Annual Increase In Prevalence Research Articles

Type 2 diabetes mellitus and cardiometabolic outcomes in metabolic dysfunction-associated steatotic liver disease population

The metabolic syndrome, characterized by type 2 diabetes mellitus (T2DM), hypertension, hyperlipidemia, and obesity, collectively increases the risk of cardiovascular diseases. Nonalcoholic fatty liver disease (NAFLD) is a prominent manifestation, affecting over a third of the global population with a concerning annual increase in prevalence. Nearly 70 % of overweight individuals have NAFLD, and NAFLD-related deaths are predicted to rise, especially among young adults. The association of T2DM and NAFLD has led to the proposal of “metabolic dysfunction-associated steatotic liver disease” (MASLD) terminology, encompassing individuals with T2DM, overweight/obesity, hypertension, hypertriglyceridemia, or low HDL-cholesterol. Patients with MASLD will likely have double the risk of developing T2DM, and the combination of insulin resistance, overweight/obesity, and MASLD significantly elevates the risk of T2DM. Cardiovascular diseases remain the leading cause of mortality in the MASLD and T2DM population, with MASLD directly associated with coronary artery disease, compounded by coexisting insulin resistance and T2DM. Urgency lies in early detection of subclinical cardiovascular diseases among patients with T2DM and MASLD. Novel strategies targeting multiple pathways offer hope for effectively improving cardiometabolic health. Understanding and addressing the intertwined factors contributing to these disorders can pave the way towards better management and prevention of cardiometabolic complications.

Revising the global biogeography of annual and perennial plants

There are two main life cycles in plants—annual and perennial1,2. These life cycles are associated with different traits that determine ecosystem function3,4. Although life cycles are textbook examples of plant adaptation to different environments, we lack comprehensive knowledge regarding their global distributional patterns. Here we assembled an extensive database of plant life cycle assignments of 235,000 plant species coupled with millions of georeferenced datapoints to map the worldwide biogeography of these plant species. We found that annual plants are half as common as initially thought5–8, accounting for only 6% of plant species. Our analyses indicate that annuals are favoured in hot and dry regions. However, a more accurate model shows that the prevalence of annual species is driven by temperature and precipitation in the driest quarter (rather than yearly means), explaining, for example, why some Mediterranean systems have more annuals than desert systems. Furthermore, this pattern remains consistent among different families, indicating convergent evolution. Finally, we demonstrate that increasing climate variability and anthropogenic disturbance increase annual favourability. Considering future climate change, we predict an increase in annual prevalence for 69% of the world’s ecoregions by 2060. Overall, our analyses raise concerns for ecosystem services provided by perennial plants, as ongoing changes are leading to a higher proportion of annual plants globally.

Risk of major congenital malformations associated with first-trimester antihypertensives, including amlodipine and methyldopa: A large claims database study 2010-2019.

To evaluate the major congenital malformation (MCM) risk of first-trimester antihypertensive exposure, specifically of amlodipine and methyldopa. A large administrative claims database was used. The prevalence of antihypertensive prescriptions during pregnancy was described in 91,390 women giving birth between 2010 and 2019. The MCM risk of first-trimester antihypertensives was evaluated in 1,185 women diagnosed with hypertensive disorders in the first trimester. The MCM risk of first-trimester amlodipine and methyldopa was evaluated in 178 women who were prescribed antihypertensives in the first trimester. Antihypertensives were prescribed to 278 (0.30%) women during their first trimester. The prescription prevalence in the first trimester was highest for methyldopa (115, 0.13%), followed by amlodipine (55, 0.06%). Antihypertensives were prescribed to 2,955 (3.23%) women during pregnancy. Nifedipine (903, 0.99%) and nicardipine (758, 0.83%) were the most frequently prescribed oral and injectable antihypertensives during pregnancy, both with a significant increase in annual prevalence. Of the 1,185 women diagnosed with hypertensive disorders in the first trimester, antihypertensives were prescribed to 178 women. The adjusted odds ratio (aOR) of MCMs in the first-trimester prescription of any antihypertensive medication was 1.124 (95% confidence interval [CI], 0.618-2.045). Amlodipine and methyldopa were prescribed to 44 and 93 of the 178 women, respectively. The aORs of MCMs in the first-trimester prescription of amlodipine and methyldopa were 1.219 (95% CI, 0.400-3.721) and 0.921 (0.331-2.564), respectively. The MCM risk of first-trimester exposure to antihypertensives, including amlodipine and methyldopa, was not suggested.

