Burden of depression in adolescents in the Western Pacific Region from 1990 to 2019: An age-period-cohort analysis of the Global Burden of Disease study.

BACKGROUND: Depression is a highly prevalent and disabling mental health condition among adolescents. The epidemiology of depression in adolescents has been changing over time, reflecting changes in risk factors as well as disease concepts and diagnosis. However, few studies have characterized the longitudinal epidemiology of depression in adolescents. Understanding trends of disease burden provides key insights to improve resource allocation and design targeted interventions for this vulnerable population. The Western Pacific Region (WPR) is home to over 1.3 billion people with tremendous diversity in culture and socioeconomic development. The epidemiology of adolescent depression in WPR remains largely unknown. In this study, we aimed to estimate trends of disease burden attributable to depressive disorders among adolescents aged 10-24 years in WPR countries between 1990 and 2019, and to investigate period and cohort effects using the Global Burden of Disease (GBD) study database. METHODS: The study utilized data from the Global Burden of Disease, Injuries, and Risk Factors Study 2019, concentrating on adolescents aged 10 to 24 years with depression. We conducted an in-depth analysis of depression, including its age-standardized prevalence, incidence, and Disability-Adjusted Life Years (DALYs), across diverse demographics such as regions, ages, genders, and socio-demographic indexes, spanning from 1990 to 2019. RESULTS: The analysis found decreasing trends in the prevalence, incidence, and DALYs of adolescent depression in the WPR between 1990-2019, although some countries like Australia and Malaysia showed increases. Specifically, the prevalence of adolescent depression in the region decreased from 9,347,861.6 cases in 1990 to 5,551,341.1 cases in 2019. The incidence rate declined from 2,508.6 per 100,000 adolescents in 1990 to 1,947.9 per 100,000 in 2019. DALYs decreased from 371.9 per 100,000 in 1990 to ASR 299.7 per 100,000 in 2019. CONCLUSION: This study found an overall decreasing trend in adolescent depression burden in the Western Pacific Region between 1990 and 2019, with heterogeneity across countries. For 30 years, the 20-24 age group accounted for the majority of depression among adolescents Widening inequality in depression burden requires policy attention. Further analysis of risk factors contributing to epidemiological trends is warranted to inform prevention strategies targeting adolescent mental health in the region.

Is there more to bitcoin mining than carbon emissions?

Critics decry cryptocurrency mining as a huge waste of energy, while proponents insist on claiming that it is a green industry. Is Bitcoin mining really worth the energy it consumes? The high power consumption of cryptocurrency mining has become the latest global flashpoint. In this paper, we define the Mining Domestic Production (MDP) as a method to account for the final outcome of the Bitcoin mining industry's production activities in a certain period time, calculate the carbon emission per unit output value of the Bitcoin mining industry in China, and compare it with three other traditional industries. The results show that Bitcoin mining does not always have the highest when compared with others. The contribution of this paper is that we give a new perspective on thinking whether Bitcoin mining is more efficient to make more profit, in terms of the same amount of carbon emissions per unit compared to other industries. Moreover, it could even be argued that Bitcoin may present an opportunity for some developing countries to build out their electrical capacity and generate revenue.

Detection of marine oil-like features in Sentinel-1 SAR images by supplementary use of deep learning and empirical methods: Performance assessment for the Great Barrier Reef marine park.

Continuous monitoring of oil discharges in coastal and open ocean waters using Earth Observation (EO) has undeniably contributed to diminishing their occurrence wherever a detection system was in place, such as in Europe (EMSA's CleanSeaNet) or in the United States (NOAA's OR&R). This study describes the development and testing of a semi-automated oil slick detection system tailored to the Great Barrier Reef (GBR) marine park solely based on EO data as no such service was routinely available in Australia until recently. In this study, a large, curated, historical global dataset of SAR imagery acquired by Sentinel-1 SAR, now publicly available, is used to assess classification techniques, namely an empirical approach and a deep learning model, to discriminate between oil-like features and look-alikes in the scenes acquired over the marine park. An evaluation of this detection system on 10 Sentinel-1 SAR images of the GBR using two performance metrics - the detection accuracy and the false-positive rate (FPR) - shows that the classifiers perform best when combined (accuracy >98 %; FPR 0.01) rather than when used separately. This study demonstrates the benefit of sequentially combining classifiers to improve the detection and monitoring of unreported oil discharge events in SAR imagery. The workflow has also been tested outside the GBR, demonstrating its robustness when applied to other regions such as Australia's Northwest Shelf, Southeast Asia and the Pacific.

Health risks of shallow groundwater in the five basins of Shanxi, China: Geographical, geological and human activity roles.

