Burden Of Disease Research Articles

The burden of ischemic heart disease among women of childbearing age in China from 1990 to 2021, and projections for the next 15 years

BackgroundThere are no studies on the burden of ischemic heart disease (IHD) among women of childbearing age (WCBA) in China. This study aims to describe the IHD burden among WCBA in China from 1990 to 2021, predict the trends over the next 15 years, and identify the contributing factors associated with IHD-related deaths.MethodsThe data was extracted from the Global Burden of Disease Database 2021. The Direct age-standardized method was used to estimate the age-standardized (AS) prevalence rate (ASPR), mortality rate (ASMR), incidence rate (ASIR), and disability-adjusted life years rate (ASDR) of IHD among WCBA. Joinpoint regression analysis was used to analyze the Annual Percent Change and Average Annual Percent Change from 1990 to 2021. The Autoregressive Integrated Moving Average model was used to predict the trend over the next 15 years.ResultsFrom 1990 to 2021, the ASPR and ASIR increased by 17.44% and 25.83%, culminating in 616.50 (95% UI, 498.42-762.38) and 79.93 (95% UI, 49.43–113.88) cases per 100,000 individuals. Conversely, the ASMR and ASDR declined to 5.17 (95% UI, 4.14–6.33) and 261.24 (95% UI, 212.03–318.03) cases per 100,000 individuals. Over the next 15 years, the ASPR is projected to increase by 25.74%, culminating in 775.20 (95% UI, 637.98–912.42) cases per 100,000 individuals. The main contributor to increased IHD-related deaths among WCBA in China was high low-density lipoprotein.ConclusionsDespite the significant decline in the ASMR and ASDR of IHD among WCBA in China over the last 30 years, the ASPR and ASIR continue to increase. Additionally, the ASPR is projected to rise over the next 15 years. These findings emphasize that effective measures and timely interventions are needed to reduce the disease burden.

Global Sociodemographic Disparities in Ischemic Heart Disease Mortality According to Sex, 1980 to 2021.

Mortality due to ischemic heart disease (IHD) has declined in countries with high socioeconomic development. Whether these declines extend to other settings, and whether socioeconomic development influences IHD mortality among men and women differently, is unknown. We obtained annual data on sex-specific IHD mortality rates for countries/territories in the GBD study (Global Burden of Disease) from 1980 to 2021. The sociodemographic index (SI), a measure of socioeconomic development, was retrieved for each country/territory. Age-adjusted IHD mortality rates were modeled as a smooth function of sex, year, and SI. From 1980 to 2021, IHD mortality rates did not decrease in low SI settings for men or women. In contrast, mortality rates relative to 1980 declined by >25% in average SI settings (age-adjusted mortality per 100 000, 153-107 for women and 218-161 for men) and >50% in high SI settings (age-adjusted mortality per 100 000, 162-69 for women and 258-114 for men). Comparing the 20th versus 80th percentile of SI in 2021 (corresponding to lower versus higher socioeconomic development), mortality rates were 81% higher for men and 111% higher for women living in socioeconomically deprived settings (P for difference by sex: 0.01), although absolute differences were larger in men. The association of low SI with higher IHD mortality was especially pronounced for mortality attributable to environmental/occupational risk factors (eg, particulate matter air pollution, lead exposure, and extremes of temperature), with mortality rates being 174% higher among women and 199% higher among men. Across the past 4 decades, low socioeconomic development was associated with no improvement in IHD mortality rates for men or women, in contrast to the large reductions observed in settings with high socioeconomic development. In contemporary settings, socioeconomic deprivation is associated with larger relative excess mortality in women and larger absolute excess mortality in men.

