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Feng Z, Fan Y, Shi X, Luo X, Xie J, Liu S, Duan C, Wang Q, Ye Y, Yin W. Dysregulation of iron transport-related biomarkers in blood leukocytes is associated with poor prognosis of early trauma. Heliyon 2024; 10:e27000. [PMID: 38463887 PMCID: PMC10923684 DOI: 10.1016/j.heliyon.2024.e27000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/22/2023] [Accepted: 02/22/2024] [Indexed: 03/12/2024] Open
Abstract
Objective The early targeted and effective diagnosis and treatment of severe trauma are crucial for patients' outcomes. Blood leukocytes act as significant effectors during the initial inflammation and activation of innate immunity in trauma. This study aims to identify hub genes related to patients' prognosis in blood leukocytes at the early stages of trauma. Methods The expression profiles of Gene Expression Omnibus (GEO) Series (GSE) 36809 and GSE11375 were downloaded from the GEO database. R software, GraphPad Prism 9.3.1 software, STRING database, and Cytoscape software were used to process the data and identify hub genes in blood leukocytes of early trauma. Results Gene Ontology (GO) analysis showed that the differentially expressed genes (DEGs) of blood leukocytes at the early stages of trauma (0-4 h, 4-8 h, and 8-12 h) were mainly involved in neutrophil activation and neutrophil degranulation, neutrophil activation involved in immune response, neutrophil mediated immunity, lymphocyte differentiation, and cell killing. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that the DEGs were mainly involved in Osteoclast differentiation and Hematopoietic cell lineage. Sixty-six down-regulated DEGs and 148 up-regulated DEGs were identified and 37 hub genes were confirmed by Molecular Complex Detection (MCODE) of Cytoscape. Among the hub genes, Lipocalin 2 (LCN2), Lactotransferrin (LTF), Olfactomedin 4 (OLFM4), Resistin (RETN), and Transcobalamin 1 (TCN1) were related to prognosis and connected with iron transport closely. LCN2 and LTF were involved in iron transport and had a moderate predictive value for the poor prognosis of trauma patients, and the AUC of LCN2 and LTF was 0.7777 and 0.7843, respectively. Conclusion As iron transport-related hub genes in blood leukocytes, LCN2 and LTF can be used for prognostic prediction of early trauma.
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Affiliation(s)
- Zhusheng Feng
- Department of Emergency, Xijing Hospital, The Air Force Medical University, Xi'an, China
| | - Yingnan Fan
- Department of Emergency, Xijing Hospital, The Air Force Medical University, Xi'an, China
| | - Xiaofei Shi
- Department of Emergency, Xijing Hospital, The Air Force Medical University, Xi'an, China
| | - Xu Luo
- Department of Emergency, Xijing Hospital, The Air Force Medical University, Xi'an, China
| | - Jiangang Xie
- Department of Emergency, Xijing Hospital, The Air Force Medical University, Xi'an, China
| | - Shanshou Liu
- Department of Emergency, Xijing Hospital, The Air Force Medical University, Xi'an, China
| | - Chujun Duan
- Department of Emergency, Xijing Hospital, The Air Force Medical University, Xi'an, China
| | - Qianmei Wang
- Department of Emergency, Xijing Hospital, The Air Force Medical University, Xi'an, China
| | - Yuqin Ye
- Department of Neurosurgery, Xijing Hospital, The Air Force Medical University, Xi'an, China
- Department of Neurosurgery, PLA 921th Hospital (Second Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Wen Yin
- Department of Emergency, Xijing Hospital, The Air Force Medical University, Xi'an, China
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Hoveidaei AH, Nakhostin-Ansari A, Heckmann ND, Hosseini-Asl SH, Khonji MS, Razi M, Mahdaviani B, Kistler NM, Aiyer AA. Increasing Burden of Lower-Extremity Fractures in the Middle East and North Africa (MENA): A 30-Year Epidemiological Analysis. J Bone Joint Surg Am 2024; 106:414-424. [PMID: 38260949 DOI: 10.2106/jbjs.23.00489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Lower-extremity fractures (LEFs) account for >30% of all skeletal injuries, contributing to the global health and economic burden. Fracture epidemiology in the Middle East and North Africa (MENA) region has been studied little. Health factors and disease epidemiology differ greatly among populations in MENA despite cultural, political, and economic similarities among the region's countries. This study examined the epidemiology of LEFs and the need for rehabilitation in MENA from 1990 to 2019. METHODS We examined the epidemiology of fractures of the pelvis, hip, femur, patella, tibia, fibula, ankle, and foot bones using Global Burden of Disease (GBD) data. Fracture incidence, counts, and rates were measured for males and females across age groups in the 21 MENA countries as identified by the GBD data set. Associations between years of healthy life lost due to disability (YLD) resulting from fracture and the Socio-demographic Index (SDI) were analyzed. RESULTS In contrast to the global trend, the age-standardized incidence rate (ASIR) of LEFs in the MENA region increased by 4.57% from 1990 to 2019. In 2019, the highest ASIR among fractures was attributed to fractures of the patella, fibula, tibia, or ankle (434.36 per 100,000), most frequently occurring among those 20 to 24 years of age. In 2019, the highest ASIR of all fractures was noted in Saudi Arabia (2,010.56 per 100,000) and the lowest, in Sudan (523.29 per 100,000). The greatest increases from 1990 to 2019 in the ASIR of LEFs were noted in Yemen (132.39%), Syria (107.27%), and Afghanistan (94.47%), while the largest decreases were found in Kuwait (-62.72%), Sudan (-48.72%), and Iran (-45.37%). In 2019, the YLD rate of LEFs had increased to 277.65 per 100,000, up from 235.55 per 100,000 in 1990. CONCLUSIONS Between 1990 and 2019, LEFs increased in the MENA region. Violence, war, and road traffic accidents increased, leading to a high rate of fractures, especially among youth. Low bone-mineral density related to vitamin D deficiency has also been reported as a risk factor for fracture in the region. Regional health authorities should be informed of fracture patterns by this study. LEVEL OF EVIDENCE Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Amir Human Hoveidaei
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nathanael D Heckmann
- Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | | | - Mohammad Saeid Khonji
- Bone and Joint Reconstruction Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Razi
- Department of Orthopedic Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Behnaz Mahdaviani
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Natalie M Kistler
- Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Amiethab A Aiyer
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
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Shen Y, Yuan Q, Shi M, Luo B. Higher insoluble fiber intake is associated with a lower risk of prostate cancer: results from the PLCO cohort. BMC Public Health 2024; 24:234. [PMID: 38243202 PMCID: PMC10799495 DOI: 10.1186/s12889-024-17768-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/14/2024] [Indexed: 01/21/2024] Open
Abstract
Studies regarding the relationship between fiber intake and prostate cancer (PCa) have conflicting results. Therefore, this study examined the relationship between fiber intake and the risk of PCa by using data from Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. A total of 54,336 participants in the United States, consisting of 6,414 patients with PCa, were included in this study. Multivariate Cox regression models were applied to estimate adjusted hazard ratios (aHRs) and corresponding 95% confidence intervals (CIs). Compared with individuals in the lowest quartile, individuals in the highest quartile of insoluble fiber intake had a significantly lower risk of PCa (aHR, 0.87; 95% CI, 0.78-0.98). By contrast, no significant associations were detected between total fiber intake (aHR, 0.90; 95% CI, 0.80-1.01) or soluble fiber intake (aHR, 0.90; 95% CI, 0.80-1.02). Subgroup analyses showed that insoluble fiber was related to a decreased risk of PCa in subjects with the following characteristics: age > 65 years, nonsmoking or former smokers, education level ≤ high school, non-Hispanic white ethnicity, or without a family history of PCa. In addition, significant combined effects of insoluble fiber intake, age and family history of PCa on the risk of PCa were observed, but no combined effects of smoking status and insoluble fiber intake were observed. In addition, total fiber, insoluble fiber, and soluble fiber intake had no influence on the mortality of PCa patients. These results show that all 3 measures of fiber suggest a protective association, but insoluble fiber may have a stronger association with the risk of PCa. Future studies are warranted to further investigate these relationships.
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Affiliation(s)
- Yang Shen
- Department of Urology, The Second Affiliated Hospital of Nanjing, University of Chinese Medicine, Nanjing, 210000, China
| | - Qinbo Yuan
- Department of Urology, Affiliated Wuxi Fifth Hospital of Jiangnan University, Wuxi, 214000, China
| | - Minhong Shi
- Department of Medical Prevention, Nantong Center for Disease Control and Prevention of Jiangsu Province, Nantong, 226007, China
| | - Banxin Luo
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 321 Zhongshan Road, Nanjing, 210000, China.
