15-year Observation Period Research Articles

National Trends and Prevalence of Atopic Dermatitis and Pandemic-Related Factors among Korean Adults, 2007–2021

Introduction: Previous studies have variably reported inconclusive trends in the prevalence of atopic dermatitis (AD) among adults, and there are limited data on the impact of the COVID-19 pandemic. We aimed to investigate the national trends and age-stratified prevalence of AD among adults from 2007 to 2021 in South Korea, focusing mainly on the impact of the COVID-19 pandemic-related factors. Methods: A nationwide cross-sectional study was conducted using the Korea National Health and Nutrition Examination Survey data from 2007 to 2021. Overall and age-stratified prevalence for AD were assessed using weighted beta coefficients or odds ratios. Results: A total of 83,566 adults over 20 years (male, 49.40%) were included. During the observation period, the prevalence of AD was stable in the overall population from 2.61% (95% CI, 2.29–2.93) in 2007–2009 to 2.15% (1.68–2.63) in 2020 and 2.38% (1.81–2.95) in 2021. However, the weighted prevalence of AD in adults aged 40–59 years old decreased during the pre-pandemic era, and the prevalence of AD in adults aged above 60 years significantly decreased during the pandemic, with a significant decline observed after the initial outbreak. From age-stratification analysis, the adults aged 40–59 years showed a significant increase after the pandemic outbreak which was evident in specific variables: individuals with rural residence, lower education, and lower household income quartiles. Adults aged above 60 years showed a significant decrease in the slope after the outbreak, evident in specific variables: individuals of female, rural residence, lower education, and lower household income quartiles. Conclusion: We observed a stable overall prevalence of AD throughout the 15-year observation period. However, the age-stratified analysis suggested significantly different trends according to age-stratified groups and the impact of the COVID-19 pandemic on the prevalence of AD.

Estimating mortality in rare diseases using a population-based registry, 2002 through 2019

BackgroundRare diseases (RD) are a heterogeneous group of diseases, sharing aspects of complexity. Prognosis is variable, even in individuals with the same disease. Real-world data on RD as a whole are scarce. The aim of this study is to provide data on mortality and survival for a substantial group of RD deriving from a population-based registry, which covers the Veneto region in Italy (4.9 million inhabitants).ResultsDuring the study period, 3367 deaths occurred, mainly in males (53.9%), elderly patients (63.5%) and patients with diseases having a reported prevalence of 1–9/100000 (65.6%). When standardizing by age, the mortality ratio was higher in RD patients than in the general population, SMR = 1.93 (95% CI 1.84–2.11), with an observed gender difference, 2.01 (95% CI 1.88–2.29) in females and 1.86 (95% CI 1.73–2.10) in males. The lowest survival rates are experienced by patients with rare neurologic diseases, rare skin diseases and rare systemic or rheumatologic diseases, 58%, 68% and 81%, respectively, after a 15-year observation period. It should be noted that only 18% of patients diagnosed with motor neuron diseases were alive after 15 years from diagnosis.ConclusionsDespite progress in diagnosis, treatment and care in recent years, RD patients globally have higher mortality rates and reduced survival compared to the general population, with specific variations according to gender, age and disease group.

Some Epidemiological Aspects of Ovarian Cancer Morbidity in the Republic of Azerbaijan over a 15-year Observation Period

Some Epidemiological Aspects of Ovarian Cancer Morbidity in the Republic of Azerbaijan over a 15-year Observation Period

The natural history of periodontal disease: The Java study-Origin, implementation, and results 35 years on.

