Trends In Incidence Research Articles

Long-term trends analysis of the incidence and mortality in patients with ovarian cancer: a large sample study based on SEER database.

To analyze long-term trends of the incidence and mortality of ovarian cancer in the United States. Patients diagnosed with ovarian cancer were obtained from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2017. Joinpoint regression analysis was used to analyze the incidence and mortality trend, and the changes were reported as average annual percentage change (AAPC) with a 95% confidence interval (CI). Kaplan-Meier survival curve and Cox regression analyses were utilized for survival analysis. A total of 74 682 patients were included, among whom 49 491 (66.27%) died and 44 487 (59.57%) died from ovarian cancer. The mean age was 61.95 ± 15.23years. The incidence of ovarian cancer showed a decreased trend from 2000 to 2017 with an AAPC of -1.9 (95%CI: -2.0, -1.7). Both the overall mortality and cancer-specific mortality for ovarian cancer decreased from 2000 to 2017, with AAPCs of -5.0 (95%CI: -5.7, -4.2) and -4.6 (95%CI: -5.4, -3.8), respectively. There was a significant decrease in the incidence and mortality of patients with the distant SEER stage, histological subtypes of serous and malignant Brenner carcinoma, and grades II and III from 2000 to 2017. Older age, Black race, histological subtypes of carcinosarcoma, higher tumor grade, and radiotherapy were associated with poorer overall survival and cancer-specific survival, whereas higher income, histological subtype of endometrioid, and surgery were associated with better survival. This study provided evidence of a statistically significant decrease in the incidence and mortality of ovarian cancer from 2000 to 2017. Key message What is already known on this topic? Ovarian cancer is one of the most common tumors in women, with high morbidity and mortality. However, trends in long-term morbidity and mortality of patients with ovarian cancer have not been reported. What this study adds Overall incidence and mortality for ovarian cancer showed a decreased trend from 2000 to 2017, and trends in incidence and mortality varied by stage, histological subtype, and tumor grade. Factors associated with overall survival and cancer-specific survival also differ. How this study might affect research, practice, or police This study provides evidence of long-term trends in ovarian cancer incidence and mortality from 2000 to 2017.

Trends in incidence and demographics of testicular cancer in California, 2000–2020

Trends in incidence and demographics of testicular cancer in California, 2000–2020

Exploring the mechanism of tetramethylpyrazine in the treatment of osteoarthritis based on network pharmacology.

Osteoarthritis (OA) is the most common joint disease, which mainly damages articular cartilage and involves the whole joint tissue. It has the characteristics of long course, repeated symptoms and high disability rate, and the incidence trend is gradually increasing. Tetramethylpyrazine (TMP) is the main alkaloid active substance in Ligusticum wallichii, a traditional Chinese medicine, which has the effect of promoting blood circulation and dredging collaterals, and has a good effect on the treatment of early OA, but its molecular mechanism has not been fully clarified so far. Based on network pharmacology, molecular docking simulation and animal experiments, this study explored the target and molecular mechanism of TMP in the treatment of OA. We used PubChem, SwissTargetPrediction, and PharmMapper databases to predict the molecular structure and potential targets of TMP. GeneCards and DisGeNET databases were used to predict the relevant targets of OA. Apply UniProt database to convert targets into unified gene names, and proofread and remove duplicate gene names. The intersection targets of TMP and OA obtained on venny2.1.0 website were submitted to the STRING database to construct a PPI network. CytoScape 3.8.2 software was used to analyze the PPI network and obtain the sub-network modules and 10 key targets. The intersection targets of TMP and OA were analyzed by Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment using DAVID 6.8 database. The intersecting targets of TMP and OA, the biological process of GO enrichment, and KEGG signaling pathway were imported into Cytoscape 3.8.2 software to construct the TMP-target-pathway network diagram. Use molecular docking technology to simulate the interaction between TMP molecules and key targets, and predict the binding mode and binding ability. Animal models of rabbit knee osteoarthritis were prepared, and magnetic resonance imager (MRI) and fluorescence quantitative PCR (RT-qPCR) were used to observe the effect of TMP in treating OA as well as the expression of key target genes. 585 potential targets of TMP, 3,857 potential targets of OA, and 49 intersecting targets of TMP and OA were obtained. The top 10 key target genes were obtained, in order of ranking: ALB, ESR1, IL10, CAT, F2, MPO, C3, CYP3A4, CYP2C9, ANXA1. GO and KEGG analysis implied that the key targets might act on OA by affecting endothelial cell permeability, peri-articular microcirculatory status, NETs production, activation of complement system and coagulation pathway, regulation of immune function of macrophages and T cells, and substance metabolism pathway in vivo, etc. The molecular mechanism might involve the formation of neutrophil extracellular trap, regulation of the actin cytoskeleton, complement and coagulation cascades, and T cell receptor signaling pathways, etc. Molecular docking simulations showed that the binding energy of IL10 and ANXA1 to TMP was greater than -5Kal/mol, but the other key target proteins showed better binding to TMP, and the binding energy was less than -5kcal/mol. Animal experiments showed that TMP had a significant therapeutic effect on OA. The TMP group had significantly reduced knee joint effusion and bone marrow damage compared to the OA group (p < 0.05). The qRT-PCR results showed that compared with the OA group, the mRNA expression of ESR1, CAT, C3, CYP3A4, CYP2C9, and ANXA1 in the TMP group increased (p < 0.05), while there was no significant difference in mRNA expression of ALB, IL-10, F2, MPO, etc. (p > 0.05). TMP is effective in the treatment of OA, with multi-target and multi-pathway interactions. ESR1, CAT, C3, CYP3A4, CYP2C9, and ANXA1 may be potential targets for TMP treatment of OA. The molecular mechanism mainly involves the formation of neutrophil extracellular trap, regulation of the actin cytoskeleton, complement and coagulation cascades, and T cell receptor signaling pathways, etc.