Rapid economic development often leads to groundwater degradation, posing health risks to those who rely on it. The groundwater discharge conditions in basins are poor. The health risk of shallow groundwater in basins needs more attentions. The health risk of shallow groundwater in the five basins of Shanxi Province, China was discussed based on the hydrochemical evolution of shallow groundwater and the water quality assessment. The results showed that arsenic (As) and chromium (Cr) in the shallow groundwater of the basins caused prominent health risks followed by fluoride (F) and nitrate (NO3-). The non-carcinogenic risks of As, F and NO3- to children were higher than that to adults, and the carcinogenic risks of As and Cr were higher for adults than children. Various hydrogeochemical reactions, geological conditions, climatic factors, and human activities are closely related to groundwater health risks, and basin topography is considered as one of key factors. Water-rock interaction, dedolomitization and cation exchange are the natural processes in the evolution of groundwater hydrochemistry, while agricultural and mining activities are the anthropogenic factors causing groundwater degradation. The leaching/dilution effects of infiltration precipitation in the basin-mountain systems cause distinct temporal changes in the chemical composition and health risks of the groundwater in the basins. Differences in climate and farming practices among the basins further complicate the spatio-temporal changes. The basin-mountain system is conducive to the convergence and enrichment of water flow and solutes in the basins, which aggravates the degradation of groundwater quality. This study highlights that the combined influences of geographical and geological factors and anthropogenic activities amplify the human health risks of groundwater in the basins.

Performance of Passive Muscle Stiffness in Diagnosis and Assessment of Disease Progression in Duchenne Muscular Dystrophy.

The aim of this study was to evaluate the performance of passive muscle stiffness in diagnosing and assessing disease progression in Duchenne muscular dystrophy (DMD). Boys with DMD and age-matched controls were recruited. Shear wave elastography (SWE) videos were collected by performing dynamic stretching of the gastrocnemius medius (GM). At ankle angles from plantar flexion (PF) 30° to dorsiflexion (DF) 20°, the shear modulus of the GM was measured for each 10° of ankle movement. Shear modulus at each ankle angle was compared between the DMD and control group. Correlation between passive muscle stiffness and motor function grading was also analyzed. A total of 26 patients with DMD and 20 healthy boys were enrolled. At multiple stretch levels, passive muscle stiffness of the GM was significantly higher in patients with DMD than in those in the control group (all p values <0.05). The shear modulus of GM at an ankle angle of DF 10° had the largest area under the receiver operating characteristic curve in differentiating DMD patients from normal subjects (AUC = 0.902, 95% confidence interval: 0.814-0.990). Motor function grading was a significant determinant of passive muscle stiffness at an ankle angle of DF 10° (B = 21.409, t = 3.372, p = 0.003). Passive muscle stiffness may potentially serve as a useful non-invasive tool to monitor disease progression in DMD patients.

Performance assessment of surface-guided radiation therapy and patient setup in head-and-neck and breast cancer patients based on statistical process control.

PURPOSE: To assess the effectiveness of SGRT in clinical applications through statistical process control (SPC). METHODS: Taking the patients' positioning through optical surface imaging (OSI) as a process, the average level of process execution was defined as the process mean. Setup errors detected by cone-beam computed tomography (CBCT) and OSI were extracted for head-and-neck cancer (HNC) and breast cancer patients. These data were used to construct individual and exponentially weighted moving average (EWMA) control charts to analyze outlier fractions and small process shifts from the process mean. Using the control charts and process capability indices derived from this process, the patient positioning-related OSI performance and setup error were analyzed for each patient. RESULTS: Outlier fractions and small shifts from the process mean that are indicative of setup errors were found to be widely prevalent, with the outliers randomly distributed between fractions. A systematic error of up to 1.6 mm between the OSI and CBCT results was observed in all directions, indicating a significantly degraded OSI performance. Adjusting this systematic error for each patient using setup errors of the first five fractions could effectively mitigate these effects. Process capability analysis following adjustment for systematic error indicated that OSI performance was acceptable (process capability index Cpk = 1.0) for HNC patients but unacceptable (Cpk < 0.75) for breast cancer patients. CONCLUSION: SPC is a powerful tool for detecting the outlier fractions and process changes. Our application of SPC to patient-specific evaluations validated the suitability of OSI in clinical applications involving patient positioning.

Building an Open Resources Repository for COVID-19 Research.

