lamp (MIL) was not illuminated. NOx emissions of some HDDVs were significantly higher than the certification standard even during hot operations where exhaust temperature was ideal for selective catalytic reduction to reduce NOx. For engines certified to the 0.20 g/bhp-hr NOx standard, hot operation NOx emissions increased with engine age at 0.081 ± 0.016 g/bhp-hr per year. The correlation between emissions and mileage was weak because six trucks showed extraordinarily high apparent emission increase rates reaching several multiples of the standard within the first 15,000 miles of operation. The overall annual increase in NOx emissions for the HDDVs in this study was two-thirds of what was observed in real-world emissions for HDDVs at the Caldecott Tunnel over the past decade. The vehicles at the Caldecott Tunnel would include those without proper maintenance, and the inclusion of these vehicles possibly explains the difference in the rate of emission increase. The results suggest that HDDVs need robust strategies to better control in-use NOx emissions.

Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study.

The severe 2019 outbreak of novel coronavirus disease (COVID-19), which was first reported in Wuhan, would be expected to impact the mental health of local medical and nursing staff and thus lead them to seek help. However, those outcomes have yet to be established using epidemiological data. To explore the mental health status of medical and nursing staff and the efficacy, or lack thereof, of critically connecting psychological needs to receiving psychological care, we conducted a quantitative study. This is the first paper on the mental health of medical and nursing staff in Wuhan. Notably, among 994 medical and nursing staff working in Wuhan, 36.9% had subthreshold mental health disturbances (mean PHQ-9: 2.4), 34.4% had mild disturbances (mean PHQ-9: 5.4), 22.4% had moderate disturbances (mean PHQ-9: 9.0), and 6.2% had severe disturbance (mean PHQ-9: 15.1) in the immediate wake of the viral epidemic. The noted burden fell particularly heavily on young women. Of all participants, 36.3% had accessed psychological materials (such as books on mental health), 50.4% had accessed psychological resources available through media (such as online push messages on mental health self-help coping methods), and 17.5% had participated in counseling or psychotherapy. Trends in levels of psychological distress and factors such as exposure to infected people and psychological assistance were identified. Although staff accessed limited mental healthcare services, distressed staff nonetheless saw these services as important resources to alleviate acute mental health disturbances and improve their physical health perceptions. These findings emphasize the importance of being prepared to support frontline workers through mental health interventions at times of widespread crisis.

Cross-cultural difference and validation of the Chinese version of Montreal Cognitive Assessment in older adults residing in Eastern China: preliminary findings.

To evaluate the psychometric properties of the Chinese Montreal Cognitive Assessment (MoCA-C) and assess cross-cultural differences in a community-based cohort residing in the Eastern China. The study included 72 patients with Alzheimer's disease (AD), 84 patients with mild cognitive impairment (MCI) and 146 cognitively normal controls. Sensitivities and specificities were calculated using the recommended cut-off scores. Receiver operator characteristic (ROC) curve analyses were performed to determine optimal sensitivity and specificity. Criterion validity, inter-rater, test-retest reliability and internal consistencies of the MoCA-C were examined, and clinical observations made. The influence of age, education level and gender on MoCA score was examined. Using the recommended cut-off score of 26, the area under the ROC (AUC) for predicting MCI groups using the MoCA-C was 0.930 (95%CI: 0.894; 0.965). The MoCA-C demonstrated 92% sensitivity and 85% specificity in screening for MCI. Cultural differences from the original MoCA affected the test response rate. The MoCA-C appears to have utility as a cognitive screen for early detection of AD and for MCI and warrants further investigation regarding its applicability in primary care settings in elderly Chinese people. It will be necessary to revise the contents of the questionnaire to account for by local characteristics.

[Application of the triage assessment system for a rapid assessment of mental health of the referral wounded and their family members in Wenchuan earthquake].

OBJECTIVE: To quickly assess the psychological status of the wounded who were transferred in the earthquake and their family members, as to promoting the system of psychological crisis intervention. METHODS: The triage assessment system was used to the 44 wounded and 37 family members, additionally, the Hamilton Depression Rating Scale (HAMD), and Hamilton Anxiety Rating Scale (HAMA) for related analysis were also administrated to verify the effectiveness of screening of the triage assessment system. RESULTS: Of the 79 wounded and their families in the triage assessment system, the score of emotion in the wounded group was (3.07 +/- 1.38), the score of cognition was (2.34 +/- 1.39), the score of behavior was (2.71 +/- 1.47), and the total score was (8.12 +/- 3.69); the score of emotion in the family group was (2.51 +/- 1.27), the score of cognition was (1.57 +/- 0.85), the score of behavior was (1.71 +/- 1.02), and the total score was (5.80 +/- 2.61). There were significant differences in the family and the wounded group in cognition, behavior and the total (t(cognition) = 2.853, P = 0.006; t(behavior) = 3.366, P = 0.001; t(total) = 3.116, P = 0.003). Both the depression and anxiety symptoms in the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) were 11.48 +/- 7.62, 9.23 +/- 5.64, and 8.49 +/- 4.87, 9.38 +/- 7.05, respectively. In the emotion, cognition, behavior and total scores of the triage assessment system related to higher with HAMD and HAMA were r(emotion-HAMD) = 0.393, P = 0.001; r(emotion-HAMA) = 0.443, P = 0.000; r(cognition-HAMD) = 0.434, P = 0.000; r(cognition-HAMA) = 0.240, P = 0.037; r(behavior-HAMD) = 0.529, P = 0.000; r(behavior-HAMA) = 0.256, P = 0.026; r(total-HAMD) = 0.517, P = 0.000; r(total-HAMA) = 0.369, P = 0.001. CONCLUSION: The triage assessment system should be the reliable method for an assessment featured by a rapid, accurate and simple one in screening and monitoring.

Media and community campaign effects on adult tobacco use in Texas.

The present study reports on the effects on adult tobacco cessation of a comprehensive tobacco-use prevention and cessation program in the state of Texas. Differences in cessation rates across treatment conditions were measured by following a panel of 622 daily smokers, recruited from the original cross-sectional sample, from baseline to follow-up. The adult media campaign combined television, radio, newspaper and billboard advertisements featuring messages and outreach programs to help adults avoid or quit using tobacco products. The ads also promoted quitting assistance programs from the American Cancer Society Smokers' Quitline, a telephone counseling service. The cessation component of the intervention focused on increasing availability of and access to cessation counseling services and pharmacological therapy to reduce nicotine dependence. Both clinical and community-based cessation programs were offered. Treatment areas which combined cessation activities with high level media campaigns had a rate of smoking reduction that almost tripled rates in areas which received no services, and almost doubled rates in areas with media campaigns alone. Analyses of the dose of exposure to media messages about smoking cessation show greater exposure to television and radio messages in the areas where high level media was combined with community cessation activities than in the other areas. Results also show that exposure to media messages was related to processes of change in smoking cessation and that those processes were related to the quitting that was observed in the group receiving the most intensive campaigns.