Radiation Implication in Pediatric Second Primary Thyroid Malignancy (SPTM) Cumulative Incidence and Mortality in the United States: Large Cohort Evidence.

To assess racial and sex variances in second primary thyroid malignancy (SPTM) cumulative incidence and temporal trends and the radiation exposure effect in pediatric SPTM. A retrospective cohort study, a non-experimental epidemiologic design, was used to assess the cumulative incidence (CmI) and temporal trends as well as the exposure effect of radiation in SPTM among children, 0-19 years, in the Surveillance, Epidemiology, and End Results (SEER) registry, National Cancer Institute (NCI), USA. Percent change (PC) and annual percent change (APC) were used to examine CmI rates and temporal trends, while chi-square statistics and binomial regression models were used to examine variable distribution by race and to determine the exposure effect of radiation on SPTM as well as mortality, respectively. The frequency of pediatric thyroid cancer was (n = 3457) between 1973 and 2013/14, while the PC was 151.2 for all races but 99.8 among whites. Of all pediatric thyroid cancers diagnosed during this period, SPTM accounted for 3% (n = 99). Compared to whites, blacks/AA were 60% less likely to present with SPTM, adjusted risk ratio, aRR = 0.40, 99% CI 0.06-2.47, while other races were 18% more likely to develop SPTM, aRR = 1.18, 99% CI 0.48-2.87. Additionally, females relative to males were 63% less likely to be diagnosed with SPTM, aRR = 0.37, 99% CI 0.22-0.61. With respect to urbanicity, compared to children in rural areas, those in urban areas were 21% less likely to develop SPTM, aRR = 0.79, 99% CI, 0.12-5.35, while children in metropolitan areas were 40% less likely to develop SPTM, aRR = 0.60, 99% CI, 0.10-3.59. Although imprecise, there was a 5% increased risk of SPTM, with radiation as an exposure effect, aRR = 1.05, 99% CI 1.01-1.75. There are increasing temporal trends in pediatric SPTM with blacks relative to whites having observed lower incidence, despite an increasing percent change among blacks/AA, indicative of the disproportionate burden of this malignant neoplasm. SPTM risk was higher among males and in rural areas, while radiation as a risk for SPTM was clinically and biologically meaningful, albeit an observed statistically insignificant inference due to sampling variability, requiring intervention mapping in radiation exposure margination among children.

