Prevalent Cases Research Articles

The burden of neck pain among adults aged 70 years and older in Iran, 1990-2019.

Neck pain is a complex musculoskeletal disorder that can result in substantial morbidity. The present article presents the neck pain burden in Iranians who were at least 70 years old, from 1990 to 2019, by sex, age group, and province. Publicly available information on the prevalence, incidence, and years lived with disability (YLD) caused by neck pain was extracted from the Global Burden of Disease study 2019. The estimates were all provided as counts and age-standardized rates (per 100,000), and included 95% uncertainty intervals. The point prevalence of neck pain in 2019 was 8710.6, while the incidence rate was 1334.7 per 100,000 population. That same year, there were number of 27.8 thousand YLDs and an YLD rate of 801.7 per 100,000. The prevalence, incidence, and YLD rates did not change substantially over the measurement period (1990-2019). The highest YLD rate was found in Tehran (960.9 per 100,000), while Kohgiluyeh and Boyer-Ahmad had the lowest (730.5 per 100,000). Females had slightly higher prevalent cases, incident cases, and YLDs, as well as their corresponding rates in 2019. In 2019, the number of prevalent cases, incident cases, and YLDs peaked in the 70-74 age group, for both sexes, and in all cases they reduced with age. In both 1990 and 2019, Iran had a higher YLD rate than that found among elderly adults in the Middle East and North Africa region. The burden of neck pain in Iran has decreased slightly over the last three decades, but it still imposes a substantial burden and is higher than that found in the rest of the region. Therefore, preventive programs should be initiated at a young age to reduce the attributable burden later in life.

Prevalence and incidence of Paget's disease of bone: Temporal trend over 20years in the province of Quebec, Canada.

Paget's disease of bone (PDB) is a focal bone disorder characterized by an increased bone remodeling and an anarchic bone structure. A decline of prevalence and incidence of PDB has been observed in some countries. No epidemiological data are available on PDB in Canada. We aimed at examining the evolution of the prevalence and incidence of PDB in Quebec (Canada) by analyzing health administrative databases. PDB case definition relied on one or more hospitalizations, or one or more physician-billing claims with a diagnosis code of PDB. To identify incident cases, a 'run-in' period of four years (1996-1999) was used to exclude prevalent cases. For each fiscal year from 2000 to 2001 to 2019-2020 (population size 2,914,480), crude age and sex-specific prevalence and incidence rates of PDB among individuals aged ≥55years were determined, and sex-specific rates were also standardized to the 2011 age structure of the Quebec population. Generalized linear regressions were used to test for linear changes in standardized prevalence and incidence rates. Over the study period, standardized prevalence of PDB has remained stable in Quebec, from 0.44% in 2000/2001 to 0.43% in 2019/2020 (mean change -0.002, p-value=0.0935). For the 2019-2020 fiscal year, 13,165 men and women had been diagnosed with PDB and prevalence of PDB increased with age. Standardized incidence of PDB has decreased over time from 0.77/1000 in 2000/2001 to 0.28/1000 in 2019-2020 (mean change -0.228/year, p-value<0.0001), the incidence decreasing from 0.82/1000 to 0.37/1000 in men and from 0.76/1000 to 0.22/1000 in women, respectively. This decrease was observed in all age categories. With the exception of a slight increase in PDB prevalence up to 0.55% in years 2005 to 2007, the prevalence of PDB has remained stable in Quebec over the past 20years, 13,160 men and women being currently diagnosed with PDB. The incidence has decreased over time. Our results support the epidemiological changes of PDB reported in other countries.

Prevalence and Risk Factors for Anemia in Pregnant Women at Jaraga Sasameh Hospital

Information about incidence and risk factor for anemia is needed to help women avoid unwanted pregnancy outcome such as possibility of bleeding during labor and worse baby outcomes. The lack of data regarding the incidence of anemia in pregnant women in Barito Selatan Regency is still a major problem. The study was to describe the prevalence cases and to analyze the risk factor that cause anemia in pregnancy. The research method was analytic with a cross sectional design. The total sample of 235 pregnant women. Descriptive data analysis was presented in the distribution table and Chi-Square statistical test using SPSS version 26. The results showed anemia occurred in 164 of 235 respondents (69.8%). There was no significant relationship between number of pregnancies on the incidence of anemia (p&gt;0.05). There was a significant relationship between maternal age, patient education, nutritional status, employment status, consumption of Fe, consumption of vitamin C and complication of pregnancy with the incidence of anemia (p&lt;0.05). The conclusion of the study was that the factors associated with the incidence of anemia in pregnant women at Jaraga Sasameh Hospital were patient education, nutritional status, consumption of Fe, consumption of vitamin c and complication of pregnancy