PS-P07-1: TERATOGENIC RISK OF FIRST TRIMESTER EXPOSURE TO ANTIHYPERTENSIVES, INCLUDING AMLODIPINE AND METHYLDOPA: AN ANALYSIS OF AN ADMINISTRATIVE DATABASE 2010–2019

Objective: No firm conclusions on the teratogenic risk of antihypertensives have been drawn, although methyldopa and amlodipine are relatively frequently prescribed in the first trimester (FT) in Japan [1]. The primary objective was to evaluate the teratogenic risk of FT exposure to antihypertensives, including amlodipine and methyldopa. Design and method: This study used a large claims database from JMDC Inc. The dates of pregnancy onset and delivery were estimated using published algorithms [2] and infant birth months. The prevalence of antihypertensive prescriptions during pregnancy was described in 91,390 women who gave birth between 2010 and 2019. The time trends of antihypertensive prescription were evaluated using a multivariate logistic regression model adjusted for maternal age. The teratogenic risk of FT antihypertensive exposure was evaluated in 1,185 women diagnosed with hypertensive disorders in the FT. The teratogenic risk of FT exposure to amlodipine and methyldopa was evaluated in 178 women who were prescribed antihypertensives in the FT. Logistic regression analysis was used to estimate the odds ratios (ORs) for overall major congenital malformations (MCMs). The results were presented for analyses adjusted for multiple confounding factors. The MCMs in claims were validated and the overall positive predictive value was 91.5% [3]. Results: Antihypertensives were prescribed to 278 (0.30%) women during their FT. The prescription prevalence in the FT was highest for methyldopa (0.13%), followed by amlodipine (0.06%), oral hydralazine (0.03%), and nifedipine (0.02%). Antihypertensives were prescribed to 2,955 (3.23%) pregnant women. Nifedipine (0.99%) was the most frequently prescribed oral antihypertensive medication, with a significant increase in annual prevalence (P < 0.0001), followed by methyldopa (0.78%), hydralazine (0.34%), and furosemide (0.14%) during pregnancy. Nicardipine (0.83%) was the most frequently prescribed injectable antihypertensive agent, with a significant increase in annual prevalence (P < 0.0001), followed by furosemide (0.42%), nitroglycerin (0.26%), and hydralazine (0.20%) during pregnancy. The adjusted OR (aOR) of MCMs in the FT prescription of any antihypertensive medication was 1.096 (95% confidence interval [CI], 0.612–1.964). The aORs of MCMs in the FT prescription of amlodipine and methyldopa were 1.161 (95% CI, 0.347–3.882) and 0.937 (0.313–2.809), respectively. Conclusions: FT exposure to antihypertensive drugs, including amlodipine and methyldopa, was not associated with MCM risk in infants. REFERENCE 1. Pharmacoepidemiol Drug Saf 2018; 27:1325–1334.2. Pharmacoepidemiol Drug Saf 2018; 27:751–762.3. Pharmacoepidemiol Drug Saf 2021; 30:975–978.

Assessment of Geographical Distribution of Emerging Zoonotic Toxoplasma gondii Infection in Women Patients Using Geographical Information System (GIS) in Various Regions of Khyber Pakhtunkhwa (KP) Province, Pakistan.

