Prevention Priorities Research Articles

Demographics and Clinical Characteristics Assessment of Severe Acute Toxic Ingestions in Pediatric Patients: A Single-Center Study in Jilin Province of China.

This study aimed to describe the demographic and clinical characteristics of severe acute toxic ingestions in children in Jilin Province and provide a reference for seeking effective measures to prevent poisoning accidents. The clinical data of patients diagnosed with acute toxic ingestions and who presented with severe life-threatening symptoms or organ dysfunction at the Pediatric Intensive Care Unit of the First Hospital of Jilin University were retrospectively analyzed. Patients with incomplete clinical medical records, unclear toxic substance, and loss to follow-up within 6 months of discharge are excluded. We sorted out these children's demographic characteristics, types of poisoning, clinical manifestations, treatment process, and follow-up, etc. This study enrolled 141 cases with no significant differences in sex and region; adolescents accounted for 44.68%. The most common poisons were pesticides and insecticides for rural areas and internal medication for urban areas. With poisoning details as a grouping variable, there was no statistical difference between sex groupings (χ2 = 6.018, P = 0.198) and no difference between region groups (χ2 = 3.775, P = 0.289). However, there were statistical differences between age groups (χ2 = 28.22, P = 0.001). In this research, patients younger than 6 years are mainly unintentionally poisoned, whereas the suicide rate of the urban group (P < 0.05), adolescents (P < 0.01), and girls (P < 0.01) has increased significantly; moreover, the suicide group is more likely to take more overdose medication or pesticides and insecticides (P < 0.01). In addition, there was a statistical difference between suicide and length of intensive care unit stay (r = 0.268, P < 0.01). A total of 90.78% of the patients were successfully discharged after comprehensive treatment. Children aged younger than 12 years had good psychological and intellectual development during the follow-up period, whereas adolescents diagnosed with depression often required long-term psychological and medication intervention. This study identified poisoning details in different ages, regions, and sex of acute severe oral poisoning in children from Jilin Province. The results presentation of different prevention priorities should vary among children of different ages and emphasize adolescent suicide being a reality in Jilin Province. There is an urgent need for further culture-specific research in this area.

Ethnic Variation in Modifiable Risk Factors for Dementia

AbstractBackgroundWe aimed to estimate the population attributable fraction (PAF) of 12 modifiable risk factors (defined by the Lancet Commission 2020), for incident dementia cases in the UK Biobank (UKB), stratified by ethnicity. We considered if ethnic differences in dementia risk, were accounted for by modifiable risk factors. To identify appropriate priorities in dementia prevention, tailored to ethnicity.MethodThe UKB is a cohort study with 502,656 volunteer participants registered between 2006‐2010, aged 40‐60 years at baseline, and followed for up to 16.8 years. To estimate the PAF of 12 modifiable risk factors (diabetes, hypertension, depression, hearing loss, obesity, traumatic brain injury (TBI), less education, social isolation, physical inactivity, air pollution, and smoking), we first estimated hazard ratios (HRs)(adjusted for age, gender, and Townsend quintiles), or when ethnicity interacted with risk factors, then we estimated HRs stratified by ethnicity. HRs were then converted to relative risk for PAF calculation.Results6,624 incident cases of dementia developed in 1.3%(95%CI = 1.3‐1.3)(n = 6316/471297){of Whites}, in 1.3%(95%CI = 1.1‐1.5)(n = 104/8031){of Blacks}, and in 1.0%(95%CI = 0.8‐1.2)(n = 79/8001){of South Asians (S.Asian)}. The mean age at dementia diagnosis was 71.6 years(SD,6.1){in S.Asians}; 71.8 years(SD,6.8){in Blacks}; and 73.6 years(SD,5.5){in Whites}. The combined PAF(95%CI) for dementia were: 35.6%(35.5‐35.8){in Whites}, 33.9%(32.8‐34.9){in Blacks}, and 41.0%(39.9‐42.0){in S.Asians}. The highest individual PAFs in each ethnic group, compared to the rest, were as follow. Blacks and S.Asians, respectively, for midlife hypertension: 9.6%(9.0‐10.3) and 10.1%(9.5‐10.8) vs 6.5%(6.4‐6.5){in Whites}. S.Asians for (1)Depression: 8.5%(7.9‐9.1) vs 4.0%(3.6‐4.4){in Blacks}, and 5.8%(5.7‐5.9){in Whites}; (2)Diabetes: 6.0%(5.4‐6.5) vs 5.1%(4.6‐5.6){in Blacks}, and 3.5%(3.4‐3.5){in Whites}; (3)Excessive alcohol: 1.4%(1.2‐1.7) vs 0.0%{in Blacks and Whites}. Whites for (1)Hearing loss: 3.6%(3.6‐3.7) vs 2.4%(2.1‐1.8){in Blacks}, and 3.0%(2.6‐3.4){in S.Asians}; (2)TBI: 2.5%(2.4‐2.5) vs 1.3%(1.1‐1.6){in Blacks}, and 1.7%(1.4‐2.0){in S.Asians}; (3)Less education: 5.0%(4.9‐5.1) vs 3.3%(2.9‐3.7){in Blacks}, and 3.2%(2.9‐3.6){in S.Asians}; (4)Physical inactivity: 2.6%(2.6‐2.7), vs 2.1%(1.8‐2.5){in Blacks}, and 2.2%(1.8‐2.5){in S.Asian; (5)Social isolation: 2.3%(2.2‐2.3) vs 1.9%(1.6‐2.1){in Blacks}, and 1.9%(1.6‐2.2){in S.Asians. The remaining risk factor PAFs did not differ between all ethnic groups.ConclusionIn this relatively wealthy, and healthy population, there remain ethnic disparities in the effect of modifiable risk factors on dementia. Interventions for midlife hypertension are a priority in South Asians and Blacks, particularly depression and alcohol consumption in South Asians.