Global, regional, and national caries of permanent teeth incidence, prevalence, and disability-adjusted life years, 1990-2021: analysis for the global burden of disease study

ObjectivesThis study aims to analyze the global, regional, and national incidence, prevalence, and disability-adjusted life years (DALYs) related to caries of permanent teeth from 1990 to 2021, as part of the Global Burden of Disease Study (GBD).Study design and methodsData on incidence, prevalence, and DALYs were extracted and analyzed for various demographic and regional categories. Age-standardized incidence rates (ASIR), age-standardized prevalence rates (ASPR), and age-standardized DALY rates (ASDAR) were calculated. Temporal trends and associations with sociodemographic index (SDI) were also examined.ResultsIn 2021, there were approximately 2.37 billion cases of caries of permanent teeth, with an ASIR of 29,777.03 per 100,000 population. The prevalence was around 2.24 billion, with an ASPR of 27,543.34 per 100,000. Females exhibited a higher disease burden than males, and the burden increased with age, peaking in the 20–24 age group. Regions with lower SDI showed higher ASIRs, while the highest burden was noted in Tropical Latin America. Significant increases in disease burden were observed from 1990 to 2021, particularly in China and Colombia, while Japan showed a decrease. The Bayesian age-period-cohort (BAPC) predictions indicate that the burden of caries of permanent teeth will continue to increase year by year.ConclusionThe burden of caries of permanent teeth varies significantly across regions and demographics, with higher rates in lower SDI areas. The findings underscore the importance of targeted interventions and resource allocation in high-burden regions to improve dental health outcomes.

EASY OR NOT. European-Asian Six countries Yearly consensus On Recent guidelines: arterial hypertension, atrial fibrillation, chronic coronary syndromes, and peripheral artery diseases. Novel Or conventional Treatment options for these patients. Position Paper 2024.

The 2024 guidelines of the European Society of Cardiology (ESC) refer to four very important therapeutic areas: arterial hypertension, atrial fibrillation, chronic coronary syndromes and peripheral artery disease. The ESC countries and their institutional members share a common goal of reducing the burden of cardiovascular diseases, which remain the leading cause of death worldwide. Experts from these six countries - three from Europe and three from Asia - gathered at the annual meeting to briefly present the epidemiological situation regarding selected issues addressed in the 2024 ESC guidelines, and to create a document highlighting the significant progress in pharmacotherapy. The new guidelines allow us to identify particularly important therapeutic areas and unmet pharmaceutical needs within the four treatment guidelines developed by the ESC in 2024. While discussing each of these four documents, 10 subjectively selected points were chosen to highlight what should be kept in mind in daily clinical practice. Altogether, a range of all-risk categories are represented, and the observations made in this position paper are of a universal nature.

A cross-sectional study of cardiac rehabilitation enrollment barriers in patients at risk for suboptimal outcomes from acute coronary syndrome

Purpose: Cardiac rehabilitation (CR) is an effective treatment to reduce the burden of cardiovascular disease (CVD) but is underutilized. This study characterized CR enrollment barriers and perceived physician endorsement of CR in patient subgroups at increased risk of poor outcomes. Materials and Methods: The association between sociodemographic and clinical characteristics and Cardiac Rehabilitation Barriers Scale (CRBS) item and subscale scores were examined using secondary data analysis of patients with acute coronary syndrome referred to, but not yet enrolled in, a 12-week CR program. Participants rated perceived strength of recommendation to attend CR on 1–5 scale. Results: The three most endorsed CRBS items were inclement weather, travel, and work responsibilities. Additional barriers (e.g. time constraints, already exercising, family responsibilities) emerged in certain patient subgroups. Perceived strength of physician endorsement was high in the overall sample. After statistical adjustment for confounds, depressed mood was positively associated with logistical (b = 0.05, p = 0.002), and comorbidity-related barriers (b = 0.02, p < 0.001). Female sex (b = 0.62, p = 0.004), higher body mass index (b = 0.05, p = 0.009), and diabetes (b = 1.08, p < 0.001), were associated with logistical barriers. Conclusions: Patients require individualized support to address CR enrollment barriers. Given their crucial role in supporting patients to access CR, nurses are well-positioned to identify and address CR barriers.

Metabolome-wide association identifies ferredoxin-1 (FDX1) as a determinant of cholesterol metabolism and cardiovascular risk in Asian populations.