Unsupervised Physics-Informed Health Indicator Estimation for Complex Systems

Developing Health Indicators (HI) is a crucial aspect of prognostics and health management of complex systems. Previous research has demonstrated the benefits of accurately determining the HI, which can lead to better performance of prognostic models. However, the existing methodologies for determining HI in complex systems are mostly semi-supervised and rely on assumptions that may not hold in real-world scenarios. The existing methods usually involve using a reference set of healthy sensor readings or run-to-failure data to infer HI. But the unsupervised inference of HI from sensor readings, which is challenging in scenarios where diverse operating conditions can mask the effect of degradation on sensor readings, has not been extensively researched. In this paper, we propose a novel physics-informed unsupervised model for determining HI. Unlike previous methods, constrained by assumptions, the proposed method uses prior general knowledge about degradation to infer HI, thereby eliminating the need for a reference set of healthy sensor readings. The proposed unsupervised model is an Autoencoder that incorporates constraints on its latent space to ensure consistency with knowledge about degradation. We assess the efficacy of the proposed model by analyzing a prevalent prognostic case study, specifically the turbofan engine dataset (N-CMAPSS). Our analysis considers the model's sensitivity to data availability and the resulting Health Index's quality, including trendability and monotonicity. Additionally, we investigate the impact of incorporating the Health Index in predicting Remaining Useful Life (RUL). We demonstrate that our proposed method generates a Health Index that exhibits greater monotonicity and trendability than the current state-of-the-art semi-supervised approach. Moreover, our approach for identifying the Health Index leads to enhanced prognostic performance compared to the existing semi-supervised approach.

Illinois Transplant Fund Experience: Is It a Pathway to Increased Transplant Access for Hispanic Patients With Kidney Failure?

The Illinois Transplant Fund, established in 2015, provides private health insurance premium support for noncitizen patients with kidney failure in Illinois and thus allows them to qualify for kidney transplants. Our objective was to describe trends in kidney transplant volumes over time to inform the development of a hypothesis regarding the impact of the Illinois Transplant Fund on kidney transplant volumes for adult Hispanic patients with kidney failure in Illinois, especially noncitizen patients. Retrospective study. We used data on the annual number of kidney transplants and kidney failure prevalence aggregated to the national and state levels from the Organ Procurement and Transplantation Network and United States Renal Data System, respectively. The annual number of transplants as a percentage of prevalent kidney failure cases among adults over time from 2010 to 2020 by race/ethnicity for all payer and private insurance-paid transplants and the annual number of transplants by citizenship status (for Hispanic patients only) were examined for the United States (US), Illinois, and 6 selected US states. Descriptive study. From pre- to post-Illinois Transplant Fund, the average annual number of transplants as a percentage of the average annual prevalent kidney failure cases for Hispanic adults increased by 4% in Illinois while the same figure increased by 33% for privately insured transplants. The observations reported in this paper cannot be interpreted as evidence for the program's impact. Observed trends suggest plausibility of developing a hypothesis that Illinois Transplant Fund's introduction may have contributed to improvement in kidney transplantation access for Hispanic patients in Illinois, especially noncitizens, but cannot constitute evidence in support of or against this hypothesis. Future research should test whether the Illinois Transplant Fund improved access to kidney transplants for noncitizens with kidney failure. Health policies regarding kidney transplant access for undocumented residents vary widely by state. The Illinois Transplant Fund (ITF) provides financial support for health insurance premiums, so undocumented patients with kidney failure in Illinois can qualify for a kidney transplant. In this study, we reported kidney transplant trends in Illinois before and after the creation of the ITF along with kidney transplant trends in the US overall and selected states that share similarities to Illinois.

