Global, regional, and national burden of five major mental disorders in working-age population, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021.

Trends and future of the disease burden of malignant neoplasms of bone and articular cartilage in China from 1990 to 2023: An analysis based on the Global Burden of Disease 2023.

Global burden and trends of depression among women of childbearing age, 1990-2021.

Burden, Trends and Projection of Lip and Oral Cavity Cancer in Central, Eastern and Western Europe: From the Global Burden of Disease 2023 Study.

Global patterns and risk factors of breast cancer in women under 35: a population-based study.

Major depressive disorder (MDD) is a leading cause of disability worldwide, placing a heavy burden on individuals and healthcare systems. Understanding global and regional epidemiological patterns is essential for designing effective interventions. This study aims to evaluate the burden of MDD and its major risk factors globally and in China, offering evidence for targeted mental health strategies. We extracted data on MDD prevalence, incidence, and disability-adjusted life years (DALYs), and selected attributable risk factors between 1990 and 2021 from the Global Burden of Disease (GBD) database. Temporal trends were assessed through estimated annual percentage change (EAPC) with 95% confidence intervals (CIs). To evaluate the association between socio-demographic development and MDD burden, natural cubic spline regression was fitted, with Spearman rank correlation applied as a sensitivity analysis. In 2021, the global MDD incidence rate reached 4,322.65 per 100,000 population, with the highest rate in High-income North America; China's rate (2,717.26 per 100,000) remained below the global average. Between 1990 and 2021, global age-standardized incidence and DALY rates rose slightly (EAPC 0.35% and 0.34%), more slowly in China (0.31% and 0.22%), while absolute case counts increased, strongly influenced by population growth and aging. The SDI-MDD burden association was weak and non-linear. Natural cubic spline analyses indicated non-linear relationships between SDI and age-standardized prevalence, incidence, and DALY rates, while Spearman rank analyses yielded weak positive ecological correlations (all P < 0.001). East Asia and Eastern Europe remained above the fitted SDI-burden trend, whereas Sub-Saharan Africa remained below it. Within the GBD comparative risk assessment framework, childhood maltreatment and intimate partner violence accounted for a substantial proportion of attributable MDD DALY burden, particularly among women. The global MDD burden has remained substantial and has risen gradually, with marked age, gender, and regional disparities. The SDI-burden association appears weak and non-linear, suggesting that socioeconomic development alone does not adequately explain this cross-national variation.These findings highlight the urgent need for region-specific, evidence-based mental health policies focused on prevention and support for vulnerable populations.

Global access to liver transplantation (LT) remains highly unequal. We analyzed worldwide patterns of LT activity, donor source, and their alignment with disease burden across sociodemographic strata. We combined country-level LT data from the Global Observatory on Donation and Transplantation (2000-2023) with prevalence and mortality estimates for cirrhosis and other chronic liver diseases from the Global Burden of Disease 2021 Study (2000-2021). LT rates and donor source were analyzed across Sociodemographic Index (SDI) categories. LT capacity was benchmarked against age-standardized prevalence rates and age-standardized mortality rates. Associations between LT intensity and the mortality-to-prevalence ratio were evaluated using pooled correlations, within-country analyses, and 2-way fixed-effects models adjusting for country-year and calendar year. From 2000 to 2023, LT activity was concentrated in high-SDI countries, whereas low-SDI countries relied almost exclusively on living donation but had extremely low overall LT rates. When benchmarked against age-standardized prevalence rates and age-standardized mortality rates, LT capacity showed a strong inverse gradient across SDI, with substantial heterogeneity among high- and middle-SDI countries. Within-country and 2-way fixed-effects models demonstrated a small but significant inverse association, indicating that higher LT activity was associated with lower mortality relative to disease prevalence at the population level. Global LT capacity remains poorly aligned with the burden of cirrhosis and other chronic liver diseases and is driven more by health system development than epidemiological need. Although prevention remains central, incremental expansion of equitable LT infrastructure may be associated with modest improvement in population-level mortality relative to disease prevalence.