The burden of cardiovascular disease is rising in the Asia-Pacific region, in contrast to falling cardiovascular disease mortality rates in Europe and North America. Here we perform quantification of 883 metabolites by untargeted mass spectroscopy in 8,124 Asian adults and investigate their relationships with carotid intima media thickness, a marker of atherosclerosis. Plasma concentrations of 3beta-hydroxy-5-cholestenoate (3BH5C), a cholesterol metabolite, were inversely associated with carotid intima media thickness, and Mendelian randomization studies supported a causal relationship between 3BH5C and coronary artery disease. The observed effect size was 5- to 6-fold higher in Asians than Europeans. Colocalization analyses indicated the presence of a shared causal variant between 3BH5C plasma levels and messenger RNA and protein expression of ferredoxin-1 (FDX1), a protein that is essential for sterol and bile acid synthesis. We validated FDX1 as a regulator of 3BH5C synthesis in hepatocytes and macrophages and demonstrated its role in cholesterol efflux in macrophages and aortic smooth muscle cells, using knockout and overexpression models.

Estimating the deferred value of pathogen genomic data for secondary use

The COVID-19 pandemic has illuminated the utility of pathogen genomics and highlighted roadblocks to international data sharing. This article describes the deferred value of pathogen genomics data for secondary use using a set of 10,110 assembled genomes of Vibrio cholerae shared via international repositories between 2010 and 2024 as an illustrative representation of a pandemic disease. Trends in the quality, representativeness, and timeliness of data sharing as well as the increasing role of microbiology services as genomic data providers resulting from gradually improving access to sequencing technologies in countries with a high burden of disease were identified. The deferred value of individual and aggregated genomic data was tracked over time and mapped to geographical hot spots of cholera. The time lag between the collection of the samples for V. cholerae cultures and the submission of the genome to an international database remained eight years on average. The data value assessment described here paves the way for the international mobilization of quality microbial genomic data for global health and knowledge discovery.

Real-world characteristics & disease history of patients with X-linked hypophosphatemia before treatment with burosumab

SummaryIn a United States claims database, 1,358 persons with familial hypophosphatemia who began treatment with burosumab were identified. Prior to treatment, high rates of several morbidities were coded including osteoarthritis, fractures, enthesopathy, spinal stenosis, hypertension, depression and opioid use, which generally increased with age, emphasizing disease burden throughout the lifespan.PurposeTo examine the characteristics and disease history of real-world patients with X-linked hypophosphatemia (XLH) in the United States, prior to initiating burosumab.MethodsThis retrospective cohort study used Komodo Health’s Healthcare Map™, a de-identified patient-level claims database. Included patients had ≥ 1 claim for familial hypophosphatemia between 01-Jan-2015 and 30-Jun-2022 (the study period) and ≥ 1 claim for burosumab between 01-Apr-2018 and 30-Jun-2022. The index date was the date of first burosumab claim. Patient demographics were measured at index; disease history was measured over the pre-index period and stratified by age. All variables were evaluated descriptively.Results1,358 patients were included (mean age 23.5 ± 19.1 years, 847 [62%] female); 720 patients (53%) were aged < 18 years. Prior to index, patients had high levels of XLH-related morbidities. Most XLH-related morbidities appeared in the youngest age groups, and the prevalence was generally greater among the older age groups. For example, arthralgia was found in 57 patients (12%) aged ≤ 11 years and 123 patients (69%) aged ≥ 50 years. Opioid use increased with age (173 patients [24%] aged < 18 years; 328 [51%] ≥ 18 years). Physical therapy use was observed across age groups (126 patients [18%] aged < 18 years; 253 [40%] ≥ 18 years).ConclusionsAt initiation of burosumab, over half of patients with XLH were < 18 years of age. Claims indicated a high prevalence of XLH-related morbidities, which began at a young age and increased over time.

Temporal trends of the disease burden of renal cell carcinoma from 1992 to 2019 in the US: a population-based analysis.