Overdiagnosis of lung cancer in Chinese populations

Abstract Background Low-dose computed tomography (LDCT) has been widely-used in employee health examinations in China since 2011. This study was designed based on the Cancer Surveillance data to quantify the overdiagnosis of lung cancer due to the introduction of LDCT in Chinese populations. Methods This registry-based cohort study included 46,978 incident cases and 34,475 deaths of lung cancer from Pudong New Area of Shanghai, China, during 2002-2020. We calculated the age-standardized rates (ASR) and average annual changes (AAC) of mortality and overall, stage-specific and histological type-specific incidence by sex to evaluate the potential overdiagnosis of lung cancer. We further estimated the numbers and proportions of lung cancer cases attributable to overdiagnosis by sex and period based on the comparison between the shape of the age-specific curves with that prior to the introduction of LDCT in the populations. Results The ASR of incidence of lung cancer increased rapidly since 2011 in both men (AAC: 1.90%; 95%CI: 0.87, 2.92) and women (AAC: 4.40%; 95%CI: 3.19, 5.62), whereas the ASR of mortality declined persistently, with AAC of -0.12% (-0.64, 0.39) in men and -0.19% (-0.47, 0.09) in women. The upward trends in incidence were mainly observed in women, for early-stage cancer and for lung adenocarcinoma. Overall, the overdiagnosis rate of lung cancer grew from 22% in 2011-2015 to 50% in 2016-2020 in women. Further analysis demonstrated elevated numbers (proportions) of lung adenocarcinoma cases attributable to overdiagnosis, which increased from 182 (8%) in 2011-2015 to 827(22%) in 2016-2020 in men, and from 1,842 (85%) to 4,171 (89%) in women. Conclusions This registry-based cohort study observed considerable and increasing overdiagnosis of lung adenocarcinoma in Chinese men and women. Guideline is urgently needed to maximize the benefits of LDCT screening and reduce the potential overdiagnosis of lung cancer in the populations. Key messages • The secular trends in incidence and mortality of lung cancer in Chinese populations demonstrated the overdiagnosis since 2011, when the LDCT was used as a part of staff health examination in China. • Overdiagnosis of lung cancer in Chinese populations increased incrementally over time and was mainly observed among women.

Incidence of MINOCA in the high-sensitivity troponin era: a meta-analysis

Abstract Background and Aim Myocardial infarction with non-obstructive coronary arteries (MINOCA) is often under-recognised in clinical practice. The reported incidence of MINOCA was estimated to be 6% of MI presentations by Pasupathy et al. in the era preceding adoption of high sensitivity troponin assays. We sought to investigate the incidence of MINOCA in the high-sensitivity troponin era as compared to incidence of MINOCA during the era of traditional cardiac biomarkers (standard troponin assays, CK, CK-MB). Methods A prospective systematic review and meta-analysis using MEDLINE and EMBASE to capture relevant papers from 1996-2022 was performed. Papers detailing incidence of MI-CAD and MINOCA as well as the utilised biomarkers were included. Patient demographics, presentation and recorded biomarkers were also analysed for pre-specified analysis. Results 47 studies detailing the results of 667 850 patients were included. 53 586 patients were identified to have MINOCA with a mean weight incidence of 9.1% (7.3-11.3, 95% CI). MI-CAD patients were more likely to be male (68.5% vs 39.3%, RR (0.59, 0.74)) and had higher incidence of traditional cardiac risk factors. Notably chronic kidney disease was not associated with higher incidence of MICAD over MINOCA (RR 0.72, 0.5-1.03). There were no significant trends in incidence of MINOCA according to median year of study recruitment (ß=-0.18, (-0.76, 0.4) p=0.537). MINOCA patients were more likely to present as NSTEMI (14.5% (11.3-18.3, 95%CI)) rather than STEMI (3.5% (2.7-4.7%)). MINOCA patients had lower cardiac biomarker elevations than patients with MICAD. Conclusions The incidence of MINOCA higher than previously estimated in the era of high sensitivity troponin. MINOCA patients are less likely to have traditional cardiac risk factors and more likely to present with NSTEMI and smaller cardiac biomarker elevations than patients with MI-CAD.MINOCA RateMINOCA vs MI-CAD Risk Factors

Updated CP*Trends: An Online Tool to Compare Cohort and Period Trends across Cancer Sites.

CP*Trends is a widely used SEER website used to explore temporal effects of period and cohort on cancer incidence and mortality. It provides a graphical display of smoothed rates, and a C-P Score that helps to assess the magnitude of the effect of cohort and period. This update provides results for African Americans and Whites. The C-P Score has an intrinsic bias favoring cohort because there are many more cohorts than periods. An adjusted C-P Score removes some of this advantage. Bootstrap confidence intervals are given, which allow one to see the effects of different sample sizes on the model results. Finally, users may control window size used in the smoothing algorithm, which helps to avoid over smoothing or masking of trends. The method is illustrated using data on cervical cancer incidence trends for African Americans and Whites, 1975-2018. Rates are higher for African Americans, and both races have contributions for cohort. However, the period effect is only strongly evident in Whites. Visual inspection of White trends suggests possible differences for those older and younger than age 50. These methods are applied in an interactive website displaying incidence and mortality trends for over 20 cancer sites in the US.

Time trends in mortality, incidence and case-fatality of acute myocardial infarction in Norway - do we see the end of the coronary heart disease epidemic?