The burden of neck pain in the Middle East and North Africa region, 1990–2019

BackgroundNeck pain is a common cause of disability across the world. The objective of the present study was to present a thorough investigation of the burden caused by neck pain in the Middle East and North Africa (MENA) region, by country, sex, age group and socio-demographic index (SDI). MethodsThe data on the burden of neck pain, encompassing its prevalence, incidence and years lived with disability (YLDs), were extracted from the Global Burden of Disease (GBD) 2019 study. These findings are reported as age-standardised numbers and rates (per 100,000), accompanied by 95 % uncertainty intervals (UIs). ResultsThe age-standardised point prevalence of neck pain in 2019 was 3066.7 (95 % UI: 2407.8 to 3894.3) per 100,000, with an age-standardised incidence rate of 649.2 (509.2–829.2) in the MENA region, neither of which have changed since 1990. The age-standardised YLD rate of neck pain was 303.0 (201.5–438.8) per 100,000 population in 2019. The highest YLD rate of neck pain was found in Iran [423.5 (280.3–609.8)] and the lowest in Kuwait [215.0 (141.0–314.1)]. The highest number of prevalent cases were seen in the 45–49 age-group for both sexes in 2019, but overall females had a higher point prevalence than males. Furthermore, over the study period (1990–2019) there was no clear and consistent relationship between the SDI and the burden of neck pain. ConclusionAlthough the burden of neck pain has largely remained stable over the past three decades, the prevalence and morbidity in the MENA region remains high. Preventive and rehabilitative programs should be implemented that firstly target middle-aged females and males.

Hyperthyroidism incidence in a large population-based study in northeastern Italy.

An improvement in iodine status in Veneto Region has been documented in the last decade. We aimed at estimating the incidence of hyperthyroidism in the Veneto Region (Italy) over the period 2013-2022. Retrospective population-based study conducted in Veneto (4.9 million people) using the population registry, an administrative health database. Between 2012 and 2022, hyperthyroidism incidence was defined thank to a health-care co-payment exemption for hyperthyroidism or any hospital diagnosis of hyperthyroidism. Incident hyperthyroidism was defined from 2013 to 2022 to exclude prevalent cases. Standardized incidence rates (IRs) were reported by age, sex, and etiology of thyroid hyperfunction too. We identified 26,602 incident cases (IR of 54.38 per 100,000 person-years, 2.47-fold higher in females than in males). IR decreased from 69.87 (95% CI: 67.49, 72.25) in 2013 to 42.83 (95% CI: 40.99, 44.66) in 2022. In 2020, an out-of-trend decrease in hyperthyroidism incidence was documented, corresponding to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic outbreak, with a realignment to the trend in the subsequent years. The annual percentage change according to the cause of hyperthyroidism was as follows: -6.62% (95% CI: 8.47, 4.73) (P < 0.0001) in toxic multinodular goiter, -7.56% in toxic uninodular goiter (95% CI: 10.54, 4.48) (P < 0.001) and -4.70% (95% CI: 6.33, 3.04) in toxic diffuse goiter (Graves' disease) (P < 0.001). We documented a decline in the incidence of hyperthyroidism in Veneto Region, paralleling the improvement of the iodine status, thanks to a long and sustained iodine prophylaxis campaign. SARS-CoV-2 pandemic and vaccination campaign did not change the declining trend of hyperthyroidism incidence in our study region. An improvement in iodine status in the population residing in the Veneto region has been documented in the last decade, thanks to a nationwide voluntary iodine prophylaxis program running since 2005, but its impact on the epidemiology of thyroid disease has never been documented. This is the largest study on the incidence rates of hyperthyroidism carried out in Italy and covers the longest observation period among all regionwide population-based studies of hyperthyroidism in our country. We documented a reduction in the incidence of hyperthyroidism, which was more pronounced in nodular goiter diagnosis but involved also toxic diffuse goiter. The decline in the incidence of hyperthyroidism in Veneto Region shows the efficacy and safety of the iodine prophylaxis campaign.

What constitutes a “Key Enabling Technology” for transition processes: Insights from the bioeconomy's technological landscape

In policy strategies, Key Enabling Technologies (KETs) are described as knowledge intensive and multidisciplinary technologies driving profound transformations for modernization of industries. However, within scientific literature the concept of KETs is rather unexplored and prevalent case studies lack any clear definition of KETs. The question therefore arises as to whether KETs are needed as a new concept and how they differ to other technology types. Therefore, in this study we apply and extend existing patent indicators targeting the identification of promising technologies for transition processes from an ex-ante as well as ex-post perspective. By relying on hierarchical clustering on principal components of patent data complemented by an expert-based survey, we delineate KETs from emerging technologies and General Purpose Technologies (GPTs). On the example of the transition towards a bio-based economy, our results highlight that KETs combine broad knowledge revealing complementarity within a specific field of transition, while emerging technologies are less knowledge intensive and GPTs accelerate further innovation. Hence, we provide guidance to managers and policymakers in developing, identifying, and promoting promising technologies as engines of transition processes and economic growth. We, thus, support designing funding schemes and directing research endeavors for development and application of KETs.

