Trends In Rates Research Articles

Age-period-cohort analysis of self-harm incidence rates by gender in Iran among individuals aged 10–39 years, 1990–2019

This study investigates trends and patterns in self-harm incidence rates among individuals aged 10–39 years in Iran from 1990 to 2019. Using Age-Period-Cohort (APC) analysis, it aims to identify significant age, period, and cohort effects, and to highlight gender-specific trends for effective prevention strategies. Utilizing data from the Global Burden of Disease (GBD) study, we performed an APC analysis to assess trends in self-harm incidence rates by gender. Data was stratified into six age groups and six five-year periods, and analyzed using the APC Web Tool from the National Cancer Institute. The average incidence rates of self-harm attempts and deaths among individuals aged 10–39 years were 93.87 and 7.55 per 100,000 individuals, respectively. Females had 1.75 times higher attempt rates than males, while males had 1.62 times higher death rates. The APC analysis revealed that males experienced stable self-harm rates over time, while females showed a significant decline. Peak incidence for both genders occurred at age 22.5 years. Self-harm incidence rates show younger females are more vulnerable to self-harm, but there has been a general decline in incidences over time, particularly for more recent cohorts but the stability of rates across ages and the lower rates in more recent cohorts highlighted in male.

Global, regional and national burden of depressive disorders and attributable risk factors, from 1990 to 2021: results from the 2021 Global Burden of Disease study.

Depressive disorders pose a significant global public health challenge, yet evidence on their burden remains insufficient. To report the global, regional and national burden of depressive disorders and their attributable risk factors from 1990 to 2021. Data from the Global Burden of Disease 2021 were analyzed for 204 countries and territories from 1990 to 2021. We explored the age-standardised incidence, prevalence and disability-adjusted life years (DALYs) of depressive disorders by age, gender and sociodemographic index. In 2021, there were 357.44 million incident cases, 332.41 million prevalent cases and 56.33 million DALYs. Age-standardised rates for incidence, prevalence and DALYs were 4333.62, 4006.82 and 681.14 per 100 000 persons, with annual declines of 0.06%, 0.03% and 0.04%. Uganda, Greenland and Lesotho had the highest prevalence, while Spain, Mexico and Uruguay showed the largest increases. Greenland and Brunei Darussalam had the highest and lowest age-standardised DALYs rates, respectively. DALYs peaked in the 55-59 age group for men and 60-64 for women, with higher rates in women. Regionally, a U-shaped association was found between the sociodemographic index and DALYs rates. Population growth was the main driver for the increase in DALYs cases. Childhood maltreatment was the leading risk factor, with intimate partner violence affecting more females and childhood sexual abuse more males. Despite decreasing trends in incidence, prevalence and DALYs rates, absolute case numbers and age-standardised rates continue to increase for depressive disorders. Tackling childhood abuse and improving depressive disorder management are crucial to reducing future burdens.

Transcriptional activity of ammonia oxidisers in response to soil temperature, moisture and nitrogen amendment

The contrasting response of AOA, AOB, and comammox Nitrospira amoA transcript abundance to temperature, moisture, and nitrogen was investigated using soil microcosms. The moisture, temperature, and nitrogen treatments were selected to represent conditions typically found in a New Zealand (NZ) dairy farm. AOB dominated all synthetic urine treated soils. Peak AOB amoA transcript abundance was positively correlated with estimated soil ammonia availability. While AOB gDNA abundance and nitrification rate trends were similar. AOA were strongly influenced by soil temperature. At 20°C, AOA amoA peak transcript abundance averaged over 1 order of magnitude higher than at 8°C. Within the AOA community a member of the Nitrosocosmicus clade was positively correlated with ammonium and estimated ammonia concentrations. The presence and relative increase of an AOA community member in a high nitrogen environment poses an interesting contrast to current scientific opinion in NZ. Comammox Nitrospira abundance showed no correlation with soil moisture. This suggests that previously found associations are more complex than originally thought. Further research is required to determine the drivers of comammox Nitrospira abundance in a high moisture environment. Overall, these results indicate that AOB are the main drivers of nitrification in New Zealand dairy farm soils.

