Comparison of Computer-based Information Support to Clinical Research in Chinese and Japanese Hospitals

Objectives: The objectives of this research are to examine the current situation of computer-based information support of clinical research in hospitals and to determine the expectations of clinicians toward clinical research support functions of hospital information systems (HISs) in both China and Japan.

Methods: 172 clinicians from 42 major hospitals in China (2 groups), and 568 clinicians from 79 university hospitals in Japan (2 groups), were surveyed by postal questionnaire during July and August, 1999. The Kruskal-Wallis test was performed to analyze the differences among the groups.

Results: The total response rate was 66.9%. The result shows that 94.8% of the Japanese clinicians, 3.5 times more than those in China, use computers almost every day. High significance was shown for the frequency of non-HIS based information resources used by clinicians between China and Japan (p <0.001), whereas no significance for the frequency of HIS use by clinicians between the China I and Japan I groups (p = 0.725) was found. 33.3% clinicians in China thought they could obtain 30-50% of the necessary patient data for clinical research from the HIS, about 2 times more than in Japan (p = 0.009).

Conclusions: Although the degree of computer involvement among clinicians in Japan is much higher than in China, the computer-based hospital information systems have not been developed well for supporting clinical research in both countries. The clinicians expect comprehensive computerized patient records (CPRs) and full use of patient related information in the existing HISs to support their clinical research.

Oceanic oxygenation events in the anoxic Ediacaran ocean

The ocean-atmosphere system is typically envisioned to have gone through a unidirectional oxygenation with significant oxygen increases in the earliest (ca. 635 Ma), middle (ca. 580 Ma), or late (ca. 560 Ma) Ediacaran Period. However, temporally discontinuous geochemical data and the patchy metazoan fossil record have been inadequate to chart the details of Ediacaran ocean oxygenation, raising fundamental debates about the timing of ocean oxygenation, its purported unidirectional rise, and its causal relationship, if any, with the evolution of early animal life. To better understand the Ediacaran ocean redox evolution, we have conducted a multi-proxy paleoredox study of a relatively continuous, deep-water section in South China that was paleogeographically connected with the open ocean. Iron speciation and pyrite morphology indicate locally euxinic (anoxic and sulfidic) environments throughout the Ediacaran in this section. In the same rocks, redox sensitive element enrichments and sulfur isotope data provide evidence for multiple oceanic oxygenation events (OOEs) in a predominantly anoxic global Ediacaran-early Cambrian ocean. This dynamic redox landscape contrasts with a recent view of a redox-static Ediacaran ocean without significant change in oxygen content. The duration of the Ediacaran OOEs may be comparable to those of the oceanic anoxic events (OAEs) in otherwise well-oxygenated Phanerozoic oceans. Anoxic events caused mass extinctions followed by fast recovery in biologically diversified Phanerozoic oceans. In contrast, oxygenation events in otherwise ecologically monotonous anoxic Ediacaran-early Cambrian oceans may have stimulated biotic innovations followed by prolonged evolutionary stasis.

Epidemiological transition and distribution of stroke incidence in Tianjin, China, 1988-2010

OBJECTIVES

To examine the trends in epidemiological transition of stroke over the last two decades in Tianjin, and investigate the subtypes of stroke.

STUDY DESIGN

A population-based epidemiological study using data from the Stroke Incidence Surveillance System of the Tianjin Centres for Disease Control and Prevention from 1988 to 2010.

METHODS

Almost 500,000 cases were analysed to examine changes in the incidence of stroke between 1988 and 2010 by age, sex, subtype, year and urban/rural status.

RESULTS

The incidence of stroke amongst males increased from 136.8/100,000 in 1988 to 387.0/100,000 in 2010, and the incidence amongst females increased from 65.9/100,000 in 1988 to 249.7/100,000 in 2010. Over the study period, the proportion of haemorrhagic strokes decreased and the proportion of ischaemic strokes increased sharply in both men and woman; the differences were significant.

CONCLUSION

The distribution of stroke subtypes changed dramatically over the study period. Changes in trend and subtypes of stroke have raised new challenges and there is a need for adjustment for stroke prevention in Tianjin.