Premature mortality risk in individuals with convulsive epilepsy: Results from a longitudinal, prospective, population-based study

ObjectiveTo assess premature mortality and identify associated risk factors among individuals with convulsive epilepsy in resource-poor settings using a longitudinal, prospective, population-based approach. MethodThe study recruited people with convulsive epilepsy who underwent assessment and management of epilepsy at primary healthcare centers in rural Northwest China, including newly diagnosed individuals and previously identified prevalent cases. All participants were confirmed to have epilepsy by neurologists according to strict criteria and were followed up monthly by primary care physicians. Demographic data and cause of death (COD) were obtained from death certificates or verbal autopsies conducted by neurologists, following the International Classification of Diseases, 10th Edition. The standardized mortality ratio (SMR) and proportionate mortality ratio (PMR) for each cause of death were estimated using the Cause-Of-Death Surveillance Dataset of China (2020). Survival analysis was used to identify risk factors associated with all-cause mortality and death directly due to epilepsy. ResultsDuring 5.9 years of follow-up with 40,947 person-years, there were 781 (11.2%) deaths among 6967 participants. The risk of premature death in people with convulsive epilepsy was 2.7-fold higher than that in the general population. Young participants had a significantly higher risk (standardized mortality ratio 26.5–52.5) of premature death. The proportionate mortality ratio was higher for cerebrovascular disease (15%), sudden unexpected death in epilepsy (SUDEP) (13.4%), cardiovascular disease (11.7%), status epilepsy (SE) (11.3%), and epilepsy-related accidents (14.0%) than other premature mortality cause of deaths. Additionally, the highest standardized proportional mortality ratio (SPMR) was observed from drowning in all cause of death (10.4, 95% confidence interval [CI]: 7.6–13.8), followed by burning (9.0, 95% CI: 3.7–18.9). Factors that increased the risk of all-cause mortality included male sex, late age of onset, short disease duration, high body mass index, monotherapy, and the frequency of generalized tonic-clonic seizures (GTCS). High frequency of generalized tonic-clonic seizures (> 3 attacks in the last year) was an independent risk factor for premature death directly due to epilepsy (including sudden unexpected death in epilepsy, status epilepsy, and epilepsy-related accidents), while early age of onset (≤ 14 years) and long duration of epilepsy (> 20 years) were independent risk factors for sudden unexpected death in epilepsy. In addition, short duration of epilepsy (≤ 20 years) was an independent risk factor for status epilepsy. ConclusionsThis study demonstrated that individuals with poorly controlled seizures are more likely to experience premature death, with most deaths being epilepsy-related and preventable. These findings underline the importance of effective seizure treatment and the potential impact on reducing premature mortality among people with convulsive epilepsy.

Factors associated with type 2 diabetes mellitus comorbidity among adult patients: a retrospective clinical audit of a medical centre in Abuja, Nigeria

Background Diabetes mellitus (DM) is a disorder of metabolism in which an absolute or relative deficiency of insulin results in hyperglycemia leading to acute and chronic complications. Over the years, the issue of incidences of DM in different regions of the globe has become a huge public health problem, especially in cases of patients with comorbidity conditions. These conditions have made the treatment and management of DM extremely difficult, especially in sub-Saharan Africa, where there are weak health systems. Methods This study was a retrospective study based on the record review of 162 patients receiving care at Federal Medical Centre, Jabi Abuja. Using the electronic medical records, key variables of interest were extracted, and the effects of comorbid conditions on Type 2 Diabetes Mellitus (T2DM) were determined. Results The summary results revealed that the incidence of T2DM was approximately 107(66.1%) had T2DM, while about 159 (98.2%) out of the 162 patients with one or more other diseases had T2DM. There were more female patients, 97(59.9%) with cases of DM than male patients. Patients aged 40-69 years have more prevalence cases of DM (73.5%), with those engaging in businesses or trading common in this category (29.63%). Most of these patients had Hypertension as a comorbid condition 110(67.9). The results based on the logistic model showed that patients with concordant comorbid conditions are 2.11 times more likely to develop T2DM. The Bayesian logistic regression model revealed a positive association between gender and comorbidity; the male patients were 1.65 times more likely to develop comorbidity, and patients with a smoking history were 1.56 times more likely to develop comorbidity. T2DM was not associated with systolic blood pressure. Conclusions This present study provides elaborate details on incidences of DM and associated comorbidity conditions in the study area and its environs. A Bayesian model seems to be more accurate than conventional logistic regression based on the present findings. This, in turn, could be used to formulate health policies geared towards effective management, control and prevention of DM of any kind and community sensitization on DM in Nigeria.