This review describes the origin and results of the prospective longitudinal study to test potential prognostic indicators for periodontal breakdown in a population deprived of regular dental care. Experimental gingivitis studies in individuals highly susceptible or highly resistant to periodontitis showed that bleeding on probing developed quite differently: 50% versus 18% bleeding, respectively, after 18 days of no oral hygiene. This formed, together with other clinical and microbiological parameters, the basis for the 15-year prospective study in the Java tea worker population to test potential prognostic indicators for periodontal breakdown. Evaluation showed that during the 15-year observation period of this population aged 15-25 years at baseline, the number of teeth decreased and the periodontal condition deteriorated. Gingival recession showed no increase during the first 7 years of observation, whereas a sixfold increase had occurred thereafter. Attachment loss doubled during the first 7 years, but almost tripled thereafter. Risk markers for disease onset/progression during the first 7 years of observation were age, the number of sites with subgingival calculus, and the subgingival presence of Aggregatibacter actinomycetemcomitans. Over the full period of 15 years the number of sites with a pocket depth of at least 5 mm and the number of sites with recession were identified as risk markers and male gender as a risk determinant. The prevalence of severe periodontitis amounted to 20% in 2002. Analysis showed that, already at baseline and throughout the study period, the periodontal condition in these individuals was more severe compared with the other participants. In conclusion, characteristics of susceptibility to periodontitis are already apparent in young adulthood.

Динаміка частоти госпіталізацій дітей віком до 5 років із ротавірусною інфекцією в умовах відсутності універсальної вакцинації проти ротавірусу (15-річне спостереження)

Purpose - to monitor the dynamics of the frequency of hospitalization of children under 5 years of age with rotavirus infection during 15 years in the absence of universal vaccination and to determine the burden of rotavirus infection and the feasibility of introducing a rotavirus vaccine into the National Vaccination Calendar. Materials and methods. Active surveillance of rotavirus infection among hospitalized children under 5 years of age was conducted according to a standard protocol prepared by WHO for the global rotavirus infection surveillance network. A comparison was made of the frequency of hospitalization of children under 5 years of age with rotavirus acute gastroenteritis (AGE) by sentinel years. Stool samples were collected within 2 days of hospitalization and sent to the virology laboratory for testing. Detection of rotavirus was carried out using ELISA. Genotyping of rotaviruses was carried out in WHO laboratories by the method of multiplex RT-PCR. Results. During 15 years (2007-2021) of observation, there were 7,821 children under the age of 5 who were hospitalized in connection with an acute intestinal infection at the Kyiv Surveillance Center. Rotavirus infection was determined in 3387 children (43.3%). A consistently high frequency of hospitalizations with rotavirus AGE was observed with a slight downward trend over the years (from 50-75% in the first years to 33-39% in 2018-2019). In 2021 (the 15th year of observation), the average annual frequency of rotavirus AGE decreased even more significantly and amounted to 21% (a 61% decrease compared to the first years of observation). The unexpected decrease in the frequency of rotavirus diarrhea among hospitalized children in the 15th year of observation in the absence of universal vaccination against rotavirus is difficult to explain. A number of factors could have contributed to the above-mentioned decrease, the most likely of which could be the coincidence in time with the epidemic of COVID-19, in which anti-epidemic measures are similar to those for intestinal infections. While the average annual frequency of hospitalizations with rotavirus infection decreased, the frequency of hospitalizations remained high in certain months of the year, starting from January to June, which increased the burden on inpatients in certain, mostly cold, months of the year. Further active monitoring of rotavirus infection is necessary to definitively resolve the issue of whether the decrease in the frequency of rotavirus infection by the 15th year is temporary or is a natural course of the epidemic process and will continue to occur. Conclusions. In Ukraine, in the absence of universal vaccination against rotavirus, during the 15-year (2007-2021) observation period, a consistently high frequency of rotavirus infection was noted among hospitalized children under 5 years of age with AGE, with a slight downward trend over the years. In the 15th year of follow-up (2021), there was an unusual decline in the proportion of rotavirus infection among hospitalized children, which may have been contributed to by a number of factors, the most likely of which could be the coincidence in the period with the COVID-19 epidemic, in which anti-epidemic measures are similar to those for intestinal infections. Even with a decrease in the average annual frequency of rotavirus AGE in the 15th year of observation, a consistently high rate of hospitalization with rotavirus gastroenteritis remains in certain months of the year, which increases the burden on inpatients. The significant burden of rotavirus infection among children under the age of 5 years old determines the expediency of including the rotavirus vaccine in the National Vaccination Calendar of Ukraine. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

QT prolongation in patients with index evaluation for seizure or epilepsy is predictive of all-cause mortality.

