Alcohol use disorder hospitalisations over the last two decades: a population-based cohort study

BACKGROUND

Alcohol use disorders are risk factors for almost all health conditions due to heavy alcohol use. The epidemiology of alcohol use disorders can be used to monitor harm from heavy alcohol consumption.

AIM

To estimate changes in the risk of alcohol use disorders over the last two decades among the Western Australian adult population.

METHODS

This population-based cohort study used hospital separation records for Western Australian residents aged 18 years and older that occurred between 1990 and 2013 with a primary diagnosis of alcohol use disorder and annual estimated residential population to estimate the annual gender- and age-specific incidence rate. A random sample of emergency presentations to public hospitals in Western Australia between 2002 and 2013 was used to account for confounding effects, such as changes in patient access to medical care and overall improvement in healthcare service in the multivariable Poisson regression model.

RESULTS

The risk of alcohol use disorder hospitalisations among the Western Australia population has increased considerably since 1998 with a decline in 2012 and 2013. The average rate remained significantly higher from 2010 to 2013 compared with previous years.

CONCLUSIONS

The trend of alcohol use disorder hospitalisations is indicative of an increase in harm due to heavy alcohol use in the population.

Efficacy and Safety of Bromocriptine-QR in Type 2 Diabetes: A Systematic Review and Meta-Analysis

Bromocriptine-QR (quick release) is a novel treatment for type 2 diabetes. The objective of this study is to assess the efficacy and safety of bromocriptine-QR in adults with type 2 diabetes mellitus based on randomized controlled trials published in peer-reviewed journals or as abstracts. We performed a comprehensive literature search of MEDLINE, Pubmed, Web of Science, EMBASE, and the Cochrane Library up to May 2015. Randomized controlled trials of bromocriptine-QR therapy in type 2 diabetes mellitus were eligible. Two reviewers independently assessed the eligibility of trials based on predefined inclusion criteria. Information was collected concerning basic study data, patient characteristics, efficacy and safety outcomes, and methodological quality. Bromocriptine-QR add-on therapy lowered hemoglobin A1c compared with placebo (weighted mean difference, - 6.52 mmol/mol; 95% CI, - 8.07 to - 4.97 mmol/mol). Bromocriptine-QR exhibited an increase in achieving an HbA1c level ≤ 53 mmol/mol (≤ 7.0%) (32.0 vs. 9.5%; odds ratio, 4.57; 95% CI, 2.42-8.62). Fasting plasma glucose was reduced with bromocriptine-QR compared with placebo (weighted mean difference,-1.04 mmol/l; 95% CI,-1.49 to-0.59 mmol/l). Moreover, bromocriptine-QR had neutral effects on postprandial glycemia, Body Mass Index (BMI), and lipid profile. Bromocriptine-QR had more gastrointestinal side effects of nausea and vomiting. Bromocriptine-QR had no increased risk of hypoglycemia, hypotension, or cardiovascular effects. Bromocriptine-QR therapy offers an alternative option to currently available antidiabetic agents for type 2 diabetes mellitus adults. Neither hypoglycemia nor other metabolic changes occur with this drug. More data for long-term efficacy and safety are needed for further observation.

High spectral purity Kerr frequency comb radio frequency photonic oscillator

Femtosecond laser-based generation of radio frequency signals has produced astonishing improvements in achievable spectral purity, one of the basic features characterizing the performance of an radio frequency oscillator. Kerr frequency combs hold promise for transforming these lab-scale oscillators to chip-scale level. In this work we demonstrate a miniature 10 GHz radio frequency photonic oscillator characterized with phase noise better than -60 dBc Hz(-1) at 10 Hz, -90 dBc Hz(-1) at 100 Hz and -170 dBc Hz(-1) at 10 MHz. The frequency stability of this device, as represented by Allan deviation measurements, is at the level of 10(-10) at 1-100 s integration time-orders of magnitude better than existing radio frequency photonic devices of similar size, weight and power consumption.

Nomogram for Predicting Time to Death After Withdrawal of Life-Sustaining Treatment in Patients With Devastating Neurological Injury

Reliable prediction of time of death after withdrawal of life-sustaining treatment in patients with devastating neurological injury is crucial to successful donation after cardiac death. Herein, we conducted a study of 419 neurocritical patients who underwent life support withdrawal at four neurosurgical centers in China. Based on a retrospective cohort, we used multivariate Cox regression analysis to identify prognostic factors for patient death, which were then integrated into a nomogram. The model was calibrated and validated using data from an external retrospective cohort and a prospective cohort. We identified 10 variables that were incorporated into a nomogram. The C-indexes for predicting the 60-min death probability in the training, external validation and prospective validation cohorts were 0.96 (0.93-0.98), 0.94 (0.91-0.97), and 0.99 (0.97-1.00), respectively. The calibration plots after WLST showed an optimal agreement between the prediction of time to death by the nomogram and the actual observation for all cohorts. Then we identified 22, 26 and 37 as cut-points for risk stratification into four groups. Kaplan-Meier curves indicated distinct prognoses between patients in the different risk groups (p < 0.001). In conclusion, we have developed and validated a nomogram to accurately identify potential cardiac death donors in neurocritical patients in a Chinese population.