The COVID-19 outbreak is a global pandemic declared by the World Health Organization, with rapidly increasing cases in most countries. A wide range of research is urgently needed for understanding the COVID-19 pandemic, such as transmissibility, geographic spreading, risk factors for infections, and economic impacts. Reliable data archive and sharing are essential to jump-start innovative research to combat COVID-19. This research is a collaborative and innovative effort in building such an archive, including the collection of various data resources relevant to COVID-19 research, such as daily cases, social media, population mobility, health facilities, climate, socioeconomic data, research articles, policy and regulation, and global news. Due to the heterogeneity between data sources, our effort also includes processing and integrating different datasets based on GIS (Geographic Information System) base maps to make them relatable and comparable. To keep the data files permanent, we published all open data to the Harvard Dataverse (https://dataverse.harvard.edu/dataverse/2019ncov), an online data management and sharing platform with a permanent Digital Object Identifier number for each dataset. Finally, preliminary studies are conducted based on the shared COVID-19 datasets and revealed different spatial transmission patterns among mainland China, Italy, and the United States.

Evaluation of the three-in-one team-based care model on hierarchical diagnosis and treatment patterns among patients with diabetes: a retrospective cohort study using Xiamen's regional electronic health records.

BACKGROUND: Xiamen is a pilot city in China for hierarchical diagnosis and treatment reform of non-communicable diseases, especially diabetes. Since 2012, Xiamen has implemented a program called the "three-in-one", a team-based care model for the treatment of diabetes, which involves collaboration between diabetes specialists, general practitioners, and health managers. In addition, the program provides financial incentives to improve care, as greater accessibility to medications through community health care centers (CHCs). The aim of this study was to evaluate the effectiveness of these policies in shifting visits from general hospitals to CHCs for the treatment of type 2 diabetes mellitus (T2DM). METHOD AND MATERIALS: A retrospective observational cohort study was conducted using Xiamen's regional electronic health record (EHR) database, which included 90% of all patients registered since 2012. Logistic regression was used to derive the adjusted odds ratio (OR) for patients shifting from general hospitals to CHCs. Among patients treated at hospitals, Kaplan-Meier(KM) curves were constructed to evaluate the time from each policy introduction until the switch to CHCs. A k-means clustering analysis was conducted to identify patterns of patient care-seeking behavior. RESULTS: In total, 89,558 patients and 2,373,524 visits were included. In contrast to increased outpatient visits to general hospitals in China overall, the percentage of visits to CHCs in Xiamen increased from 29.7% in 2012 to 66.5% in 2016. The most significant and rapid shift occurred in later periods after full policy implementation. Three clusters of patients were identified with different levels of complications and health care-seeking frequency. All had similar responses to the policies. CONCLUSIONS: The "three-in-one" team-based care model showed promising results for building a hierarchical health care system in China. These policy reforms effectively increased CHCs utilization among diabetic patients.

Hepatitis C infection, related services, and barriers to HCV treatment among drug users in methadone maintenance treatment (MMT) clinics in Shanghai, China.

BACKGROUND: The purpose of this study was to document the prevalence of hepatitis C among MMT patients, hepatitis C virus (HCV) knowledge of patients and MMT staff members, and the barriers preventing them from receiving or delivering HCV-related services in MMT clinics of China. METHODS: Data were collected from 240 MMT patients and 58 staff members in Shanghai MMT clinics. Structured questionnaires (HCV Knowledge Scale and Alcohol Use Disorders Identification Test) and several self-developed questionnaires were used to assess (1) patient and staff HCV knowledge, (2) attitudes toward HCV-related services in MMT clinics, and (3) what type of HCV-related services the staff members have provided in their routine work. The HCV test results were based on the patients' medical records. RESULTS: The HCV seropositive rate was high (70%), and both patients and staff had limited HCV knowledge. The mean score of patient HCV knowledge was 6.8 out of 20 (SD = 3.7), whereas the mean score of staff HCV knowledge was 10.9 out of 20 (SD = 3.1). For HCV-positive patients, only 13.7% had accessed HCV medical treatment. Barriers included the cost of medical treatment, lack of HCV knowledge, lack of professional training for patients to receive HCV-related services from individuals or MMT clinics, and lack of an adequate policy-making system. CONCLUSIONS: HCV infection remains an important problem among MMT patients in China. Barriers to HCV-related services are attributable to individual, clinical, and policy-related factors. This study may provide evidence-based information for future work to optimize the resources of MMT clinics. TRIAL REGISTRATION: ClinicalTrials.gov NCT01647191 . Registered 17 April 2012.

Safety performance of traffic phases and phase transitions in three phase traffic theory.

Crash risk prediction models were developed to link safety to various phases and phase transitions defined by the three phase traffic theory. Results of the Bayesian conditional logit analysis showed that different traffic states differed distinctly with respect to safety performance. The random-parameter logit approach was utilized to account for the heterogeneity caused by unobserved factors. The Bayesian inference approach based on the Markov Chain Monte Carlo (MCMC) method was used for the estimation of the random-parameter logit model. The proposed approach increased the prediction performance of the crash risk models as compared with the conventional logit model. The three phase traffic theory can help us better understand the mechanism of crash occurrences in various traffic states. The contributing factors to crash likelihood can be well explained by the mechanism of phase transitions. We further discovered that the free flow state can be divided into two sub-phases on the basis of safety performance, including a true free flow state in which the interactions between vehicles are minor, and a platooned traffic state in which bunched vehicles travel in successions. The results of this study suggest that a safety perspective can be added to the three phase traffic theory. The results also suggest that the heterogeneity between different traffic states should be considered when estimating the risks of crash occurrences on freeways.