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Pervez T, Malik M. Tertiary Trauma Survey on Emergency Department Observational Units: A Systematic Literature Review. Cureus 2024; 16:e53187. [PMID: 38425587 PMCID: PMC10901675 DOI: 10.7759/cureus.53187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
In today's competitive world with a fast-paced lifestyle, trauma is on the rise and is globally recognized as the leading cause of mortality, morbidity, and disability. Despite the development of major trauma centers and the introduction of advanced trauma training courses and management guidelines, there remains a substantial risk of missed or delayed diagnosis of injuries with potentially life-changing physical, emotional, and financial implications. The proportion of such incidents is potentially higher in busy emergency departments and developing countries with fewer dedicated major trauma centers or where focused emergency and trauma training and skills development is still in its infancy. In the last decade, tertiary trauma surveys have been recognized as an important re-assessment protocol in reducing such missed injuries or delayed diagnoses in patients involved in major trauma. This naturally leads to the presumption that tertiary trauma surveys could also play an important role in observational medicine. This also brings into question whether a standardized tertiary trauma survey of major trauma patients on emergency observation units could reduce missed injuries, especially in low-income countries with fewer resources and trauma expertise. Thus, the purpose of this systematic literature review is to explore the potential role of tertiary trauma survey as a tool to reducing missed or delayed diagnosis in the emergency observation units and its applicability and feasibility in less-developed healthcare systems and in low- and middle-income countries. A broad-based systematic literature review was conducted to include electronic databases, grey literature, reference lists, and bibliographies using the keywords: tertiary trauma survey, major trauma, observational medicine, emergency observation units, clinical decision unit, adult, missed injuries, and delayed diagnosis. Over 19,000 citations were identified on initial search. Following a review of abstracts, application of inclusion and exclusion criteria, and review of the full article, 19 publications were finally selected for the purpose of this systematic literature review. Current evidence shows a general trend that tertiary trauma surveys performed 24 hours after admission play an important role in identifying injuries missed at the time of initial primary and secondary survey, and its implementation in observational medicine could prove beneficial, especially in resource-depleted healthcare systems.
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Affiliation(s)
- Tamkeen Pervez
- Emergency Medicine, Combined Military Hospital, Rawalpindi, PAK
| | - Mehreen Malik
- Family Medicine, Heavy Industries Taxila (HIT) Hospital, Taxila, PAK
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Albaaj H, Attergrim J, Strömmer L, Brattström O, Jacobsson M, Wihlke G, Västerbo L, Joneborg E, Gerdin Wärnberg M. Patient and process factors associated with opportunities for improvement in trauma care: a registry-based study. Scand J Trauma Resusc Emerg Med 2023; 31:87. [PMID: 38012791 PMCID: PMC10680227 DOI: 10.1186/s13049-023-01157-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/20/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Trauma is one of the leading causes of morbidity and mortality worldwide. Morbidity and mortality review of selected patient cases is used to improve the quality of trauma care by identifying opportunities for improvement (OFI). The aim of this study was to assess how patient and process factors are associated with OFI in trauma care. METHODS We conducted a registry-based study using all patients between 2017 and 2021 from the Karolinska University Hospital who had been reviewed regarding the presence of OFI as defined by a morbidity and mortality conference. We used bi- and multivariable logistic regression to assess the associations between the following patient and process factors and OFI: age, sex, respiratory rate, systolic blood pressure, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), survival at 30 days, highest hospital care level, arrival on working hours, arrival on weekends, intubation status and time to first computed tomography (CT). RESULTS OFI was identified in 300 (5.8%) out of 5182 patients. Age, missing Glasgow Coma Scale, time to first CT, highest hospital care level and ISS were statistically significantly associated with OFI. CONCLUSION Several patient and process factors were found to be associated with OFI, indicating that patients with moderate to severe trauma and those with delays to first CT are at the highest odds of OFI.
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Affiliation(s)
- Hussein Albaaj
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
| | - Jonatan Attergrim
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Sweden
| | - Lovisa Strömmer
- Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Olof Brattström
- Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Martin Jacobsson
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Huddinge, Sweden
| | - Gunilla Wihlke
- Trauma and Reparative Medicine, Karolinska University Hospital, Solna, Sweden
| | - Liselott Västerbo
- Trauma and Reparative Medicine, Karolinska University Hospital, Solna, Sweden
| | - Elias Joneborg
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Martin Gerdin Wärnberg
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Sweden
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Safdarian M, Trinka E, Rahimi-Movaghar V, Thomschewski A, Aali A, Abady GG, Abate SM, Abd-Allah F, Abedi A, Adane DE, Afzal S, Ahinkorah BO, Ahmad S, Ahmed H, Amanat N, Angappan D, Arabloo J, Aryannejad A, Athari SS, Atreya A, Azadnajafabad S, Azzam AY, Babamohamadi H, Banik PC, Bardhan M, Bashiri A, Berhie AY, Bhat AN, Brown J, Champs AP, Charalampous P, Chukwu IS, Coberly K, Dadras O, Yada DY, Dai X, Dandona L, Dandona R, Dessalegn FN, Desta AA, Dhingra S, Diao N, Diaz D, Dibas M, Dongarwar D, Dsouza HL, Ekholuenetale M, El Nahas N, Elhadi M, Eskandarieh S, Fagbamigbe AF, Fares J, Fatehizadeh A, Fereshtehnejad SM, Fischer F, Franklin RC, Garg T, Getachew M, Ghaffarpasand F, Gholamrezanezhad A, Gholizadeh Mesgarha M, Ghozy S, Golechha M, Goleij P, Graham SM, Gupta VK, Haagsma JA, Hamidi S, Harlianto NI, Harorani M, Hasanian M, Hassan A, Hassen MB, Hoveidaei AH, Iravanpour F, Irilouzadian R, Iwu CCD, Jacob L, Jaja CJ, Joseph N, Joshua CE, Jozwiak JJ, Kadashetti V, Kandel A, Kantar RS, Karaye IM, Karkhah S, Khader YS, Khan EA, Khan MJ, Khayat Kashani HR, Khonji MS, Khormali M, Kim G, Krishnamoorthy V, Kumaran SD, Malekpour MR, Meretoja TJ, Mesregah MK, Mestrovic T, Micheletti Gomide Nogueira de Sá AC, Miller TR, Mirahmadi A, Mirghaderi SP, Mirza M, Misganaw A, Misra S, Mohammad Y, Mohammadi E, Mokdad AH, Möller H, Momtazmanesh S, Moni MA, Mostafavi E, Mulita F, Naghavi M, Nassereldine H, Natto ZS, Nejati K, Nguyen HLT, Nguyen VT, Nogueira de Sá AT, Olagunju AT, Olufadewa II, Omotayo AO, Owolabi MO, Patil S, Pawar S, Pedersini P, Petcu IR, Polinder S, Pourbagher-Shahri AM, Qureshi MF, Raghav PR, Rahman M, Rahnavard N, Rajabpour-Sanati A, Rashidi MM, Rawaf S, Roberts NLS, Saddik B, Saeed U, Samadzadeh S, Samy AM, Sarveazad A, Seylani A, Shafie M, Shahbandi A, Sharew MMS, Sheikhi RA, Shetty PH, Yigit A, Shobeiri P, Shool S, Shorofi SA, Sibhat MM, Sinaei E, Singh P, Singh S, Solomon Y, Sotoudeh H, Tadesse BA, Umair M, Valadan Tahbaz S, Valdez PR, Venketasubramanian N, Vu LG, Wickramasinghe ND, Zare I, Yazdanpanah F, Wu AM, Zhang ZJ. Global, regional, and national burden of spinal cord injury, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2023; 22:1026-1047. [PMID: 37863591 PMCID: PMC10584692 DOI: 10.1016/s1474-4422(23)00287-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/05/2023] [Accepted: 07/21/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Spinal cord injury (SCI) is a major cause of health loss due to premature mortality and long-term disability. We aimed to report on the global, regional, and national incidence, prevalence, and years of life lived with disability (YLDs) for SCI from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS Using GBD 2019 data pooled in DisMod-MR 2.1, a Bayesian meta-regression tool, we systematically derived numbers and age-standardised rate changes with 95% uncertainty intervals (95% UIs) for the incidence, prevalence, and YLDs for SCI from 1990 to 2019 for the whole world, 21 GBD regions, and 204 countries and territories. We report trends based on age, sex, year, cause of injury, and level of injury. FINDINGS Globally, 20·6 million (95% UI 18·9 to 23·6) individuals were living with SCI in 2019. The incidence of SCI was 0·9 million (0·7 to 1·2) cases with an estimated 6·2 million (4·5 to 8·2) YLDs. SCI rates increased substantially from 1990 to 2019 for global prevalence (81·5%, 74·2 to 87·1), incidence (52·7%, 30·3 to 69·8), and YLDs (65·4%, 56·3 to 76·0). However, global age-standardised rates per 100 000 population showed small changes in prevalence (5·8%, 2·6 to 9·5), incidence (-6·1%, -17·2 to 1·5), and YLDs (-1·5%, -5·5 to 3·2). Data for 2019 shows that the incidence of SCI increases sharply until age 15-19 years, where it remains reasonably constant until 85 years of age and older. By contrast, prevalence and YLDs showed similar patterns to each other, with one peak at around age 45-54 years. The incidence, prevalence, and YLDs of SCI have consistently been higher in men than in women globally, with a slight and steady increase for both men and women from 1990 to 2019. Between 1990 and 2019, SCI at neck level was more common than SCI below neck level in terms of incidence (492 thousand [354 to 675] vs 417 thousand [290 to 585]), prevalence (10·8 million [9·5 to 13·9] vs 9·7 million [9·2 to 10·4]), and YLDs (4·2 million [3·0 to 5·8] vs 1·9 million [1·3 to 2·5]). Falls (477 thousand [327 to 683] cases) and road injuries (230 thousand [122 to 389] cases) were the two leading causes of SCI globally in 2019. INTERPRETATION Although age-standardised rates of incidence, prevalence, and YLDs for SCI changed only slightly, absolute counts increased substantially from 1990 to 2019. Geographical heterogeneity in demographic, spatial, and temporal patterns of SCI, at both the national and regional levels, should be considered by policy makers aiming to reduce the burden of SCI. FUNDING Bill & Melinda Gates Foundation.
