Insufficient Sleep and Health Care Utilization: A Scoping Review

Insufficient sleep is a common problem among older adults with 26% over the age of 65 reporting less than seven hours sleep in a 24 hour time period. Evidence indicates that untreated sleep disorders are associated with osteoarthritis, heart disease, hypertension, diabetes, obesity, falls, decreased cognitive performance, and decreased health related quality of life in older adults. A scoping review was undertaken to determine what is known about the association between insufficient sleep or insomnia and health care utilization. The Joanna Briggs Institute, Methodology for JBI Scoping Reviews was used to guide the review. Searches were conducted in PubMed, HINARI, Google Scholar and Cochrane databases. Twenty nine studies were included. Overall, the review indicates that reduced sleep is associated with a greater odds of difficulties in daily activities, higher rates of health care utilization and costs, and poly pharmacy. Findings also reveal sociodemographic and geographic variations in prevalence of healthy sleep duration. Although the majority of studies focused on the causes and consequences of insomnia and recommended clinical and behavioral health promotion interventions, there is a gap in studies related to the public health or economic impact of insufficient sleep. Research in this area will provide perspectives on the need to raise awareness of the importance of sleep and to incorporate the awareness into policies that improve sleep health.

Changes in paleo-underground water levels revealed by water wells and their relationship with climate variations in imperial China

Based on the records of the bottom elevations of 482 ancient water wells collected from published archaeological reports, we reconstructed the paleo-underground water levels (PUWL) in the urban areas of Chengdu, Changsha, Nanjing, Suzhou, Suqian, and Yancheng cities in the vicinity of 30° N in China. The PUWL fluctuations varied between the inland and the coastal regions and their transitional areas. There were four PUWL phases in the inland areas: low in Han (206 B.C.–A.D. 220), high in Tang (A.D. 618–907), low in Song (A.D. 960–1279), and high in Ming (A.D. 1368–1644). In contrast, there were five PUWL phases in the coastal regions: high in Han (206 B.C.–A.D. 220), low in Jin-Northern & Southern Dynasties (A.D. 266–589), high in Tang-Song (A.D. 618–1279), low in Ming (A.D. 1368–1644), and high in Qing-Republic of China (A.D. 1644–1949). Yet, there were no apparent changes in PUWL in the transitional areas between the inland and the coastal regions. Regional hydrological factors cause the geographic variations of the PUWL fluctuations. Precipitation changes drove the rise and fall of PUWL in the inland areas. In contrast, the variations of PUWL in the coastal regions were attributed to the temperature-induced sea-level changes. This study illustrates the potential of using PUWL in tracing paleo-environment changes and their driving factors, which is a novel approach in environmental archaeology.

Geographic Variations in the Toxin Profile of the Xanthid Crab Zosimus aeneus in a Single Reef on Ishigaki Island, Okinawa, Japan

Toxic crabs of the family Xanthidae contain saxitoxins (STXs) and/or tetrodotoxin (TTX), but the toxin ratio differs depending on their habitat. In the present study, to clarify within reef variations in the toxin profile of xanthid crabs, we collected specimens of the toxic xanthid crab Zosimus aeneus and their sampling location within a single reef (Yoshihara reef) on Ishigaki Island, Okinawa Prefecture, Japan, in 2018 and 2019. The STXs/TTX content within the appendages and viscera or stomach contents of each specimen was determined by instrumental analyses. Our findings revealed the existence of three zones in Yoshihara reef; one in which many individuals accumulate extremely high concentrations of STXs (northwestern part of the reef; NW zone), another in which individuals generally have small amounts of TTX but little STXs (central part of the reef; CTR zone), and a third in which individuals generally exhibit intermediate characteristics (southeastern part of the reef; SE zone). Furthermore, light microscopic observations of the stomach contents of crab specimens collected from the NW and CTR zones revealed that ascidian spicules of the genus Lissoclinum were dominant in the NW zone, whereas those of the genus Trididemnum were dominant in the CTR zone. Although the toxicity of these ascidians is unknown, Lissoclinum ascidians are considered good candidate source organisms of STXs harbored by toxic xanthid crabs.

Trends and Inequalities in the Incidence of Acute Myocardial Infarction among Beijing Townships, 2007–2018

Acute myocardial infarction (AMI) poses a serious disease burden in China, but studies on small-area characteristics of AMI incidence are lacking. We therefore examined temporal trends and geographic variations in AMI incidence at the township level in Beijing. In this cross-sectional analysis, 259,830 AMI events during 2007–2018 from the Beijing Cardiovascular Disease Surveillance System were included. We estimated AMI incidence for 307 consistent townships during consecutive 3-year periods with a Bayesian spatial model. From 2007 to 2018, the median AMI incidence in townships increased from 216.3 to 231.6 per 100,000, with a greater relative increase in young and middle-aged males (35–49 years: 54.2%; 50–64 years: 33.2%). The most pronounced increases in the relative inequalities was observed among young residents (2.1 to 2.8 for males and 2.8 to 3.4 for females). Townships with high rates and larger relative increases were primarily located in Beijing’s northeastern and southwestern peri-urban areas. However, large increases among young and middle-aged males were observed throughout peri-urban areas. AMI incidence and their changes over time varied substantially at the township level in Beijing, especially among young adults. Targeted mitigation strategies are required for high-risk populations and areas to reduce health disparities across Beijing.