Abstract Background In Norway and most industrialized countries the mortality rates from acute myocardial infarction (AMI) increased after World War II, peaked in the 1960s – 1970s, and have since that time declined (Figure). Recent studies have suggested that the decline may have leveled off, and that the favourable trends do not include younger age groups, possibly due obesity and diabetes. Also, the relative contribution of a reduction in incidence and improved case-fatality rates (CFR) to the AMI mortality trends are not known with certainty. We examined mortality trends of AMI in Norway during 1951 – 2021, and the incidence and CFR of hospitalized and non-hospitalized AMI during 2013-2021. Methods Fatal AMI cases were identified in the National Causes of Death Registry. Norwegian hospitals are required by law to register all patients hospitalized for AMI in the Norwegian AMI Registry. Hospitalized cases not registered in the AMI registry were retrieved from the Norwegian Patient Registry which contains discharge diagnoses for hospitalized patients. The national unique 11-digit identification number allowed linkage of the registries and identification of transfers between hospitals and re-hospitalizations. An AMI (either hospitalization or death) was classified as incident if no hospitalization was found for that individual during the previous 5 years. We calculated age-adjusted rates with the Norwegian population in 2017 as standard. Results Norwegian AMI mortality rates increased from 1951, peaked in the late 1960s, and have since that time declined steadily, although steeper after around 1990 (Figure). Present AMI mortality rates are lower than in the 1950s, and are still declining. Incidence of AMI (hospitalized and non-hospitalized) fell from 391/100 000 in 2013 to 271/100 000 in 2021, corresponding to a mean reduction of 3.6 % per year (p&amp;lt;0.001). Incidence of out-of-hospital fatal AMI fell by 6.5 % per year, incidence of hospitalized ST-segment elevation AMI (STEMI) fell by 2.3 % per year, and incidence of non-ST-segment elevation AMI (NSTEMI) fell by 3.1 % per year (all p&amp;lt;0.001). 30-days CFR of hospitalized and non-hospitalized AMI fell from 21.3 % in 2013 to 17.5 % (3.6 % per year; p&amp;lt;0.001). CFR after NSTEMI fell from 8.2 % in 2013 to 6.4 % in 2021 (4.4 % per year; p&amp;lt;0.001), whereas there was no significant change in CFR after STEMI (13.3 % in 2013 and 12.0 % in 2021). The incidence and CFR trends were similar in men and women aged 20-49, 50-79 and 80+ years. Comments Declining incidence of out-of-hospital fatal AMI and declining incidence of hospitalized STEMI and NSTEMI were major contributors to the declining AMI mortality rates in Norway. Improved case-fatality rates among hospitalized patients have contributed to the declining mortality rates, but there was no improvement in case-fatality in STEMI during 2013-2021.

10.I. Scientific session: A National E-Infrastructure for Aging Research to Improve Public Health

Abstract Global life expectancy gains over the last half-century are remarkable. Yet the resulting demographic shift towards an older population poses substantial public health challenges, particularly in healthcare. To address these challenges, a profound and scientifically-based understanding of older adults’ health and care requirements is needed. Recognizing the need for a better understanding of the aging process and public health challenges, the National E-infrastructure for Aging Research (NEAR) was founded in 2018. NEAR seeks to promote and support aging research by facilitating longitudinal population-based data usage from 15 well-known Swedish cohort studies on aging and health. It is based on a collaboration between eight Swedish universities and includes 15 databases with individual assessments. NEAR comprises a broad range of biomedical, clinical, social, and psychological health data from more than 90,000 adults who are 50+ years old. These individuals have been followed between 12 and 52 years. The objective of this workshop is to give an overview of the NEAR infrastructure, present results from three ongoing NEAR projects, and their implications for public health: 1) Temporal trends in dementia incidence in Sweden; 2) Personality and biomarkers of neurodegeneration and Alzheimer’s disease in Swedish older adults, and 3) Characterizing risk profiles and transitions across living and care settings in Sweden. Infrastructures such as NEAR offer high-quality epidemiological data for achieving broad, interdisciplinary research goals that single databases often cannot provide. Moreover, the value added to these kinds of data includes enhanced sample sizes, variations, representativeness, and generalizability. In turn, this can address an aging society’s public and clinical health demands. Eventually, this could lead to sustainable intervention strategies for improving older persons’ health in the coming decades. Key messages • Discover new avenues in public health aging research: Gain insights into cutting-edge aging research opportunities in Sweden, exploring key NEAR projects. • Recognize the value of national infrastructures using high-quality epidemiological data in fostering collaborative and nationally representative public health research.

Trends in cardiovascular disease incidence among 22 million people in the UK over 20 years: population based study.

Trends in cardiovascular disease incidence among 22 million people in the UK over 20 years: population based study.