BackgroundAsbestos exposure remains a persistent occupational hazard in China, yet updated national estimates of asbestos-related diseases (ARDs) after 2019 are scarce. This study quantified long-term trends and demographic patterns of ARDs from 1990 to 2023 using Global Burden of Disease data and joinpoint regression.MethodsWe analyzed incidence, prevalence, deaths, and disability-adjusted life years (DALYs) for asbestosis and asbestos-attributable cancers (mesothelioma, tracheal/bronchus/lung cancer, laryngeal cancer, and ovarian cancer). Absolute numbers and age-standardized rates were assessed overall and stratified by sex and age. joinpoint regression identified significant temporal inflection points.ResultsThe absolute burden of ARDs increased continuously from 1990 to 2023. Age-standardized prevalence and incidence rates of asbestosis peaked in 2001, while mortality and DALY rates peaked in 2004. Major turning points for asbestos-attributable cancers occurred around 2010–2011, marking historical peaks followed by declines. A modeled increase in mortality and DALYs was observed from 2020 to 2022 across nearly all ARDs. Males consistently demonstrated higher burdens than females, and older adults (≥65 years) carried the greatest burden, with a secondary mesothelioma peak at 55–59 years in males.ConclusionsAlthough ARD indicators have declined from historical peaks, a statistically modeled increase was observed in 2020–2022, warranting continued public-health attention. These findings aim to provide evidence for clinicians, epidemiologists, and policymakers to strengthen occupational disease prevention, reinforce labor protection laws, and improve asbestos-control policies in China.

Acute hepatitis B (AHB), an acute manifestation triggered by hepatitis B virus infection, has emerged as a significant international public health concern, particularly endangering women of childbearing age (WCBA) who are prone to persistent infection, adverse pregnancy outcomes, and mother-to-child transmission threats. However, research on acute hepatitis B lags, mainly focusing on chronic cases or clinical treatments. This study aims to quantify its global disease burden from 1990 to 2021 among women of childbearing age and predict epidemiological trends to inform targeted prevention and control strategies. Data of AHB burden from 1990 to 2021were obtained from the GBD 2021 via Global Health Data Exchange (GHDx). Frontier analysis was utilized to find the unrealized health potential. The age-period-cohort model was applied to analyze trends across different age groups, periods, and birth cohorts. The joinpoint regression model was used to identify significant changes in data trends over time. The Bayesian age-period-cohort model was utilized for forecasting future epidemiological trajectories. A decreasing trend in age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and disability-adjusted life-years rates (ASDR) was observed among the women of childbearing age worldwide from 1990 to 2021. The disease burden was disproportionately higher in low socio-demographic index (SDI) regions. The Bayesian age-period-cohort model revealed that by 2050, the ASIR and ASPR show similar downward trends, as do the ASMR and ASDR, but the latter decline less steeply than the former. The global disease burden of AHB in WCBA was declining, which is consistent with the vaccination and perinatal prevention, yet marked geographic disparities persist in low-resource regions. Modeling projections show that continued declines may contribute to progress toward the WHO viral hepatitis elimination goals, but vaccine coverage, safe injection and sufficient prevention of mother-to-child transmission remain essential. Not applicable.