Refractory epilepsy confers a considerable lifetime risk of sudden unexplained death in epilepsy (SUDEP). Mechanisms may overlap with sudden cardiac death (SCD), particularly regarding QTc prolongation. Guidelines in the United States do not mandate the use of electrocardiography (ECG) in diagnostic evaluation of seizures or epilepsy. The purpose of this study was to determine the frequency of ECG use and of QT prolongation, and whether QT prolongation predicts mortality in patients with seizures. We performed a retrospective cohort study including all patients seen at Mayo Clinic in Rochester, Minnesota, from January 1, 2000, to July 31, 2015, with index evaluation for seizure or epilepsy. Patients with an ECG were categorized by the presence of a prolonged QT interval with a primary endpoint of all-cause mortality after the 15-year observation period. Optimal cutoff QT intervals most predictive of mortality were identified. Median age was 40.0 years. An ECG was obtained in 18,222 patients (57.4%). After patients with confounding ECG findings were excluded, primary prolonged QT intervals were seen in 223 cases (1.4%), similar to the general population. Kaplan-Meier analysis demonstrated a significant increase in mortality (Cox hazard ratio [HR] 1.90; 95% confidence interval [CI] 1.76-2.05) for prolonged optimal cutoff QT, maintained after adjustments for age, Charlson comorbidity index, and sex (HR 1.48; 95% CI 1.37-1.59). Use of ECG in diagnostic workup of patients with seizures is poor. A prolonged optimal cutoff QTc interval predicts all-cause mortality in patients evaluated for seizure and those diagnosed with epilepsy. We advocate the routine use of a 12-lead ECG at index evaluation in patients with seizure or epilepsy.

Morbidity and mortality in adults with congenital heart defects in the third and fourth life decade

ObjectivesThe population of adults with congenital heart defects (ACHD) is continuously growing. Data on morbidity and mortality of ACHD are limited. This longitudinal observational study examined a group of ACHD with surgically corrected or palliated congenital heart defects (CHD) during a 15-year period.MethodsACHD that had participated in the initial study were invited for a follow-up examination. Mortality and hospitalization data were compared with a healthy control group.ResultsFrom 05/2017 to 04/2019 a total of 249/364 (68%) ACHD participated in the follow-up study: 21% had mild, 60% moderate and 19% severe CHD. During the observational period, 290 health incidents occurred (cardiac catheterization 37%, cardiovascular surgery 27%, electrophysiological study/ablation 20%, catheter interventional treatment 14%, non-cardiac surgery 3%). Events were more frequent in ACHD with moderate (53%) and severe (87%) compared to those with mild CHD (p < 0.001). 24 individuals died at a median age of 43 years during the observation period. 29% of them had moderate and 71% severe CHD corresponding to a mortality rate of 0%, 0.29% and 1.68% per patient-year in ACHD with mild, moderate and severe CHD. Long-term survival was significantly reduced in patients with severe CHD in comparison to individuals with mild and moderate CHD (p < 0.001).ConclusionAfter correction or palliation of CHD, there was remarkable ongoing morbidity and mortality in ACHD patients over the 15-year observation period, particularly in individuals with moderate and severe CHD when compared with the general population. Thus, life-long special care is required for all surgically corrected or palliated ACHD patients.Graphical abstract

Undergraduate Dental Education in Gerodontology in Germany between 2004 and 2019—A case for compulsory teaching?

The study surveys the present state of undergraduate dental education in gerodontology in Germany and highlights changes between 2004 and 2019. In 2019, questionnaires were emailed to the department heads of all German dental schools. Data were analysed descriptively and compared to existing data from 2004, 2009 and 2014. Thirty-nine (86.7%) out of forty-five responding department heads stated to teach aspects of gerodontology in traditional core subject lecture series. Overall, 15 (55.6%) out of 27 responding dental university schools are offering special education in gerodontology (dedicated lecture series and/or practical training). A stronger focus on non-dental topics has been observed over the years. The 15-year observation period in Germany shows that teaching gerodontology should be mandatory. There is a lack of specialists in gerodontology at the dental schools, although specialisation has been possible for many years in the German professional association. Students should be sure that, as in other subjects, they are well trained for the very heterogeneous patient group of seniors. The financial and personnel prerequisites for the universities need to be established. Inclusion of gerodontology in the national syllabus is a decisive factor for the integration of the subject into undergraduate courses. The recommendations of the European College of Gerodontology (2009) and of the German Association of Gerodontology (DGAZ) regarding didactical and practical teaching should be implemented in the respective compulsory syllabus to prepare current undergraduate dental students for the demographic challenges of tomorrow.