Temporal Trends in Dementia Incidence in Sweden: Insights from NEAR Data

Abstract Background This study investigates the temporal trends of dementia incidence in Sweden over a span of 35 years, drawing on data from the National E-Infrastructure for Aging Research (NEAR). Methods Our comprehensive analysis encompassed over 10,000 participants aged 50 and above. We estimated dementia incidence rates across the study period, considering birth cohort, age, and sex while controlling for potential confounders. Additionally. We explored potential modifiers influencing the estimated trend of dementia incidence. Results The analysis reveals a notable decline in dementia incidence rates, particularly among individuals born in more recently. Octogenarians born in the 1920-1930 cohort had a 74% lower dementia incidence rate compared to their counterparts born before 1900. Similarly, nonagenarians born in the 1910-1920 cohort experienced a 45% lower incidence rate. We further investigate determinants influencing this declining trend, shedding light on various factors shaping the observed patterns. Conclusions The incidence rate of dementia in Sweden has shown a consistent decline over the past 35 years, with a notable birth cohort effect indicating lower rates among individuals born more recently. This finding suggests evolving factors in lifestyle, healthcare, or environmental conditions contributing to improved cognitive health outcomes. Key Messages • These findings underscore the importance of proactive public health measures aimed at sustaining and enhancing cognitive health outcomes among aging populations. • Understanding the temporal dynamics and underlying factors driving these trends can inform strategies for promoting healthy aging and improving the quality of life for older adults.

Night shift work increases the risk of irritable bowel syndrome, which is mediated by inflammation

Abstract Background The impact of long-term night shift work on the incidence of irritable bowel syndrome (IBS) is still largely unknown, and the underlying mechanism remains unclear. We aimed to investigate the association of night shift work with IBS risk and further explore whether low-grade inflammation mediated this relationship. Methods This cohort study included 239,760 participants who were in paid employment or self-employed from the UK Biobank. In-depth lifetime employment information was used to calculate duration and frequency of night shifts. Low-grade inflammation index (INFLA-score) was calculated from five circulating inflammatory biomarkers. Cox proportional hazard models were used to estimate the relationships between long-term night shift work and IBS risk, and mediation analyses were also performed. Results An increasing trend of IBS incidence was observed from day workers to regular night shift workers. Compared to day workers, rarely/some night shift workers (HR 1.097, 95% CI 1.007-1.195) and usual/permanent night shift workers (HR 1.213, 95% CI 1.046-1.407) had higher risk of IBS. Workers with longer duration (≥3 years) (HR 1.241, 95% CI 1.073-1.436) and higher frequency of night shifts (&amp;gt;7 shifts/month) (HR 1.248, 95% CI 1.045-1.491) also showed higher IBS risks. INFLA-score significantly mediated the association of long-term night shift exposure with increased IBS risk (mediation proportion 3.6%, P &amp;lt; 0.05). Conclusions Long-term exposure to night shift work is associated with a higher risk of IBS, the potential underlying mechanism may be the heightened low-grade inflammation. Key messages • Current night shift exposure, longer night shift duration and higher night shift frequency were significantly associated with higher risk of IBS. • Our findings indicate that night shift work may increase the IBS risk by triggering a cascade of low-grade inflammatory processes.

Bias in Evaluating Trends of Thyroid Cancer Incidence between Rural and Urban Populations

Abstract Background Diagnosis of thyroid cancer is based on fine needle aspiration cytology of thyroid nodules, based on nodules’ sonographic appearance and size. The American Thyroid Association published new guidelines for management of thyroid nodules in 2009 and 2015, where in some cases, only follow-up of thyroid nodules without any other procedure is recommended. This may lead to a decrease in diagnosed thyroid cancer cases. We studied thyroid cancer trends in Israel between the Arab population who are more likely to be living in rural areas, and the Jewish population who predominantly living in urban areas, and assesses whether these guidelines were reflected in the trends. Methods Data on new thyroid cancer cases were retrieved for Jews and Arabs separately from the Israel National Cancer Registry. Trends in age standardized incidence rates between 1996-2019 were evaluated for the two population groups using joinpoint regression model. Population group was included in the regression models to compare the trends between the two groups. We also studied trends in treatment of thyroid cancer at Rambam Health Care Campus. Results In both populations, age standardized thyroid cancer incidence rate increased between 1996 and 2013. However, between 2013-2019, Annual Percentage Change continuously increased in Arabs, but decreased in Jews. In the hospital study, we found that the Arab patients were 30% more likely to have surgery for small tumors. Conclusions The decrease in thyroid cancer incidence in the Jewish population compared with the Arab population may be related to differences in implementing the 2009 guidelines, which do not recommend fine needle aspiration cytology for very small tumors. We have found evidence that these guidelines were not followed to the same extent among Arab community clinics. This may explain the persisting increasing trend among Arabs, and could be one of the possible explanations for the differences in trends between the two groups. Key messages • Updated Guidelines regarding thyroid cancer diagnosis may be differently implemented by rural and urban populations. • Trends assessment may be biased due to differences in guidelines implementation.