Macroeconomic Determinants of Effective Corporate Tax Rates: The Case of the Slovak Republic

The effective corporate tax rate is a critical measure reflecting a nation’s fiscal policy and its attractiveness to foreign investment. This study investigates the relationship between macroeconomic determinants and effective corporate tax rates, focusing on Slovakia’s competitiveness within the European Union from 2004 to 2022. Using a panel regression model, the research identifies significant correlations between nominal tax rates, unemployment, government debt, and effective tax rates. Our findings reveal a consistent downward trend in both nominal and effective tax rates across EU member states, with Slovakia maintaining relatively lower effective tax rates compared to older EU members, thus enhancing its fiscal competitiveness. However, discrepancies persist among member states, influenced by differences in tax policies, enforcement, and exemptions. The study underscores the complex interplay between fiscal policies and macroeconomic conditions, highlighting the importance of aligning effective tax rates with broader economic goals. Policymakers are advised to consider reforms that balance tax competitiveness with fiscal sustainability, ensuring that effective tax rates reflect intended policy outcomes. This analysis offers valuable insights into tax policy dynamics within the EU and provides a framework for designing strategies to attract investment while maintaining economic stability.

Epidemiological trends and age-period-cohort effects on ischemic stroke burden across the BRICS-plus from 1992 to 2021

BackgroundIschemic stroke, accounting for 85% of stroke cases, leads to severe disabilities and increased mortality. Its global incidence rose by 87.55% from 1990 to 2019, posing significant health and economic burdens. The BRICS-plus nations—Brazil, Russia, India, China, South Africa, and five others—represent a large global population, presenting unique public health challenges. This study aims to evaluate the epidemiological trends and variations in the burden of ischemic stroke across BRICS-plus nations in a timely manner.MethodsData on the number, all-age rate, age-standardized rate, and relative change in ischemic stroke disability-adjusted life years (DALYs) from 1992 to 2021 within BRICS-plus were obtained from the Global Burden of Disease Study (GBD) 2021. Relationships between the DALYs rate and the Socio-demographic Index (SDI) were evaluated using Pearson correlation analyses. Additionally, age-period-cohort modeling was employed to estimate net drift, local drift, age, period, and cohort effects over the past three decades.ResultsFrom 1992 to 2021, total DALYs due to ischemic stroke increased by 47.14%, while the age-standardized DALYs rate decreased by 33.79%. All BRICS-plus countries exhibited a declining trend in the age-standardized DALYs rate over the past three decades. Egypt reported the highest age-standardized DALYs rate (2,462.60 per 100,000 population) in 2021, whereas the most substantial reduction of 59.37% was observed in Brazil. The annual net drift in the ischemic stroke DALYs rate ranged from -3.04% for Brazil to -0.48% for Egypt among the ten countries. A significant positive correlation was observed between the DALYs rate of ischemic stroke and SDI values. Countries exhibited similar age effect patterns, with an increasing risk of DALYs rate with advancing age. Period and cohort effects highlighted declines in observed nations, indicating improved ischemic stroke management strategies.ConclusionThe burden of ischemic stroke showed an overall declining trend across the BRICS-plus from 1992 to 2021, but persistent health inequalities between these countries were driven by socioeconomic disparities. Furthermore, it emphasizes the necessity for targeted interventions across age, period, and cohort dimensions to address the distinct challenges posed by ischemic stroke in these rapidly developing countries.

Impact of policy changes expanding access to direct acting antivirals on hepatitis C virus-related hospitalizations in people with HIV: a population-based study