Toxoplasmosis is a zoonotic parasitic disease caused by T. gondii, an obligate intracellular apcomplexan zoonotic parasite that is geographically worldwide in distribution. The parasite infects humans and all warm-blooded animals and is highly prevalent in various geographical regions of the world, including Pakistan. The current study addressee prevalence of Toxoplasma infection in women in various geographical regions, mapping of endemic division and t district of Khyber Pakhtunkhwa province through geographical information system (GIS) in order to locate endemic regions, monitor seasonal and annual increase in prevalence of infection in women patients. Setting: Tertiary hospitals and basic health care centers located in 7 divisions and 24 districts of Khyber Pakhtunkhwa (KP) province of Pakistan. During the current study, 3586 women patients from 7 divisions and 24 districts were clinically examined and screened for prevalence of T. gondii infection. Participants were screened for Toxoplasma infection using ICT and latex agglutination test (LAT) as initial screening assay, while iELISA (IgM, IgG) was used as confirmatory assay. Mapping of the studied region was developed by using ArcGIS 10.5. Spatial analyst tools were applied by using Kriging/Co-kriging techniques, followed by IDW (Inverse Distance Weight) techniques. Overall prevalence of T. gondii infection was found in 881 (24.56%) patients. A significant (<0.05) variation was found in prevalence of infection in different divisions and districts of the province. Prevalence of infection was significantly (<0.05) high 129 (30.07%) in Kohat Division, followed by 177 (29.06%), 80 (27.87%), 287 (26.72%), 81 (21.21%), 47 (21.07%), and 80 (13.71%) cases in Hazara Division, D.I Khan Division, Malakand Division, Mardan Division, Bannu Division, and Peshawar Division. Among various districts, a significant variation (<0.05) was found in prevalence of infection. Prevalence of infection was significantly (<0.05) high 49 (44.95%) in district Karak, while low (16 (10.81%) in district Nowshera. No significant (>0.05) seasonal and annual variation was found in prevalence of Toxoplasma infection. LAT, ICT and ELISA assays were evaluated for prevalence of infection, which significantly (<0.05) detected T. gondii antibodies. LAT, ICT and ELISA assays significantly (<0.05) detected infection, while no significant (>0.05) difference was found between positivity of LAT and ICT assays. A significant difference (<0.05) was found in positivity of Toxoplasma-specific (IgM), (IgG) and (IgM, IgG) immunoglobulin by ICT and ELISA assay. The current study provides comprehensive information about geographical distribution, seasonal and annual variation of Toxoplasmosis infection in various regions of Khyber Pakhtunkhwa province of Pakistan. Infection of T. gondii in women shows an alarming situation of disease transmission from infected animals in the studied region, which is not only a serious and potential threat for adverse pregnancy outcomes, but also cause socioeconomic burden and challenges for various public and animal health organizations in Pakistan and across the country.

Pregnancy-Associated Diabetes Mellitus and Stillbirths by Race and Ethnicity among Hospitalized Pregnant Women in the United States.

Racial disparities in preexisting diabetes mellitus (PDM) and gestational diabetes mellitus (GDM) remain largely unexplored. We examined national PDM and GDM prevalence trends by race/ethnicity and the association between these conditions and fetal death. This was a retrospective cross-sectional analysis of 69,539,875 pregnancy-related hospitalizations from 2002 to 2017 including 674,040 women with PDM (1.0%) and 2,960,797 (4.3%) with GDM from the US Nationwide Inpatient Sample Survey. Joinpoint regression was used to evaluate trends in prevalence. Survey logistic regression was used to evaluate the association between exposures (PDM and GDM) and outcome. Overall, the average annual increase in prevalence was 5.2% (95% confidence interval [CI] 4.2-6.2) for GDM and 1.0% (95% CI -0.1 to 2.0) for PDM, during the study period. Hispanic (average annual percentage change 5.3, 95% CI 3.6 - 7.1) and non-Hispanic Black (average annual percentage change 0.9, 95% CI 0.1 - 1.7) women had the highest average annual percentage increase in the prevalence of GDM and PDM, respectively. After adjustment, the odds of stillbirth were highest for Hispanic women with PDM (odds ratio 2.41, 95% CI 2.23-2.60) and decreased for women with GDM (odds ratio 0.51, 95% CI 0.50-0.53), irrespective of race/ethnicity. PDM and GDM prevalence is increasing in the United States, with the highest average annual percentage changes seen among minority women. Furthermore, the reasons for the variation in the occurrence of stillbirths among mothers with PDM and GDM by race/ethnicity are not clear and warrant additional research.

Intestinal lipase inhibitors in the treatment of metabolic syndrome in children

Obesity and overweight among children and adolescents are accepted worldwide as a chronic multifactorial disorder, with a significant increase in annual prevalence. Abdominal obesity in association with other metabolic risk factors such as hypertension, high cholesterol and triglycerides, as well as low HDL cholesterol are grouped into a syndrome defined as„Reaven syndrome” or „metabolic syndrome”. MetS is often associated with cardiovascular and diabetic risk in children and also with liver damage. Current strategies addressed for the treatment of obesity and metabolic syndrome in children include adequate nutrition, combating sedentary lifestyle, drug therapy, which are used alone, or in combination. These measures are taken to reduce overweight, dyslipidemia, high blood pressure and insulin resistance in children and adolescents.