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Han C, Chen W, Ye XL, Cheng F, Wang XY, Liu AB, Mu ZH, Jin XJ, Weng YH. Risk factors analysis of surgical site infections in postoperative colorectal cancer: a nine-year retrospective study. BMC Surg 2023; 23:320. [PMID: 37872509 PMCID: PMC10594825 DOI: 10.1186/s12893-023-02231-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) patients undergoing surgery are at a high risk of developing surgical site infections (SSIs), which contribute to increased morbidity, prolonged hospitalization, and escalated healthcare costs. Understanding the incidence, risk factors, and impact of SSIs is crucial for effective preventive strategies and improved patient outcomes. METHODS This retrospective study analyzed data from 431 CRC patients who underwent surgery at Huangshan Shoukang Hospital between 2014 and 2022. The clinical characteristics and demographic information were collected. The incidence and impact of SSIs were evaluated, and independent risk factors associated with SSIs were identified using multivariable logistic regresison. A nomogram plot was constructed to predict the likelihood of SSIs occurrence. RESULTS The overall incidence rate of SSIs was 7.65% (33/431). Patients with SSIs had significantly longer hospital stays and higher healthcare costs. Risk factors for SSIs included elevated Body Mass Index (BMI) levels (odds ratio, 1.12; 95% CI, 1.02-1.23; P = 0.017), the presence of diabetes (odds ratio, 3.88; 95% CI, 1.42 - 9.48; P = 0.01), as well as specific surgical factors such as open surgical procedures (odds ratio, 2.39; 95% CI [1.09; 5.02]; P = 0.031), longer surgical duration (odds ratio, 1.36; 95% CI [1.01; 1.84]; P = 0.046), and the presence of a colostomy/ileostomy (odds ratio, 3.17; 95% CI [1.53; 6.62]; P = 0.002). Utilizing multivariable regression analysis, which encompassed factors such as open surgical procedures, the presence of diabetes and colostomy/ileostom, the nomogram plot functions as a visual aid in estimating the individual risk of SSIs for patients. CONCLUSIONS Risk factors for SSIs included higher BMI levels, the presence of diabetes, open surgical procedures, longer surgical duration, and the presence of colostomy/ileostomy. The nomogram plot serves as a valuable tool for risk assessment and clinical decision-making.
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Affiliation(s)
- Cong Han
- Department of Surgery, Huangshan Shoukang Hospital, 58 Meiling Rd, Huangshan, 245000, China
| | - Wei Chen
- Department of Surgery, Huangshan Shoukang Hospital, 58 Meiling Rd, Huangshan, 245000, China
| | - Xiao-Li Ye
- Department of Surgery, Huangshan Shoukang Hospital, 58 Meiling Rd, Huangshan, 245000, China
| | - Fei Cheng
- Department of Surgery, Huangshan Shoukang Hospital, 58 Meiling Rd, Huangshan, 245000, China
| | - Xin-You Wang
- Department of Surgery, Huangshan Shoukang Hospital, 58 Meiling Rd, Huangshan, 245000, China
| | - Ai-Bin Liu
- Department of Surgery, Huangshan Shoukang Hospital, 58 Meiling Rd, Huangshan, 245000, China
| | - Zai-Hu Mu
- Department of Surgery, Huangshan Shoukang Hospital, 58 Meiling Rd, Huangshan, 245000, China
| | - Xiao-Jun Jin
- Department of Surgery, Huangshan Shoukang Hospital, 58 Meiling Rd, Huangshan, 245000, China
| | - Yan-Hong Weng
- Department of Surgery, Huangshan Shoukang Hospital, 58 Meiling Rd, Huangshan, 245000, China.
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8
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Mohan S, Walker S, Sengooba F, Kiracho EE, Mayora C, Ssennyonjo A, Aliti CT, Revill P. Supporting the revision of the health benefits package in Uganda: A constrained optimisation approach. HEALTH ECONOMICS 2023; 32:1244-1255. [PMID: 36922365 DOI: 10.1002/hec.4664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 05/04/2023]
Abstract
This study demonstrates how the linear constrained optimization approach can be used to design a health benefits package (HBP) which maximises the net disability adjusted life years (DALYs) averted given the health system constraints faced by a country, and how the approach can help assess the marginal value of relaxing health system constraints. In the analysis performed for Uganda, 45 interventions were included in the HBP in the base scenario, resulting in a total of 26.7 million net DALYs averted. When task shifting of pharmacists' and nutrition officers' tasks to nurses is allowed, 73 interventions were included in the HBP resulting in a total of 32 million net DALYs averted (a 20% increase). Further, investing only $58 towards hiring additional nutrition officers' time could avert one net DALY; this increased to $60 and $64 for pharmacists and nurses respectively, and $100,000 for expanding the consumable budget, since human resources present the main constraint to the system.
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Affiliation(s)
- Sakshi Mohan
- Center for Health Economics, University of York, York, UK
| | - Simon Walker
- Center for Health Economics, University of York, York, UK
| | - Freddie Sengooba
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Chrispus Mayora
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Aloysius Ssennyonjo
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Paul Revill
- Center for Health Economics, University of York, York, UK
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Khan NU, Khan U, Khudadad U, Ali A, Raheem A, Waheed S, Razzak JA. Trends in mortality related to unintentional poisoning in the South Asian region from 1990 to 2019: analysis of data from the Global Burden of Disease Study. BMJ Open 2023; 13:e062744. [PMID: 36754559 PMCID: PMC9923325 DOI: 10.1136/bmjopen-2022-062744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
OBJECTIVE This study aimed to estimate the burden of unintentional poisoning in South Asian countries from 1999 to 2019. DESIGN An ecological study conducted at the regional level for South Asian countries, based on data from the Global Burden of Disease Study 2019. SETTING We extracted unintentional poisoning data from the Global Burden of Disease Study data set from 1990 to 2019 to assess trends in mortality, disability-adjusted life-years (DALYs), years of life lost, years lived with disability (YLDs) and causative agents in South Asian countries (Bangladesh, Bhutan, India, Nepal and Pakistan). OUTCOME MEASURES We determined the per cent change and 95% CI for the period between 1990 and 2019 by age, gender and country. We also conducted Poisson regression to measure the percentage change in the rate per year. RESULTS The absolute number of deaths due to unintentional poisoning in South Asia decreased (-32.6%) from 10 558 deaths in 1990 to 7112 deaths in 2019. The age standardised death rate from unintentional poisoning in South Asia has seen a downward trend (-55.88%), declining from 0.87 (0.67-1.01) age-standardised per 100 000 population in 1990 to 0.41 (0.34-0.47) in 2019. Among age groups, under 9 years and 10-19 years have seen downward trends for death and DALYs, accounting for -93.5% and -38.3%, respectively. YLDs have seen an upward trend (5.9%), increasing from 10 461.7 per 100 000 in 1990 to 11 084 per 100 000 in 2019. YLDs in women increased by 7.4%, from 11 558.2 per 100 000 to 12 418.3 per 100 000. The incidence rate ratios (IRRs) adjusted by all age groups and gender for DALYs in all South Asian countries has reduced significantly (IRR 0.97, 95% CI 0.96 to 0.97) from 1990 to 2019. CONCLUSION This study showed reduction in death and DALYs due to unintentional poisoning in South Asia except YLDs which is showing an increasing trend. Public health systems should continue efforts to minimise and prevent disabilities arising from unintentional poisoning in South Asia.