Craniofacial clefts are among the most prevalent congenital anomalies worldwide and represent a substantial public health burden. Their impact is disproportionately high in Africa, where limited access to timely surgical care and comprehensive health services-including feeding support, speech therapy, and psychosocial care-exacerbates outcomes and contributes to long-term disability and reduced quality of life. This study provides a novel contribution by systematically contextualizing both the fatal and nonfatal burden of craniofacial clefts across 54 African nations, thereby generating evidence to inform health policy and guide resource allocation. We used the Global Burden of Disease (GBD) 2023 framework to estimate the prevalence, incidence, disability-adjusted life-years (DALYs), and mortality associated with craniofacial clefts. Data sources included vital registration systems, household surveys, disease registries, and published scientific literature. Estimates were generated using the disease modeling meta-regression tool DisMod-MR 2.1, and the Cause of Death Ensemble model (CODEm) to derive cause-specific mortality rates. Results were stratified by age, sex, location, and year for the period 1990-2023 in Africa, and are presented as counts and age-standardized rates per 100,000 person-years. For each measure, 95% uncertainty intervals (UIs) were calculated based on the 2.5th and 97.5th percentiles of the posterior distribution. Forecasts of future trends were produced using an autoregressive integrated moving average (ARIMA) model. In 2023, Africa recorded an estimated 839,000 cases of craniofacial cleft (95% uncertainty interval [UI] 677,000-1,030,000), 223,000 DALYs (67,400-682,000), and 1900 deaths (300-7100), accounting for 19.7% of global prevalence, 40.2% of global DALYs, and 57.6% of global craniofacial cleft-related mortality. Between 1990 and 2023, the absolute number of cases doubled, although the age-standardized prevalence rate remained relatively stable. In 2023, age-standardized DALY rates ranged from 9.0 per 100,000 (5.6-13.6) in north Africa to 12.6 per 100,000 (3.4-41.8) in eastern sub-Saharan Africa. Over the same period, total DALY counts declined by 36.1% (-72.1 to 144.6), and the age-standardized DALY rate decreased by 61.4% (-82.8 to 32.5). By 2030, DALYs attributable to craniofacial clefts in Africa are projected to reach 200,000 (146,000-255,000), with an age-standardized rate of 8.1 per 100,000 (5.1-11.1). The quality of care index (QCI) showed modest improvement, rising from 72.5% in 1990 to 78.9% in 2023 across both sexes. In 2023, Tunisia (99.5%) and Libya (99.1%) reported the highest QCI scores, while Somalia (26.3%) and the Central African Republic (14.1%) recorded the lowest. Notable gains were observed in Ethiopia (from 30.9% to 71.2%) and Mozambique (from 30.5% to 63.1%) over the past 3 decades. Quality of care was strongly correlated with the Sociodemographic Index (SDI; r=0.87, P<0.001). Craniofacial clefts in Africa contribute disproportionately to DALYs and mortality, with slower declines in premature deaths compared with high SDI regions. Quality of care was strongly correlated with SDI, reflecting persistent inequities. Although age-standardized prevalence, incidence, mortality, and DALY rates have declined-suggesting progress from preventive strategies and expanded surgical access-the overall burden remains high and heterogeneous across countries. Sustained investment in prevention, timely surgery, and rehabilitation, alongside stronger health systems, is essential to reduce disability and improve outcomes.

Intimate partner violence (IPV) in the Middle East and North Africa represents a significant issue with both clinical and societal implications. This study aimed to highlight the prevalence of major depressive disorder (MDD) linked to IPV against women in these regions, using data from the Global Burden of Disease 2021. The prevalence, incidence, Disability-Adjusted Life Years (DALYs), and Years of Life Lost (YLLs) associated with MDD were analyzed across all ages for the period from 1990 to 2021. DALYs due to MDD specifically attributed to intimate partner violence (IPV) against women were assessed and further broken down by country and age group. Results were presented in absolute counts as well as estimates per 100,000 population, accompanied by a 95% uncertainty interval. The age-standardized prevalence rate of MDD in 2021 was 4,883 per 100,000 population [95% UI: 4,013 to 5,940], marking a 16% change compared to 1990 levels. Over 14million women in North Africa and the Middle East were affected by MDD and almost 22million [21,810,159; 95% UI 17,783,296 to 26,732,692] incidence in 2021, this rate of incidence has nearly doubled compared to 1990. Age-standardized DALYs of MDD attributed to IPV in women in 2021 was 102.87 [95% UI 0.42 to 226.38] per 100,000. All ages count estimates of DALYs of MDD attributed to IPV against women was 314,734 [95% UI 1,307 to 692,580] in 2021. The highest age-standardized DALYs of MDD attributed to IPV was in Palestine, 180.74 [95% UI 1.11 to 416.15], followed by Afghanistan [152.62; 95% UI 0.88 to 347.86], and Tunisia [136.03; 95% UI 0.38 to 317.19] per 100,000. The findings highlighted a high prevalence of depression in this super region, underscoring the significant burden posed by this mental health condition. Additionally, IPV emerged as a contributing factor to MDD. These insights emphasize the need for health policies that tackle the impact of depressive disorders while addressing the influence of IPV. Therefore it is necessary to move towards preventing the negative consequences of IPV by increasing social awareness.