Determinants of survival in patients with chronic heart failure: a population-based study in Reggio Emilia, Italy.

We aim to monitor and improve the quality of the heart failure (HF) integrated assistance model defined by national and regional guidelines and implemented in the province of Reggio Emilia, Italy. Specific aims of the audit were to estimate the prevalence of HF, describe the characteristics of patients with HF and the rate of patients enrolled in the integrated care treated in primary care, and identify socioeconomic and geographic determinants of the 4-year survival of these patients. Retrospective analysis of a cohort of prevalent cases of HF, diagnosed before 31 December 2015 in Reggio Emilia, Italy, alive on 1 January 2016, and residing at the time of diagnosis on the provincial territory. Age and sex-adjusted prevalence of HF by area of residence were calculated according to the standard European population 2013. Patients were followed until death or 31 December 2019, whatever came first. The outcome measure of the study was four-year case fatality. Cox proportional hazards models, adjusted for age, sex, and duration of disease were used to determine the association between socio-geographic factors and death. The 4-year case-fatality rate was 36.7%, and it was the highest in the mountains (50.8%) compared with hills (34.6%), lowland (35.4%) and city (37.7%). The prevalence of HF was the lowest in the mountain [149.9, 95% confidence interval (CI) 112.1-187.7] and the highest in the lowland (340.8, 95% CI 308.7-372.9) and city (308, 95% CI 276.0-321.2). Patients living in the mountains had a lower deprivation index, and fewer hospitalizations prior to official diagnosis, although these characteristics were not statistically significant determinants of HF death in multivariate analysis. Behavioural (smoking and obesity) and socio-geographic characteristics (educational level, deprivation index and area of residence) were not significantly associated with mortality in both univariable and multivariable analysis; however, patients who live in mountains (hazard ratio 1.10, 95% CI 0.73-1.66) or hills (hazard ratio 1.11, 95% CI 0.90-1.37) had a slightly higher risk of death than those living in the city. Only 197 (12.1%) of patients in the cohort were enrolled in the integrated care pathway over the course of 4years. Although clinical determinants outweigh the geographic and behavioural disparities in the survival of patients with CHF treated in primary care, effective prevention strategies are needed to address environmental and socio-geographic inequalities in access to primary care and to hasten equitable linkage to integrated care.

Negative log-binomial model with optimal robust variance to estimate the prevalence ratio, in cross-sectional population studies