99Increasing prevalence of primary biliary cholangitis in Victoria, Australia

Abstract Background The prevalence of primary biliary cholangitis (PBC) reported in different countries varies significantly and in some parts of the world appears to be increasing. The aim of this study was to determine the 2013 prevalence of PBC in Victoria, Australia, and to determine the time trend by comparing it with previous studies undertaken in 1991 and 2002. Methods Four case-finding methods were used to identify cases of PBC in Victoria: (1) physicians’ survey; (2) tertiary hospital search; (3) liver transplant database search; and (4) private pathology antimitochondrial antibody search. Results The prevalence of PBC in Victoria, Australia, is 189.0 per million using all four methods. The average annual increase in prevalence from 1991 to 2013 was 7.7 per million per year. Using the same case-finding methods as the 1991 Victorian prevalence study (methods 1 and 2), the prevalence of PBC increased from 19.1 per million in 1991 to 49.4 per million in 2002 (P &amp;lt; 0.001) and to 80.7 per million in 2013 (P &amp;lt; 0.001). Conclusions The current prevalence of PBC in Victoria is significantly higher than previously reported. The use of private pathology-based case-finding methods is important in identifying the maximum number of PBC cases. Key messages PBC prevalence in Victoria increased significantly since previous surveys, to 189 per million persons. Including pathology-based case ascertainment yields improved identification of cases.

Increase in Prevalence of Diabetic Ketoacidosis at Diagnosis Among Youth With Type 1 Diabetes: The SEARCH for Diabetes in Youth Study.

OBJECTIVEWe previously reported a high (˜30%) but stable prevalence of diabetic ketoacidosis (DKA) at youth-onset diagnosis of type 1 diabetes (2002 and 2010). Given the changing demographics of youth-onset type 1 diabetes, we sought to evaluate temporal trends in the prevalence of DKA at diagnosis of type 1 diabetes from 2010 to 2016 among youth <20 years of age and evaluate whether any change observed was associated with changes in sociodemographic distribution of those recently diagnosed.RESEARCH DESIGN AND METHODSWe calculated prevalence of DKA within 1 month of type 1 diabetes diagnosis by year and evaluated trends over time (2010–2016) (n = 7,612 incident diabetes cases; mean [SD] age 10.1 [4.5] at diagnosis). To assess whether trends observed were attributable to the changing distribution of sociodemographic factors among youth with incident type 1 diabetes, we estimated an adjusted relative risk (RR) of DKA in relation to calendar year, adjusting for age, sex, race/ethnicity, income, education, health insurance status, language, season of diagnosis, and SEARCH for Diabetes in Youth Study site.RESULTSDKA prevalence increased from 35.3% (95% CI 32.2, 38.4) in 2010 to 40.6% (95% CI 37.8, 43.4) in 2016 (Ptrend = 0.01). Adjustment for sociodemographic factors did not substantively change the observed trends. We observed a 2% annual increase in prevalence of DKA at or near diagnosis of type 1 diabetes (crude RR 1.02 [95% CI 1.01, 1.04] and adjusted RR 1.02 [95% CI 1.01, 1.04]; P = 0.01 for both).CONCLUSIONSPrevalence of DKA at or near type 1 diabetes diagnosis has increased from 2010 to 2016, following the high but stable prevalence observed from 2002 to 2010. This increase does not seem to be attributable to the changes in distribution of sociodemographic factors over time.

Forecasting of the Prevalence of Dementia Using the LSTM Neural Network in Taiwan

The World Health Organization has urged countries to prioritize dementia in their public health policies. Dementia poses a tremendous socioeconomic burden, and the accurate prediction of the annual increase in prevalence is essential for establishing strategies to cope with its effects. The present study established a model based on the architecture of the long short-term memory (LSTM) neural network for predicting the number of dementia cases in Taiwan, which considers the effects of age and sex on the prevalence of dementia. The LSTM network is a variant of recurrent neural networks (RNNs), which possesses a special gate structure and avoids the problems in RNNs of gradient explosion, gradient vanishing, and long-term memory failure. A number of patients diagnosed as having dementia from 1997 to 2017 was collected in annual units from a data set extracted from the Health Insurance Database of the Ministry of Health and Welfare in Taiwan. To further verify the validity of the proposed model, the LSTM network was compared with three types of models: statistical models (exponential smoothing (ETS), autoregressive integrated moving average model (ARIMA), trigonometric seasonality, Box–Cox transformation, autoregressive moving average errors, and trend seasonal components model (TBATS)), hybrid models (support vector regression (SVR), particle swarm optimization–based support vector regression (PSOSVR)), and deep learning model (artificial neural networks (ANN)). The mean absolute percentage error (MAPE), root-mean-square error (RMSE), mean absolute error (MAE), and R-squared (R2) were used to evaluate the model performances. The results indicated that the LSTM network has higher prediction accuracy than the three types of models for forecasting the prevalence of dementia in Taiwan.