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Affiliation(s)
- Nadeem Ullah Khan
- Department of Emergency Medicine, The Aga Khan University, Karachi, Pakistan
| | - Uzma Khan
- Department of Emergency Medicine, The Aga Khan University, Karachi, Pakistan
| | - Umerdad Khudadad
- Department of Emergency Medicine, The Aga Khan University, Karachi, Pakistan
| | - Asrar Ali
- Department of Emergency Medicine, The Aga Khan University, Karachi, Pakistan
| | - Ahmed Raheem
- Department of Emergency Medicine, The Aga Khan University, Karachi, Pakistan
| | - Shahan Waheed
- Department of Emergency Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Junaid Abdul Razzak
- Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, USA
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10
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Maqsood R, Khattab A, Bennett AN, Boos CJ. Association between non-acute Traumatic Injury (TI) and Heart Rate Variability (HRV) in adults: A systematic review and meta-analysis. PLoS One 2023; 18:e0280718. [PMID: 36689421 PMCID: PMC9870143 DOI: 10.1371/journal.pone.0280718] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/07/2023] [Indexed: 01/24/2023] Open
Abstract
Heart rate variability (HRV) is a non-invasive measure of autonomic function. The relationship between unselected long-term traumatic injury (TI) and HRV has not been investigated. This systematic review examines the impact of non-acute TI (>7 days post-injury) on standard HRV indices in adults. Four electronic databases (CINAHL, Medline, Scopus, and Web of Science) were searched. The quality of studies, risk of bias (RoB), and quality of evidence (QoE) were assessed using Axis, RoBANS and GRADE, respectively. Using the random-effects model, mean difference (MD) for root mean square of successive differences (RMSSD) and standard deviation of NN-intervals (SDNN), and standardized mean difference (SMD) for Low-frequency (LF): High-Frequency (HF) were pooled in RevMan guided by the heterogeneity score (I2). 2152 records were screened followed by full-text retrieval of 72 studies. 31 studies were assessed on the inclusion and exclusion criteria. Only four studies met the inclusion criteria. Three studies demonstrated a high RoB (mean RoBANS score 14.5±3.31) with a low QoE. TI was associated with a significantly higher resting heart rate. Meta-analysis of three cross-sectional studies demonstrated a statistically significant reduction in RMSSD (MD -8.45ms, 95%CI-12.78, -4.12, p<0.0001) and SDNN (MD -9.93ms, 95%CI-14.82, -5.03, p<0.0001) (low QoE) in participants with TI relative to the uninjured control. The pooled analysis of four studies showed a higher LF: HF ratio among injured versus uninjured (SMD 0.20, 95%CI 0.01-0.39, p<0.04) (very low QoE). Albeit low QoE, non-acute TI is associated with attenuated HRV indicating autonomic imbalance. The findings might explain greater cardiovascular risk following TI. Trial registration PROSPERO registration number: CRD: CRD42021298530.
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Affiliation(s)
- Rabeea Maqsood
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom
| | - Ahmed Khattab
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom
| | - Alexander N. Bennett
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Loughborough, United Kingdom
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Christopher J. Boos
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom
- Department of Cardiology, University Hospital Dorset, NHS Trust, Poole, United Kingdom
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11
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Lihua L, Yuning W, Henghui H, Xiang L, Min J, Zehao L, Lianjie L, Qian L. Retrospective analysis of 217 fatal intoxication autopsy cases from 2009 to 2021: temporal trends in fatal intoxication at Tongji center for medicolegal expertise, Hubei, China. Front Public Health 2023; 11:1137649. [PMID: 37139384 PMCID: PMC10150053 DOI: 10.3389/fpubh.2023.1137649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/27/2023] [Indexed: 05/05/2023] Open
Abstract
This retrospective analysis of fatal intoxication case autopsies was performed at Tongji Center for Medicolegal Expertise in Hubei (TCMEH) from 2009 to 2021 to obtain up-to-date information on intoxication cases. The objective was to describe important data about evolving patterns in intoxication occurrences, enhance public safety policies, and assist forensic examiners and police in more efficient handling of such cases. Analyses based on sex, age, topical exposure routes, toxic agents, and mode of death were performed using 217 records of intoxication cases collected from TCMEH as a sample, and the results were compared with reports previously published (from 1999 to 2008) from this institution. Deaths from intoxications occurred at a higher rate in males than in females and were most common among individuals aged 30-39 years. The most frequent method of exposure was oral ingestion. The causative agents of deadly intoxications have changed when compared to the data from the previous 10 years. For instance, deaths from amphetamine overdoses are becoming more prevalent gradually, whereas deaths due to carbon monoxide and rodenticide intoxication have declined dramatically. In 72 cases, pesticides continued to be the most frequent intoxication cause. A total of 60.4% of the deaths were accidental exposure. Men died from accidents at a higher rate than women, although women were more likely to commit suicide. Particular focus is needed on the use of succinylcholine, cyanide, and paraquat in homicides.
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12
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Xu Y, Chen M, Yang R, Wumaierjiang M, Huang S. Global, Regional, and National Burden of Road Injuries from 1990 to 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16479. [PMID: 36554366 PMCID: PMC9779128 DOI: 10.3390/ijerph192416479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Understanding occurrence can help formulate effective preventative laws and regulations. However, the most recent global burden and road injuries (RIs) trends have not been reported. This study reports the burden of RIs globally from 1990 to 2019. (2) Methods: RIs data were downloaded from the Global Burden of Disease 2019. Incidence, deaths, and disability-adjusted life years (DALYs) described the trend and burden of RIs. We calculated age-standardized rates (ASRs) and estimated annual percentage change (EAPC) for the above indexes to evaluate the temporal trend of RIs. We evaluated the social-demographic index (SDI) with epidemiological RI parameters and reported proportions of age-standardized rates due to RI. (3) Results: In 2019, the global incidence of RIs reached 103.2 million. The EAPC of RI incidence increased, whereas deaths and DALYs decreased. Age-standardized incident rate (ASIR) was highest in low-middle SDI regions, age-standardized death rate (ASDR) was high in middle SDI regions, and age-standardized DALYs increased in low SDI regions. The highest accident rates were found in those aged 20-24 years old. Cyclist injuries were the leading RIs (34%), though pedestrian and motor vehicle accidents were the leading cause of death (37.4%, 37.6%) and DALYs (35.7%, 32.3%), respectively. (4) Conclusions: Over the past 30 years, RIs incidence increased annually, though death and DALY rates decreased. RIs places a considerable burden on public health in low SDI countries. Data should be used to develop and implement effective measures to reduce the burden of RIs.
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Affiliation(s)
- Yifan Xu
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710049, China
| | - Meikai Chen
- Department of Intensive Care Unit, The Affiliated Drum Tower Hospital, Medical School, Nanjing University, Nanjing 210093, China
| | - Ruitong Yang
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710049, China
| | - Muhemaiti Wumaierjiang
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710049, China
| | - Shengli Huang
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710049, China
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13
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Zhang Y, Li Y, Xia Q, Li Y, Jin S, Mao Q, Liu C, Fan X, Lin H. Cell membrane-coated human hair nanoparticles for precise disease therapies. J Nanobiotechnology 2022; 20:480. [DOI: 10.1186/s12951-022-01673-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/14/2022] [Indexed: 11/17/2022] Open
Abstract
AbstractPrecision medicine is the ultimate goal for current disease therapies, including tumor and infection. The lack of specific targeted drugs for liver cancer and the lack of specific anti-infective drugs in the treatment of diabetic foot ulcer with infection (DFI) are the representative obstacles in those 2 major diseases currently plaguing human beings. Inventing natural biocompatible polymers derived from natural materials is one of the main development directions of current bio-medical materials. Though previous studies have demonstrated the potential application values of human black hair-derived nanoparticles (HNP) in cancer, methicillin-resistant Staphylococcus aureus (MRSA) infection, and thrombosis scenarios treatments, it still has not solved the problem of low local therapeutic concentration and general targeting ability. Here, we firstly modified the HNP with membrane encapsulations, which endowed these dual-pure natural bio-fabricated materials with better targeting ability at the disease sites with no reduction in photothermal therapy (PTT) effect. HNP coated by red blood cell membrane loaded with DSPE-PEG-cRGD peptide for the therapeutic application of liver cancer greatly prolonged in vivo circulation time and enhanced local targeting efficacy as well as low toxicity; HNP coated by the murine macrophage cell membrane (RAWM) for the DFIs treatment greatly promoted the adhesive ability of HNP on the bacteria and thereby improved the killing effect. Briefly, the appropriate cell membranes camouflaged HNP nanomedicine has the characteristics of excellent photothermal effect, an all-natural source with excellent biocompatibility and easy access, which is expected to have huge potential in both benign and malignant diseases.
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14
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Xiang D, Hu S, Mai T, Zhang X, Zhang L, Wang S, Jin K, Huang J. Worldwide cancer statistics of adults over 75 years old in 2019: a systematic analysis of the global burden of disease study 2019. BMC Public Health 2022; 22:1979. [PMID: 36307792 PMCID: PMC9617321 DOI: 10.1186/s12889-022-14412-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 10/17/2022] [Indexed: 12/24/2022] Open
Abstract
Background and purpose Cancer has become one of the major killers of humanity due to the number of people over the age of 75 increasing with population ageing. The aim of this study was to analyse the incidence and mortality rates in people over 75 of 29 cancer types in 204 countries and regions, as well as the trends from 1990 to 2019. Methods Twenty-nine cancer types were collected from the Global Burden of Disease (GBD) 2019 database(https://vizhub.healthdata.org/gbd-results/). We collected global cancer data for 2019 in terms of sex, age, sociodemographic index (SDI), region, etc. The estimated annual percentage change (EAPC) was calculated to assess the trend of the cancer incidence and mortality rate from 1990 to 2019. Results In 2019, the number of new cancer cases and deaths among people 75 and older was almost 3 and 4.5 times that of 1990, respectively. From 1990 to 2019, there was a slow rise in incidence and a slight decline in mortality. There were significant differences in the cancer burden based on sex, age, region, and SDI. The cancer burden in men was higher than in women. In addition, the cancer burden varied from region to region. The highest cancer burden occurred in high-income North America. In addition, the higher the SDI was, the greater the burden of cancer. The incidence of cancer in high SDI was approximately seven times that of low SDI, and the trend of increase in high SDI was obvious. However, the trend of mortality in high SDI was decreasing, while it was increasing in low SDI. Conclusions The present study focused on the cancer burden in adults over 75 years old. The findings in the study could serve as the basis for an analysis of the types of cancers that are most prevalent in different regions. This is beneficial for strategies of prevention and treatment according to the characteristics of different countries and regions to reduce the burden of cancer in older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14412-1.