BackgroundNeurodevelopmental disorders (NDDs) are substantial burdens for individuals and health systems; yet, their long-term epidemiology in South America is poorly characterized.ObjectiveTo describe the trends from 1990 to 2023 in the age-standardized prevalence rates (ASPRs) of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and idiopathic developmental intellectual disability (IDID) across 12 South American countries using Global Burden of Disease (GBD) 2023 estimates.MethodsCountry-specific annual ASPRs and 95% uncertainty intervals (95%UIs) were obtained from the GBD 2023. Sex-stratified ASPRs were used to calculate male-to-female ratios (MFRs) and summarize long-term sex disparities. Temporal trends were assessed using the average annual percent change (AAPC) from log-linear regression for each country.ResultsIn 2023, the ASPRs ranged from 0.57 to 1.06% for ASD, from 1.00 to 2.55% for ADHD, and from 0.42 to 0.54% for IDID across countries. Between 1990 and 2023, the ASD ASPRs increased in all countries, with AAPCs from +0.35%/year (Paraguay) to +0.79%/year (Chile). The ADHD ASPRs showed little net change, with AAPCs from −0.10%/year (Argentina) to +0.39%/year (Brazil). And the IDID ASPRs declined consistently, with AAPCs from −0.79%/year (Bolivia) to −0.30%/year (Suriname). Sex differences in ASPRs were large and persistent for ASD and ADHD, but small for IDID. The MFR trajectories suggested a slight widening of the ASD male–female gap, largely stable ADHD disparities, and minimal variability for IDID.ConclusionOver 3 decades, the ASD ASPRs rose modestly, the ADHD ASPRs were broadly stable, and the IDID ASPRs declined across South America. The GBD 2023 estimates point to enduring diagnostic and structural inequities and to the need for strengthened surveillance and more equitable access to developmental assessment.

Rheumatoid arthritis (RA) imposes a substantial global health burden, contributing significantly to chronic disability and escalating healthcare costs. Accurate, long-term prevalence forecasts are essential to inform strategic planning for rheumatology services and health resource allocation. Hence, we developed and calibrated a sex-specific illness-death model (IDM) at global, regional, and national scales using GBD data (1990-2021). To uncover underlying epidemiological patterns, we augmented our projections with a frontier analysis that evaluates the efficiency of RA burden relative to sociodemographic index (SDI). We project the global age-standardized prevalence rate (ASPR) will rise by 6.3% to 222.06 per 100,000 (95% CI, 220.49-223.6) by 2040. While females bear a higher absolute prevalence, the growth rate is projected to be faster in males (8.75% vs. 5.67%). Significant disparities exist at regional and national levels: Andean Latin America and Peru are anticipated to have the highest ASPRs, while Oceania and Indonesia are projected to have the lowest. An increasing trend is projected globally, across 18 GBD regions, and in 167 nations. Critically, frontier analysis reveals that higher sociodemographic development frequently coincides with a larger "RA efficiency gap," indicating economic progress alone is insufficient for disease control. Therefore, mitigating the projected rise in RA requires strategies that move beyond relying on general economic advancement. Future health policies must actively integrate targeted prevention of modifiable lifestyle risks and bridge healthcare access gaps to effectively curb the coming global burden. Key Points • Projects a 6.3% global increase in RA prevalence by 2040, with faster growth in males. • Identifies an "RA efficiency gap" where higher development correlates with higher burden. • Forecasts severe geographic disparities, with Andean Latin America having the highest burden. • Concludes that targeted prevention, not just economic progress, is needed to curb future burden.