Abstract Background The burden of hepatitis C virus (HCV)-related hospitalizations is substantial, particularly among people with HIV and HCV (HIV/HCV). In Ontario, Canada, use of direct-acting antivirals (DAAs) increased following policies removing fibrosis stage restrictions and the approval of pan-genotypic agents in 2017 and 2018, respectively. We examined the impact of expanded DAA access on HCV-related hospitalizations in people with HIV. Methods We conducted a population-based study using administrative databases between April 2003, and December 2022. We used segmented negative binomial regression to examine changes in level and trend of quarterly HCV-related hospitalization rates in people with HIV following the policy changes and compared predicted rates in the absence of expanded DAA access with observed rates during this period. Results We identified 2943 HCV-related hospitalizations among people with HIV during our study period. Rates of HCV-related hospitalizations were substantially higher among people with HIV than individuals without HIV. In the post-intervention period, there was an immediate level increase in the rate of HCV-related hospitalizations (rate ratio [RR]1.23; 95% confidence interval [CI], 1.18 to 1.29) followed by a decrease in trend (RR 0.94 per quarter; 95% CI, 0.93 to 0.94). We estimated that expanding DAA access was associated with 192 fewer hospitalizations in people with HIV between 2018 and 2022. Discussion Policies expanding DAA access have reduced HCV-related hospitalizations in people with HIV. However, rates were higher relative to those in people without HIV. Further research is needed to identify and address disparities in clinical outcomes among people with HIV and HCV.

Bibliometric analysis of glycolysis and prostate cancer research from 2004 to 2024

BackgroundProstate cancer (PCa) ranks as the second most common disease among men and the fourth most prevalent cancer worldwide. Enhanced glycolysis and excessive lactate secretion are recognized as critical factors driving the progression of various cancers. This study systematically investigated the research trends associated with glycolysis in PCa through bibliometric analysis.MethodIn this study, we conducted a systematic search of the Web of Science and PubMed databases for literature pertaining to the glycolysis of PCa that was published between January 1, 2004, and June 30, 2024. To achieve this objective, we employed CiteSpace software to generate visualizations that illustrate countries/regions, institutions, journals, and keywords. Additionally, we extracted pertinent quantitative data. Furthermore, we utilized VOSviewer software to create a collaboration network map among various journals.ResultsBetween 2004 and 2024, a total of 408 research articles on glycolysis in PCa were published, indicating a consistent upward trend in the annual publication rate. In this field, the United States not only leads in the volume of research papers but also has the highest degree of centrality. The journal "Cancer Research" is recognized as the most influential in the field, whereas "Prostate and Cancer" serves as a significant platform for disseminating research related to glycolysis in PCa. Keyword analysis has identified four primary research directions that have dominated this field over the past two decades. The role of glycolysis and its associated enzymes in PCa underpins this research. Glycolysis has also demonstrated significant clinical value in the diagnosis and prognosis of PCa. Moreover, drugs targeting glycolytic inhibitors and natural products have exhibited therapeutic potential against this disease. By modulating glycolytic mechanisms, there is potential to increase resistance in PCa. Currently, leading research in this area encompasses the application of nanotechnology to PCa glycolysis, the roles of long noncoding RNAs (lncRNAs) and microRNAs (miRNAs) in this metabolic pathway, and the interactions between glycolysis and other biological processes in PCa.ConclusionThis study employs bibliometric analysis to provide a comprehensive overview of research on glycolysis in PCa over the past two decades. It highlights the current state of knowledge in this field, identifies key research hotspots, and explores emerging frontiers, particularly nanotechnology, lncRNA, and miRNA, which are driving innovative research directions.

Incidence Trends in Head and Neck Cancer Subsites: A National Population-Based Study (2001-2020).

This descriptive epidemiological study aims to investigate trends in head and neck cancer (HNC) within the anatomical divisions of laryngeal, oropharyngeal, and oral cavity cancers over the past two decades. Retrospective population-based observational study. Scotland, a constituent country of the United Kingdom, with a population of 5.5 million. Newly diagnosed HNC patients in Scotland registered in the Scottish Cancer Registry from 2001 to 2020. Trends in age-standardised incidence rates from 2001 to 2020 for each HNC subsite, anatomical division, and individual sociodemographic using joinpoint regression analysis and Poisson regression analysis. Overall, HNC incidence rates have remained stable, with an average annual percentage change (AAPC) of 0.29% (p = 0.34). However, oropharyngeal cancer showed a significant increase in incidence rates with an AAPC of 3.76% (p < 0.001); the tonsils (C09) and the base of the tongue (C01) experienced the greatest increases in AAPC of 4.63% (p = 0.001) and 4.79% (p < 0.001), respectively. Conversely, laryngeal cancer rates declined significantly, with an AAPC of -2.56% (p < 0.001). This decline was primarily influenced by annual reductions of -2.40% (p = 0.09) in cancers affecting the glottis (C32.0). Incidence rates for oral cavity cancer remained mostly stable, with an AAPC of -0.60% (p = 0.08). This analysis highlights that behind a stable HNC incidence rate over the past 20 years, there are differential trends among various anatomical divisions with an overall increasing burden of oropharyngeal cancer and declining rates of laryngeal cancer.