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15
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Abstract
Snakebite envenoming is an important cause of preventable death. The World Health Organization (WHO) set a goal to halve snakebite mortality by 2030. We used verbal autopsy and vital registration data to model the proportion of venomous animal deaths due to snakes by location, age, year, and sex, and applied these proportions to venomous animal contact mortality estimates from the Global Burden of Disease 2019 study. In 2019, 63,400 people (95% uncertainty interval 38,900-78,600) died globally from snakebites, which was equal to an age-standardized mortality rate (ASMR) of 0.8 deaths (0.5-1.0) per 100,000 and represents a 36% (2-49) decrease in ASMR since 1990. India had the greatest number of deaths in 2019, equal to an ASMR of 4.0 per 100,000 (2.3-5.0). We forecast mortality will continue to decline, but not sufficiently to meet WHO's goals. Improved data collection should be prioritized to help target interventions, improve burden estimation, and monitor progress.
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16
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Maqsood R, Khattab A, Bennett AN, Boos CJ. Association between non-acute traumatic injury (TI) and heart rate variability (HRV) in adults: A systematic review protocol. PLoS One 2022; 17:e0273688. [PMID: 36026501 PMCID: PMC9417186 DOI: 10.1371/journal.pone.0273688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/12/2022] [Indexed: 12/05/2022] Open
Abstract
Heart Rate Variability (HRV) is an indirect measure of autonomic function. Attenuated HRV is linked to worsening health outcomes including Major Adverse Cardiovascular Events (MACE). The relationship between traumatic injury (TI) and HRV has been limitedly studied. This research protocol has been designed to conduct a systematic review of the existing evidence on the association between non-acute TI and HRV in adults. Four electronic bibliographic databases (Web of Science, CINAHL, Medline, and Scopus) will be searched. The studies on non-acute (>7 days post injury) TI and HRV in adults will be included, followed by title-abstract screening by two reviewers independently. The quality and risk of bias of the included studies will be assessed using Axis and a six-item Risk of Bias Assessment tool for of Non-randomized Studies (RoBANS) respectively. Grading of Recommendations Assessment, Development and Evaluation (GRADE) will assess the quality of evidence. The extracted data will be synthesized using narrative syntheses and a Forest plot with or without meta-analysis- whichever permitted by the pooled data. This will be the first systematic review to examine the relationship between generalized TI and HRV in adults. Trial registration: (PROPSERO registration number: CRD: CRD42021298530) https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021298530.
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Affiliation(s)
- Rabeea Maqsood
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom
- * E-mail:
| | - Ahmed Khattab
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom
| | - Alexander N. Bennett
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall, Loughborough, United Kingdom
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Christopher J. Boos
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom
- Department of Cardiology, University Hospital Dorset, NHS Trust, Poole, United Kingdom
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17
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Charalampous P, Pallari E, Gorasso V, von der Lippe E, Devleesschauwer B, Pires SM, Plass D, Idavain J, Ngwa CH, Noguer I, Padron-Monedero A, Sarmiento R, Majdan M, Ádám B, AlKerwi A, Cilovic-Lagarija S, Clarsen B, Corso B, Cuschieri S, Dopelt K, Economou M, Fischer F, Freitas A, García-González JM, Gazzelloni F, Gkitakou A, Gulmez H, Hynds P, Isola G, Jakobsen LS, Kabir Z, Kissimova-Skarbek K, Knudsen AK, Konar NM, Ladeira C, Lassen B, Liew A, Majer M, Mechili EA, Mereke A, Monasta L, Mondello S, Morgado JN, Nena E, Ng ESW, Niranjan V, Nola IA, O'Caoimh R, Petrou P, Pinheiro V, Ortiz MR, Riva S, Samouda H, Santos JV, Santoso CMA, Milicevic MS, Skempes D, Sousa AC, Speybroeck N, Tozija F, Unim B, Uysal HB, Vaccaro FG, Varga O, Vasic M, Violante FS, Wyper GMA, Polinder S, Haagsma JA. Methodological considerations in injury burden of disease studies across Europe: a systematic literature review. BMC Public Health 2022; 22:1564. [PMID: 35978333 PMCID: PMC9382747 DOI: 10.1186/s12889-022-13925-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background Calculating the disease burden due to injury is complex, as it requires many methodological choices. Until now, an overview of the methodological design choices that have been made in burden of disease (BoD) studies in injury populations is not available. The aim of this systematic literature review was to identify existing injury BoD studies undertaken across Europe and to comprehensively review the methodological design choices and assumption parameters that have been made to calculate years of life lost (YLL) and years lived with disability (YLD) in these studies. Methods We searched EMBASE, MEDLINE, Cochrane Central, Google Scholar, and Web of Science, and the grey literature supplemented by handsearching, for BoD studies. We included injury BoD studies that quantified the BoD expressed in YLL, YLD, and disability-adjusted life years (DALY) in countries within the European Region between early-1990 and mid-2021. Results We retrieved 2,914 results of which 48 performed an injury-specific BoD assessment. Single-country independent and Global Burden of Disease (GBD)-linked injury BoD studies were performed in 11 European countries. Approximately 79% of injury BoD studies reported the BoD by external cause-of-injury. Most independent studies used the incidence-based approach to calculate YLDs. About half of the injury disease burden studies applied disability weights (DWs) developed by the GBD study. Almost all independent injury studies have determined YLL using national life tables. Conclusions Considerable methodological variation across independent injury BoD assessments was observed; differences were mainly apparent in the design choices and assumption parameters towards injury YLD calculations, implementation of DWs, and the choice of life table for YLL calculations. Development and use of guidelines for performing and reporting of injury BoD studies is crucial to enhance transparency and comparability of injury BoD estimates across Europe and beyond. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13925-z.
