Burden Of Injury Research Articles

How Does Age Affect Injury Characteristics in Young Elite Footballers?-A Prospective Cohort Study of a German Youth Academy.

Little is known about age-related changes in injury characteristics and burden, and existing data are inconsistent, highlighting the need for new studies on this topic. This study aimed to describe age-related injury risk, severity and burden in a German elite youth football academy. A prospective cohort study was conducted in the 2012/2013 season, reporting 109 time-loss injuries among 138 young athletes playing at an elite football academy in Germany. For the most severe injuries, the injury burden in the different age groups was considered separately. Athletes missed a total of 2536 days of exposure, resulting in an overall incidence of 2.6 per 1000 h (1.7-3.0; 95% CI) and a burden of 60.6 days lost per 1000 h (40.8-80.3; 95% CI). The incidence and burden of joint sprains and muscle injuries were higher in the older age groups. Physeal injuries peaked in the U14 age group during the pubertal growth spurt. Bone injuries and contusions showed no age trend. Injury characteristics vary with age. The overall incidence, severity and burden of injuries increased with the age of the athletes. To ensure the optimal development of young athletes, it is important to be aware of the differences in injury susceptibility between age groups in order to implement tailored prevention programmes.

The Health System Services and Insurance Affects Welfare and Socio-Economic Growth of a Country

This paper focuses on the Health System Services, and how affects welfare and socio-economic growth, as an important sector to improve the socio-economic well-being of a developing country such as Kosovo. This study also provides key recommendations of some important policies to be undertaken by the government to improve the Health System Services with the aim for increasing social welfare and socio-economic growth of the country. Some of the different types of government policies and programs have been put in place reducing the Burden of Injury, to improve the health of the population. (Ganguli, I; Grawford, M L; Usadi, B; Mulligan, K L; O'Malley, A J; Yang, C W; Fisher, E S; Morden, N E;, 2023). In our paper we focused on secondary quantitative data collection. The data were provided by the annual health services report for 2022, Pristina Municipality related to the Family Medical Centers “FMC", for 2022. In our study we’ve used the descriptive method, and through tables and charts we’ve provided a comparative analysis, based on some statistics which are expressed in percentage (%) (Sejdiu, Rexha , & Deda, 2023). However, the main purpose is to show the employment structure of the Family Medical Centers "FMC", in Kosovo for 2022, according to the sectors: Primary Health Care and Dental Polyclinic.
 
 Received: 29 July 2023 / Accepted: 19 October 2023 / Published: 5 November 2023

Evaluating a digital hybrid training-of-trainers (TOT) approach for lay first responder trauma education in urban Nigeria during the COVID-19 pandemic

IntroductionRoad traffic injuries (RTIs) are the largest contributor to the global burden of injury, and in 2016 were among the five leading causes of global disability-adjusted life years (DALYs). In regions with limited emergency medical services (EMS), training lay first responders (LFRs) has been shown to increase availability of prehospital care for RTIs, but sustainable mechanisms to scale these programs remain unstudied. MethodsUsing a training of trainers (TOT) model, a 5.5-h LFR training program was launched in Lagos, Nigeria. The course was taught in a hybrid fashion with primary didactics using videoconferencing software and practical breakout sessions in-person concurrently. Thirty TOTs proceeded to train 350 transportation providers as LFRs over one month. A 23-question, pre- and post-assessment was administered digitally to assess knowledge acquisition. Participants responded to a five-point Likert survey assessing instruction quality and post-course confidence. ResultsTOTs scored a median of 56.5 % (IQR:43.5 %,71.7 %) and 91.3 % (IQR:88.0 %,95.7 %) on the pre- and post-assessments, respectively, with bleeding control scores increasing most (+69.4 %). LFR course trainees scored a median of 34.8 % (IQR: 26.0 %, 43.5 %) and 73.9 % (IQR: 65.2 %, 82.6 %) on the pre- and post-assessments respectively, with airway and breathing increasing the most (+48.6 %). All score increases were statistically significant with p < 0.001. All 30 TOT trainers instructed at least one training session after their initial session. LFR participants’ rated confidence in first aid skills went from 3/5 (IQR 3, 4) pre-course to 5/5 (IQR:5,5) post-course, and in emergency transportation it went from 4/5 (IQR:3, 4) to 5/5 (IQR:5, 5), (p < 0.001). LFR course participants rated the quality of education content and TOT instructors to be 5/5 (IQR:5,5). 144 responders provided emergency care in the six-months following training for a total of 351 interventions. Active responders provided a median of 2 (IQR:1,3) interventions. ConclusionsThis is the first time that a digital hybrid instruction for first responder trainers in low- and middle-income countries has been investigated. Our findings demonstrate negligible attrition, high educational quality ratings, equally effective knowledge acquisition to that of prior in-person courses, and high post-training skill usage. Future work will examine the cost-effectiveness of the training of LFRs and the effect of LFRs on trauma outcomes.