Plasma proteomic profiles predict individual future health risk.

Developing a single-domain assay to identify individuals at high risk of future events is a priority for multi-disease and mortality prevention. By training a neural network, we developed a disease/mortality-specific proteomic risk score (ProRS) based on 1461 Olink plasma proteins measured in 52,006 UK Biobank participants. This integrative score markedly stratified the risk for 45 common conditions, including infectious, hematological, endocrine, psychiatric, neurological, sensory, circulatory, respiratory, digestive, cutaneous, musculoskeletal, and genitourinary diseases, cancers, and mortality. The discriminations witnessed high accuracies achieved by ProRS for 10 endpoints (e.g., cancer, dementia, and death), with C-indexes exceeding 0.80. Notably, ProRS produced much better or equivalent predictive performance than established clinical indicators for almost all endpoints. Incorporating clinical predictors with ProRS enhanced predictive power for most endpoints, but this combination only exhibited limited improvement when compared to ProRS alone. Some proteins, e.g., GDF15, exhibited important discriminative values for various diseases. We also showed that the good discriminative performance observed could be largely translated into practical clinical utility. Taken together, proteomic profiles may serve as a replacement for complex laboratory tests or clinical measures to refine the comprehensive risk assessments of multiple diseases and mortalities simultaneously. Our models were internally validated in the UK Biobank; thus, further independent external validations are necessary to confirm our findings before application in clinical settings.

Setting research priorities for prevention and response to child marriage in communities in the Arab region: findings from a multi-stage Delphi study involving practitioners across the region

Globally, more than 12 million girls under the age of 18 are forced to marry every year. Progress on ending child marriage in the Arab region is slowing, and risks being reversed, due to an increase in conflict-affected populations and widespread economic crisis. The aim of this paper is to consider the research priorities across the region to inform effective and accelerated child marriage prevention and response programming within the Arab region. Seventy-three specialists supporting child marriage prevention and response programming in the Arab region engaged with up to three phases of an online Delphi consultation process on research gaps and the research environment between July 2019 and December 2021. Proposals of research gaps were elicited, reviewed, and rated by participants to confirm a shared learning agenda. Participants identified 50 different research gaps across 7 main areas, reaching a high level of consensus support for 23 of 50 statements. Clear consensus was reached in relation to an increased need to produce and use evidence to support programme development, and further research on specific drivers and consequences of child marriage. The least consensus was found in relation to how research can inform prevention and response efforts within the law and legal system. The results provide the foundation of a child marriage research agenda for the Arab region which takes into account regional distinctiveness and builds on the global momentum for child marriage research. Mechanisms are in place to do this through the Regional Action Forum, and other networks across the region.