Gout is one of the most common inflammatory arthritides and represents a growing health burden worldwide. This study compares the disease burden of gout and its attributable risk factors between China and European Union (EU) countries from 1990 to 2023 using data from the Global Burden of Disease Study 2023 (GBD 2023). In addition, the study evaluates potential causal relationships between key risk factors and gout and projects future trends in disease burden. Using GBD 2023 data, we analyzed the epidemiology of gout in China and EU countries. Analyses included descriptive statistics and age- and sex-specific comparisons. Joinpoint regression models were used to calculate annual percentage changes (APC) and average annual percentage changes (AAPC) to assess long-term trends. An autoregressive integrated moving average (ARIMA) model was applied to project gout burden trends in China and EU countries from 2024 to 2040. In addition, a two-sample Mendelian randomization (MR) approach was used to investigate the potential causal relationship between key risk factors and gout at the genetic level. In 2023, China's age-standardized incidence rate (ASIR), prevalence rate (ASPR), and disability-adjusted life year rate (ASDR) for gout were 151.27/100,000, 809.69/100,000, and 25.14/100,000, respectively, all higher than in 1990. In comparison, EU countries showed lower levels for these indicators in both 1990 and 2023. Joinpoint regression analysis demonstrated an overall increasing trend in gout burden in both China and the EU between 1990 and 2023, although China experienced a brief decline in APC between 1990 and 1994. The burden of gout was higher among males than among females. Projections suggest that ASIR, ASPR, and ASDR will continue to increase in both China and European countries between 2024 and 2040. Mendelian randomization analysis further indicated a significant positive causal relationship between body mass index (BMI) and gout. This study combines GBD 2023 epidemiological data with Mendelian randomization analysis to characterize trends in the burden of gout in China and EU countries. The findings show a continuing increase in gout burden over time, particularly in China. The identified causal association between elevated BMI and gout highlights the importance of addressing modifiable metabolic risk factors to help reduce the future burden of gout. Key Points • An increasing burden of gout could be observed in China and the European Union from 1990 to 2023. • A higher age-standardized burden of gout was observed in China than in the European Union. • Future projections indicate that the burden of gout will continue to increase through 2040. • A causal association between elevated body mass index and gout risk was supported by Mendelian randomization analysis.

The Global Burden of Rheumatic Heart Disease: 1990-2021.

The global burden of injury is a key indicator for assessing public health and medical needs. During the COVID-19 pandemic, this burden was impacted. This study aims to explore how the pandemic influenced the injury burden globally and regionally, and provide recommendations to relieve this burden. The burden of injury-related data is derived from the Global Burden of Disease (GBD) 2021 Study. Autoregressive integrated moving average (ARIMA) and ARIMA-Long short-Term Memory (LSTM) models were adopted for counterfactual inference to predict the scenario without the pandemic. During the COVID-19 pandemic, the observed global age-standardized incidence rate (ASIR) of injury exceeded the predicted value by 107.31 per 100,000, and the observed age-standardized prevalence rate (ASPR) was higher than the predicted value by 102.81 per 100,000. Self-harm and interpersonal violence saw the largest deviations above predicted values in Europe and parts of Asia. Specifically, Armenia's ASIR was 7,829.33 per 100,000 higher than predicted, and its ASDR exceeded projections by 5,186.32 per 100,000. Besides, traffic injuries exceeded predicted levels most significantly in Southeast Asia, with Indonesia's ASIR 25.48 per 100,000 higher than projected. And the observed ASIR of unintentional injuries in China was 379.61 per 100,000 higher than the predicted value. During the COVID-19 pandemic, the global burden of injuries surpassed the predicted levels for a scenario without the pandemic in 2020-2021, especially in Europe and Asia. In addressing an epidemic, prevention and emergency measures for high-burden injury types and key populations should be strengthened based on local socio-cultural contexts.

ObjectiveThis study aimed to analyze global and regional trends in the burden of subarachnoid hemorrhage (SAH) from 1990 to 2021, focusing on incidence, prevalence, disability-adjusted life years (DALYs), and mortality, and to examine socioeconomic inequalities across 204 countries and territories using Global Burden of Disease (GBD) data.MethodsUtilizing GBD 2021 data, we assessed SAH burden by incidence, prevalence, DALYs, and mortality, stratified by Socio-Demographic Index (SDI), sex, and region. Age-standardized rates were calculated to ensure comparability. Socioeconomic inequalities were evaluated using the Slope Index of Inequality (SII) and Concentration Index (CII). Spearman correlation analyses explored associations between SAH burden and SDI.ResultsFrom 1990 to 2021, global SAH incident cases increased from 508,789 (95% UI 441,504–587,616) to 697,486 (95% UI 614,334–795,785), and prevalent cases rose from 4.90 million (95% UI 4.42–5.39 million) to 7.85 million (95% UI 7.16–8.58 million). Age-standardized incidence, prevalence, DALY, and mortality rates declined significantly, from 11.69 to 8.33, 109.90 to 92.17, 275.85 to 125.20, and 9.54 to 4.18 per 100,000, respectively. East Asia showed the largest declines (e.g., incidence from 17.74 to 7.89 per 100,000), while Andean Latin America had the highest burden (2021 prevalence: 172.03 per 100,000). Females had higher incidence and prevalence but lower DALYs and mortality. Middle SDI regions exhibited the largest case increases and rate declines. Socioeconomic inequalities worsened, with 2021 DALY SII at −47.27 (95% CI −71.58, −22.97) and mortality SII at −1.33 (95% CI −2.14, −0.51), indicating a shift in burden toward lower-income groups. SAH burden showed weak negative correlations with SDI, stronger for DALYs (r = −0.3541, p < 0.001) and mortality (r = −0.3058, p < 0.001).ConclusionDespite increasing absolute SAH cases due to population growth and aging, age-standardized rates declined, reflecting improved risk factor management and healthcare. However, persistent regional disparities and growing socioeconomic inequalities, with heavier burdens in low SDI regions and lower-income groups, underscore the need for targeted interventions, enhanced healthcare access, and further research into region-specific risk factors to reduce the global SAH burden and address health inequities.