Significant advances in the management, in particular the treatment, of renal cell carcinoma (RCC) has have been made over the years. However, it is not clear whether these advances reduce the disease burden of RCC at the population level. Using data from the Surveillance, Epidemiology, and End Results database, we estimated the temporal trends of RCC incidence, incidence-based mortality (IBM), and survival rates in the United States (US) from 1992 to 2019. From 2008 to 2019, the incidence increased slowly at 1.1% annually (95% CI: 0.6% to 1.5%). The overall IBM rate of RCC increased by 6.8% per year (95% CI: -1.1% to 15.3%) between 1994 and 1997, plateaued between 1997 and 2015, and then decreased nonsignificantly after 2015. During the study period, the overall Five year survival rate of RCC continuously increased from 53.69 in 1992 to 72.90% in 2014, with the best improvement observed for RCC patients with distant disease. However, we projected that, given the current trends, the incidence of RCC in the US will continue to increase from 6.92 per 100,000 in 2015-2019 to 9.59 per 100,000 in 2040-2044. Over the years, the mortality of RCC has been decreased reducing at the US population level mainly because the considerably significantly improved survival of RCC patients at all stages through the advances in treatment. However, the overall incidence of RCC is continuously increasing, indicating that more effective preventive strategies should be developed to reduce the disease burden of RCC.

Resectable Pancreatic Cancer with CA19-9 > 500U/mL: A Biological Indicator for Survival Benefit with Intensive Neoadjuvant Chemotherapy.

While anatomical resectability guides pancreatic cancer treatment, carbohydrate antigen (19-9 (CA19-9) serves as a biological indicator of disease burden. Current guidelines suggest considering neoadjuvant chemotherapy (NAC) for cases with markedly elevated CA19-9, but specific threshold values and treatment strategies remain undefined. This retrospective study aimed to evaluate the efficacy of intensive NAC using gemcitabine plus nab-paclitaxel or fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX) for anatomically resectable pancreatic cancer with elevated CA19-9 (> 500U/mL). We analyzed patients with anatomically resectable pancreatic cancer and CA19-9 > 500U/mL treated between 2014 and 2022. Initial planned treatments were either 4-month intensive NAC followed by surgery (NAC group) or upfront surgery (UPS group). Survival outcomes were evaluated using retrospective intention-to-treat analysis. Among 184 included patients, 46 received NAC and 138 underwent upfront surgery. The NAC group demonstrated significantly improved overall survival compared with the UPS group (median 52.7 vs. 22.7months, P < 0.001). Resection rates were 89.1% and 76.1% in the NAC and UPS groups, respectively. Among resected cases, the NAC group achieved higher lymph node-negative resection rates (53.7% vs. 23.8%, P < 0.001) and better post-resection CA19-9 normalization rates (75.6% vs. 56.1%, P = 0.037). Survival benefits were maintained even in cases with CA19-9 > 2000U/mL (median OS 52.7 vs. 18.9months, P = 0.025). CA19-9 > 500U/mL serves as an effective indicator for implementing intensive NAC in anatomically resectable pancreatic cancer. This biomarker-based strategy effectively extracts the beneficial group from NAC, prolonging survival outcomes through better systemic disease control.

Cysticercosis and neurocysticercosis in people from Mocuba district, Zambézia province: A Mozambican community-based study.