Lost in transition: Exploring injury risk in academy footballers shifting between the second and first teams

ObjectivesTo compare the injury profiles of football players shifting between second and first teams with those of second- and first-team players, and to examine the opinions of shifting players. DesignProspective cohort study. Methods170 male players from Athletic Club (second team = 90, shifting = 20, first team = 60) were followed over eight seasons. Injuries and exposure time were recorded following the FIFA consensus, and 18 shifting players answered a seven-item questionnaire on their experience. Results35 % shifting players became full-time first-team players, in contrast to only 8 % of second-team players (odds ratio = 6.4, p < 0.01). There were no differences in the overall injury incidence, but the overall burden of injuries was higher in second-team (172 days lost/1000 h) and shifting players (194 days lost/1000 h) compared with first-team players (114 days lost/1000 h, p < 0.01). Shifting players had a higher burden of knee joint/ligament injuries compared with first-team players (137 vs. 18 days lost/1000 h, p < 0.01) and anterior cruciate ligament (ACL) ruptures (122 vs. 10 days lost/1000 h, p < 0.01). There was a trend towards a higher burden of ACL ruptures in shifting players than in second-team players (122 vs. 41 days lost/1000 h, p = 0.07). Shifting players reported constant pressure and better communication with the second-team coaching staff than with the first-team staff. ConclusionsThe high burden of injuries in shifting players, particularly from ACL ruptures, highlights the need for action. Ensuring high-quality communication between second- and first-team staff remains a key challenge.

Changes in head staff members in male elite-level football teams are associated with increased hamstring injury burden for that season: the UEFA Elite Club Injury Study

ObjectiveTo evaluate whether a change of head coach or other head staff before or during a season is correlated to hamstring injury (HI) burden in male elite-level football (soccer) in...

Global, regional and national burdens of non-melanoma skin cancer attributable to occupational exposure to solar ultraviolet radiation for 183 countries, 2000–2019: A systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury

BackgroundA World Health Organization (WHO) and International Labour Organization (ILO) systematic review reported sufficient evidence for higher risk of non-melanoma skin cancer (NMSC) amongst people occupationally exposed to solar ultraviolet radiation (UVR). This article presents WHO/ILO Joint Estimates of global, regional, national and subnational occupational exposures to UVR for 195 countries/areas and the global, regional and national attributable burdens of NMSC for 183 countries, by sex and age group, for the years 2000, 2010 and 2019. MethodsWe calculated population-attributable fractions (PAFs) from estimates of the population occupationally exposed to UVR and the risk ratio for NMSC from the WHO/ILO systematic review. Occupational exposure to UVR was modelled via proxy of occupation with outdoor work, using 166 million observations from 763 cross-sectional surveys for 96 countries/areas. Attributable NMSC burden was estimated by applying the PAFs to WHO’s estimates of the total NMSC burden. Measures of inequality were calculated. ResultsGlobally in 2019, 1.6 billion workers (95 % uncertainty range [UR] 1.6–1.6) were occupationally exposed to UVR, or 28.4 % (UR 27.9–28.8) of the working-age population. The PAFs were 29.0 % (UR 24.7–35.0) for NMSC deaths and 30.4 % (UR 29.0–31.7) for disability-adjusted life years (DALYs). Attributable NMSC burdens were 18,960 deaths (UR 18,180–19,740) and 0.5 million DALYs (UR 0.4–0.5). Men and older age groups carried larger burden. Over 2000–2019, attributable deaths and DALYs almost doubled. ConclusionsWHO and the ILO estimate that occupational exposure to UVR is common and causes substantial, inequitable and growing attributable burden of NMSC. Governments must protect outdoor workers from hazardous exposure to UVR and attributable NMSC burden and inequalities.

