It remains an enigma whether gestational hypertension (GH) and pre-eclampsia (PE) are distinct entities or different spectrum of the same disease. We aimed to compare the risk factors and outcomes between GH and PE. A total of 7,633 pregnant women recruited between 12 and 20 weeks of gestation in the Ottawa and Kingston Birth Cohort from 2002 to 2009 were included in the analysis. Cox proportional hazards model was used to identify and compare the risk factors for GH and PE by treating gestational age at delivery as the survival time. Logistic regression model was used to compare outcome. Subgroup analysis was performed for early- and late-onset PE. GH and PE shared most risk factors including overweight and obesity, nulliparity, PE history, type 1 and 2 diabetes, and twin birth. Effect size of PE history (RR = 14.1 for GH vs. RR = 6.4 for PE) and twin birth (RR = 4.8 for GH vs. RR = 10.3 for PE) showed substantial difference. Risk factors modified gestational age at delivery in patients with GH and PE in similar pattern. Subgroup analysis showed that early- and late-onset PE shared some risk factors with different effect sizes, whereas folic acid supplementation showed protective effect for early-onset PE only. PE was strongly associated with several adverse outcomes including cesarean section, placental abruption, small for gestational age, preterm birth, and 5 min Apgar score < 7, whereas GH was associated with increased risk of preterm birth only. GH and PE shared common risk factors. Differences in effect sizes of risk factors and outcomes indicate that the conditions may have different pathophysiology and mechanism.

Objective: Atopic dermatitis (AD) is a prevalent, burdensome, and psychologically important pediatric concern. It has been reported that the intervention of interest is the use of probiotics for treatment of AD in children. Some reports have assessed the efficacy of probiotics in AD in children; however, evidence for their use has yet to be firmly established. Methods: To assess the effects of probiotics on AD in children, the PubMed/Medline, Cochrane Library Scopus, and OVID databases were searched for reports published in the English language. Results: Thirteen studies were identified. Significantly higher SCORAD values favoring probiotics over controls were observed (mean difference [MD], –3.07; 95% confidence interval [CI], –6.12 to –0.03; P < 0.001). The reported efficacy of probiotics in children < 1 year old was –1.03 (95%CI, –7.05 to 4.99) and that in children 1–18 years old was –4.50 (95%CI, –7.45 to –1.54; P < 0.001). Subgroup assessment showed in Europe, no effect of probiotics on SCORAD, whereas significantly lower SCORAD values were reported for Asia (MD, –5.39; 95%CI, –8.91 to –1.87). Lactobacillus rhamnosus GG (MD, 3.29; 95%CI, –0.30 to 6.88; P = 0.07) and Lactobacillus plantarum (MD, –0.70; 95%CI, –2.30 to 0.90; P = 0.39) showed no significant effect on SCORAD values in children with AD. However, Lactobacillus fermentum (MD, –11.42; 95%CI, –13.81 to –9.04), Lactobacillus salivarius (MD, –7.21; 95%CI, –9.63 to –4.78), and a mixture of different strains (MD, –3.52; 95%CI, –5.61 to –1.44) showed significant effects on SCORAD values in children with AD. Conclusions: Finding from this meta-analysis might not draw a robust conclusion that probiotics have beneficial effects on treating children with AD. Moreover, caution is needed when generalizing our results due to heterogeneity in the populations studied. More adequately powered randomized controlled trials involving larger samples are necessary to determine which species of probiotics and dosages and what periods of treatment are most efficacious against AD in children.

The overall suicide rate in China has dropped substantially since the 1990s, with patterns changing significantly. This study aims to further explore the latest changes in suicide rates in China. Data on gender-age-specific suicide rates for rural and urban residents aged 15 years and above were retrieved from official records. Joinpoint regression analyses were applied to analyze time trends of suicide rates. Overall, suicide rates in China dropped significantly from 2002 to 2015. However, the national suicide rates have decreased at a slower pace since 2006. Joinpoints on time trends of suicide rates were also observed among rural males, rural females and urban males in 2005, 2006 and 2008, respectively. Declines in suicide rates of a majority of groups aged 25-54 slowed around 2007, and even reversed among males aged 25-34 in both areas and rural males aged 45-54. Male suicide rates were increasingly higher than females' after 2006. Rural suicide rates were about twice those of urban groups in recent years. Data on suicide is based on a large-sampled surveillance system, which may suffer from some quality flaws. Improvements in the quality of suicide rate data may lead to bias. Information on other potential differences in suicide rates over time is not available. Although the suicide rate in China dropped significantly from 2002-2015, a slowdown in the decrease and even a reversing trend was observed in some certain groups, which highlights the urgent need for targeted suicide prevention programs.