Suicide Among American Indian and Alaska Native Veterans Who Use Veterans Health Administration Care: 2004-2018.

Background:American Indian and Alaska Natives (AI/ANs) veterans may be at elevated risk for suicide, but little is known about suicide among this population.Methods:We conducted a retrospective cohort analysis of AI/AN veterans who received health care services provided or paid for by the Veterans Health Administration (VHA) between October 1, 2002, and September 30, 2014, and who were alive as of September 30, 2003. Age-specific and age-adjusted suicide rates through 2018, per 100,000 person-years (PY) at risk and 95% confidence intervals were computed.Results:Age-adjusted suicide rates among AI/AN veterans in this cohort more than doubled (19.1–47.0/100,000 PY) over the 15-year observation period. In the most recent observation period (2014–2018), the age-adjusted suicide rate was 47.0 per 100,000 PY, with the youngest age group (18–39) exhibiting the highest suicide rate (66.0/100,000 PY). The most frequently used lethal means was firearms (58.8%), followed by suffocation (19.3%), poisoning (17.2%), and other (4.7%).Conclusions:Results suggest that: (1) suicide is an increasing problem among AI/AN VHA veterans; and (2) younger AI/AN VHA veterans are at particularly high risk and warrant focused prevention efforts. Findings are similar to those observed in general AI/AN population. There is a compelling need to review and strengthen VHA suicide prevention efforts directed towards AI/AN veterans.

Analysis of the Proportion of Incidental Water in Annual Wastewater Inflows to a Selected Treatment Plant During a 15-Year Observation Period

Analysis of the Proportion of Incidental Water in Annual Wastewater Inflows to a Selected Treatment Plant During a 15-Year Observation Period

Factors Impacting Survival in Patients With Major Burn-Induced Acute Kidney Injury Postrenal Replacement Therapy: A Nationwide Study With 15 Years Follow-Up in Taiwan.

Major burn-induced acute kidney injury (AKI) causes extremely high mortality, even though renal replacement therapy (RRT) was thought of as the most efficient treatment. There was scanty research for investigating the characteristic of burn-AKI-RRT patients during intensive care. This study aims to investigate the factors impacting the survival outcomes in those burn-AKI-RRT cases. Using the Taiwan National Health Insurance Research Database and its affiliated database, the Registry for Catastrophic Illness Patients, we defined a cohort composed of 171 patients encountering major burn-induced AKI and receiving RRT during burn care for a 15-year observation period. Demographic characteristic, comorbidities, total body surface area (TBSA), major procedures, and complications were analyzed to explore the factors affecting the survival outcomes during acute burn care and 1 year after discharge. Patients who underwent tracheostomy and skin grafting had higher survival rates during acute burn care (tracheostomy: mortality vs survival, 15.7% vs 30.2%; P = 0.0257; skin grafting: mortality vs survival, 57.4% vs 76.2%; P = 0.0134). Multivariate regression analysis showed that tracheostomy group significantly presented with lower mortality risk by 65% (odds ratio [OR], 0.35; P = 0.0372), and subgroup analysis of delaminating follow-up duration showed that patients with tracheostomy had higher overall survival by 22% (90-day postburn mortality: nontracheostomy vs tracheostomy, 58.3% vs 36.3%; adjusted hazards ratio, 0.39; 95% confidence interval, 0.22-0.69; P = 0.0011), especially during postburn first 30 days (adjusted hazards ratio, 0.15; 95% confidence interval, 0.05-0.49; P = 0.0016). Total body surface area did not significantly affect survival; however, mortality risk was significantly higher in those with a larger TBSA (TBSA, ≥80%; OR, 6.48; P = 0.0022; TBSA, 60-79%; OR, 3.12; P = 0.0518; TBSA, 40-59%; OR, 1.88; P = 0.2402; TBSA, 30-39% as reference). For patients with major burn-induced AKI receiving RRT, tracheostomy and skin grafting may improve survival in the cases living through acute burn stage.