Accident case-driven study on the causal modeling and prevention strategies of coal-mine gas-explosion accidents: A systematic analysis of coal-mine accidents in China

Post-accident prevention measures in Chinese coal mining enterprises were based on single accident case training, and the learning of accident information is limited to the violation in the accident or incident. The nature of accidents proves that accident prevention encompasses not only visible violations and hazardous materials, but also deep-rooted organizational factors. How to obtain valuable and learnable safety information from limited accident date remains a key issue. This study investigated the use of a modeled accident-prevention framework for combining accident case data to construct an accident causation network for targeted data mining, which in turn could help obtain accident-prevention measures with more control values. The results of the study showed that (1) A framework for categorizing the factors influencing coal mine accidents, including four layers and 42 indicators, was identified through a literature review and factor extraction from 86 coal mine accident reports. (2) A causation network model of gas-explosion accidents comprising 163 accident causation nodes and 681 connected edges was established, and SP02(failure to implement the stop production instruction), SA01 (poor awareness of system compliance), PB03(fluke psychology) and SH01(habitual violation of procedures and rules) were the most influential accidental causes in the accidental network. (3) An F-Score-based attack strategy for accident-causing networks was proposed, which is superior to generalized attack strategies for reducing accident network connectivity and more conducive to rapidly obtaining accident prevention priorities. (4) A gas explosion accident prevention strategy based on the combination of accident network model and dynamic Bayesian network was constructed, and inference simulation was performed for four cases such as IA01 (unchecked gas concentration), verifying that it has the possibility of predicting accident hazards in the workplace. This study provided accident data-driven prevention interventions to reduce future mining accidents.

Social, Structural, Behavioral, and Clinical Barriers Influencing Pre-exposure Prophylaxis (PrEP) Use Among Young Black Men Who Have Sex with Men in the South: A Qualitative Update to a 2016 Study.

Antiretroviral pre-exposure prophylaxis (PrEP) is highly effective in preventing HIV. Despite its promise, PrEP use is low, especially among young Black men who have sex with men (YBMSM). The prevalence of HIV in Mississippi (MS) is among the highest in the United States, with the bulk of new infections occurring amongst YBMSM living in Jackson, MS. We recruited 20 PrEP-eligible YBMSM and 10 clinic staff from MS health clinics between October 2021 and April 2022. Data were collected remotely using in-depth interviews and a brief survey, which lasted approximately 45-60min. Interview content included PrEP knowledge/experiences, HIV risk perception, and PrEP use barriers and facilitators. Qualitative data were coded then organized using NVivo. Using thematic analysis methodology, data were assessed for current barriers to PrEP use. An array of barriers were identified by participants. Barriers included structural factors (cost of PrEP, lack of discreet clinics, time commitment, competing interests); social factors (unaware of HIV risk, stigma and homophobia, fear that partners would find out about PrEP use, not knowing anyone on PrEP); behavioral factors (sexual risk factors, denial, less priority for prevention vs treatment); and clinical factors (misunderstood side effects, fear PrEP won't work). Significant barriers to PrEP use among YBMSM stem from structural, social, behavioral, and clinical factors. These results will inform intervention efforts tailored to mitigate barriers and improve PrEP uptake among YBMSM in the southern United States.

Urban-rural differences in key factors of depressive symptoms among Chinese older adults based on random forest model

BackgroundDepression is a major challenge in the global healthy aging process, and exploring the key factors of depression in urban and rural older adults is essential for differentiated and precise interventions. ObjectiveTo explore the urban-rural differences and key influencing factors of depressive symptoms among Chinese older adults. MethodsThe data of 5267 older adults were obtained from the China Health and Retirement Longitudinal Survey (CHARLS2018). Random forest model and logistic regression were used to analyze the key factors influencing depressive symptoms 19 variables. ResultsThe detection rate of depressive symptoms in older adults was 31.0 %, with 22.3 % and 34.8 % in urban and rural areas, respectively. Education, self-rated health, self-rated pain, and self-rated vision were common factors. Physical activity (OR = 0.716 for Moderate PA), social activity (OR = 0.671 for social activity), and self-rated hearing (OR = 0.602 for good) were key factors specific to urban older adults, and alcohol consumption (OR = 0.716 for drinking more than once a month) and marital status (OR = 0.689 for cohabitation) were key factors specific to depressive symptoms in rural older adults (all P < 0.05). LimitationCross-sectional data cannot reflect dynamic processes among variables; The cultural background might affect the cross-cultural validity of the study. ConclusionThe key factors of depressive symptoms among older adults in urban and rural areas differed, which provides priority and references for differential prevention and precise intervention of depressive symptoms to promote the process of healthy aging.