Proteomic analysis of tilapia Oreochromis niloticus Streptococcus agalactiae strains with different genotypes and serotypes

Nine tilapia Oreochromis niloticus group B streptococcus (GBS) strains differing in serotype and genotype were selected and paired. Two-dimensional difference gel electrophoresis (2D DIGE) and matrix-assisted laser-desorption ionization time-of-flight-mass spectrometry (MALDI-TOF-MS) were used to analyse the protein profiles of the strain pairs. Forty-three proteins corresponding to 66 spots were identified, of which 35 proteins were found in the seven selected strain pairs that represented pairs differing in genotype and serotype. Among the 35 proteins, numbers of differentially expressed proteins in strains of different serotypes were greater than found in strains of different genotypes, suggesting that serotype plays a more essential role than genotype in the differential protein expression among GBS strains. No distinct pattern was found with respect to genotype and the protein expression profile of GBS strains. Several proteins were identified as surface-associated cytoplasmic proteins that possessed the typical immunity-eliciting characteristics of surface proteins. The identified proteins were found to be involved in 16 biological processes and seven Kyoto encyclopaedia of genes and genomes (KEGG) pathways. The data, for the first time, identified differentially expressed proteins in O. niloticus GBS strains of different serotypes, which play a major role in immunogenicity of O. niloticus GBS than does genotype, offering further information for design of a vaccine against O. niloticus GBS.

Subtypes of major depression: latent class analysis in depressed Han Chinese women

BACKGROUND

Despite substantial research, uncertainty remains about the clinical and etiological heterogeneity of major depression (MD). Can meaningful and valid subtypes be identified and would they be stable cross-culturally?

METHOD

Symptoms at their lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾ 30 years, with recurrent DSM-IV MD. Latent class analysis (LCA) was performed in Mplus. RESULTS; Using the nine DSM-IV MD symptomatic A criteria, the 14 disaggregated DSM-IV criteria and all independently assessed depressive symptoms (n = 27), the best LCA model identified respectively three, four and six classes. A severe and non-suicidal class was seen in all solutions, as was a mild/moderate subtype. An atypical class emerged once bidirectional neurovegetative symptoms were included. The non-suicidal class demonstrated low levels of worthlessness/guilt and hopelessness. Patterns of co-morbidity, family history, personality, environmental precipitants, recurrence and body mass index (BMI) differed meaningfully across subtypes, with the atypical class standing out as particularly distinct.

CONCLUSIONS

MD is a clinically complex syndrome with several detectable subtypes with distinct clinical and demographic correlates. Three subtypes were most consistently identified in our analyses: severe, atypical and non-suicidal. Severe and atypical MD have been identified in multiple prior studies in samples of European ethnicity. Our non-suicidal subtype, with low levels of guilt and hopelessness, may represent a pathoplastic variant reflecting Chinese cultural influences.

The prevalence of schizophrenia in mainland China: evidence from epidemiological surveys

OBJECTIVE

Schizophrenia is a severe mental disorder. Its prevalence appears inconsistent in different regions of China; thus, we conducted this meta-analysis to estimate the prevalence of schizophrenia in mainland China.

METHOD

Studies on the prevalence of schizophrenia in mainland China were identified from electronic databases up to July 2013. Meta-analysis was used for prevalence of schizophrenia estimate.

RESULTS

For lifetime prevalence of schizophrenia, prevalence of 5.44 per 1000 (overall), 5.33 per 1000 (males), 5.51 per 1000 (females), 6.60 per 1000 (urban) and 4.73 per 1000 (rural) were estimated; there was no significant difference between males and females, while prevalence for urban dwellers was higher than for rural (OR=1.44, 95%CI: 1.30-1.59). For point prevalence of schizophrenia, prevalence of 4.62 per 1000 (overall), 4.63 per 1000 (males), 4.95 per 1000 (females), 5.15 per 1000 (urban) and 4.44 per 1000 (rural) were estimated; no statistical difference was found in males and females, but prevalence for urban dwellers was higher than for rural (OR=1.20; 95%CI: 1.02-1.41).

CONCLUSION

The prevalence estimate results were consistent with the international prevalence estimate of schizophrenia in mainland China. There was no significant difference between males and females, while prevalence for urban dwellers was higher than for rural.