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Affiliation(s)
- Periklis Charalampous
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Elena Pallari
- Health Innovation Network, Minerva House, Montague Close, London, UK
| | - Vanessa Gorasso
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Sara M Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Dietrich Plass
- Department for Exposure Assessment, and Environmental Health Indicators, German Environment Agency, Berlin, Germany
| | - Jane Idavain
- Department of Health Statistics, National Institute for Health Development, Tallinn, Estonia
| | - Che Henry Ngwa
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Isabel Noguer
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | | | - Rodrigo Sarmiento
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain.,Medicine School, University of Applied and Environmental Sciences, Bogota, Colombia
| | - Marek Majdan
- Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
| | - Balázs Ádám
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ala'a AlKerwi
- Directorate of Health, Service Epidemiology and Statistics, Luxembourg, Luxembourg
| | | | - Benjamin Clarsen
- Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway.,Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Barbara Corso
- Institute of Neuroscience, National Research Council, Rome, Italy
| | - Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel.,Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Mary Economou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Alberto Freitas
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | | | | | - Artemis Gkitakou
- Department of Internal Medicine and Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Hakan Gulmez
- Department of Family Medicine, Faculty of Medicine, İzmir Democracy University, Izmir, Turkey
| | - Paul Hynds
- Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Lea S Jakobsen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Zubair Kabir
- Public Health & Epidemiology, School of Public Health, University College Cork, Cork, Ireland
| | - Katarzyna Kissimova-Skarbek
- Department of Health Economics and Social Security, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Ann Kristin Knudsen
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Naime Meriç Konar
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Kirsehir Ahi Evran University, Kirsehir, Turkey
| | - Carina Ladeira
- H&TRC - Health & Technology Research Center, Escola Superior de Tecnologia da Saúde (ESTeSL), Instituto Politécnico de Lisboa, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Brian Lassen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Aaron Liew
- Clinical Sciences Institute, School of Medicine, National University of Ireland, Galway, Galway City, Ireland
| | - Marjeta Majer
- Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Enkeleint A Mechili
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece.,Department of Healthcare, Faculty of Public Health, University of Vlora, Vlora, Albania
| | - Alibek Mereke
- Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Lorenzo Monasta
- Institute of Maternal, Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Joana Nazaré Morgado
- Environmental Health and Nutrition Laboratory, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Evangelia Nena
- Laboratory of Social Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Vikram Niranjan
- School of Public Health, Physiotherapy and Sport Sciences, University College Dublin, Dublin, Ireland
| | - Iskra Alexandra Nola
- Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Rónán O'Caoimh
- Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, Cork City, Ireland
| | - Panagiotis Petrou
- Pharmacoepidemiology-Pharmacovigilance, Pharmacy School, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
| | - Vera Pinheiro
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Silvia Riva
- Department of Psychology and Pedagogic Science, St Mary's University, London, UK
| | - Hanen Samouda
- Population Health Department, Luxembourg Institute of Health, Nutrition and Health Research Group, Luxembourg, Luxembourg
| | - João Vasco Santos
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.,Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, Lisbon, Portugal
| | | | | | | | - Ana Catarina Sousa
- Department of Biology, School of Science and Technology, University of Évora, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
| | - Niko Speybroeck
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Fimka Tozija
- Institute of Public Health of Republic of North Macedonia, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia.,Faculty of Medicine, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia
| | - Brigid Unim
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore Di Sanità, Rome, Italy
| | - Hilal Bektaş Uysal
- Department of Internal Medicine, Adnan Menderes University School of Medicine, Aydin, Turkey
| | | | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Milena Vasic
- Faculty of Dentistry Pancevo, University Business Academy in Novi Sad, Pancevo, Serbia.,Institute of Public Health of Serbia Dr Milan Jovanović Batut, Belgrade, Serbia
| | - Francesco Saverio Violante
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.,Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Grant M A Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland, UK
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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18
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Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019. THE LANCET PUBLIC HEALTH 2022; 7:e657-e669. [PMID: 35779567 PMCID: PMC9329128 DOI: 10.1016/s2468-2667(22)00134-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 01/22/2023] Open
Abstract
Background Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10–24 years during the past three decades. Methods Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolute numbers and age-standardised rates per 100 000 population by sex, age group (10–14, 15–19, and 20–24 years), and sociodemographic index (SDI) with 95% uncertainty intervals (UIs). We report percentage changes in deaths and DALYs between 1990 and 2019. Findings In 2019, 369 061 deaths (of which 214 337 [58%] were transport related) and 31·1 million DALYs (of which 16·2 million [52%] were transport related) among adolescents aged 10–24 years were caused by transport and unintentional injuries combined. If compared with other causes, transport and unintentional injuries combined accounted for 25% of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout adolescence, transport and unintentional injury fatality rates increased by age group. The unintentional injury burden was higher among males than females for all injury types, except for injuries related to fire, heat, and hot substances, or to adverse effects of medical treatment. From 1990 to 2019, global mortality rates declined by 34·4% (from 17·5 to 11·5 per 100 000) for transport injuries, and by 47·7% (from 15·9 to 8·3 per 100 000) for unintentional injuries. However, in low-SDI nations the absolute number of deaths increased (by 80·5% to 42 774 for transport injuries and by 39·4% to 31 961 for unintentional injuries). In the high-SDI quintile in 2010–19, the rate per 100 000 of transport injury DALYs was reduced by 16·7%, from 838 in 2010 to 699 in 2019. This was a substantially slower pace of reduction compared with the 48·5% reduction between 1990 and 2010, from 1626 per 100 000 in 1990 to 838 per 100 000 in 2010. Between 2010 and 2019, the rate of unintentional injury DALYs per 100 000 also remained largely unchanged in high-SDI countries (555 in 2010 vs 554 in 2019; 0·2% reduction). The number and rate of adolescent deaths and DALYs owing to environmental heat and cold exposure increased for the high-SDI quintile during 2010–19. Interpretation As other causes of mortality are addressed, inadequate progress in reducing transport and unintentional injury mortality as a proportion of adolescent deaths becomes apparent. The relative shift in the burden of injury from high-SDI countries to low and low–middle-SDI countries necessitates focused action, including global donor, government, and industry investment in injury prevention. The persisting burden of DALYs related to transport and unintentional injuries indicates a need to prioritise innovative measures for the primary prevention of adolescent injury. Funding Bill & Melinda Gates Foundation.
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19
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Haagsma JA, Charalampous P, Ariani F, Gallay A, Moesgaard Iburg K, Nena E, Ngwa CH, Rommel A, Zelviene A, Abegaz KH, Al Hamad H, Albano L, Liliana Andrei C, Andrei T, Antonazzo IC, Aremu O, Arumugam A, Atreya A, Aujayeb A, Ayuso-Mateos JL, Engelbert Bain L, Banach M, Winfried Bärnighausen T, Barone-Adesi F, Beghi M, Bennett DA, Bhagavathula AS, Carvalho F, Castelpietra G, Caterina L, Chandan JS, Couto RAS, Cruz-Martins N, Damiani G, Dastiridou A, Demetriades AK, Dias-da-Silva D, Francis Fagbamigbe A, Fereshtehnejad SM, Fernandes E, Ferrara P, Fischer F, Fra.Paleo U, Ghirini S, Glasbey JC, Glavan IR, Gomes NGM, Grivna M, Harlianto NI, Haro JM, Hasan MT, Hostiuc S, Iavicoli I, Ilic MD, Ilic IM, Jakovljevic M, Jonas JB, Jerzy Jozwiak J, Jürisson M, Kauppila JH, Kayode GA, Khan MAB, Kisa A, Kisa S, Koyanagi A, Kumar M, Kurmi OP, La-Vecchia C, Lamnisos D, Lasrado S, Lauriola P, Linn S, Loureiro JA, Lunevicius R, Madureira-Carvalho A, Mechili EA, Majeed A, Menezes RG, Mentis AFA, Meretoja A, Mestrovic T, Miazgowski T, Miazgowski B, Mirica A, Molokhia M, Mohammed S, Monasta L, Mulita F, David Naimzada M, Negoi I, Neupane S, Oancea B, Orru H, Otoiu A, Otstavnov N, Otstavnov SS, Padron-Monedero A, Panda-Jonas S, Pardhan S, Patel J, Pedersini P, Pinheiro M, Rakovac I, Rao CR, Rawaf S, Rawaf DL, Rodrigues V, Ronfani L, Sagoe D, Sanmarchi F, Santric-Milicevic MM, Sathian B, Sheikh A, Shiri R, Shivalli S, Dora Sigfusdottir I, Sigurvinsdottir R, Yurievich Skryabin V, Aleksandrovna Skryabina A, Smarandache CG, Socea B, Sousa RARC, Steiropoulos P, Tabarés-Seisdedos R, Roberto Tovani-Palone M, Tozija F, Van de Velde S, Juhani Vasankari T, Veroux M, Violante FS, Vlassov V, Wang Y, Yadollahpour A, Yaya S, Sergeevich Zastrozhin M, Zastrozhina A, Polinder S, Majdan M. The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study. Arch Public Health 2022; 80:142. [PMID: 35590340 PMCID: PMC9121595 DOI: 10.1186/s13690-022-00891-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/02/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries. METHODS We performed a secondary database descriptive study using the GBD 2019 results on injuries in 44 European countries from 2000 to 2019. Inequality in DALY rates between these countries was assessed by calculating the DALY rate ratio between the highest-ranking country and lowest-ranking country in each year. RESULTS In 2019, in Eastern Europe 80 [95% uncertainty interval (UI): 71 to 89] people per 100,000 died from injuries; twice as high compared to Central Europe (38 injury deaths per 100,000; 95% UI 34 to 42) and three times as high compared to Western Europe (27 injury deaths per 100,000; 95%UI 25 to 28). The injury DALY rates showed less pronounced differences between Eastern (5129 DALYs per 100,000; 95% UI: 4547 to 5864), Central (2940 DALYs per 100,000; 95% UI: 2452 to 3546) and Western Europe (1782 DALYs per 100,000; 95% UI: 1523 to 2115). Injury DALY rate was lowest in Italy (1489 DALYs per 100,000) and highest in Ukraine (5553 DALYs per 100,000). The difference in injury DALY rates by country was larger for males compared to females. The DALY rate ratio was highest in 2005, with DALY rate in the lowest-ranking country (Russian Federation) 6.0 times higher compared to the highest-ranking country (Malta). After 2005, the DALY rate ratio between the lowest- and the highest-ranking country gradually decreased to 3.7 in 2019. CONCLUSIONS Injury mortality and DALY rates were highest in Eastern Europe and lowest in Western Europe, although differences in injury DALY rates declined rapidly, particularly in the past decade. The injury DALY rate ratio of highest- and lowest-ranking country declined from 2005 onwards, indicating declining inequalities in injuries between European countries.