BackgroundCross-sectional studies are useful for the estimation of prevalence of a particular event with concerns in specific populations, as in the case of diseases or other public health interests. Most of these studies have been carried out with binary binomial logistic regression model which estimates OR values that could be overestimated due to the adjustment of the model. Thus, the selection of the best multivariate model for cross-sectional studies is a priority to control the overestimation of the associations.MethodsWe compared the precision of the estimates of the prevalence ratio (PR) of the negative Log-binomial model (NLB) with Mantel–Haenszel (MH) and the regression models Cox, Log-Poisson, Log-binomial, and the OR of the binary logistic regression in population-based cross-sectional studies. The prevalence from a previous cross-sectional study carried out in Colombia about the association of mental health disorders with the consumption of psychoactive substances (e.g., cocaine, marijuana, cigarette, alcohol and risk of consumption of psychoactive substances) were used. The precision of the point estimates of the PR was evaluated for the NLB model with robust variance estimates, controlled with confounding variables, and confidence interval of 95%.ResultsThe NLB model adjusted with robust variance showed accuracy in the measurements of crude PRs, standard errors of estimate and its corresponding confidence intervals (95%CI) as well as a high precision of the PR estimate and standard errors of estimate after the adjustment of the model by grouped age compared with the MH PR estimate.Obtained PRs and 95%CI entre NLB y MH were: cocaine consumption (2.931,IC95%: 0.723–11.889 vs. 2.913, IC95%: 0.786–12.845), marijuana consumption (3.444, IC95%: 1.856–6.391 vs. 3.407, IC95%: 1.848, 6.281), cigarette smoking (2.175,IC95%: 1.493, 3.167 vs. 2.209, IC95%: 1.518–3.214), alcohol consumption (1.243,IC95%: 1.158–1.334 vs. 1.241, IC95%: 1.157–1.332), and risk of consumption of psychoactive substances (1.086, IC95%: 1.047–1.127 vs. 1.086, IC95%: 1.047, 1.126). The NLB model adjusted with robust variance showed mayor precision when increasing the prevalence, then the other models with robust variance with respect to MH.ConclusionsThe NLB model with robust variance was shown as a powerful strategy for the estimation of PRs for cross-sectional population-based studies, as high precision levels were identified for point estimators, standard errors of estimate and its corresponding confidence intervals, after the adjustment of confounding variables. In addition, it does not represent convergence issues for high prevalence cases (as it occur with the Log-binomial model) and could be considered in cases of overdispersion and with greater precision and goodness of fit than the other models with robust variance, as it was shown with the data set of the cross-sectional study used in here.

Prevalence, demographic and spatial distribution of treated epilepsy in France in 2020: a study based on the French national health data system

BackgroundAlthough still incomplete, the epidemiology of epilepsy shows substantial variations in the burden of the condition according to demographic, social and territorial characteristics. This study aimed to estimate the prevalence of treated epilepsy and to investigate its demographic and spatial distribution in 2020 in France, a country where the nationwide epidemiological situation of the condition remains largely unknown.MethodsWe used the French national health data system, which covers nearly the entire population residing in France (over 67 million of inhabitants in metropolitan and overseas departments). Prevalent cases were identified using long-term disease status, hospitalisation for epilepsy (ICD-10 codes G40 or G41), and reimbursements for antiseizure medications and electroencephalograms.ResultsIn 2020, we identified 685,122 epilepsy cases, corresponding to an overall prevalence of 10.2 per 1000 inhabitants [95% confidence interval 10.1–10.2], with similar rates in men and women. Estimates were found to increase with age, with an accelerated rise in the second half of the life, which occurred earlier in men than in women. We observed a monotonic gradient of variation with socio-economic deprivation (in non-military metropolitan subjects aged 18–54 years) as well as territorial heterogeneity, with the mountainous centre of France as well as some French overseas departments having the highest prevalence.ConclusionsOur results revise upwards the estimation of epilepsy prevalence in France, showing that it now ranks among the highest in developed countries. Our study also confirms the important socio-territorial heterogeneity of the condition that reflects health inequalities in this country.

Validity of claims-based diagnoses for infectious diseases common among immunocompromised patients in Japan

BackgroundTo validate Japanese claims-based disease-identifying algorithms for herpes zoster (HZ), Mycobacterium tuberculosis (MTB), nontuberculous mycobacteria infections (NTM), and Pneumocystis jirovecii pneumonia (PJP).MethodsVALIDATE-J, a multicenter, cross-sectional, retrospective study, reviewed the administrative claims data and medical records from two Japanese hospitals. Claims-based algorithms were developed by experts to identify HZ, MTB, NTM, and PJP cases among patients treated 2012–2016. Diagnosis was confirmed with three gold standard definitions; positive predictive values (PPVs) were calculated for prevalent (regardless of baseline disease-free period) and incident (preceded by a 12-month disease-free period for the target conditions) cases.ResultsOf patients identified using claims-based algorithms, a random sample of 377 cases was included: HZ (n = 95 [55 incident cases]); MTB (n = 100 [58]); NTM (n = 82 [50]); and PJP (n = 100 [84]). PPVs ranged from 67.4–70.5% (HZ), 67.0–90.0% (MTB), 18.3–63.4% (NTM), and 20.0–45.0% (PJP) for prevalent cases, and 69.1–70.9% (HZ), 58.6–87.9% (MTB), 10.0–56.0% (NTM), and 22.6–51.2% (PJP) for incident cases, across definitions. Adding treatment to the algorithms increased PPVs for HZ, with a small increase observed for prevalent cases of NTM.ConclusionsVALIDATE-J demonstrated moderate to high PPVs for disease-identifying algorithms for HZ and MTB using Japanese claims data.