Risk assessment of breast cancer in Guangdong, China: a community-based survey.

OBJECTIVES: Compared with Western countries, the incidence rates for breast cancer in China are still low. However, breast cancer appears to be hitting Chinese women at a much younger age, with a peak between 40 and 50 years. Furthermore, breast tumors of Asian women have molecular and genetic characteristics that are different from those of Caucasian women. METHODS: A community-based study was designed to evaluate the relationship between lifestyles and breast cancer risk in Chinese women residing in Guangzhou. 16,314 subjects completed the questionnaire. Potential confounding factors included sociodemographic characteristics. RESULTS: 33 individuals reported a history of breast cancer, yielding a prevalence rate of 202.3/100000. Associations between subjects'demographic and breast cancer risk factors were assessed. Breast cancer is associated with family history of breast cancer, X-rays received, benign breast disease and hyperlipoidemia or hypercholesteremia with elevated odds ratios. CONCLUSIONS: Family history of breast cancer, X-ray received benign breast disease and hyperlipoidemia or hypercholesteremia were significantly associated with risk of breast cancer and may have potential for breast cancer risk assessment.

Association between depression and malnutrition-inflammation complex syndrome in patients with continuous ambulatory peritoneal dialysis.

OBJECTIVE: Depression, the most common psychological disorder among patients with end-stage renal disease (ESRD), is associated with poor survival. The prevalence of depression and its relation with the malnutrition-inflammation complex syndrome (MICS) have not yet been clearly defined in Chinese continuous ambulatory peritoneal dialysis (CAPD) patients. PATIENTS AND METHODS: A total of 142 patients on CAPD were enrolled in the First Affiliated Hospital of Sun Yat-Sen University. The Hamilton Depression Scale (HAMD) and the malnutrition-inflammation score (MIS) were used for depression and MICS evaluation, respectively. Clinical, socioeconomic, and malnutrition-inflammation factors were compared among patients with and without depression. Binary regression analysis was performed to investigate the independent association between depression and MICS. RESULTS: The mean HAMD and MIS scores were 7.12 ± 5.28 and 4.45 ± 3.56, respectively. According to HAMD, 37 patients (26.1%) had depression and 70 patients (49.3%) had potential depression. Older age, longer dialysis vintage, worse residual renal function, lower employment and reimbursement status, and higher comorbidity index were positively correlated with depression. Compared to non-depressed patients, the depressed ones also showed lower levels of serum albumin and higher levels of C-reactive protein (CRP). Correlation results showed that the HAMD scores were significantly and positively correlated with MIS (r = 0.46, P < 0.01). Moreover, the incidence of peritonitis was significantly higher in depressed compared to non-depressed patients. Binary regression analysis showed that MIS was the only independent risk factor for depression. CONCLUSION: Depression is commonly encountered in Chinese CAPD patients. A close relationship exists between depression and MICS.

A longitudinal study of blood pressure variability in African-American and European American youth.

OBJECTIVES: High blood pressure variability is increasingly used as a predictor of target-organ damage and cardiovascular events. However, little is known about blood pressure variability changes with age and its possible sociodemographic, anthropometric, and genetic moderators. METHODS: Twenty-four-hour ambulatory blood pressure was measured up to 12 times over a 15-year period in 344 European Americans and 297 African-Americans with an average age of 14 years at the initial visit. Blood pressure variability was indexed by the weighted 24-h standard deviation of ambulatory blood pressure recordings. RESULTS: Both systolic and diastolic blood pressure variability increased with age and ambulatory blood pressure mean values. Men had higher levels of blood pressure variability (P < 0.001) and showed steeper linear increase rates with age than women. African-Americans showed higher values of blood pressure variability (P < 0.05) than European Americans. Body mass index and waist circumference were also associated with higher blood pressure variability levels (P < 0.001). Individuals with higher father's education level showed lower blood pressure variability. In the full model which included all the above factors, ethnic difference in systolic blood pressure variability was no longer significant. CONCLUSION: The results of the present study suggest that men and African-Americans have higher blood pressure variability than women and European Americans. Apart from these ethnicity and sex effects, blood pressure variability increases with increases in age (especially in men), ambulatory blood pressure mean values and adiposity as well as decreased socioeconomic status.