Estimating unplanned and planned hospitalization incidents among older Australian women aged 75 years and over: The presence of death as a competing risk.

To estimate the incidence of unplanned and planned hospitalization and identify associated factors among older women aged 75 years and over. This study is a prospective longitudinal cohort study (over the period 2001-2016). Women born between 1921 and 1926 were included from the Australian Longitudinal Study on Women's Health (ALSWH). ALSWH self-reported data were linked with New South Wales's state Admitted Patient Data Collection. A competing risk analysis was performed using SAS v 9.4. Overall, during the 15-year observation period, 86.7% of women experienced at least one unplanned admission and 60.3% experienced at least one planned admission. The complement of Kaplan-Meier survival function overestimates hospitalization incidence compared to cumulative incidence function in the presence of a competing risk, that is, "death." Predisposing factors (older age and not partnered) and need factors (hospital doctor visit, GP or family doctor visit, poor perceived general health, and having at least one chronic disease) were associated with increased unplanned admission. First language other than English and not having private health insurance showed a negative association with planned admission; specialist doctor visits had a positive association. Hospital admission was influenced by predisposing and enabling factors, as well as need. Intervention aiming to support older people who do not have private health insurance may be required to improve the goal of equal access to healthcare through planned admissions people with equal need.

The incidence and characteristics of accelerated knee osteoarthritis among women: the Chingford cohort

BackgroundPrior research on accelerated knee osteoarthritis (AKOA) was primarily confined to the Osteoarthritis Initiative, which was enriched with people with risk factors for knee osteoarthritis (KOA). It is unclear how often AKOA develops in a community-based cohort and whether we can replicate prior findings from the Osteoarthritis Initiative in another cohort. Hence, we determined the incidence and characteristics of AKOA among women in the Chingford Study, which is a prospective community-based cohort.MethodsThe Chingford Study had 1003 women with quinquennial knee radiographs over 15 years. We divided the 15-year observation period into three consecutive 5-year phases. Within each 5-year phase, we selected 3 groups of participants among women who started a phase without KOA (Kellgren-Lawrence [KL] < 2): 1) incident AKOA developed KL grade ≥ 3, 2) typical KOA increased radiographic scoring (excluding AKOA), and 3) no KOA had the same KL grade over time. Study staff recorded each participant’s age, body mass index (BMI), and blood pressure at baseline, 5-year, and 10-year study visits. We used multinomial logistic regression models to test the association between groups (outcome) and age, BMI, and blood pressure at the start of each phase. The cumulative incidences and odds ratios (OR) from each phase were pooled using a fixed-effect meta-analysis model.ResultsThe person-based cumulative incidence of AKOA was 3.9% over 5 years (pooled estimate across the three 5-year phases). Among incident cases of KOA, AKOA represented ~ 15% of women with incident KOA. Women with AKOA were older than those with typical (OR = 1.56, 95%CI = 1.16–2.11) or no KOA (OR = 1.84, 95%CI = 1.40–2.43). Women with AKOA had a greater BMI than those without KOA (OR = 1.52, 95%CI = 1.17–1.97). We observed no association between group and blood pressure.ConclusionsIn a community-based cohort, > 1 in 7 women with incident KOA had AKOA. Like the Osteoarthritis Initiative, people with AKOA were more likely to have greater age and BMI.