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Affiliation(s)
- Juanita A. Haagsma
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Periklis Charalampous
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Filippo Ariani
- Epidemiology Unit, Central Tuscany Local Health Authority, Florence, Italy
| | - Anne Gallay
- grid.493975.50000 0004 5948 8741Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - Kim Moesgaard Iburg
- grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Evangelia Nena
- grid.12284.3d0000 0001 2170 8022Laboratory of Social Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Che Henry Ngwa
- grid.8761.80000 0000 9919 9582School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ,grid.22903.3a0000 0004 1936 9801Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Alexander Rommel
- grid.13652.330000 0001 0940 3744Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ausra Zelviene
- Institute of Hygiene, Health Information Center, Kaunas, Lithuania
| | - Kedir Hussein Abegaz
- grid.412132.70000 0004 0596 0713Department of Biostatistics, Near East University, Nicosia, Cyprus ,Department of Biostatistics and Health Informatics, Madda Walabu University, Bale Robe, Ethiopia
| | - Hanadi Al Hamad
- grid.413548.f0000 0004 0571 546XGeriatrics and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar
| | - Luciana Albano
- grid.9841.40000 0001 2200 8888Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Catalina Liliana Andrei
- grid.8194.40000 0000 9828 7548Cardiology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Tudorel Andrei
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Ippazio Cosimo Antonazzo
- grid.7563.70000 0001 2174 1754Research Center On Public Health, University of Milan-Bicocca, Monza, Italy
| | - Olatunde Aremu
- grid.19822.300000 0001 2180 2449Department of Public Health, Birmingham City University, Birmingham, UK
| | - Ashokan Arumugam
- grid.412789.10000 0004 4686 5317Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Alok Atreya
- grid.429382.60000 0001 0680 7778Department of Forensic Medicine, Lumbini Medical College, Palpa, Nepal
| | - Avinash Aujayeb
- grid.451090.90000 0001 0642 1330Northumbria Healthcare NHS Foundation Trust, Cramlington, UK
| | - Jose Luis Ayuso-Mateos
- grid.411251.20000 0004 1767 647XHospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain ,grid.413448.e0000 0000 9314 1427Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Luchuo Engelbert Bain
- grid.36511.300000 0004 0420 4262Lincoln International Institute for Rural Health (LIIRH), University of Lincoln, Lincoln, UK ,Global South Health Services and Research, GSHS, Amsterdam, The Netherlands
| | - Maciej Banach
- grid.8267.b0000 0001 2165 3025Department of Hypertension, Medical University of Lodz, Lodz, Poland ,grid.415071.60000 0004 0575 4012Polish Mothers’ Memorial Hospital Research Institute, Lodz, Poland
| | - Till Winfried Bärnighausen
- grid.7700.00000 0001 2190 4373Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany ,grid.38142.3c000000041936754XT.H. Chan School of Public Health, Harvard University, Boston, MA USA
| | - Francesco Barone-Adesi
- grid.16563.370000000121663741Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | | | - Derrick A. Bennett
- grid.4991.50000 0004 1936 8948Clinical Trials Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Akshaya S. Bhagavathula
- grid.43519.3a0000 0001 2193 6666Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates ,grid.4491.80000 0004 1937 116XDepartment of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Prague, Czech Republic
| | - Félix Carvalho
- grid.5808.50000 0001 1503 7226Research Unit On Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Giulio Castelpietra
- Outpatient and Inpatient Care Service, Central Health Directorate, Friuli Venezia Giulia Region, Trieste, Italy
| | - Ledda Caterina
- grid.8158.40000 0004 1757 1969Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Joht Singh Chandan
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Rosa A. S. Couto
- grid.5808.50000 0001 1503 7226Department of Chemical Sciences, University of Porto, Porto, Portugal
| | - Natália Cruz-Martins
- grid.5808.50000 0001 1503 7226Faculty of Medicine, University of Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Institute for Research & Innovation in Health (i3S), University of Porto, Porto, Portugal ,Institute of Research and Advanced, Training in Health Sciences and Technologies (INFACTS), Gandra, Portugal
| | - Giovanni Damiani
- grid.4708.b0000 0004 1757 2822Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, University of Milan, Milan, Italy ,grid.67105.350000 0001 2164 3847Department of Dermatology, Case Western Reserve University, Cleveland, OH USA
| | - Anna Dastiridou
- grid.411299.6Department of Ophthalmology, University Hospital of Larissa, Larissa, Greece
| | - Andreas K. Demetriades
- grid.418716.d0000 0001 0709 1919Edinburgh Spinal Surgery Outcome Studies Group, Department of Neurosurgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Diana Dias-da-Silva
- grid.5808.50000 0001 1503 7226Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Adeniyi Francis Fagbamigbe
- grid.9582.60000 0004 1794 5983Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Seyed-Mohammad Fereshtehnejad
- grid.28046.380000 0001 2182 2255Division of Neurology, Department of Medicine, University of Ottawa, Ottawa, ON Canada ,grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Department of Neurobiology, Karolinska Institute, Stockholm, Sweden
| | - Eduarda Fernandes
- grid.5808.50000 0001 1503 7226Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal
| | - Pietro Ferrara
- grid.7563.70000 0001 2174 1754Research Center On Public Health, University of Milan-Bicocca, Monza, Italy
| | - Florian Fischer
- grid.6363.00000 0001 2218 4662Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Urbano Fra.Paleo
- grid.8393.10000000119412521Research Institute for Sustainable Land Development (Interra), University of Extremadura, Caceres, Spain
| | - Silvia Ghirini
- grid.416651.10000 0000 9120 6856National Center On Addictions and Doping, Istituto Superiore Di Sanità, Rome, Italy
| | - James C. Glasbey
- grid.6572.60000 0004 1936 7486NIHR Global Health Research Unit On Global Surgery, University of Birmingham, Birmingham, UK
| | - Ionela-Roxana Glavan
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Nelson G. M. Gomes
- grid.5808.50000 0001 1503 7226Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Department of Chemistry, University of Porto, Porto, Portugal
| | - Michal Grivna
- grid.43519.3a0000 0001 2193 6666Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Netanja I. Harlianto
- grid.7692.a0000000090126352Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain ,Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - M. Tasdik Hasan
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh ,grid.10025.360000 0004 1936 8470Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Sorin Hostiuc
- grid.8194.40000 0000 9828 7548Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania ,Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Ivo Iavicoli
- grid.4691.a0000 0001 0790 385XDepartment of Public Health, University of Naples Federico II, Naples, Italy
| | - Milena D. Ilic
- grid.413004.20000 0000 8615 0106Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
| | - Irena M. Ilic
- grid.7149.b0000 0001 2166 9385Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Mihajlo Jakovljevic
- grid.448878.f0000 0001 2288 8774N. A. Semashko Department of Public Health and Healthcare, I. M. Sechenov First Moscow State Medical University, Moscow, Russia ,grid.413004.20000 0000 8615 0106Department of Global Health, Economics and Policy, University of Kragujevac, Kragujevac, Serbia
| | - Jost B. Jonas
- grid.7700.00000 0001 2190 4373Department of Ophthalmology, Heidelberg University, Mannheim, Germany ,grid.414373.60000 0004 1758 1243Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
| | - Jacek Jerzy Jozwiak
- grid.107891.60000 0001 1010 7301Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | - Mikk Jürisson
- grid.10939.320000 0001 0943 7661Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Joonas H. Kauppila
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden ,grid.10858.340000 0001 0941 4873Surgery Research Unit, University of Oulu, Oulu, Finland
| | - Gbenga A. Kayode
- grid.421160.0International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria ,grid.5477.10000000120346234Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands
| | - Moien A. B. Khan
- grid.43519.3a0000 0001 2193 6666Department of Family Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates ,grid.451052.70000 0004 0581 2008Primary Care Department, NHS North West London, London, England
| | - Adnan Kisa
- grid.457625.70000 0004 0383 3497School of Health Sciences, Kristiania University College, Oslo, Norway ,grid.265219.b0000 0001 2217 8588Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA USA
| | - Sezer Kisa
- grid.412414.60000 0000 9151 4445Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain ,grid.425902.80000 0000 9601 989XCatalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Manasi Kumar
- grid.10604.330000 0001 2019 0495Department of Psychiatry, University of Nairobi, Nairobi, Kenya ,grid.83440.3b0000000121901201Division of Psychology and Language Sciences, University College London, London, UK
| | - Om P. Kurmi
- grid.25073.330000 0004 1936 8227Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada ,grid.8096.70000000106754565Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Carlo La-Vecchia
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Demetris Lamnisos
- grid.440838.30000 0001 0642 7601Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Savita Lasrado
- grid.414767.70000 0004 1765 9143Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India
| | - Paolo Lauriola
- grid.5326.20000 0001 1940 4177Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Shai Linn
- grid.18098.380000 0004 1937 0562School of Public Health, University of Haifa, Haifa, Israel
| | - Joana A. Loureiro
- grid.5808.50000 0001 1503 7226Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), University of Porto, Porto, Portugal
| | - Raimundas Lunevicius
- grid.10025.360000 0004 1936 8470Department of General Surgery, School of Medicine, Liverpool University Hospitals NHS Foundation Trust, University of Liverpool, Liverpool, UK
| | - Aurea Madureira-Carvalho
- Institute of Research and Advanced, Training in Health Sciences and Technologies (INFACTS), Gandra, Portugal ,grid.5808.50000 0001 1503 7226Laboratório de Farmacognosia, Departamento de Química, Faculdade de Farmácia, Universidade Do Porto, Porto, Portugal
| | - Enkeleint A. Mechili
- grid.8127.c0000 0004 0576 3437Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece ,Department of Healthcare, Faculty of Public Health, University of Vlora, Vlora, Albania