Burn and Trauma Burden and Screening for Interpersonal Violence During the COVID-19 Pandemic

IntroductionNationwide shelter-in-place (SIP) orders during the pandemic have had long-lasting effects, including increased rates of domestic violence and interpersonal violence. Screening for violence varies by institution, which tool is used, and when. Given increases in burn and trauma admissions over the course of the pandemic, we sought to examine trends at our institution during this time period to better guide care and anticipate system-level effects. MethodsWe performed a retrospective cohort study of pediatric burn and adult burn and trauma patients at our level 1 trauma/burn center between March-May 2019 and March-May 2020. Home safety screening was performed by nursing staff using a 1-part screening questionnaire. Patients presenting before March 15, 2020, were defined as “pre-SIP; ” between March 16-May 19, 2020, were “during SIP; ” and those after May 19, 2020, were designated as “post-SIP.” Descriptive and chi-square statistics were used. Demographic, injury patterns, and screening information were collected. ResultsBlunt trauma comprised 60% of injuries, followed by burns (30%) then penetrating injury (7%). Over the entire time period analyzed, 1822 patients had documented home safety screening; ∼2% of patients screened reported a safety concern pre-SIP, compared to 3% of patients during SIP. There were higher rates of burns and penetrating injury during SIP compared to other periods (P ≤ 0.0001). Home safety screening rates were 94%-95% pre- and during SIP, but dropped to 85% post-SIP (P < 0.0001). Home safety concerns were reported almost 2% of the time pre-SIP and 3% during SIP (P = 0.016). ConclusionsWe noted an increase in trauma and burns during and after SIP orders, consistent with the experiences of other institutions. Implementation of a nurse-driven screening process demonstrated high compliance with appropriate referrals. The burden of burn and traumatic injury remains significant, highlighting a need for continued psychosocial screening and the provision of psychosocial support resources in the acute trauma setting.

Effect of antiplatelet and anticoagulant medication use on injury severity and mortality in patients with traumatic brain injury treated in the intensive care unit

BackgroundAntiplatelet and anticoagulant medication are increasingly common and can increase the risks of morbidity and mortality in traumatic brain injury (TBI) patients. Our study aimed to quantify the association of antiplatelet or anticoagulant use in intensive care unit (ICU)–treated TBI patients with 1-year mortality and head CT findings.MethodWe conducted a retrospective, multicenter observational study using the Finnish Intensive Care Consortium database. We included adult TBI patients admitted to four university hospital ICUs during 2003–2013. The patients were followed up until the end of 2016. The national drug reimbursement database provided information on prescribed medication for our study. We used multivariable logistic regression models to assess the association between TBI severity, prescribed antiplatelet and anticoagulant medication, and their association with 1-year mortality.ResultsOf 3031 patients, 128 (4%) had antiplatelet and 342 (11%) anticoagulant medication before their TBI. Clopidogrel (2%) and warfarin (9%) were the most common antiplatelets and anticoagulants. Three patients had direct oral anticoagulant (DOAC) medication. The median age was higher among antiplatelet/anticoagulant users than in non-users (70 years vs. 52 years, p < 0.001), and their head CT findings were more severe (median Helsinki CT score 3 vs. 2, p < 0.05). In multivariable analysis, antiplatelets (OR 1.62, 95% CI 1.02–2.58) and anticoagulants (OR 1.43, 95% CI 1.06–1.94) were independently associated with higher odds of 1-year mortality. In a sensitivity analysis including only patients over 70, antiplatelets (OR 2.28, 95% CI 1.16–4.22) and anticoagulants (1.50, 95% CI 0.97–2.32) were associated with an increased risk of 1-year mortality.ConclusionsBoth antiplatelet and anticoagulant use before TBI were risk factors in our study for 1-year mortality. Antiplatelet and anticoagulation medication users had a higher radiological intracranial injury burden than non-users defined by the Helsinki CT score. Further investigation on the effect of DOACs on mortality should be done in ICU–treated TBI patients.