On the Problem of Taking into Account the Effect of Meteorological Factors on Large Precision Systems: A Case Study of the Baksan Large-Base Laser Interferometer

Variations in ambient temperature and atmospheric pressure coincide with the wave train of the lunar–solar tide in the diurnal and semidiurnal frequency ranges, where they have the greatest influence on deformation measurements by laser interferometers. Based on data from the Baksan laser interferometer of the Sternberg Astronomical Institute of Moscow University over a 15-year observation period, it is shown that the response of large measuring systems to these variations has a pronounced frequency dependence. Using the constructed mathematical model the problem of taking into account how meteorological factors influence measurements is solved in the frequency domain with the aid of images of deformation time series and meteorological factors, obtained by Fourier transform. A transient function is constructed in the form of the so-called aperiodic link, which takes into account the frequency dependence and delay of thermoelastic deformation of the measuring system on the variation in ambient temperature. The converted temperature and pressure images are subtracted from the deformation image using the corresponding transient functions. As a result, the new deformation image bears virtually no influence of meteorological factors; inverse transform yields a new deformation time series.

Long-Term Outcomes of Tooth-Implant-Supported Rehabilitation of Periodontally Compromised and Treated Patients Refusing Bone Grafting Surgical Therapies.

To evaluate the long-term incidence of complications in abutment teeth and dental implants in periodontally treated and maintained patients, refusing bone grafting surgical therapies, rehabilitated with full-arch telescopic-retained retrievable prostheses (TRPs) and full-arch fixed prosthesis (FPs), both supported by teeth-implants combination. After active periodontal therapy, 18 patients were rehabilitated with full-arch TRPs, whereas 17 patients were rehabilitated with full-arch FPs. Patients were annually evaluated for technical and/or biological failures/complications. During the 15-year observation period, 6 of 164 (3.6%) implants failed and 19 of 233 teeth were extracted (9.2%) in the TRPs group, whereas 6 of 152 (3.9%) implants failed and 23 of 221 (10.4%) abutment teeth were extracted in the FPs group. Differences in implant failures and abutment teeth loss between the 2 groups were not statistically significant. In both the groups, Cox regressions identified significant difference (P < 0.05) for mean initial bone loss, aggressive periodontitis, and smoking, as factors contributing to tooth loss and implant failures in general. In periodontally treated patients, refusing bone grafting surgical therapies, rehabilitated with full-arch TRPs and full-arch fixed prostheses, both supported by teeth-implants connection, high survival rates can be expected if regular supportive periodontal therapy had been performed.

Features of extrapulmonary tuberculosis localization depending on the presence or absence of confirmation of the diagnosis in children over a 15-year observation period

Features of extrapulmonary tuberculosis localization depending on the presence or absence of confirmation of the diagnosis in children over a 15-year observation period

Full arch fixed prostheses vs. full arch telescopic-retained retrievable prostheses both supported by implants and natural tooth abutments in periodontally treated patients: Results at 15 years.

BackgroundThe clinical outcome of full arch fixed prostheses vs. full arch telescopic-retained retrievable prostheses supported by implants and natural tooth abutments in periodontally treated patients has been reported by few studies, with controversial results. The objective of this study was to evaluate long-term (15 years) complications of abutment teeth and dental implants in periodontally treated patients, rehabilitated with full arch telescopic-retained retrievable prostheses (TRP)s vs. full arch fixed prostheses (FP)s supported by teeth and implants.Material and MethodsAfter active periodontal therapy (non-surgical and surgical), and implant placement (replacement of hopeless teeth and in edentulous sites), 18 patients were rehabilitated in both dental arches with full arch TRPs, and 17 patients were rehabilitated with full arch FPs. Patients were annually recalled for technical and/or biological complications monitoring.ResultsDuring the 15-year observation period, 29 of 164 (17.6%) implants failed in the TRP group and 26 of 152 (17.1 %) implants in the FP group. Due to progression of periodontal disease, endo-perio untreatable lesion and caries, 22 of 233 abutment teeth were extracted (8.1) % in the TRP group and 23 of 221 (10.4%) abutment teeth were extracted in the FP group. Difference in implant failures and abutment teeth loss between the two groups were found not statistically significant (p >0.05). Poisson regression analysis showed that in both groups, factors such as smoking habits, FMBS>20, number of pockets >6 mm, mean bone loss, and bone loss/age, contribute to tooth and implant failure (p<0.05).ConclusionsIn this clinical study, in periodontally treated patients, full arch telescopic-retained retrievable prostheses, and full arch fixed prosthesis, supported by teeth and implants presented comparable long-term results of tooth loss and implant failure, if regular periodontal therapy is implemented. Key words:Periodontal disease, implants, tooth-implant connection, telescopic prosthesis, fixed prosthesis.