Epidemiology of Clostridioides difficile PCR ribotype 181 after the COVID-19 pandemic in Northern Greece.

Clostridioides difficile infection (CDI) is one of the most significant causes of diarrhea in hospitalized patients. The aim of this study was to investigate the incidence and epidemiology of CDI after the COVID-19 pandemic in hospitalized patients in a rehabilitation center in Thessaloniki, Greece. Αretrospective observational cohort study was performed in inpatients diagnosed with diarrhea of all ages (January 2023 - December 2023) who were initially screened for CDI. From the total cohort of patients with proven CDI, some patients were randomly selected based on their monthly isolation incidence throughout the study period, to investigate their epidemiological data and clinical characteristics. Laboratory diagnosis of CDI was performed by enzyme immunoassay, followed by specific anaerobic culture and molecular testing for detection of toxigenic C. difficile. The isolated C. difficile strains were further characterized by PCR ribotyping. The annual incidence of CDI during the studyperiod was 27.1% (130/480). The linear trend of CDI incidence decreased from 32.5% to 18.2% (P= 0.024). The all-cause mortality rate was 5.0% (3/60). A positive correlation was observed between the length of hospital stay and the number of recurrences (r = 0.546, P < 0.001), while 28 patients (46.7%) experienced recurrence of the infection. Seven different PCR ribotypes were identified in thisstudy. C. difficile tcdA+, tcdB+, cdtA+, cdtB+ PCR ribotype 181 (RT181) was the predominant (76.6%, 46/60), followed by toxin A-negative PCR RT017 (11.6%, 7/60). The annual incidence of CDIdecreased after the COVID-19 pandemic. Our study demonstrates predominance of C. difficile RT181 with tcdA+, tcdB+, cdtA+, cdtB+ toxin gene profile after COVID-19 pandemic in Northern Greece.

Temporal trends in mitral valve surgery in Denmark: changes in patient characteristics and outcomes from 1996 to 2021

Abstract Background Mitral valve regurgitation (MR) is associated with increased morbidity and mortality. Mitral valve surgery (MVS) is recommended in severe MR, which is the second most common cause of heart valve surgery in the Western world. Data on national practice patterns are lacking and are essential for the continuous epidemiologic surveillance of the disease. Purpose To investigate temporal trends in patient characteristics, incidence and mortality in patients undergoing MVS for MR in Denmark from 1996 to 2021. Methods Using Danish nationwide registries, we identified all patients ≥18 years undergoing MVS for MR. Patients operated due to infective endocarditis were excluded. The study population was grouped into one 6-year and four 5-year calendar bands and type of MVS (mitral valve repair, mechanical or biological valve replacement and transcatheter-edge-to-edge repair (TEER)). Temporal trends in patient characteristics were computed. Annual incidence rates were calculated while considering the total Danish population ≥18 years at risk. For one-year postoperative mortality analysis, the reverse Kaplan-Meier estimator and a multivariable Cox proportional hazard analysis were used. Results We identified 7,813 patients (median age 67.3 years, 65.6% males) undergoing MVS. Over calendar time, burden of comorbidities decreased while median age increased, Table 1. From 1996 to 2021, a stepwise increase was seen in the overall incidence rate for MVS from 3.87 [95% CI 3.32-4.51] to 7.06 [95% CI 6.34-7.58] per 100,000 person-years (p&amp;lt;0.001). The incidence of mechanical valve replacement statistically significantly decreased (p&amp;lt;0.001), while the incidence of mitral valve repair (p=0.004), biological replacement (p≤0.001) and TEER statistically increased (p=0.015), Figure 1. For the overall study period, one-year mortality was 5.0% for mitral valve repair, 12.7% for mechanical valve replacement, 15.7% for biological valve replacement and 19.0% for TEER. Demographics and one-year mortality stratified by calendar period are shown in Table 1. In the mitral valve repair group, adjusted analysis showed a stepwise statistically significant decrease in one-year mortality with HR 0.30 (95% CI 0.17-0.53, p≤0.001) in 2017-2021 as compared to 1996-2001. In the remaining surgical groups, trends were towards decreasing one-year mortality over calendar periods but did not reach statistical significance. Conclusion(s) In this Danish nationwide cohort study, we observed an increase in the incidence of overall mitral valve surgery from 1996 to 2021. The incidence of mechanical valve replacement decreased, while the incidence of mitral valve repair, biological replacement and TEER increased. Mortality rates significantly improved for mitral valve repair patients over calendar time. Continuous epidemiological surveillance of this patient group is required in an era of development in treatment guidelines, surgical methods and patient demographics.Table 1Figure 1

Lyme disease in UK primary care: a knowledge, attitude and practice survey.