Taenia solium cysticercosis represents a significant public health concern, especially in low-income countries such as Mozambique, where especially the sub form neurocysticercosis can be associated with acute symptomatic seizures, epilepsy and other neurological and psychiatric disorders. Therefore, this study aimed to determine the prevalence of T. solium cysticercosis, neurocysticercosis, seizures and chronic headaches in the Mocuba district, Zambézia province, Mozambique, and to assess their associations. The overall study combined both a community-based and a clinic-based segment, including epidemiological, clinical, laboratory and neuroradiological approaches, to investigate the prevalence and the association of cysticercosis, neurocysticercosis, seizure activity and chronic headaches in the Mocuba district. The community-based study involved 6,932 participants who were asked a questionnaire related to signs/symptoms of neurocysticercosis and who were asked to provide a blood sample for serological testing. Serological tests (Antigen-ELISA and Western blot) were used to detect cysticerci specific antigens and antibodies, respectively, in the participants. The clinic-based study included cerebral computed tomography (CT) of 233 individuals - a subset of those recruited from the community (with and without seizure activity and with and without cysticercosis based on serology). The prevalence of seizures and chronic headaches in the community-based study was 6.5% and 46.2% respectively, and the cysticercosis seroprevalence was 9.6%. Seizures and chronic headaches presented significant associations with cysticercosis seropositivity (p < 0.05). The clinic-based study revealed 9 (3.9%) of 233 individuals with neurocysticercosis-typical lesions on CT-scan of whom one case was negative on serology and on screening for seizure activity. The community-based prevalence of seizure activity and cysticercosis was high in the Mocuba district. There was also a significant association of seizure activity and chronic headaches with the seroprevalence of cysticercosis and 8 out of 9 people with neurocysticercosis had seizure activity. This highlights the importance of increased awareness and the need for building health literacy within the healthcare workforce and the communities as well as the implementation of targeted interventions, both for people with seizure activity with and without neurocysticercosis. Future research should also assess the impact of preventive measures in reducing disease burden caused by T. solium.

Psychological Processes Related to Persistent Physical Symptoms in Patients With a Suspected Rare Disease: a Cross-sectional Interview Study.

This cross-sectional interview study aimed to investigate subjective experiences and illness models of patients presenting at a rare disease center. Additionally, we strove to identify psychological factors that may be associated with patients' heterogeneous and often unspecific persistent physical symptoms (PPS). We conducted semi-structured interviews with 27 adult patients (56% female; mean age: M(SD)=44(15.3) years) with a suspected rare disease presenting at the Martin Zeitz Center for Rare Diseases in Hamburg, Germany. Numeric rating scales and open-ended questions assessed disease burden, experiences with the healthcare system, and subjective thoughts and feelings related to PPS, along with psyche-soma interactions and the subjective illness theory. Data were analyzed with qualitative content analysis. All patients reported negative experiences with the healthcare system, including strained doctor-patient relationships (82%), for instance through stigmatization, and dissatisfaction with care (85%). Patients described several aspects that negatively influenced their PPS, including significant life events before symptom onset (41%), mental stress (44%) and the intense mental focus on symptoms (22%). Participants also described factors improving their PPS, such as psychotherapy (26%) and an optimistic attitude (26%). Some patients had an illness model that integrated psychosocial aspects (19%) while others had a biomedical explanation (26%). Patients with a suspected rare disease describe a variety of challenging experiences with their somatic symptoms and the diagnostic process. Our results support the assumption that psychological aspects may contribute to the heterogeneous and often unspecific somatic symptoms that patients at rare disease centers present with.

Global burden of disease from cyclist road injuries in youth and young adults aged 15–39 years, 1990–2021

BackgroundCyclist: individuals who ride bicycles as a mode of transportation or recreation. Cyclist Road Injuries (CRI): road traffic injuries sustained by cyclists, including collisions with motor vehicles, pedestrians, or other cyclists, as well as single-vehicle crash’s (e.g., falls or crashes without external collision). Detailed analyses of the global burden of CRI among youth and young adults aged 15–39 remain limited. This study evaluates the disease burden of CRI from 1990 to 2021 using Global Burden of Disease (GBD) 2021 data.MethodsAge-standardized incidence (ASIR), death (ASDR), and disability-adjusted life year (DALY) rates were calculated across 204 countries and 21 regions, stratified by socio-demographic index (SDI). Linear regression modeling estimated annual percentage changes (EAPC) to assess trends.ResultsGlobally, ASIR, ASDR, and DALY rates declined from 1990 to 2021 (EAPCs: −1.26, −0.38, −0.80). However, absolute numbers of death cases and DALYs increased by 26.63 and 11.19%, respectively. High-middle SDI regions had the highest ASIR (259.70) and DALY rate (53.77), while middle SDI regions showed the highest ASDR (0.68). East Asia exhibited the highest ASDR and DALY rates. Andean Latin America saw the largest increases (EAPCs: 0.85, 2.13, 1.43), whereas high-income Asia Pacific showed the most significant declines (EAPCs: −3.52, −6.37, −5.20).ConclusionDespite declining rates, CRI burden remains significant, particularly in high-middle and middle SDI regions like East Asia and the Caribbean. Andean Latin America showed rising trends, while high-income Asia Pacific achieved substantial reductions.