Demographics and Comorbidities of United States Service Members with Combat-Related Lower Extremity Limb Salvage.

This retrospective study describes the demographics and injury characteristics of a recently identified cohort of US Service members with combat-related lower extremity limb salvage (LS). US Service members with combat trauma were identified from the Expeditionary Medical Encounter Database and Military Health System Data Repository and stratified into primary amputation (PA), LS, and non-threatened limb trauma (NTLT) cohorts based on ICD-9 codes. Disparities in demographic factors and injury characteristics were investigated across cohorts and within the LS cohort based on limb retention outcome. Cohort demographics varied by age but not by sex, branch, or rank. The mechanism of injury and injury characteristics were found to be different between the cohorts, with the LS cohort exhibiting more blast injuries and greater injury burden than their peers with NTLT. A sub-analysis of the LS population revealed more blast injuries and fewer gunshot wounds in those that underwent secondary amputation. Neither demographic factors nor total injury burden varied with limb retention outcome, despite slight disparities in AIS distribution within the LS cohort. In accordance with historic dogma, the LS population presents high injury severity. Demographics and injury characteristics are largely invariant with respect to limb retention outcomes, despite secondary amputation being moderately more prevalent in LS patients with blast-induced injuries. Further study of this population is necessary to better understand the factors that impact the outcomes of LS in the Military Health System.

Road traffic injuries and associated mortality in the Islamic Republic of Iran.

Road traffic accidents are a major public health problem globally, causing millions of injuries, deaths and disabilities, and a huge loss of financial resources, especially in low- and middle-income countries. To determine the incidence of road traffic injuries and associated mortality from 1997 to 2020 in the Islamic Republic of Iran. This retrospective study used data from the Legal Medicine Organization of the Islamic Republic of Iran to estimate the annual rates of road traffic injuries and associated mortality from 21 March 1997 to 20 March 2020. The data were analysed using STATA version 14 and the annual rates are reported per 100 000 population. During the study period, 5 760 835 road traffic injuries and 472 193 deaths were recorded in the Islamic Republic of Iran. The mortality rate increased from 22.4 per 100 000 in 1997 to 40 per 100 000 in 2005 and decreased to 18.4 per 100 000 in 2020. The injury rate increased from 111.1 per 100 000 in 1997 to 394.9 per 100 000 in 2005. It decreased in 2006 and 2007 and increased from then until 2010, finally reaching 331.8 per 100 000 in 2020. The male to female ratio for road traffic mortality was 3.9 in 1997 and 4.6 in 2020. The case fatality rate was highest (20.1%) in 1997 and decreased to 5.6% in 2020. Continuous interventions are needed to reduce the burden of road traffic injuries and associated mortality in the Islamic Republic of Iran.

Burn injury as a public health problem in Odisha: clinico-epidemiological study of patients admitted in a tertiary care hospital and prospects for control

Background: Burn injuries continue to pose a significant and preventable global health challenge, with developing countries like India experiencing a troubling rise in cases. This study aimed to investigate the socio-demographic characteristics and patterns of burn injuries among patients admitted to a tertiary care hospital's. Methods: Over a six-month period, a hospital-based cross-sectional study was conducted using semi-structured questionnaires, with prior consent from patients or their caregivers. Clinical assessments were also conducted to determine the percentage of total body surface area (TBSA) affected and the most severely affected body part. Results: 145 patients included in the study, the females were (56.55%), primarily aged between 21 and 40 years. Hindus (58.62%), lived in rural areas (63.45%), and were married (66.90%). Accidental burns accounted for 81.38% of cases, mainly occurring at home (84.83%). Flame burns were more common among females, while electric burns were more prevalent among males. The majority of burn injuries covered up to 30% of TBSA (44.83%), with the upper limbs being the most severely affected (42.76%). Alarmingly, only 36.55% of patients were admitted on the same day as the injury. Infection (55.86%) and amputation (8.97%) were the most common complications observed, and 14 deaths (9.66%) occurred during the study period. Conclusions: This study highlights the vulnerability of females to flame burns, often stemming from unsafe cooking practices. Delayed hospital admissions were associated with a higher mortality rate. Efforts to promote safety and awareness, particularly in rural areas, are crucial to reducing the burden of burn injuries in India.