Lyme disease (LD) cases in the UK most commonly present within the primary care setting. Despite an upward trend of incidence, little is known regarding general practitioner (GP) experience with diagnosis and treatment. This study aims to describe baseline primary care clinician Knowledge, Attitude and Practice (KAP) in Scotland and England. Online KAP survey on Lyme disease for UK based practising GPs. An online KAP questionnaire was developed for use in UK primary care. The survey was distributed through UK based research networks, professional societies and via social media. 191 complete responses were analysed (England n=130, Scotland n=61). The Scotland-based respondent group had more relevant consultations in the previous 3 years. Respondents from Scotland demonstrated a greater awareness that erythema migrans (EM) is pathognomonic for Lyme disease and that serological testing of this patient group is not indicated. Less common cardiac and neurological symptoms were not as well associated with Lyme disease by both respondent groups for the former and England-based respondents for the latter. Prescribing according to the National institute for Health and Care Excellence (NICE) guidance was identified in 70% of Scotland and 42% of England-based GP responses. Targeted resources may improve clinician confidence on exposure risk, symptom recognition, testing limitations and treatment dose and duration. Scotland-based respondents' better survey performance potentially reflects greater clinical exposure and public awareness of the disease, due to high endemicity within the nation.

Temporal trends of thyroid cancer in China and globally from 1990 to 2021: an analysis of the global burden of Disease Study 2021

The incidence of thyroid cancer (TC) is increasing annually worldwide, with a growing burden. This study aims to analyze temporal trends in the burden of TC by age and sex in China and globally from 1990 to 2021, including incidence, prevalence, mortality, and disability-adjusted life years (DALYs) rates, and to predict future trends. We obtained data on TC in China and globally from 1990 to 2021 from the Global Burden of Disease (GBD) database. Using the Joinpoint regression model, we calculated and analyzed the trends in age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). Specifically, we estimated the annual percent change (APC), the average annual percent change (AAPC), and the corresponding 95% confidence intervals (95% CI) for each metric. Additionally, we conducted a decomposition analysis to investigate the impact of aging, population growth, and epidemiological factors on the incidence and mortality rates of TC. Furthermore, the autoregressive integrated moving average (ARIMA) model was employed to predict the burden of TC from 2022 to 2036. From 1990 to 2021, the ASIR for TC in China increased from 1.249 (95% uncertainty interval [UI]: 1.009–1.473) per 100,000 to 2.473 (95% UI: 1.993–3.088) per 100,000. Conversely, the ASMR decreased from 0.473 (95% UI: 0.403–0.550) per 100,000 to 0.387 (95% UI: 0.307–0.472) per 100,000. Both males and females demonstrated an upward trajectory in ASIR. However, while the ASMR for females decreased, that for males showed an overall increase despite a decline in the last decade. The age of peak onset for TC ranged from 30 to 79 years, whereas the age of peak mortality was between 50 and 89 years. The analysis using the AAPC indicates that the growth in the ASIR (AAPC = 2.242, 95% CI: 2.112–2.371) and ASPR (AAPC = 2.975, 95% CI: 2.833–3.117) in China exceeds the global rate. Furthermore, the reduction in ASMR (AAPC = -0.651, 95% CI: -0.824 - -0.479) and ASDR (AAPC = -0.590, 95% CI: -0.787 - -0.392) in China is also more pronounced than globally. Decomposition analysis indicates that the increasing TC burden in China is primarily driven by population aging, whereas globally, population growth plays a more significant role. Projections based on predictive models suggest that from 2021 to 2036, the ASIR for both China and the global population is expected to continue rising, while the ASMR is anticipated to decline further. The incidence rates of TC in China and globally have shown a continuous upward trend, which is expected to persist over the next 15 years. Additionally, although the number of male TC cases is relatively lower compared to females, the overall ASMR and ASDR for males have shown an upward trend, despite a slight decline in recent years. This highlights the need to enhance prevention, diagnosis, and treatment measures, and to develop differentiated screening and treatment strategies based on age and sex.