To assess the global burden of blindness and vision loss (BVL) in individuals aged 0 to 24 years from 1990 to 2021, project trends, and analyze inequalities. Systematic epidemiological analysis of the Global Burden of Disease 2021 database. Data from 204 countries and territories, stratified by age, sex, and Socio-Demographic Index (SDI). Age-standardized prevalence rates (ASPR) and disability-adjusted life years (DALYs) were extracted from Global Burden of Disease 2021. Estimated annual percentage changes (EAPC) quantified trends. Analyses included decomposition, age-period-cohort modeling, frontier analysis, and inequality assessment via the Slope Index of Inequality and Concentration Index. ASPR and DALYs for BVL. From 1990 to 2021, the global age-standardized DALY rate decreased (EAPC: -0.20; 95% CI: -0.36 to -0.03), while ASPR slightly increased (EAPC: 0.02; 95% CI: -0.20 to 0.24). Absolute case numbers rose due to population growth. Females and older adolescents (15-24 years) bore a disproportionately higher burden. Low and middle SDI regions exhibited rising ASPR, while high SDI regions showed declines. Projections suggest rising total cases by 2030, with modest declines in ASPR and DALY rates. Frontier analysis indicated substantial improvement potential in several countries. Despite a global decrease in the health loss from BVL, the absolute number of affected young individuals is rising. The burden remains unequally distributed, with relative inequalities increasing over time. Targeted public health policies focusing on prevention, early intervention, and equitable resource allocation-especially in low SDI regions and among older adolescents-are urgently required.

Nutritional deficiencies (ND) remain a major global health challenge, significantly affecting population well-being. As part of the Global Burden of Disease (GBD) study, we conducted a comprehensive assessment of the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) attributed to ND from 1990 to 2021. This study analyzed temporal trends in nutritional deficiencies by estimating the estimated annual percentage change (EAPC) over the study period. We examined age-standardized prevalence rates (ASPR), incidence rates (ASIR), death rates (ASDR), and DALYs (ASDALYs) across various demographic and geographic dimensions. Data were stratified by sex, 20 age groups, 21 GBD regions, 204 countries and territories, and five socio-demographic index (SDI) quintiles. To project future trends, we applied the Bayesian age-period-cohort (BAPC) model. In 2021, nutritional deficiencies continued to impose a substantial global health burden, with approximately 1.85 billion cases (95% UI: 1.81-1.88 billion) and an ASPR of 23,859 per 100,000 population (95% UI: 23,446-24,321). The ASIR was 7725 per 100,000 (95% UI: 7404-8109). The ASDR was 3.0 per 100,000 (95% UI: 2.7-3.4), and the ASDALY rate reached 657.6 per 100,000 (95% UI: 489.9-869.6). Marked regional disparities were observed: low SDI regions exhibited the highest ASPR, ASIR, ASDR, and ASDALYs, while high SDI regions had the lowest ASDR. Central Sub-Saharan Africa recorded the highest rates across most indicators, whereas Western Europe had the lowest ASDR. Projections indicate a significant decline in the global burden of nutritional deficiencies from 2021 to 2040. These findings underscore the urgent need for targeted public health strategies to address the persistent and disproportionate burden of nutritional deficiencies in low SDI regions.

Rising burden of MASLD and CKM syndrome in Asia: A decade of trends and future projections.