Global, regional and national burden of traumatic brain injury and spinal cord injury, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

ObjectivesTo evaluate the most up-to-date burden of traumatic brain injury (TBI) and spinal cord injury (SCI) and analyse their leading causes in different countries/territories.DesignAn analysis of Global Burden of Disease...

The burden of nonalcoholic fatty liver disease (NAFLD) is rapidly growing in every region of the world from 1990 to 2019.

The latest meta-analyses suggest NAFLD is increasing globally. Its limitations may preclude accurate estimates. We evaluated the global NAFLD burden and its' trends in prevalence and NAFLD liver-related mortality (LRM) by sex, age, region, and country over the past 3 decades using data from the Global Burden of Disease (GBD) 2019 study. Crude and age-standardized NAFLD prevalence and NAFLD-LRM rates were obtained for all-age individuals with NAFLD from 204 countries/territories between 1990 and 2019. Joinpoint trend analysis assessed time trends. Weighted average of the annual percent change (APC) over the period 1990-2019 and 2010-2019 were reported. All-age (children and adults) crude global NAFLD prevalence increased:10.5% (561 million)-16.0% (1,236 million); an APC increase: + 1.47% (95% CI, 1.44%, 1.50%). Among adults (+20y), crude NAFLD prevalence increased (1990: 17.6%, 2019:23.4%; APC: + 1.00%, 95% CI: 0.97%, 1.02%). In all-age groups, the crude NAFLD-LRM rate (per 100,000) increased (1990: 1.75%, 2019: 2.18%; APC: + 0.77% (95% CI, 0.70%, 0.84%). By Joinpoint analysis, from 2010 to 2019, worsening all-age trends in NAFLD prevalence and LRM were observed among 202 and 167 countries, respectively. In 2019, there were 1.24 billion NAFLD prevalent cases and 168,969 associated deaths; Asia regions accounted for 57.2% of all-age prevalent cases and 46.2% of all-age NAFLD-LRM. The highest all-age crude NAFLD prevalence rate was the Middle East and North Africa (LRM 26.5%); the highest all-age crude NAFLD-LRM rate was Central Latin America (5.90 per 100,000). NAFLD is increasing globally in all-age groups-over 80% of countries experienced an increase in NAFLD and NAFLD-LRM. These data have important policy implications for affected countries and for global health.

Influence of neighborhood-level socioeconomic deprivation and individual socioeconomic position on risk of developing type 2 diabetes in older men: a longitudinal analysis in the British Regional Heart Study cohort

IntroductionEvidence from longitudinal studies on the influence of neighborhood socioeconomic deprivation in older age on the development of type 2 diabetes mellitus (T2DM) is limited. This study investigates the prospective...

Burden and risk factors of chronic obstructive pulmonary disease in Sub-Saharan African countries, 1990–2019: a systematic analysis for the Global Burden of disease study 2019

Sub-Saharan Africa (SSA) has experienced a surge of non-communicable diseases (NCDs) including chronic obstructive pulmonary disease (COPD) over the past two decades. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), in this study we have estimated the burden and attributable risk factors of COPD across SSA countries between 1990 and2019. COPD burden and its attributable risk factors were estimated using data from the 2019 GBD. Percentage change was estimated to show the trend of COPD estimates from 1990 to 2019. COPD estimates attributable by risk factors were also reported to ascertain the risk factor that brings the greatest burden by sex and locations (at country and regions level). In 2019, all-age prevalent cases of COPD in SSA were estimated to be 10.3 million (95% Uncertainty Intervals (UI) 9.7 million to 10.9 million) showing an increase of 117% compared with the number of all-age COPD cases in 1990. From 1990 to 2019, SSA underwent an increased percentage change in all-age YLDs due toCOPD ranging from 41% in Lesotho to 203% in Equatorial Guinea. The largest premature mortality due to COPD was reported from Central SSA accounting for 729 subjects (95% UI, 509-1078). The highest rate of DALYs attributable to COPD was observed in Lesotho. Household air pollution from solid fuel was the primary contributor of the age standardized YLDs, death rate, and DALYs rate per 100,000 population. The prevalence of COPD in SSA has had a steady increase over the past three decades and has progressively become a major public health burden across the region. Household air pollution from solid fuel is the primary contributor to COPD related burden, and its percentage contribution showed a similar trend to the reduction of COPD attributed age-standardized DALY rate. The methodological limitations of surveys and datapoints included in the GBD need to be considered when interpreting these associations. There are no specific fundings received for this study. The Global Burden of Disease study was supported by funding from the Bill & Melinda Gates Foundation.