Research on Accessibility Optimization of Emergency Shelters in Chengdu Ring Eco-zone from the Perspective of Resilient City

Frequent natural disasters have put forward higher requirements for the comprehensive ability of disaster prevention and resilience in urban areas with a large number of people, and green space, as the most commonly used land for disaster prevention and risk avoidance, plays a key role in disaster prevention and risk avoidance. As a new development area in Chengdu, the central area of Chengdu has a long history and extensive population density, but there are still problems such as insufficient per capita park green space, imperfect road network structure, "misalignment" between the layout of green space for disaster prevention and risk avoidance and urban population density, and the hot spots of residents' production and life. Based on ArcGIS network analysis, Open Street Map traffic network analysis and existing Gaussian theory, this paper analyzes the rationality of the spatial layout of the existing green space for disaster prevention and risk avoidance in the central urban area of Chengdu by combining the four indicators of population ratio served, service area ratio, per capita avoidable area and population allocation gap. Based on Chengdu's "14th Five-Year Plan" for disaster prevention and mitigation, this project will first summarize the evaluation system of resilient cities at home and abroad, try to build a resilient city evaluation system suitable for Chinese cities, and then conduct a comprehensive analysis through satellite cloud data and POI point of interest crawling to preliminarily determine the reasons for the failure to meet the standard, and then conduct field research on the field feelings of residents around a certain part of the green belt around the city. It can be summarized as follows: (1) Combined with literature review, the theoretical and practical results of the existing research and evaluation on the accessibility of disaster prevention green space at home and abroad were fitted. Through the theoretical and research results, the regional characteristics and geological hazards of the disaster-prevention green space in the Chengdu Ring Ecological Zone were determined, and the residents in the central area of Chengdu were questioned based on a questionnaire survey to understand their cognition of the disaster-prevention green space and the current status of disaster-prevention green space services. (2) Based on the theory of resilient city, for the research on the accessibility of special disaster prevention green space, the buffer zone analysis method, the kernel density analysis method, the two-step mobile search method, and the traffic resistance accessibility evaluation model were comprehensively used to evaluate the accessibility of emergency shelters from the aspects of service radius buffer zone analysis, per capita service analysis, and per capita accessibility road analysis of disaster prevention green space, and the relevant data of the overall disaster prevention accessibility evaluation of Chengdu Ring Ecological Zone were calculated. The scoring results of each ecological region were Qingyang District (0.2547), Jinjiang District (0.2507), Wuhou District (0.2336), Chenghua District (0.2119), and Jinniu District (0.2547). (3) Based on the evaluation results and data, combined with the research results, the accessibility optimization scheme of Chengdu Ring Ecological Zone was analyzed. There are common problems in all districts, such as the mismatch between refuge sites and human settlements, the lack of refuge sites in road sections with high accessibility, and the isolation of the utilization rate of refuge sites. In view of the above problems, it is proposed to fully integrate the living environment to set up a disaster prevention green space. Disaster prevention green space traffic optimization and priority measures; Raise awareness of the use of disaster-proof green space facilities and resource conservation. Under the theoretical system of disaster prevention green space accessibility evaluation system, this paper uses the perspective of resilient city to construct special research data and optimization measures for Chengdu Ring City Ecozone.

Research prioritisation on prevention and management of preterm birth in low and middle-income countries (LMICs) with a special focus on Bangladesh using the Child Health and Nutrition Research Initiative (CHNRI) method.