Traumatic head injuries in Moldova: a cross-sectional analysis of medical registry data.

The aims of this study were to evaluate the demographics and crash profiles of road traffic-related traumatic brain injury (TBI) patients treated at two emergency departments in the Republic of Moldova, and to identify areas for prevention.

How safe and effective are paediatric virtual fracture clinics? A systematic review.

Virtual fracture clinics (VFC) involve a consultant-led multidisciplinary team meeting where cases are reviewed before a telephone consultation with the patient. VFCs have the advantages of reducing waiting times, outpatient appointments and time off school compared to face-to-face (F2F) fracture clinics. There has been a surge in VFC use since the COVID-19 pandemic but there are still concerns over safety in the paediatric population. Fractures make up a large burden of paediatric injuries, therefore research is required on the safety and efficacy of paediatric VFCs. This systematic review will look at the safety and effectiveness of paediatric VFCs, as well as determine the cost-effectiveness and parent preferences. As per the PRISMA guidelines two independent reviewers searched the following databases: Medline, Embase and Web of Science. Studies were included if children under 18 years old presented to A&E with a suspected or confirmed simple un-displaced fracture and were referred to a VFC. The primary outcomes assessed were effectiveness and safety, with the secondary outcomes of cost-effectiveness and parent satisfaction. Six studies met the inclusion criteria for this systematic review. There was a high rate of direct discharge from the VFC leading to reduced outpatient appointments. All patients were seen within 72 h of presentation. There were limited incidences of missed fractures and the rates of re-presentation were similar to that of F2F orthopaedic clinics. There were significant cost savings for the hospitals and high parent satisfaction. VFCs have shown to be safe and effective at managing most stable, low operative risk paediatric fractures. Safety must be ensured with a telephone helpline and an open return to fracture clinic policy. More research is needed into specific paediatric fracture types to be managed in the VFC. https://www.crd.york.ac.uk/PROSPERO/#searchadvanced, identifier: CRD42023423795.

7.D. Workshop: Data, tools and methodologies on injury burden in Europe: current limitations and future directions

Abstract Globally, injuries cause over 4.3 million deaths per year with incalculable costs for the health, legal, and social systems. Many countries have adopted metrics to monitor the burden of injury but the complexity behind data collection, data management and analysis remains high and this affects the usability of data in prevention efforts. Most of the countries in Europe still lack the systems for accurate and comprehensive data collection on the burden of injuries and this increases the gap between data availability, data quality and usability. Even in countries with advanced data collection systems, there is considerable methodological variation across injury parameters and disability calculations, which introduce uncertainty and bias in the estimations of injury burden. Recent studies conducted by the COST Action CA18218 (European Burden of Disease Network) and the KFV (as part of the IDB network) identified different levels of country-level preparedness among the various European regions in terms of collection and management of data on the burden of injury. However, efforts to harmonize injury outcomes remain inconsistent and insufficient, specifically for certain injury populations and health outcome domains. Latest research emphasizes the lack of adequate epidemiological data on the burden of injuries and urges governments to prioritize investment in well-designed injury data management systems. Several studies acknowledge the methodological challenges that need attention for health systems to generate “valid data” that will allow governments to prioritize areas for intervention and maximize the impact of their resources. Coding systems currently used to classify injuries vary considerably, resulting in less homogenous calculations in terms of injury severity and duration. Matching variables, records and data sources, ensuring independence while addressing heterogeneity and population coverage are demanding tasks, which require commitment from a variety of stakeholders, allocation of sufficient resources and a strong political will. It seems more critical than ever to introduce rigorous methodological processes, modern and valid tools and assessments and robust analysis systems to facilitate decision-making processes for injury policy formulation across European regions. A main goal of the workshop is to highlight the importance of “valid data” in policy making and turn the attention towards “evidence-based strategies” for reducing the incidence and consequences of injury. The workshop will describe the latest developments in injury severity classification and disability measurements. Limitations of injury measurement, analysis and reporting will be identified as well as factors introducing uncertainty and potential bias in estimation of the burden of injury. Modern, validated measures that are feasible and usable in both research and clinical contexts will be presented and success stories from Europe will be shared to provide valuable lessons for other regions and countries. Key messages • Validated and easy to use measures and data linkage is crucial to enhance comparability of burden of injury estimates across Europe. • Strengthening data collection systems is critical to better understand the injury patterns.