Increasing prevalence of cerebral palsy among children and adolescents in China 1988-2020: A systematic review and meta-analysis.

ObjectivesTo investigate the pooled prevalence of cerebral palsy in China, analyse the differences between different subgroups, and explore the trend over the 32-year period from 1988 to 2020.MethodsAll potential studies related to the prevalence of cerebral palsy among children and adolescents in China were identified from 3 English-language databases and 4 Chinese-language databases. Pooled prevalence was calculated to estimate the prevalence of cerebral palsy among 0-18 years old and different geographical regions in China, using a random-effects meta-analysis model. Continuous fractional polynomial regression modelling was used to estimate the trend in prevalence of cerebral palsy over time. Subgroup analysis and meta-regression were conducted to investigate heterogeneity. Funnel plots and Egger’s test were used to explore potential publication bias.ResultsThe pooled prevalence of cerebral palsy over the study period among 0–18 years old and different geographical regions in China was 2.07‰ (95% confidence interval (95% CI) 1.66–2.47‰), and the prevalence of cerebral palsy was higher in males compared with females (2.25‰ vs 1.59‰), and in rural residents compared with urban residents (2.75‰ vs 1.90‰), respectively. The prevalence of cerebral palsy varied significantly between different geographical regions. In subjects with birthweights < 2.5 and > 4 kg, the prevalence of cerebral palsy was significantly higher than in subjects with birthweights between 2.5 and 4 kg. The trend in pooled prevalence of cerebral palsy increased continuously over the period studied, and could be divided into 3 stages; the mean annual increase in prevalence from 1988 to 1996 and from 2008 to 2019 was more rapid. Multivariate meta-regression found that the year of study was one of the sources of heterogeneity among overall prevalence. (p-value = 0.006).ConclusionThe pooled prevalence of cerebral palsy over the 32-year period from 1988 to 2020 was 2.07‰. There was an increasing trend in prevalence of cerebral palsy among children and adolescents in China over this period.LAY ABSTRACTThere are few reports regarding trends in childhood cerebral palsy in China over the past 30 years. This study searched and statistically analysed all potentially relevant studies regarding cerebral palsy. The trend in childhood cerebral palsy in China increased continuously over the period studied, and could be subdivided into 3 stages. From 1988 to 1996, and from 2008 to 2019, the mean annual increase in prevalence was more rapid than for the other years studied. Counter-measures, such as health monitoring and management of infants and young children, are recommended to reduce the prevalence of childhood cerebral palsy in China.

Increasing prevalence of primary biliary cholangitis in Victoria, Australia.

The prevalence of primary biliary cholangitis (PBC) reported in different countries varies significantly and in some parts of the world appears to be increasing. The aim of this study was to determine the 2013 prevalence of PBC in Victoria, Australia, and to determine the time trend by comparing it with previous studies undertaken in 1991 and 2002. Four case-finding methods were used to identify cases of PBC in Victoria: (1) physicians' survey; (2) tertiary hospital search; (3) liver transplant database search; and (4) private pathology antimitochondrial antibody search. The prevalence of PBC in Victoria, Australia, is 189.0 per million using all four methods. The average annual increase in prevalence from 1991 to 2013 was 7.7 per million per year. Using the same case-finding methods as the 1991 Victorian prevalence study (methods 1 and 2), the prevalence of PBC increased from 19.1 per million in 1991 to 49.4 per million in 2002 (P<0.001) and to 80.7 per million in 2013 (P<0.001). The current prevalence of PBC in Victoria is significantly higher than previously reported. The use of private pathology-based case-finding methods is important in identifying the maximum number of PBC cases.