Fifteen million babies are born preterm globally each year, with 81% occurring in low- and middle-income countries (LMICs). Preterm birth complications are the leading cause of newborn deaths and significantly impact health, quality of life, and costs of health services. Improving outcomes for newborns and their families requires prioritising research for developing practical, scalable solutions, especially in low-resource settings such as Bangladesh. We aimed to identify research priorities related to preventing and managing preterm birth in LMICs for 2021-2030, with a special focus on Bangladesh. We adopted the Child Health and Nutrition Research Initiative (CHNRI) method to set research priorities for preventing and managing preterm birth. Seventy-six experts submitted 490 research questions online, which we collated into 95 unique questions and sent for scoring to all experts. A hundred and nine experts scored the questions using five pre-selected criteria: answerability, effectiveness, deliverability, maximum potential for burden reduction, and effect on equity. We calculated weighted and unweighted research priority scores and average expert agreement to generate a list of top-ranked research questions for LMICs and Bangladesh. Health systems and policy research dominated the top 20 identified priorities for LMICs, such as understanding and improving uptake of the facility and community-based Kangaroo Mother Care (KMC), promoting breastfeeding, improving referral and transport networks, evaluating the impact of the use of skilled attendants, quality improvement activities, and exploring barriers to antenatal steroid use. Several of the top 20 questions also focused on screening high-risk women or the general population of women, understanding the causes of preterm birth, or managing preterm babies with illnesses (jaundice, sepsis and retinopathy of prematurity). There was a high overlap between research priorities in LMICs and Bangladesh. This exercise, aimed at identifying priorities for preterm birth prevention and management research in LMICs, especially in Bangladesh, found research on improving the care of preterm babies to be more important in reducing the burden of preterm birth and accelerating the attainment of Sustainable Development Goal 3 target of newborn deaths, by 2030.

Mental Health and well-being During the COVID-19 Pandemic and After the Russian Invasion of Ukraine

The study compared the mental health of university students during the COVID-19 pandemic and the Russian invasion of Ukraine. A repeated online cross-sectional study was performed twice among university students in Ukraine: in November 2020 (Pre-war sample, n = 752) and September-October 2022 (During-war sample, n = 862). The survey measured life satisfaction (SWLS), perceived stress (PSS-10), anxiety (GAD-7), and depression (PHQ-9). Stress, anxiety, and life satisfaction levels were similar during the war and pandemic, while symptoms of depression decreased during the war, compared to the pandemic. Network analysis showed that anxiety has a crucial effect on depression and stress, and stress is most closely related to life satisfaction. The association of life satisfaction with anxiety and depression disappeared in wartime, in contrast to the pandemic. The priority of prevention and intervention programs in wartime Ukraine should focus on anxiety as the most influential factor in other mental health and well-being problems. The results showed high resistance and adaptation to war conditions among university students in Ukraine.

Availability and quality of data related to cultural and linguistic diversity in the Victorian Suicide Register: A pilot study

ObjectiveWhile people from culturally and linguistically diverse (CALD) backgrounds have been identified as a priority for suicide prevention in Australia, little is known about suicide in CALD communities. We aim to describe the availability and quality of CALD data in the Victorian Suicide Register (VSR). MethodsA retrospective consecutive case series review of suicides reported to the Coroners Court of Victoria during 2016 was conducted. Using the VSR, we identify suicides showing evidence of CALD identity and relevant variables were extracted and coded according to an adapted Australian Institute of Health and Welfare framework. ResultsDuring 2016, 126 of 652 suicides (19.3%, 95% confidence intervals 16.4-22.6) were flagged as showing evidence of CALD. The two most frequent CALD indicators for which information was recorded were country of birth and year of arrival. There was less information pertaining to citizenship, residency/visa status, preferred language, English language proficiency and religious affiliation. ConclusionsThis study demonstrates that the VSR, like other databases, has substantial gaps in availability and quality of CALD data. ImplicationsA framework to capture richer data on cultural, religious and linguistic diversity when coding suicides is needed to inform policy on suicide prevention initiatives designed for CALD communities.

Self-harm in 5-to-24 year olds: Retrospective examination of hospital presentations to emergency departments in New South Wales, Australia, 2012 to 2020.

There is some evidence that self-harm presentations in children and young people have increased over the past decade, yet there are few up-to-date studies examining these trends. This study aims to describe trends in the rates and severity of emergency department self-harm presentations for youth aged 5-24 years in New South Wales, Australia between 1 January 2012 and 31 December 2020. We analysed self-harm hospital presentations using join point analysis to compare quarterly growth in rates and urgency of presentation since 2012 by age group and sex. Binomial logistic modelling was used to identify risks for re-presentation for self-harm, including age group, sex, country of birth, mode of arrival, inpatient status, triage category, rurality, and socio-economic disadvantage. In total, 83,111 self-harm presentations for 51,181 persons were analysed. Overall rates of self-harm among those aged 5-24 years increased by 2.4% (p < .001) per quarter in females and 1.6% (p < .001) per quarter in males, with statistically significant average quarterly increases observed across all age groups. Overall and age-specific self-harm triage urgency rates increased statistically significantly for potentially serious, and potentially- and immediately life-threatening categories. A higher likelihood of re-presentation to any emergency department for self-harm was associated with younger age, female, residing in a regional area, arriving by ambulance, admitted as an in-patient, and a more severe index self-harm presentation. Hospital self-harm presentations have been growing steadily over the past decade, with the greatest growth in the youngest people. Understanding the reasons for these sustained upward trends is a priority for suicide prevention.