A new Norwegian Injury Registration System as a starting point to assess the burden of injuries in Norway

Abstract Introduction The police register is the main database for monitoring traffic injuries. A study made by Safe Traffic in Norway found that only one of three severe traffic injuries is registered in this register. For giving more complete data, a health-based injury monitoring system was established in 2022 for a period of five years, financed by the traffic safety authorities. Methods An Injury Minimum Data Set (MDS) is collected from all injuries that are treated in ten hospitals and seven municipality AEDs in the primary health care, a representative sample of all medically treated injuries in Norway. By recording the unique birth number of the patient, double registrations are deleted. When fully developed, this system will register about 50 % of all injuries treated in the hospitals as in- and out-patients, and about 10 % of all injuries in the primary health care system in Norway. Max AIS (Abbreviated Injury Scale) and diagnosis (ICD-10 - hospitals, and ICPC-2 - primary health care) are among the registered variables for each injury. Based on the ICD-10 codes, long term disability weights (DW) can be calculated (Gabbe et al 2014). Then the injury burden of injuries in Norway can be shown by: 1) Threat to life: a) minor (AIS 1), b) moderate (AIS 2) and c) serious, (AIS 3+, including AIS 4-6). 2) Threat of disability: a) low, b) medium and c) high probability of long-term disability. Results Data from 2023 seems to be complete enough to enable calculations of the annual injury burden in Norway. Future work There is a need to establish internationally agreed disability weights to enable comparisons across countries. And to establish conversions from ICPC-2 codes to ICD-10 codes for enabling calculations of DWs of injuries treated in the primary health system.

Data collection and analysis on the burden of injuries: Lessons learned from the IDB network

Abstract The EU-IDB (European Injury Database) contains cross-national data on the external causes and circumstances of injuries treated in the emergency departments of hospitals. Its primary purpose is to facilitate the development and evaluation of injury prevention policies and programmes, which aim to control external risks. The information is complementary to death and hospital discharge statistics and specific surveillance systems on road and workplace accidents. Unique is the wealth of information about external circumstances of injuries as needed for evidence-based prevention actions. The IDB data are collected by dedicated national agencies and provided to the Italian National Institute of Health (ISS) which hosts the databank. As part of the EU BRIDGE-Health initiative 2017 (WP9-Injury Surveillance Platform), the EU-IDB Network was commissioned to generate comparable burden of injury estimates across Europe: “Disability Adjusted Life Year (DALY) estimates for injury utilising the European Injury Data Base (IDB)”. DALY estimates were generated for IDB countries and years where both fatal and non-fatal injury data were available. Non-fatal injury data were acquired from Emergency Department data recorded in the IDB Minimum Data Set (MDS), fatal data were obtained from the European Detailed Mortality Database (EDMD). The general approach to calculating DALYs followed that of the Global Burden of Disease (GBD) study but utilised new and different disability weights created by the the Injury-VIBES cohort and detailed injury incidence data from nineteen countries. DALY estimates were between 2-10 times larger than estimates generated by previous studies such as the GBD study, due to much higher incidence figures and larger disability weights. In the workshop, the most recent results of the EU-IDB and the respective DALY estimates will be presented and discussed.