A General Assessment of India's Extremely Low Number of Transgender Cancer Patients

Physiological transgender (TJ) is one of the most marginalized and oppressed community in the Indian subcontinent. The observable percentage of physiological transgender (TJ) cancer patients is extremely low. This concise report aims to assess the factors that contribute to the scarcity of transgender cancer patients. The hospital database (2012-2021) of 2 centers in New Delhi (population 32 million) & 1 in Kolkata (15 million) were evaluated. In addition, 28 senior oncologists (ONC) and 17 trans women (TWs) completed a six-point questionnaire. ONC was asked how many TJ patients they had seen in their career, as well as histopathology/site. Furthermore, the data was extrapolated to account for all clinicians' cumulative years of experience. The questions for TWs were age and where they go if you have a disease or illness. And, do they know any TJ cancer patients? India's last census (2011) revealed a half-million TJ population. TJ density must be at least 1 million to be comparable to the rest of the world. Hospital databases counted 10,486 patients, with no patient identified as TJ. A total of 37 TJ cancer patients were reported by 28 ONC with an average and collective years of their medical service of 23.1±4.1 and 646 years; distributed in 3 metropolis of 67 million (combined) population (Kolkata, New Delhi, and Mumbai). The average lifetime number of TJ cancer patients/oncologist was 1.3±1.1. Total 12 cases were head neck cancers, with 4 caused by human papillomavirus. The remaining 25 patients have 5 lung, 5 gynecological, 4 breast, 3 brain cancers, 2 soft tissue sarcomas, and 6 cases of unknown origin. The density of 5-year prevalent cancer cases in India is 0.2%, with an estimated 0.007% of TJ cancer patients. TW could not identify any cancer patients in their community. Being transgender is a social taboo in this part of the world. Their legal rights and classification as the third gender are uncommon. TJs are denied access to standard education, mainstream occupations, and social respect. Although the exact number has never been determined, it is estimated that a large proportion (≈90%) of TJ people are forced to choose roadside begging and working as cheap sex workers. There is no clinical reason why TJs should have fewer cancer incidents, they should be more susceptible to cancer due to unhealthy living conditions, unprotected sex, lack of medical care, proper nutrition, and all other factors associated with their very low socioeconomic status. Nonetheless, it's difficult to find single TJ cancer patients in both public and private hospital OPD. They may be unable to access a traditional clinic due to social discrimination, financial constraints, or they may be unwilling to disclose their true sex. Even TJ's do not show up at free public clinics. The disclosure of true sex may be beneficial in obtaining better treatment, but the more prevalent reason is social unacceptability, which can be overcome through proper education and community economic growth.

The Global Burden of Vascular Intestinal Disorders in 204 Countries and Territories From 1990 to 2019: Global Burden of Diseases Study.

Objectives: Assess the prevalence, mortality, and disability-adjusted life years (DALYs) of vascular intestinal disorders (VID) from 1990 to 2019. Methods: This study conducted a secondary data analysis utilizing the Global Burden of Diseases Study 2019. The prevalence, mortality and DALYs of VID were analyzed by sex, age and socio-demographic index (SDI), respectively. Analyses were performed by using R software. Results: Globally, the number of prevalent VID cases increased from 100,158 (95% uncertainty interval: 89,428-114,013) in 1,990-175,740 (157,941-198,969) in 2019. However, the age-standardized rates (ASR) of VID prevalence declined from 2.47 (95% uncertainty interval: 2.24-2.76) per 100,000 population to 2.21 (1.98-2.48) per 100,000 population between 1990 and 2019. Furthermore, the ASR of mortality also decreased from 1990 to 2019. Between 1990 and 2019, the regions with high and high-middle level exhibited the highest diseases burden. Conclusion: Globally, the diseases burden associated with VID demonstrated a decline from 1990 to 2019. However, concerted efforts are still required to enhance measures to combat VID within countries categorized as high and high-middle SDI.