Recent 5‑year trends in biliary tract cancer survival rates: An analytical big data survey

Recent 5‑year trends in biliary tract cancer survival rates: An analytical big data survey

Rising cardiovascular mortality among obstructive sleep apnea patients: United States epidemiological trends (1999-2019).

Obstructive sleep apnea (OSA) prevalence has risen significantly, affecting millions globally and posing a major healthcare burden. OSA is strongly associated with cardiovascular diseases (CVD) such as heart failure, stroke, and ischemic heart disease. However, trends in CVD-related mortality among individuals with OSA remain underexplored. This study aims to assess the trends of OSA and CVD related mortality rates and variations in mortality based on demographics and regions in the US. Mortality data for adults aged ≥25 with OSA and CVD were extracted from the CDC WONDER database. Age-adjusted mortality rates (AAMRs) per 100,000 and annual percent change (APC) with 95 % confidence intervals (CIs) were calculated, stratified by year, sex, race/ethnicity, age, urbanization, and Census regions. Between 1999 and 2019, 168,111 OSA-related CVD deaths were recorded. Overall AAMRs rose significantly, particularly for hypertensive disease (1999-2006 APC: 13.2 %, 95 % CI: 11.6-15.7). Men consistently had higher AAMRs than women, and Black individuals showed the highest racial disparities. AAMRs varied geographically, with the Midwest recording the highest rates and rural areas showing notable increases. States like Oregon and Montana had rates three times higher than New York and Massachusetts. OSA-related CVD mortality has risen substantially, with marked disparities by sex, race, and region. These findings emphasize the need for targeted public health interventions to reduce mortality in high-risk groups.

Chinese burden of depressive disorders from 1990 to 2021 and prediction for 2030: analysis of data from the global burden of disease study 2021

BackgroundThis study aims to examine the temporal changes in the incidence, prevalence, and disability-adjusted life years (DALYs) of depressive disorders as well as its association with age, period, and birth cohort among Chinese from 1990 to 2021, and forecast the future trends of incidence rates and numbers from 2022 to 2030.MethodsData for analysis were obtained from the Global Burden of Disease (GBD) 2021. Joinpoint analysis was used to calculate the annual percentage change (APC) and average annual percent change (AAPC) to describe the rates of depressive disorders. Age, period, and cohort model was utilized to disentangle age, period, and birth cohort effects on rates of depressive disorders. Bayesian age-period-cohort (BAPC) analysis was capitalized to forecast the incidence rates and numbers for different sexes and age groups from 2022 to 2030.ResultsThe age-standardized incidence (ASIR, AAPC: -0.35 [95%CI: -0.65, -0.04]), prevalence (ASPR, AAPC: -0.20 [95%CI: -0.24, -0.16]), and DAYLs (AAPC: -0.28 [95%CI: -0.51, -0.05]) rates of both sexes showed a downward trend from 1990 to 2021, despite a volatility growth in recent years (APC in 2019–2021 of ASPR: 0.96 [95%CI: 0.70, 1.23]). Females exhibited a higher burden of depressive disorders compared to males but experienced a more rapid rate of reduction changes. The burden of depressive disorders was most owing to the age effect and period effect in recent years. The ASIR was predicted to decrease in the whole population (males in 2030: 1,546.3 per 100,000 people; females in 2030: 2,465.8 per 100,000 people), but in children, adolescents, and the elderly demonstrate unfavorable trends in the future.ConclusionThe burden of depressive disorders decreased in China from 1990 to 2021 in terms of age-standardized rates, but increased in recent years. Children, adolescents, and the elderly are the risk groups for future depressive disorders. Considering the large population, the increasing fewer children, and the aging trend, as well as the possible long-term effects of COVID-19 on human psychological burden, more sex-age-sensitive social healthcare programs should be considered in the future to minimize the burden of depressive disorders in China.