Forecasting the trend of tuberculosis incidence in Anhui Province based on machine learning optimization algorithm, 2013–2023

Tuberculosis has been one of the most common communicable diseases raising global concerns. Accurately predicting the incidence of Tuberculosis remains challenging. Here we constructed a time-series analysis and fusion tool using multi-source data, and aimed to more accurately predict the incidence trend of tuberculosis of Anhui Province from 2013 to 2023. Random forest algorithm (RF), Feature Recursive Elimination (RFE) and Least absolute shrinkage and selection operator (LASSO) were implemented to improve the derivation of features related to infectious diseases and feature work. Based on the characteristics of infectious disease data, a model of RF-RFE-LASSO integrated particle swarm optimization multiple inputs long short term memory recurrent neural network (RRL-PSO-MiLSTM) was created to perform more accurate prediction. Results showed that the PSO-MiLSTM achieved excellent prediction results compared with common single-input and multi-input time-series models (test set MSE:42.3555, MAE: 59.3333, RMSE: 146.7237, MAPE: 2.1133, R2: 0.8634). PSO-MiLSTM enriches and complements the methodological research content of calibrating the time-series predictive analysis of infectious diseases using multi-source data, and can be used as a brand-new benchmark for the analysis of influencing factors and trend prediction of infectious diseases at the public health level in the future, as well as providing a reference for incidence rate prediction of infectious diseases.

A 5-Year retrospective analysis of adverse events in dentistry at the Dental Hospital, Faculty of Dentistry, Chulalongkorn University

BackgroundPatient safety is a critical concern in dentistry. Adverse events (AEs) can harm patients, increase costs, and decrease satisfaction. Understanding AE types and frequencies is crucial for effective risk management and quality improvement. This study analyzes incident reports to identify preliminary incident patterns as a starting point for developing risk management strategies. However, under-reporting limits the ability to identify true incident patterns, highlighting the need for improved reporting systems and encouragement of incident reporting. Further research is underway to develop such a system and promote reporting to ensure sufficient data quality for effective risk management.MethodsA retrospective analysis of 1,618 incident reports from December 2018 to August 2023 was conducted. A validated classification system, developed from a 5-year retrospective analysis and approved by 14 experts, categorized patient safety incidents, aligning with Thailand’s Hospital Accreditation standards. Descriptive statistics summarized AE frequency and distribution.ResultsOf the reports, 752 were patient safety, 503 personnel safety, and 363 organizational safety incidents. Top patient safety incidents included medical record errors (176), accidental damage (66), post-operative complications (65), medical emergencies (64), and communication errors (53). Personnel safety incidents involved inappropriate working conditions (135) and work-related injuries with contact transmission risk (117). Organizational safety incidents mainly concerned policy and operational processes (131).ConclusionsThis study reveals the preliminary patterns of adverse events (AEs) in dental settings and underscores the limitations due to under-reporting, which affect the ability to fully understand true incident patterns. To effectively manage risks, there is a critical need for improving the existing incident reporting system and encouraging a culture of comprehensive reporting among dental professionals. Future efforts should focus on enhancing reporting systems to ensure high-quality data, enabling better identification of incident trends and supporting targeted risk management strategies to improve patient safety in dentistry.

Declining invasive and rising insitu melanoma incidence trends in Iceland: A nationwide cohort study.

Melanoma is increasing worldwide, with incidence rates of invasive melanoma and melanoma insitu (MIS) varying by country. To provide updated invasive melanoma and MIS incidence and mortality trends in Iceland and explore differences among sex and rurality. In this whole-population study using the Icelandic Cancer Registry, patients diagnosed with invasive melanoma or MIS between 1957 and 2021 were included. Sex-specific world standardized incidence (WSR) and mortality rates were assessed by rurality. Joinpoint analysis was used to calculate trends using annual per cent change (APC). Invasive melanoma incidence rates increased from 0.66 to 7.0 (men) and 1.6 to 11.0 (women) per 100,000 person-years, and from 0.2 to 4.0 and 0.9 to 9.5 per 100,000 person-years for MIS in men and women, respectively, with a statistically significant linear trend (p = 0.001). WSR peaked in both men and women (10.7, 17.9 per 100,000 person-years) between 2002 and 2006 and has since been trending down. Between 1991 and 2005, the rise in invasive melanoma occurred more frequently in urban regions. Between 2003 and 2005, joinpoint analysis demonstrated a downtrend in invasive melanoma in men and women (-0.29, -0.73; p < 0.05). For MIS, the WSR peaked at 12.4 per 100,000 person-years in women between 1997 and 2001 before down-trending to 4.2. In recent years (2017-2021), the WSR has been steadily increasing in women with an APC of 1.43. Melanoma-specific mortality has decreased since 2012 (-0.07; p < 0.05). Declining invasive melanoma incidence and mortality rates in conjunction with the recent rise in MIS may reflect the impact of Iceland's sun safety and anti-sunbed educational campaigns, federal regulation of sunbeds and earlier melanoma detection in urban areas.