Prevalence of Type 2 Diabetes Among Asymptomatic Adults of Lahore Pakistan

Research from all over the world has shown a marked annual increase in prevalence of type 2 diabetes. Early screening of type 2 diabetes among asymptomatic adults especially in those who are obese or have as a familial trait could lessen the risk of developing microvascular complications like cardiovascular diseases, nephropathy, retinopathy and neuropathy. To find the prevalence of type 2 diabetes among asymptomatic adults. Two centers of Pakistan Health Research Council namely National Health Research Complex and Fatima Jinnah took part in conducting this 15 months long survey. After the ethical clearance voluntary study, participants fulfilling inclusion criteria were enrolled (2500 participants with age ≥ 35 years) from the nine towns and Defense Housing Authority of Lahore. There socio-demographic and clinical characteristics were noted by using a well-structured proforma. Each participant was tested for their HbA1C level using auto-analyzing system. Data were analyzed using SPSS version 20. Glycated hemoglobin (HbA1C) level greater than 7.0% was reported in 33.7% of participants interpreting type 2 diabetes in them. Family history of diabetes was seen in 31.9% participants. There were 32.5 and 6.5% hypertensive and cardiovascular disease participants. Obesity was present in 28.4% participants with a higher rate in those having type 2 diabetes. Thirty-four percent of adult population in Lahore is potentially type 2 diabetic. Early identification can save many lives from developing type 2 diabetes and its complications.

Trends in Prescribed Central Nervous System Depressant Medications Among Adults Who Regularly Consume Alcohol: United States 1999 to 2014.

Although the risks of using central nervous system depressant (CNS-D) medications with alcohol are well documented, little is known about trends in prescribed use of these medications among individuals who regularly consume alcohol (i.e., trends in "concurrent use"). We examined changes in the prevalence of prescribed CNS-D medications among individuals who drank alcohol on 52 or more occasions in the past year ("regular drinking"). CNS-D medications included sedative-hypnotics (subclassified as anxiolytics or sleep medications) and opioids. We used 8 cross-sectional cycles of the National Health and Nutrition Examination Survey (1999-2000 to 2013-2014) from participants aged 20 and older (n=37,709). We used log-binomial regression to examine (i) prevalence trends of prescribed CNS-D medication use, (ii) trend differences by drinking status, and (iii) correlates of CNS-D medication use. Among those who drink regularly, the relative annual increase in prevalence of sedative-hypnotic use was 5.3% (95% CI: 2.7 to 7.9): Anxiolytic and sleep medication use increased annually by 3.7% (95% CI: 0.8 to 6.7) and 11.2% (95% CI: 6.5 to 16.0), respectively. Opioid use trends among those who drink regularly were not statistically significant but were nonlinear. Differences in CNS-D medication trends between those who drink regularly and those who drink infrequently/abstain were not statistically significant. Those who drink regularly were less likely than those who drink infrequently/abstain to use opioids (adjusted relative risk [ARR]: 0.69, 95% CI: 0.60 to 0.78) and anxiolytics (ARR: 0.71, 95% CI: 0.61 to 0.81), but not sleep medications (ARR: 1.04, 95% CI: 0.80 to 1.35). Those aged 40 and older were 2 to 5 times as likely as those aged 20 to 29 to use sedative-hypnotics. Among those who drink regularly, the prevalence of prescribed sedative-hypnotic use increased and prescribed opioid use remained common. These trends indicate that a substantial portion of the population is at risk of alcohol-related adverse drug reactions-particularly those aged 40 and older.

Pharmaco-epidemiology of antidepressant exposure in a UK cohort record-linkage study.