Real-world disease burden and planned treatment optimization after MANAGE-PD implementation in Germany: a cross-sectional study

BackgroundIn Germany, the approach to treatment optimization for patients with advanced Parkinson's disease (PD) is considered somewhat conservative. The MANAGE-PD tool (www.managepd.eu) was developed to help identify patients with advanced PD and to facilitate treatment decision making and appropriate allocation of patients to device-aided therapies (DAT). This prospective, non-interventional study aimed to investigate the real-world disease burden of PD and treatment optimization after MANAGE-PD implementation.MethodsAdult PD patients (N = 278) visited specialist clinics and neurologist’s practices in Germany in 2022. Disease burden was assessed using the Unified PD rating scale (UPDRS parts II-IV), the non-motor symptoms scale (NMSS) and the 8-item Parkinson’s disease Questionnaire (PDQ-8). Data on planned treatment changes were collected. Data were analyzed by disease control categories according to the MANAGE-PD tool.ResultsMean scores for motor and non-motor symptoms, quality of life, and comorbidity burden were worse in patients with lower disease control measured by MANAGE-PD. For 52.8% of patients in Category 2 (inadequately controlled—might benefit from oral optimization), no change in oral treatment was planned. No change in oral treatment and no DAT initiation was planned for 37.9% and 65.0% of patients in Category 3 (inadequately controlled—might benefit from DAT). Patient refusal and needing more time to decide were the most common reasons for not making treatment changes.ConclusionsThis study supports the validity of MANAGE-PD by showing its high association with disease burden and emphasizes the importance of timely provision of necessary information to enable informed decisions about treatment optimization.

Global, regional, and national burden of congenital musculoskeletal and limb anomalies, 1990–2021: a systematic analysis of the global burden of disease in 2021

BackgroundCongenital musculoskeletal and limb (CML) anomalies are uncommon, multifactorial conditions whose global incidence trends remain underexplored. This study delineates the epidemiology and temporal evolution of CML anomalies from 1990 to 2021.MethodsWe extracted data from the 2021 global burden of disease (GBD) Study, stratifying by sex, region, country and socio-demographic index (SDI). We calculated age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), age-standardized prevalence rate (ASPR), and estimated annual percentage change (EAPC). Decomposition analysis quantified the contributions of population growth, aging, and epidemiological change. Projections to 2031 were made using an autoregressive integrated moving average (ARIMA) model. Health inequities were assessed via the slope index of inequality (SII) and concentration index (CI).ResultsGlobal epidemiological patterns of CML anomalies exhibited significant disparities between 1990 and 2021. Brunei Darussalam demonstrated the highest ASIR, while Afghanistan and the United Mexican States recorded the highest ASMR and ASPR, respectively. Absolute case and death burdens predominantly clustered in populous nations, with India and China reporting the highest absolute numbers. ARIMA modeling projected a 0.85% increase in incident cases (from 2,437,890.12 to 2,458,596.45), a 25.46% decrease in mortality (from 13,599.83 to 10,137.02), and a 3.55% increase in prevalence (from 18,549,408.27 to 19,207,414.19) by 2031. Decomposition analyses revealed that population growth was the primary driver of increased cases in middle SDI regions, whereas epidemiological transitions and aging were the main contributors to mortality reductions. In lower-middle SDI regions, concurrent demographic expansion and epidemiological changes amplified case burdens. Health inequality significantly increased, with the incidence CI rising from 0.28 to 0.35 and the mortality CI from 0.34 to 0.42 between 1990 and 2021. Significant correlations were observed between EAPC and baseline ASIR/ASMR, with declining trends in mortality and rising prevalence driven by population growth and epidemiological transitions.ConclusionFrom 1990 to 2021, CML anomalies’ incidence and mortality exhibited divergent trends across SDI strata, with less favorable outcomes in lower-SDI countries. Tailored interventions are essential to mitigate the growing burden in these settings.