Sociodemographic index–age differences in the global prevalence of cardiovascular diseases, 1990–2019: a population-based study

BackgroundThis study aims to assess the global burden and trends in cardiovascular diseases (CVDs) prevalence, stratified by sociodemographic index (SDI) categories and age groups, across 204 countries and territories.MethodsUtilizing data from the Global Burden of Disease Study 2019, this study analyzed trends in the age-standardized prevalence rate of overall and type-specific CVDs, including rheumatic heart disease, ischemic heart disease, stroke, hypertensive heart disease, non-rheumatic valvular heart disease, cardiomyopathy and myocarditis, atrial fibrillation and flutter, peripheral artery disease, endocarditis, and other cardiovascular and circulatory diseases. Age-standardized prevalence rates were stratified by SDI categories (low, low-middle, middle, high-middle, and high) and age groups (0–14, 15–49, 50–69, and ≥ 70 years). The corresponding average annual percentage change was calculated to assess temporal trends.ResultsFrom 1990 to 2019, the global age-standardized prevalence rate per 100,000 population for CVD decreased from 6728.04 (95% UI 6394.55 to 7059.66) to 6431.57 (95% UI 6109.95 to 6759.8), with an average annual percent change of -0.15% (95% CI -0.17 to -0.13). When stratified by SDI category, the age-standardized prevalence rate of CVD decreased significantly in high-middle and high SDI countries but increased in middle, low-middle, and low SDI countries. By age group, the age-standardized prevalence rate of CVD declined in the 50–69 and ≥ 70 years groups but increased in the 0–14 and 15–49 years groups. SDI levels were negatively associated with faster increases in the age-standardized prevalence rate of CVD across all ages and age groups. Low SDI countries consistently showed the highest age-standardized prevalence rates of CVD in the younger age groups (0–14 and 15–49 years), while high-middle SDI countries had the highest rates in the older age groups (50–69 and ≥ 70 years). The age-standardized prevalence rate of CVD was negatively associated with SDI levels in the 0–14 and 15–49 years groups and positively associated with SDI levels in the 50–69 and ≥ 70 years groups. Type-specific CVDs such as rheumatic heart disease, other cardiovascular and circulatory diseases, non-rheumatic valvular heart disease, and hypertensive heart disease showed increased age-standardized prevalence rates from 1990 to 2019.ConclusionsThis study highlights significant disparities in CVD prevalence across sociodemographic and age groups. While the global prevalence of CVD has generally decreased, the rise in CVD prevalence in lower SDI countries and younger populations calls for tailored intervention strategies. Addressing these disparities is crucial to mitigating the growing burden of CVD and promoting cardiovascular health on a global scale.

Age-Specific Trends in Pregnancy-Associated Suicide and Homicide Rates by Race/Ethnicity, 2005-2021.

Age-Specific Trends in Pregnancy-Associated Suicide and Homicide Rates by Race/Ethnicity, 2005-2021.

Interrupted-time-series analysis of the impact of COVID-19 pandemic on blood culture utilization in Shanghai