The burden of dietary risk factors in the Nordic and Baltic countries

Abstract Background The Nordic Nutrition Recommendations (NNR) gives the scientific basis for national dietary guidelines for the Nordic and Baltic countries. The Global Burden of Diseases, Injuries, and Risk Factors study (GBD) provides comparative estimates of the disease burden related to suboptimal diet in 195 countries. The aim of the study was to employ data from GBD 2021 to improve the knowledge base for NNR. Methods A comparative risk assessment approach was used to estimate the proportion of disease-specific burden that could be attributed to fifteen dietary risk factors in the population aged 25 and older in the Nordic and Baltic countries. The analyses included four steps: (1) estimating dietary intake on a population level; (2) determining the relative risks of dietary factors on disease endpoints; (3) determining the level of exposure with minimum risk; and (4) estimating the final disease burden, defined as disability-adjusted life-years (DALYs), attributed to each dietary risk. Results A suboptimal intake was found for all dietary risk factors in all countries. A total of 60 350 deaths and 1 079 087 DALYs were attributed to dietary factors. The highest age standardised mortality rates attributed to diet were found in Lithuania (371 per 100 000), and lowest in Norway (101 per 100 000). Low intake of whole grains was the largest dietary risk factor for mortality and DALYs in all countries except Estonia. Other highly-ranked factors in all countries included a diet high in processed meat and low in fruit. The results are preliminary, with final GBD 2021 estimates expected to be published medio 2023. Conclusions GBD offers a powerful resource to model trends in diet-related burden of diseases in the Nordic and Baltic countries. Estimates from GBD can provide countries with insight into the potential of reducing disease burden by targeting specific dietary risks. Key messages • Suboptimal diet leads to a substantial and avoidable mortality and disease burden in the Nordic and Baltic countries. • Detailed and comparative estimates from GBD can help countries identify their most important dietary risk factors.

Pediatric injuries classification using openAI: new opportunities for epidemiological surveillance

Abstract Background The burden of unintentional pediatric injuries remains a significant concern for healthcare systems worldwide. Timely and accurate surveillance is critical for injury prevention and resource allocation. However, the diagnosis reported in the emergency department records is often not coded, and the manual coding of these records is labor-intensive, time-consuming, and prone to errors. To implement an automatic coding system using GPT-based models to extract and classify injury data in the Italian language from pediatric emergency department records. Methods The study included 283,468 admission records to the pediatric Emergency Department of Padova University Hospital from 2007 to 2018. Each access is mandatorily registered in an electronic data collection system. For each emergency department access, both coded (administrative and demographic data) and free-text (diagnosis) information are reported. A random subset of 40,030 records underwent classification of free-text diagnosis (as injury or not) by an expert clinician (gold standard). OpenAI was used for the classification task. OpenAI is an extensive language model based on the GPT architecture. Specifically, the GPT-3.5 variant was employed for the present work. openAI was accessed through a public application programming interface (API) using R software. Results Preliminary results showed a classification accuracy of 96.2%. The tool's ability to correctly classify the injuries (sensitivity) was 95%, while the specificity was 96.5%. Conclusions The performance of the classification task was excellent. The present results demonstrate the feasibility of GPT-based models for processing unstructured free text information from medical records. Key messages • OpenAI would represent a promising opportunity to improve pediatric injuries surveillance • OpenAI would improve the classification of unstructured information from medical records

Global burden of spinal cord injury: future directions

Global burden of spinal cord injury: future directions

Burden of dengue, leishmaniasis and lymphatic filariasis in India and its states from 1990-2019: Analysis from the Global Burden of Disease study (GBD 2019).

Vector-borne diseases such as dengue, leishmaniasis, and lymphatic filariasis, constitute significant sources of illness, disability, and mortality among the poor and vulnerable in many countries around the world, including India. Based on the global burden of diseases, injuries, and risk factors study 2019, we analyse the burden of dengue, leishmaniasis, and lymphatic filariasis, in India from 1990 to 2019. Over this period, there was a reduction in the burden of lymphatic filariasis and leishmaniasis. Notably, dengue emerged as the most common vector-borne disease, exhibiting high fatality rate above 15 years of age and the highest DALY within 15-49 age group. Additionally, dengue cases surged substantially between 1990 and 2019. Leishmaniasis related mortality and DALY declined in the year 2019 compared to the year 1990, with high mortality and DALY in the 0-49-year-old age group. For lymphatic filariasis, DALY was more pronounce among those in the 15-49-year age group, which underwent reduction in 2019. Males had a higher burden in other vector-borne diseases than females, although females had a slightly elevated dengue burden. These findings highlight the evolving epidemiological trends related to vector-borne diseases in India, over the last three decades and underline the critical significance of sustained efforts for the elimination and control of vector-borne diseases.