Antidepressants are the most commonly prescribed psychiatric medication but concern has been raised about significant increases in their usage in high income countries. We aimed to quantify antidepressant prevalence, incidence, adherence and predictors of use in the adult population. The study record-linked administrative prescribing and morbidity data to the Generation Scotland cohort ( N = 11,052), between 2009 and 2016. Prevalence and incidence of any antidepressant use was determined. Antidepressant adherence was measured using Proportion of Days Covered and Medication Possession Ratio. Time-to-event analysis for incident antidepressant use within 5 years of Generation Scotland: Scottish Family Health Study (GS:SFHS) recruitment was performed to reveal patient-level predictors of use. Almost one-third (28.0%, 95%CI 26.9-29.1) of the adults in our sample were prescribed at least one antidepressant in the 5-year period 2012-2016. There was a 36.2% increase in annual prevalence between 2010 and 2016. Incidence was 2.4(2.1-2.7)% per year. The majority of antidepressant episodes (57.6%) were greater than 9 months duration and adherence was generally high (69.0% with Proportion of Days Covered >80%). Predictors of new antidepressant use included history of affective disorder, being female, physical comorbidities, higher neuroticism scores, and lower cognitive function scores. Antidepressant prevalence is greater than previously reported but incidence remains relatively stable. We found the majority of antidepressant episodes to be of relatively long duration with good estimated adherence. Our study supports the hypothesis that increased long-term use among existing (and returning) users, along with wider ranges of indications for antidepressants, has significantly increased the prevalence of these medications.

Discharge Against Medical Advice in the United States, 2002-2011

ObjectiveTo describe the national frequency, prevalence, and trends of discharge against medical advice (DAMA) among inpatient hospitalizations in the United States and identify differences across patient- and hospital-level characteristics, overall and in clinically distinct diagnostic subgroups. Patients and MethodsWe conducted a retrospective, cross-sectional analysis of inpatient hospitalizations (≥18 years), discharged between January 1, 2002, and December 31, 2011, using the Nationwide Inpatient Sample. Descriptive statistics, multivariable logistic, and joinpoint regression were used for statistical analyses. ResultsBetween January 1, 2002, and December 31, 2011, more than 338,000 inpatient hospitalizations were discharged against medical advice each year, with a 1.9% average annual increase in prevalence over the decade (95% CI, 0.8%-3.0%). Temporal trends in DAMA varied by principal diagnosis. Among patients hospitalized for mental health- or substance abuse-related disorders, there was a −2.3% (95% CI, −3.8% to −0.8%) average annual decrease in the rate of DAMA. A statistically significant temporal rate change was not observed among hospitalizations for pregnancy-related disorders. Multivariable regression revealed several patient and hospital characteristics as predictors of DAMA, including lack of health insurance (odds ratio [OR], 3.78; 95% CI, 3.62-3.94), male sex (OR, 2.40; 95% CI, 2.36-2.45), and northeast region (OR, 1.91; 95% CI, 1.72-2.11). Other predictors included age, race/ethnicity, income, primary diagnosis, severity of illness, and hospital location/type and size. ConclusionRates for DAMA have increased in the United States, and key differences exist across patient and hospital characteristics. Early identification of vulnerable patients and preventive measures such as improved patient-provider communication may reduce DAMA.

Modeled Impacts of Chronic Wasting Disease on White-Tailed Deer in a Semi-Arid Environment.

White-tailed deer are a culturally and economically important game species in North America, especially in South Texas. The recent discovery of chronic wasting disease (CWD) in captive deer facilities in Texas has increased concern about the potential emergence of CWD in free-ranging deer. The concern is exacerbated because much of the South Texas region is a semi-arid environment with variable rainfall, where precipitation is strongly correlated with fawn recruitment. Further, the marginally productive rangelands, in combination with erratic fawn recruitment, results in populations that are frequently density-independent, and thus sensitive to additive mortality. It is unknown how a deer population in semi-arid regions would respond to the presence of CWD. We used long-term empirical datasets from a lightly harvested (2% annual harvest) population in conjunction with 3 prevalence growth rates from CWD afflicted areas (0.26%, 0.83%, and 2.3% increases per year) via a multi-stage partially deterministic model to simulate a deer population for 25 years under four scenarios: 1) without CWD and without harvest, 2) with CWD and without harvest, 3) with CWD and male harvest only, and 4) with CWD and harvest of both sexes. The modeled populations without CWD and without harvest averaged a 1.43% annual increase over 25 years; incorporation of 2% annual harvest of both sexes resulted in a stable population. The model with slowest CWD prevalence rate growth (0.26% annually) without harvest resulted in stable populations but the addition of 1% harvest resulted in population declines. Further, the male age structure in CWD models became skewed to younger age classes. We incorporated fawn:doe ratios from three CWD afflicted areas in Wisconsin and Wyoming into the model with 0.26% annual increase in prevalence and populations did not begin to decline until ~10%, ~16%, and ~26% of deer were harvested annually. Deer populations in variable environments rely on high adult survivorship to buffer the low and erratic fawn recruitment rates. The increase in additive mortality rates for adults via CWD negatively impacted simulated population trends to the extent that hunter opportunity would be greatly reduced. Our results improve understanding of the potential influences of CWD on deer populations in semi-arid environments with implications for deer managers, disease ecologists, and policy makers.