BackgroundLimited information is available regarding the changes in blood culture utilization following the COVID-19 pandemic. Blood culture utilization rate is a critical indicator of diagnostic efficiency for infectious diseases. This study aims to describe the impact of the COVID-19 pandemic on blood culture utilization rate in Shanghai.MethodsWe conducted an interrupted time-series analysis based on electronic health records from the Shanghai Changzheng hospital from January 2014 to October 2023. The outcome measure was the rate of blood culture utilization among inpatients with a temperature of ≥ 39.4 °C. The impact of the COVID-19 pandemic on blood culture utilization was quantified by fitting linear segmented regression models and modelling the relative cumulative effect by the end of the study. The pandemic period was defined from February 2020, following the implementation of strict containment measures in Shanghai.ResultsA total of 23,761 inpatients with a temperature of ≥ 39.4 °C were included in the analysis. From 2014 to 2023, the utilization rate of hospital blood cultures increased initially and then declined, with a significant change point following the onset of the COVID-19 pandemic (Cochran-Armitage trend test, P < 0.001). The COVID-19 pandemic was associated with a significant change in the slope of the blood culture utilization rate (pre-COVID-19 vs. during-COVID-19: 0.31% per month vs. -0.30% per month, P < 0.001), resulting in a relative cumulative effect of -12.55% at the end of the study (95% confidence interval, -19.08 to -6.03). This corresponds to 407 inpatients who did not have blood cultures taken during-pandemic, which represents a significant deviation from pre-pandemic trends.ConclusionsThe upward trend in blood culture utilization rate among inpatients stalled during the COVID-19 pandemic and did not return to pre-pandemic levels following the pandemic. These findings suggest that the pandemic had a lasting impact on diagnostic practices. More targeted intervention measures are needed to promote appropriate utilization of blood cultures.

Analysis of the Temporal Trend and Factors Associated With Aids Mortality in Bahia, 2009-2019

Objective: To analyze the temporal trend of AIDS mortality rates in Bahia, from 2009 to 2019, taking into account the sociodemographic characteristics of patients. Theoretical framework: Increased access to testing and highly active antiretroviral therapy have favored the reduction of opportunistic diseases, enabling a better quality of life for people living with Acquired Immunodeficiency Syndrome (AIDS). In recent years, there has been an increase in the number of cases in the Northeast region. In the 1990s, Bahia was relevant in the occurrence of deaths from HIV, leading to the need to to analyze the epidemiological picture of this disease to direct control actions. Method: The spatial distribution of average HIV death rates in Bahia from 2009 to 2019 will be investigated using data from the Mortality Information System and trend analysis, using simple linear regression with residual correction, according to the Prais Winsten methodology. Results and discussion: The analysis of the temporal trend showed that the rates by sex and race were stationary, while the rates by race/color (mixed race and indigenous people) were increasing. This highlights the need to plan health policies and reorganize specialized services to serve people with AIDS, considering the epidemiological profile of each region and the most vulnerable populations. Research implications: The results can contribute to the management and planning of public health policies, highlighting the need for a deeper understanding of the aspects that interfere with AIDS mortality, considering local and regional specificities to combat the disease, especially in Bahia. Originality/Value: The epidemiological picture of AIDS mortality in Bahia has been little analyzed at the local level.

A Spectrochemical Series for Electron Spin Relaxation.

Controlling the rate of electron spin relaxation in paramagnetic molecules is essential for contemporary applications in molecular magnetism and quantum information science. However, the physical mechanisms of spin relaxation remain incompletely understood, and new spectroscopic observables play an important role in evaluating spin dynamics mechanisms and structure-property relationships. Here, we use cryogenic magnetic circular dichroism (MCD) spectroscopy and pulse electron paramagnetic resonance (EPR) in tandem to examine the impact of ligand field (d-d) excited states on spin relaxation rates. We employ a broad scope of square-planar Cu(II) compounds with varying ligand field strength, including CuS4, CuN4, CuN2O2, and CuO4 first coordination spheres. An unexpectedly strong correlation exists between spin relaxation rates and the average d-d excitation energy (R2 = 0.97). The relaxation rate trends as the inverse 11th power of the excited-state energies, whereas simplified theoretical models predict only an inverse second power dependence. These experimental results directly implicate ligand field excited states as playing a critical role in the ground-state spin relaxation mechanism. Furthermore, ligand field strength is revealed to be a particularly powerful design principle for spin dynamics, enabling formation of a spectrochemical series for spin relaxation.

Spatio-temporal distribution and socioeconomic inequality of low birthweight rate in China from 1992 to 2021 and its predictions to 2030.