LOCALLY-ADVANCED SIGMOID CANCER WITH CARCINOMATOSIS AND MULTIPAY RECURRENCES. 15 YEARS OF OBSERVATION

Peritoneal carcinomatosis is a major reason for treatment failure. However, combination of «aggressive» surgical approach with chemotherapy allows achieving good results. In this clinical case, a locally advanced tumor was presented with large carcinomatous node in anomentum. Cytoreductive surgery with a complete cytoreduction in combination with intra-abdominal chemotherapy prevented generalization of carcinomatosis. Subsequently, the patient underwent three surgeries for repeated local recurrence of colon cancer. A 15-year period of observation of the patient suggests that this approach is promising, which significantly increases the length of patients life expectancy.

High risk of overdose death following release from prison: variations in mortality during a 15-year observation period.

The time post-release from prison involves elevated mortality, especially overdose deaths. Variations in overdose mortality both by time since release from prison and time of release has not been investigated sufficiently. Our aims were to estimate and compare overdose death rates at time intervals after prison release and to estimate the effect on overdose death rates over calendar time. This 15-year cohort study includes all individuals (n=91 090) released from prison (1 January 2000 to 31 December 2014) obtained from the Norwegian prison registry, linked to the Norwegian Cause of Death Registry (2000-14). All-cause and cause-specific mortality were examined during different time-periods following release: first week, second week, 3-4weeks and 2-6months, and by three different time intervals of release. We calculated crude mortality rates (CMRs) per 1000 person-years and estimated incidence rate ratios (IRR) by Poisson regression analysis adjusting for time intervals after prison release, release periods and time spent in prison. Overdose deaths accounted for 85% (n=123) of all deaths during the first week following release (n=145), with a peak during the 2 days immediately following release. Compared with week 1, the risk of overdose death was more than halved during week 2 [IRR=0.43; 95% confidence interval (CI)=0.31-0.59] and reduced to one-fifth in weeks 3-4 (IRR=0.22; 95% CI=0.16-0.31). The risk of overdose mortality during the first 6months post-release was almost twofold higher in 2000-04 compared with 2005-09 (IRR=0.53; 95% CI=0.43-0.65) and 2010-14 (IRR=0.47; 95% CI=0.37-0.59). The risk of overdose death was highest for those incarcerated for 3-12months compared with those who were incarcerated for shorter or longer periods, and recidivism was associated with risk of overdose death. There is an elevated risk of death from drug overdose among individuals released from Norwegian prisons, peaking in the first week. The risk has reduced since 2000-04, but is greatest for those serving 3-12months compared with shorter or longer periods.

Decline in semen quality among 30,636 young Chinese men from 2001 to 2015

To provide information of semen quality among young Chinese men in the past 15years. Retrospective cross-sectional study. Sperm bank. A total of 30,636 young adult men who applied to be sperm donors at the Hunan Province Human Sperm Bank of China in 2001-2015 were included in the study. Physical examination and analysis of blood and semen samples. Semen parameters, such as semen volume, sperm concentration, total sperm count, progressively motile sperm count, sperm progressive motility, sperm morphology, and round cells. Many of the semen parameters showed a decreasing trend over the 15-year observation period. The sperm concentration and percentage of sperm with normal morphology decreased from 68 × 106/mL to 47 × 106/mL and from 31.8% to 10.8%, respectively. Although sperm progressive motility showed irregular variation, the progressively motile sperm count decreased from 34 × 106 to 21 × 106 over the 15-year period. Furthermore, the rate of qualified donors fell from 55.78% in 2001 to 17.80% in 2015, and the rate for 2015 was approximately threefold lower than the corresponding rates in2001. The semen quality among young Chinese men has declined over a period of 15years, especially in terms of sperm concentration, total sperm count, sperm progressive motility, and normal morphology.