The rising burden of diabetes and state-wise variations in India: insights from the Global Burden of Disease Study 1990–2021 and projections to 2031

BackgroundDiabetes is a major public health concern in India, contributing significantly to morbidity and mortality. With variations in disease burden across states, a detailed understanding of trends in incidence, prevalence, and Disability Adjusted Life Years (DALYs) is essential for targeted interventions.MethodsThis study utilized Global Burden of Disease (GBD) data from 1990 to 2021 to examine trends in diabetes across Indian states. Age-standardized incidence, prevalence, mortality, and DALYs were analyzed using Join point regression to estimate Annual Percentage Change (APC). Autoregressive Integrated Moving Average (ARIMA) models were employed to project diabetes trends up to 2031.While the GBD data provide robust national and regional estimates, their modeled nature may not capture the full spectrum of local epidemiological variations.ResultsDiabetes incidence increased from 162.74 to 264.53 per 100,000 between 1990 and 2021, with an APC of 0.63%. Joinpoint analysis identified episodic surges in incidence, with APCs of 2.25% during 1996–1999 and 2.07% during 2005–2011, suggesting intervals of accelerated increase relative to the gradual progression typically observed in chronic conditions. Mortality rose from 23.09 to 31.12 per 100,000 (APC: 0.12%). Southern and Western states, such as Tamil Nadu and Goa, exhibited the highest prevalence and DALYs. Forecasted trends indicate that by 2031, the prevalence will reach 8585.45 per 100,000, and DALYs will exceed 1241.57 per 100,000.ConclusionThe burden of diabetes in India has risen markedly over the past three decades. These findings underscore the urgent need for health policies that emphasize lifestyle modifications and improved healthcare access. A comprehensive approach that integrates primary prevention through community-based health education, dietary counseling, and initiatives to promote physical activity with secondary prevention measures such as systematic screening and timely clinical management, is essential for effective diabetes control and management in high-burden states.

Trends and projections of the burden of gastric cancer in China and G20 countries: a comparative study based on the global burden of disease database 2021.

Trends and projections of the burden of gastric cancer in China and G20 countries: a comparative study based on the global burden of disease database 2021.

Global burden and cross-country inequalities in gallbladder and biliary tract cancer (1990–2021) with projections to 2050: insights from the global burden of disease study 2021

BackgroundGallbladder and biliary tract cancer (GBTC) presents a worldwide health challenge with a poor prognosis. Previous studies indicated an escalating burden and potential health inequalities, necessitating an updated investigation.MethodsThis study utilized data from the Global Burden of Disease (GBD) study, covering 204 countries from 1990 to 2021. Joinpoint regression evaluated temporal trends in age-standardized incidence rates (ASIR) and age-standardized disability-adjusted life years rates (ASDR) for GBTC. The Bayesian age-period-cohort (BAPC) model projected disease burden up to 2050. Inequality analysis assessed disparities by genders across countries, and decomposition analysis determined the contributions of demographic and epidemiological factors.ResultsFrom 1990 to 2021, the incident cases of GBTC increased from 107,797 to 216,768, while Disability-Adjusted Life Years (DALYs) rose from 2,326,089 years to 3,732,121. Joinpoint regression analysis revealed a global decrease in ASIR (AAPC = −0.39, 95% CI: −0.49 to −0.28) and ASDR (AAPC = −0.97, 95% CI: −1.07 to −0.88). Gender disparities were notable, with a polar reversal observed: females exhibited consistently higher ASDR levels across three decades, although both ASDR and ASIR showed continuous decreases. In contrast, males experienced a decreased ASDR but increased ASIR, with both metrics eventually surpassing those of females. The projection model also suggested diverging ASIR trends between genders. Cross-country inequality analysis revealed persistent disparities, where higher SDI countries continue to bear a greater burden, and global improvement in health equity for males remains insufficient. Decomposition analysis indicated that population growth and ageing were primary drivers of disease burden increase, whereas epidemiological changes contributed to a reduction, particularly in higher SDI quintiles.ConclusionDespite improvements, GBTC burden is still greater in high SDI regions compared to lower SDI areas, contrary to expectations. Unexpected polar reversal of gender differences warrants further attention.