This paper aims to investigate the trend, spatio-temporal distribution, and socioeconomic inequality of the low birthweight rate (LBWR) in China from 1992 to 2021 and to project the LBWR to 2030. We performed a secondary analysis of data from the China Health Statistics Yearbook. LBWR refers to the ratio of the number of infants born with a birth weight less than 2,500 grams to the number of live births in a given year. We used joinpoint regression models to estimate LBWR trends from 1992 to 2021 for the whole country and from 2002 to 2021 for the three regions (eastern, central, and western regions) and each province. The slope index of inequality (SII) and relative index of inequality (RII) were calculated for each year from 2002 to 2021 based on provincial data. LBWR increased from 2.52% (1992) to 3.70% (2021), and the average annual percentage change (AAPC) (95% confidence interval [CI]) was 1.35% (0.22%, 2.49%) in China. The overall LBWR from 2002 to 2021 was greatest in the Eastern region, but LBWR had the fastest increase in the Western region, with an AAPC (95% CI) of 3.15% (2.59%, 3.12%). There were spatio-temporal differences in the LBWR and trends between provinces. The SII and RII increased linearly from -0.15 and 0.94 to 0.53 (B = 0.035%, p < 0.001) and 1.16 (B = 0.011, p < 0.01), respectively, over the past 20 years. The results of the ARIAM model showed that the National LBWR will be increasedfrom 3.70% in 2021 to 5.28% in 2030. The LBWRs in the eastern, central and western regions in 2030 will be 4.93%, 6.02% and 5.82%, respectively. National and local governments must prioritize disadvantaged groups to mitigate the rapid prevalence of LBWR, reduce regional disparities, and improve perinatal and infant health and health equity in China.

Effects of Immediate Postpartum Diuretic Treatment on Postpartum Blood Pressure among Individuals with Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis.

Hypertensive disorders of pregnancy (HDP) are associated with ongoing postpartum hypertension (HTN) and increased morbidity. Extravascular water and sodium mobilization is implicated in postpartum blood pressure (BP) elevation, however trials of postpartum diuretics in HDP have had mixed results. Our meta-analysis aimed to analyze the impact of postpartum diuretics on postpartum hypertension following HDP. Systematic review identified randomized controlled trials (RCTs) studying the efficacy of diuretics in the treatment of postpartum BP. Meta-analysis outcomes included persistent HTN up to 10 days postpartum, mean postpartum systolic and diastolic BPs, and use of additional antihypertensive medications. From 9 RCTs, 1273 subjects were included in the meta-analysis. Postpartum diuretic use was associated with lower systolic BP (SMD standard mean difference]: -0.36; 95% confidence interval [CI]: -0.72; -0.01) without a difference in diastolic BP (SMD: 0.01; 95% CI: -0.22; 0.23) compared with controls. There was no difference in rates of persistent HTN between the postpartum diuretics group versus controls (OR: 0.70; 95% CI: 0.4; 1.05) or in antihypertensive medication use (OR: 0.66; 95% CI: 0.42; 1.05). Postpartum diuretic use was associated with lower systolic BP compared with controls and non-significant trends of lower rates of persistent HTN and postpartum antihypertensive medication use. Due to the low certainty of evidence, uniform postpartum diuretic use with HDP cannot be recommended. Future studies are needed to evaluate specific HDP subgroups who may benefit from diuretic use.

Global, regional, and national trends in drug use disorder mortality rates across 73 countries from 1990 to 2021, with projections up to 2040: a global time-series analysis and modelling study