Socio-psychological prevention of suicide among minors

Socio-psychological prevention is aimed at creating psychological, pedagogical, and socio-psychological conditions for optimal provision of the process of the individual’s socialization and the organization of psychological socio-pedagogical assistance to families and adolescents. Prevention of adolescent suicide in the educational environment is carried out on the basis of such principles as strategic integrity, which defines a single prevention strategy (directions, methodological approaches, and specific measures), priority of social issues prevention, and accessibility and efficiency of assistance and support. In the process of socio-psychological prevention, it is crucial for a teenager with a suicidal risk to have changes in the perception of his/ her own «I» and the surrounding reality.

Projected smoke impacts from increased prescribed fire activity in California's high wildfire risk landscape

California has experienced multiple catastrophic wildfires over the last decade, fostering the need for increased forest management and understanding of the health impacts of wildfire and prescribed fire smoke. We calculated air quality impacts from past wildfires and prescribed fires and estimated how air quality may be affected under a future scenario in which prescribed fire is proposed to more than double. We merged satellite and agency records to establish a 10-year (2008–2017) baseline wildfire and prescribed fire inventory for California. Daily emissions and dispersion modeling were used to evaluate relative contributions from wildfire and prescribed fire. We scaled up prescribed burns to reach the >200,000 ha per year target, modeled over eight cycles (years) to encompass 1.6 million hectare of California Department of Forestry and Fire Prevention Priority Landscapes 4&5. We found that baseline wildfire contributes up to 20x more smoke PM2.5 concentrations than baseline prescribed fire. Target prescribed fire scenario smoke concentrations are anticipated to be ∼3x that of baseline prescribed fire. Baseline and target prescribed fire scenarios do not contribute sufficient PM2.5 to exceed air quality standards from smoke alone at the community (ZIP code) level. Baseline wildfires contribute enough PM2.5 to cause unhealthy air quality, even without contributions from ambient background PM2.5. The target prescribed fire scenario only exceeds the baseline smoke from wildfire and prescribed fire in 4% of California ZIP codes. Overall, we found that air quality is impacted significantly more from wildfires than prescribed fires, past and proposed, for the majority of California.

Preventive Priority Setting Against Multiple Controller Failures in Software Defined Networks

This paper proposes a preventive priority setting model to minimize the worst-case maximum utilization ratio against multiple controller failures in software defined networks. For a set of controllers able to manage a switch, we introduce a priority for each controller to become the main controller that controls the switch. Once the existing main controller fails, the survived controller which has the highest priority works as the main controller. This reassignment is automatically obtained according to the priority setting decided at the network operation start time. In this way, the proposed model provides a prompt recovery with reducing the network instability due to unnecessary controller reassignment. We formulate the proposed model in two different forms, which are an integer linear programming formulation and a min-max formulation. We prove that the considered problem is NP-hard. A basic heuristic is introduced based on the min-max formulation. Its two extensions are further developed considering the accuracy and the computation time in practical computation. Numerical results reveal that, compared to two baselines that sacrifice certain network stability to achieve a more flexible reassignment, the proposed model reduces the network instability by <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$27\%$</tex-math></inline-formula> and <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><tex-math notation="LaTeX">$52\%$</tex-math></inline-formula> in average, respectively, with obtaining the comparable maximum utilization ratio.

Sequential Dengue Infection: Prevention Priorities.