Time-trend analysis of prevalence, incidence and traditional Chinese medicine use among children with asthma: a population-based study.

This study determined annual prevalence and incidence trends of asthma among children in Taiwan from 2002 to 2008. Risk factors and traditional Chinese medicine (TCM) use were examined. A random sample was selected for a population-based study with a selection probability of 0.5 from all 3-18 years insurants. The annual prevalence and incidence of asthma were estimated according to age, sex, insurance premium and degree of urbanization. The prevalence of asthma increased from 12.99% in 2002 to 16.86% in 2008. The increase was greatest in 2008, among boys, 11-15 years, ≥medium insurance premium, and high- and medium-density urban area. TCM use in asthma-prevalent children decreased from 1.16% in 2002 to 0.59% in 2008. The incidence fluctuated, ranging from 1.01% in 2002 to 1.49% in 2005. The highest was in 2005, among boys, 3-5 years, ≥medium insurance premium and high-density urban area. TCM use in asthma-incident children decreased from 3.59% in 2002 to 1.69% in 2008. This study demonstrated a substantial increase in annual prevalence of asthma among children in Taiwan from 2002 to 2008. The incidence fluctuated. The TCM use showed a decreasing linear trend and was higher in incident than in prevalent cases.

Rapid increase of the parasitic fungus Laboulbenia formicarum in supercolonies of the invasive garden ant Lasius neglectus

A key feature among invasive ant species is their ability to dominate vast areas by forming dense networks of connected nests in contrast to the smaller and discrete, spatially dispersed colonies of most social insects. However, it was recently proposed that such supercolonies are more vulnerable to infection by parasites and diseases as they would serve as large targets with high rates of transmission from nests to nest. We studied the invasive garden ant Lasius neglectus, a pest species currently spreading throughout Europe. Several populations are infected with an ectoparasitic fungus, Laboulbenia formicarum, itself an introduced species, yielding a new host–parasite relationship. Long-term monitoring of the prevalence and intensity of infection in two populations (supercolonies) over 4–10 years revealed epizootic spread of the parasite with a 14 % annual increase in prevalence until ca. 80 % of all ants were infected. In contrast, no other local ant species with discrete colonies carried the parasite, although a local species (Lasius niger) proved susceptible in a cross-infection experiment. These results support the hypothesis that supercolonies potentially face an important challenge from parasites and diseases, with interesting perspectives for biological control of such ant species.

Current report from Russian Diabetic Retinopathy Register

A pandemic expansion of diabetes mellitus (DM) observed nowadays across the globe is increasingly acknowledged as a disaster by all peoples of the world. Statistical analysis indicates an annual increase in prevalence of DM in Russian Federation that had reached 3 779 423 registered patients by 01.01.2013. Besides the humanitarian aspects, DM poses severe economic challenges for this country ? challenges that stem both from high mortality and growing disability rate due to limb loss, decrease in visual acuity and need for hemodialysis, plaguing many DM patients. Aim. To produce an epidemiological evaluation based on the dynamics of prevalence of diabetic retinopathy in the Russian Federation ? nationwide and in individual regions ? across the last 13 years. Materials and Methods. Current survey included patients from various regions of the Russian Federation that were examined during epidemiological missions conducted by the federal Endocrinology Research Centre (2000?2009), as well as National Programmes ?Health? (2007) and ?Diabetes ? Learn In Advance? (2012?2013). Results. In the Russian Federation registered more than 630,000 patients with different stages of diabetic retinopathy. The prevalence of diabetic retinopathy among adults (18 years and older) with type 1 diabetes is 35.25%, while in type 2 diabetes - 16.67%. On average, this means that almost one in five patients (17.63%) with diabetes have certain eye problems. Conclusion. In summary, our data indicate a dramatic growth in the rate of diabetic ocular complications, with a particular increase in proliferative diabetic retinopathy, complicated cataract and neovascular glaucoma. These findings call for an even closer attention to early diagnostics, adequate management and, above everything else, timely prevention of ocular pathologies in patients with DM.