Drug use disorder (DUD) poses a major public health crisis globally, necessitating immediate attention to global trends and future projections to develop effective health policies and interventions. Thus, we aimed to estimate the global trends in DUD mortality rates from 1990 to 2021 and future projections of DUD deaths until 2040 across 73 countries. In this time-series analysis and modelling study, we investigated the global trends in DUD mortality rates from 1990 to 2021 using the WHO Mortality Database and forecasted future trends through 2040. Global trend analysis was analysed using a locally weighted scatter plot smoother (LOESS) curve, and future projections were calculated based on a Bayesian age-period-cohort analysis. In addition, we performed a decomposition analysis to identify the variations in DUD deaths, specifically examining factors such as population growth, ageing, and epidemiological changes. Of the 73 countries included in the analysis of DUD mortality, 45 were high-income countries (HICs), and 28 were low to middle-income countries (LMICs). The LOESS estimates of the global DUD mortality rate were 1.84 deaths per 1,000,000 people (95% CI,-0.44 to 4.12) in 1990 and 13.09 deaths per 1,000,000 people (95% CI, 10.74-15.43) in 2021. Notably, HICs showed a significant increase in DUD mortality from 1.43 deaths per 1,000,000 people (95% CI,-1.55 to 4.42) in 1990 to 17.19 deaths per 1,000,000 people (95% CI, 13.84-20.53) in 2021. A significant increase in DUD mortality was observed among individuals aged 25-64 and males. Our analysis also identified associations between DUD mortality rates and several log-transformed parameters, including Human Development Index (β, 14.92; p<0.0001), Socio-demographic Index (β, 11.80; p<0.0001), reverse Gender Gap Index (β,-12.02; p<0.0001), and Gini coefficient (β,-1.84; p<0.0001). From 1990 to 2021, the increase in the number of DUD deaths globally can be attributed to two prominent factors: epidemiological change and population growth. In HICs, the impacts of epidemiological changes for increasing DUD mortality rates were particularly prominent compared to other factors. In the Bayesian age-period-cohort models, the predicted number of global DUD deaths up to 2040 were estimated to increase from 25.95 deaths per 1,000,000 people (95% credible interval [CrI], 24.72-27.28) in 2021 to 38.45 (95% CrI, 30.48-49.33) in 2030, and 42.43 (95% CrI, 23.67-77.77) in2040. An increasing trend in global DUD mortality was observed from 1990 to 2021, especially in HICs. Future DUD deaths were also predicted to increase until 2040 at the global level. Therefore, these findings suggest urgent and proactive strategies for DUD to reduce the mortality rates related to DUD are needed. However, further prospective research that accounts for potential confounding factors, such as socioeconomic variables and the quality of reporting data from individual countries, is imperative for more accurate estimation. National Research Foundation and Ministry of Science and ICT of South Korea.

Disease burden and trend of melanoma among middle-aged and elderly population in China from 1990 to 2020, and prediction for 2022 to 2035.

To analyze the disease burden and trend from 1990 to 2020 of melanoma among middle-aged and elderly populations in China, and to predict the future trend from 2022 to 2035. Data from the Global Burden of Disease Study (GBD) 2021 were utilized to collect incidence and mortality rates of melanoma, disability-adjusted life years (DALYs), and corresponding age crude rates among the middle-aged and elderly population in China. Additionally, the estimated annual percentage change (EAPC) was employed to assess the temporal trends. Age-period-cohort (APC) and Bayesian age-period-cohort (BAPC) models were utilized to compute age, period, and cohort effects on incidence and mortality rates of melanoma, as well as to predict future trends up to 2035. During 1990-2021, the incidence rate of melanoma for males was higher than that for females among the middle-aged and elderly population in China, and the overall incidence rate increased annually with an EAPC of 2.13 (1.90, 2.36), while the overall mortality rate and DALY rate showed a declining trend with an EAPC of －0.28 (－0.41, －0.15) and －0.54 (－0.68, －0.41),respectively. The results of the APC model analysis revealed that age effects on both incidence and mortality rates of melanoma in China's middle-aged and elderly population were significant, with both increasing with age. Period and cohort effects showed an upward trend for incidence rates but a downward trend for mortality rates. Moreover, the period and cohort effects for mortality rates were not significant among females. In the BAPC prediction model, the number of incidences of melanoma in middle-aged and elderly people in China would increase dramatically. By 2035, the number of incidence cases is expected to reach approximately 9600 (males) and 10 300 (females), corresponding to an incidence rate of 2.66/105 and 2.67/105, respectively; the number of deaths is projected to be about 2600 (males) and 3500 (females) by 2035, corresponding to a mortality rate of 0.72/105 and 0.91/105, respectively. The disease burden of melanoma among the middle-aged and elderly population in China remains substantial and is expected to increase over the next decade.