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International patterns and trends in the brain cancer incidence and mortality: An observational study based on the global burden of disease

BackgroundBrain cancer is a serious issue in the global burden of diseases. This observational research aimed to assess trends of the brain cancer incidence and mortality in the world in the period 1990–2019. MethodsBrain cancer incidence and mortality data were retrieved from the Global Burden of Disease 2019 study database. The joinpoint regression analysis was done to assess the brain cancer indicence and mortality trends: the average annual percent change (AAPC) along with its 95% confidence interval (95% CI) was calculated. ResultsIn both sexes, the highest age-standardized rates of incidence and mortality were found in high-income regions (Europe and America), while the lowest were observed in the African Region. A significant rise in brain cancer incidence rates both in males and females was observed in all regions, with one exception of a significantly decreased trend only among males in the South-East Asia Region. Among countries with increased trends in incidence and mortality from brain cancer, Cuba experienced the most marked increase in both incidence (AAPC = +5.7% in males and AAPC = +5.4% in females) and mortality rates (AAPC = +5.5% in males and AAPC = +5.1% in females). Among countries that experienced a decline in brain cancer incidence and mortality, Hungary and Greenland showed the most marked decline in both sexes (equally by −1.0%). ConclusionBrain cancer shows increasing global incidence rates in both sexes and represents a priority for prevention and further research.

The priority for prevention and control of infectious diseases: Reform of the Centers for Disease Prevention and Control - Occasioned by "the WHO chief declares end to COVID-19 as a global health emergency".

The novel coronavirus disease 2019 (COVID-19) pandemic has revealed that infectious diseases will present a significant worldwide threat for a long time in the future. Centers for Disease Prevention and Control (CDCs) worldwide have developed for nearly 80 years to fight against infectious disease and protect public health. However, at the advent of the 21th century, the responsibility for prevention and control of infectious diseases has gradually been marginalized in the CDC system. The COVID-19 pandemic has also provided a glimpse into the overburdened operational process and inadequate personnel reserve of the current system of CDCs. In addition, a long-term multisectoral joint mechanism has not been created for sharing information and cooperation to facilitate public health. Reform of the system of CDCs or public health is very necessary. A global prevention and control system should be envisioned and implemented worldwide, and vertical management should be implemented throughout all levels of CDCs to improve their structure and administrative status. The WHO should expand its scope of responsibilities, especially with regard to mechanisms for joint prevention and control of infectious diseases, to substantially implement the "One Health" concept. The International Health Regulations (IHR) and relevant laws and regulations should enshrine the CDC's authority in administration and policy-making to deal with outbreaks or pandemics of infectious diseases.

Review of fruit cork spot disorder of Asian pear (Pyrus spp.).

Cork spot disorder has affected the fruit of Asian pear since the 1990s and has become serious in recent years with increasingly affected cultivars and areas. The commodity value of affected fruit is greatly decreased, resulting in severe economic losses. Cork spot disorder of pear fruit is a physiological disorder, and the factors responsible are relatively complex. Research on the cause of cork spot disorder is still at an early stage and, thus, further investigations are needed to elucidate the underlying mechanism of the disorder. In this review, current knowledge of the factors associated with the incidence of cork spot disorder in Asian pear fruit is summarized, including fruit growth and development, fruit nutrient status, and environmental factors. Potential preventive measures and priorities for future research are outlined.

The global burden of schizophrenia and the impact of urbanization during 1990–2019: An analysis of the global burden of disease study 2019

Background and hypothesisThe burden of schizophrenia is increasing. Assessing the global distribution of schizophrenia and understanding the association between urbanization factors and schizophrenia are crucial. Study designWe conducted a two-stage analysis utilizing public data from GBD (global burden of disease) 2019 and the World Bank. First, the distribution of schizophrenia burden at the global, regional, and national levels as well as temporal trends was analyzed. Then, four composite indicators of urbanization (including demographic, spatial, economic, and eco-environment urbanization) were constructed from ten basic indicators. Panel data models were used to explore the relationship between urbanization indicators and the burden of schizophrenia. ResultsIn 2019, there were 23.6 million people with schizophrenia, an increase of 65.85% from 1990, and the country with the largest ASDR (age-standardized disability adjusted life years rate) was the United States of America, followed by Australia, and New Zealand. Globally, the ASDR of schizophrenia rose with the sociodemographic index (SDI). In addition, six basic urbanization indicators including urban population proportion, employment in industry/services proportion, urban population density, the population proportion in the largest city, GDP, and PM2.5 concentration were positively associated with ASDR of schizophrenia, with the largest coefficients being urban population density. Overall, demographic, spatial, economic, and eco-environment urbanization all had positive effects on schizophrenia, and the estimated coefficients indicated that demographic urbanization was the most significant influence. ConclusionsThis study provided a comprehensive description of the global burden of schizophrenia and explored urbanization as a factor contributing to the variation in the burden of schizophrenia, and highlighted policy priorities for schizophrenia prevention in the context of urbanization.