Population-Wide Depression Incidence Forecasting Comparing Autoregressive Integrated Moving Average and Vector Autoregressive Integrated Moving Average to Temporal Fusion Transformers: Longitudinal Observational Study.

Accurate prediction of population-wide depression incidence is vital for effective public mental health management. However, this incidence is often influenced by socioeconomic factors, such as abrupt events or changes, including pandemics, economic crises, and social unrest, creating complex structural break scenarios in the time-series data. These structural breaks can affect the performance of forecasting methods in various ways. Therefore, understanding and comparing different models across these scenarios is essential. This study aimed to develop depression incidence forecasting models and compare the performance of autoregressive integrated moving average (ARIMA) and vector-ARIMA (VARIMA) and temporal fusion transformers (TFT) under different structural break scenarios. We developed population-wide depression incidence forecasting models and compared the performance of ARIMA and VARIMA-based methods to TFT-based methods. Using monthly depression incidence from 2002 to 2022 in Hong Kong, we applied sliding windows to segment the whole time series into 72 ten-year subsamples. The forecasting models were trained, validated, and tested on each subsample. Within each 10-year subset, the first 7 years were used for training, with the eighth year for setting hold-out validation, and the ninth and tenth years for testing. The accuracy of the testing set within each 10-year subsample was measured by symmetric mean absolute percentage error (SMAPE). We found that in subsamples without significant slope or trend change (structural break), multivariate TFT significantly outperformed univariate TFT, vector-ARIMA (VARIMA), and ARIMA, with an average SMAPE of 11.6% compared to 13.2% (P=.01) for univariate TFT, 16.4% (P=.002) for VARIMA, and 14.8% (P=.003) for ARIMA. Adjusting for the unemployment rate improved TFT performance more effectively than VARIMA. When fluctuating outbreaks happened, TFT was more robust to sharp interruptions, whereas VARIMA and ARIMA performed better when incidence surged and remained high. This study provides a comparative evaluation of TFT and ARIMA and VARIMA models for forecasting depression incidence under various structural break scenarios, offering insights into predicting disease burden during both stable and unstable periods. The findings support a decision-making framework for model selection based on the nature of disruptions and data characteristics. For public health policymaking, the results suggest that TFT may be a more suitable tool for disease burden forecasting during periods of stable burden level or when sudden temporary interruption, such as pandemics or socioeconomic variation, impacts disease occurrence.

The crucial role of allergists in the clinical management and treatment of eosinophilic esophagitis.

Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus affecting mainly young individuals with a high burden of comorbid atopic diseases and is associated with increased morbidity. Proton pump inhibitors (PPIs) is often the first line of treatment by inducing clinical remission in 30-50% of patients. Recently new drugs, such as budesonide orodispersible tablets and a monoclonal antibody targeting interleukin-4 and 13, have been found to be effective in clinical trials and approved to treat this condition. A prompt diagnosis and correct management of these patients is of paramount importance to prevent fibrostenosis of the oesophagus and to improve the quality of life. The complex management of patients living with EoE requires the integrated cooperation of several specialists, including allergists, gastroenterologists, pathologists, dietitians, and psychologist.