HIV incidence among men who have sex with men in mainland China: a systematic review protocol

Background Men who have sex with men (MSM) are disproportionately affected by HIV in China. Globally, younger MSM are at higher risk for incident HIV infections, but there has been substantial variation in the estimates of age-stratified HIV incidence among MSM in mainland China, potentially due to regional differences in the nature of the epidemic. Given the need for quality epidemiological data to meet the global goal of ending new HIV infections by 2030, this systematic review and meta-analysis aims to determine age-stratified HIV incidence in mainland China, including consideration by geographic region and time. Methods This review will include longitudinal studies, cross-sectional surveys, and surveillance reports among MSM in mainland China that have reported HIV incidence. We will search studies and reports published from January 1, 2003, to April 30, 2020, in both English and Chinese language literature databases. For each study considered, two reviewers will independently screen, determine eligibility, and extract relevant data, with discrepancies resolved by consensus of a third reviewer. The methodological quality of included studies will be assessed by the Quality Assessment Tool for Systematic Reviews of Observational Studies Score (QATSO). We will develop age-stratified estimates of HIV incidence with geographic variations and temporal trends. Heterogeneity will be examined using statistical techniques appropriate to the dataset. For subgroup analyses, we will conduct mixed-effects meta-analysis models. Discussion This review will contribute to a better understanding of the HIV epidemic among MSM in mainland China by providing age-stratified estimates of HIV incidence with a portrayal of geographic and temporal variations. Findings will reflect epidemic dynamics, informing local and national intervention programs and policies for HIV prevention, and providing estimation data to inform future research among MSM in China. Systematic review registration PROSPERO ID 154834

Ecogeographical Adaptation Revisited: Morphological Variations in the Plateau Brown Frog along an Elevation Gradient on the Qinghai–Tibetan Plateau

Several anurans have broad elevational and latitudinal distribution ranges; distinct species and populations may face various environmental and selection stresses. Due to their environmental sensitivity, adaptation is critical for the long-term persistence of anurans. Previous studies have tried to identify the ecogeographical pattern and its mechanism in anurans, suggesting different patterns, but the related explanatory mechanisms are yet to be generally supported and are suggested to be complicated. To explore the elusive mechanisms, we studied the morphological variation of the plateau brown frog (Rana kukunoris) along an elevational gradient on the eastern margin of the Qinghai–Tibetan Plateau. Using body size, extremity length, and the ratio between them (extremities/body size) as testing indicators, we examined potential ecogeographical adaptations and investigated how environmental and biological factors could shape the morphological development in R. kukunoris. We found that males and females showed different variations in body size and extremities along the elevational gradient, whereas both of them showed a decreasing extremities/body size ratio along elevation. Together with the strong correlations between environmental and biological factors and the morphometrics, we identified ecogeographical adaptation and a sexual difference in the selective pressures on the extremities and body size of the plateau brown frog. Our results imply that geographic variations in anuran morphological traits should be understood as an outcome of environmental and biological factors. Furthermore, ecogeographical adaptation in anurans can manifest as an interactive change between body size and extremities.

Estimating need for alcohol treatment in Ireland using national treatment surveillance data

Background International evidence indicates that about 10% of people with alcohol dependence will seek and commence treatment each year. Based upon Irish estimates of prevalence of dependence, a target of 690.0 treated cases per 100,000 population per annum is expected. Aims This study analyses routine national surveillance data on alcohol treatment to measure how treatment need is being met. Methods National treatment surveillance data on problem alcohol use collected by the National Drug Treatment Reporting System (NDTRS) were analysed. The study included cases resident in Ireland, aged 18–64 years entering treatment for alcohol use disorder (AUD) between 2015 and 2019 (n = 44,079). Treatment rates were calculated per 100,000 of the population. Descriptive and exploratory statistics were used to describe characteristics of cases treated. Results National rate of treated AUD was 270 cases per 100,000 annually, with a rate of treated alcohol dependence of 165/100,000. There was a fivefold difference between the lowest and highest rates (119 cases per 100,000 in Meath versus 633 in Waterford). Drinking patterns indicate high levels of alcohol consumption and prolonged use prior to treatment. The use of other drugs alongside alcohol was common. Conclusions Despite high rates of alcohol consumption and dependence, the rate of treatment entry nationally is sub-optimal, although there are wide geographic variations. There is a need to better understand the reasons for low treatment entry rates in Ireland for people with alcohol dependence. Monitoring and surveillance play a key role in measuring the successful efforts to reduce the harm of alcohol.