| | - Azeem Majeed
- grid.7445.20000 0001 2113 8111Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Ritesh G. Menezes
- grid.411975.f0000 0004 0607 035XForensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Alexios-Fotios A. Mentis
- grid.418497.7Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece ,grid.411299.6Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Atte Meretoja
- grid.1008.90000 0001 2179 088XSchool of Health Sciences, University of Melbourne, Melbourne, VIC Australia ,grid.15485.3d0000 0000 9950 5666Neurology Unit, Helsinki University Hospital, Helsinki, Finland
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Dr Zora Profozic Polyclinic, Zagreb, Croatia ,grid.502995.20000 0004 4651 2415University Centre Varazdin, University North, Varazdin, Croatia
| | - Tomasz Miazgowski
- grid.107950.a0000 0001 1411 4349Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | - Bartosz Miazgowski
- grid.107950.a0000 0001 1411 4349Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
| | - Andreea Mirica
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Mariam Molokhia
- grid.13097.3c0000 0001 2322 6764Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Shafiu Mohammed
- grid.7700.00000 0001 2190 4373Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany ,grid.411225.10000 0004 1937 1493Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Francesk Mulita
- grid.412458.eDepartment of General Surgery, University General Hospital of Patras, Patras, Greece
| | - Mukhammad David Naimzada
- grid.18763.3b0000000092721542Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia ,grid.411191.d0000 0000 9146 0440Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russia
| | - Ionut Negoi
- grid.8194.40000 0000 9828 7548Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania ,Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Subas Neupane
- grid.502801.e0000 0001 2314 6254Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland ,grid.502801.e0000 0001 2314 6254Gerontology Research Center, Tampere University, Tampere, Finland
| | - Bogdan Oancea
- grid.5100.40000 0001 2322 497XAdministrative and Economic Sciences Department, University of Bucharest, Bucharest, Romania
| | - Hans Orru
- grid.10939.320000 0001 0943 7661Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia ,grid.12650.300000 0001 1034 3451Department of Public Health and Clinical Medicine, Sustainable Health, Umea University, Umea, Sweden
| | - Adrian Otoiu
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Nikita Otstavnov
- grid.18763.3b0000000092721542Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
| | - Stanislav S. Otstavnov
- grid.18763.3b0000000092721542Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia ,grid.410682.90000 0004 0578 2005Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Alicia Padron-Monedero
- grid.512889.f0000 0004 1768 0241National School of Public Health, Institute of Health Carlos III, Madrid, Spain
| | - Songhomitra Panda-Jonas
- grid.7700.00000 0001 2190 4373Department of Ophthalmology, Heidelberg University, Mannheim, Germany
| | - Shahina Pardhan
- grid.5115.00000 0001 2299 5510Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - Jay Patel
- grid.9909.90000 0004 1936 8403Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Paolo Pedersini
- grid.418563.d0000 0001 1090 9021IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Marina Pinheiro
- grid.5808.50000 0001 1503 7226Department of Chemistry, University of Porto, Porto, Portugal
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Chythra R. Rao
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Salman Rawaf
- grid.7445.20000 0001 2113 8111Department of Primary Care and Public Health, Imperial College London, London, UK ,grid.271308.f0000 0004 5909 016XAcademic Public Health Department, Public Health England, London, UK
| | - David Laith Rawaf
- grid.7445.20000 0001 2113 8111World Health Organization (WHO) Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK ,grid.439749.40000 0004 0612 2754University College London Hospitals, London, UK
| | | | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Dominic Sagoe
- grid.7914.b0000 0004 1936 7443Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Francesco Sanmarchi
- grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Milena M. Santric-Milicevic
- grid.7149.b0000 0001 2166 9385Faculty of Medicine, University of Belgrade, Belgrade, Serbia ,grid.7149.b0000 0001 2166 9385School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Brijesh Sathian
- grid.413548.f0000 0004 0571 546XGeriatrics and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar ,grid.17236.310000 0001 0728 4630Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Aziz Sheikh
- grid.4305.20000 0004 1936 7988Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK ,grid.38142.3c000000041936754XDivision of General Internal Medicine, Harvard University, Boston, MA USA
| | - Rahman Shiri
- grid.6975.d0000 0004 0410 5926Finnish Institute of Occupational Health, Helsinki, Finland
| | - Siddharudha Shivalli
- grid.8991.90000 0004 0425 469XDepartment of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Inga Dora Sigfusdottir
- grid.9580.40000 0004 0643 5232Department of Psychology, Reykjavik University, Reykjavik, Iceland ,Icelandic Centre for Social Research and Analysis (ICSRA), Reykjavik, Iceland ,grid.21729.3f0000000419368729Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY USA
| | - Rannveig Sigurvinsdottir
- grid.9580.40000 0004 0643 5232Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | | | | | - Catalin-Gabriel Smarandache
- grid.8194.40000 0000 9828 7548Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan Socea
- grid.8194.40000 0000 9828 7548Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Raúl A. R. C. Sousa
- Professional Association of Licensed Optometry Professionals, Linda-a-Velha, Portugal
| | - Paschalis Steiropoulos
- grid.12284.3d0000 0001 2170 8022Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, Alexandroupolis, Greece
| | - Rafael Tabarés-Seisdedos
- grid.413448.e0000 0000 9314 1427Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain ,grid.5338.d0000 0001 2173 938XDepartment of Medicine, University of Valencia, Valencia, Spain
| | - Marcos Roberto Tovani-Palone
- grid.11899.380000 0004 1937 0722Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Fimka Tozija
- grid.7858.20000 0001 0708 5391Institute of Public Health of Republic of North Macedonia, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia
| | - Sarah Van de Velde
- grid.5284.b0000 0001 0790 3681Centre for Population, Family and Health, Department of Sociology, University of Antwerp, Antwerp, Belgium
| | | | - Massimiliano Veroux
- grid.8158.40000 0004 1757 1969Department of Medical, Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Francesco S. Violante
- grid.6292.f0000 0004 1757 1758Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy ,grid.412311.4Occupational Health Unit, Sant’Orsola Malpighi Hospital, Bologna, Italy
| | - Vasiliy Vlassov
- grid.410682.90000 0004 0578 2005Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Yanzhong Wang
- grid.13097.3c0000 0001 2322 6764School of Population Health and Environmental Sciences, King’s College London, London, UK
| | - Ali Yadollahpour
- grid.11835.3e0000 0004 1936 9262Psychology Department, University of Sheffield, Sheffield, UK
| | - Sanni Yaya
- grid.28046.380000 0001 2182 2255School of International Development and Global Studies, University of Ottawa, Ottawa, ON Canada ,grid.4991.50000 0004 1936 8948The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Mikhail Sergeevich Zastrozhin
- Laboratory of Genetics and Genomics, Moscow Research and Practical Centre On Addictions, Moscow, Russia ,grid.465497.dAddictology Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Anasthasia Zastrozhina
- grid.465497.dPediatrics Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Suzanne Polinder
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marek Majdan
- grid.412903.d0000 0001 1212 1596Department of Public Health, Institute for Global Health and Epidemiology, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
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20
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Yi S, Ramachandran A, Epps L, Mayah A, Burkholder TW, Jaung MS, Haider A, Whesseh P, Shakpeh J, Enriquez K, Bills C. Emergency department antimicrobial use in a low-resource setting: results from a retrospective observational study at a referral hospital in Liberia. BMJ Open 2022; 12:e056709. [PMID: 35437249 PMCID: PMC9016394 DOI: 10.1136/bmjopen-2021-056709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Data on antimicrobial use in low-income and middle-income countries (LMICs) remain limited. In Liberia, the absence of local data impedes surveillance and may lead to suboptimal treatment, injudicious use and resistance against antimicrobials. This study aims to examine antimicrobial prescribing patterns for patients in the emergency department (ED) of a large Liberian public hospital. Secondarily, this prescribing was compared with WHO prescribing indicators. DESIGN Retrospective observational study. SETTING An adult ED of a large public hospital in Monrovia, Liberia. PARTICIPANTS A total of 1082 adult patients (>18 years of age) were recorded in the ED, from 1 January to 30 June 2019. MAIN OUTCOME MEASURES Number, type and name of antimicrobials ordered per patient were presented as number and percentages, with comparison to known WHO prescribing indicators. Pearson χ2 tests were used to assess patient variables and trends in medication use. RESULTS Of the total patients, 44.0% (n=476) were female and the mean age was 40.2 years (SD=17.4). An average of 2.78 (SD=2.02) medicines were prescribed per patient encounter. At least one antimicrobial was ordered for 64.5% encounters (n=713) and two or more antimicrobials for 35.7% (n=386). All antimicrobial orders in our sample used the generic name. Ceftriaxone, metronidazole and ampicillin were the most common and accounted for 61.2% (n=743) of antimicrobial prescriptions. The majority (99.9%, n=1211) of antimicrobials prescribed were from the WHO Essential Drugs List. CONCLUSION This study is one of the first on ED-specific antimicrobial use in LMICs. We revealed a high rate of antimicrobial prescription, regardless of patient demographic or diagnosis. While empiric antimicrobial use is justified in certain acute clinical scenarios, the high rate from this setting warrants further investigation. The results of this study underscore the importance of ED surveillance to develop targeted antimicrobial stewardship interventions and improve patient care.
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Affiliation(s)
- Sojung Yi
- Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA
| | - Anu Ramachandran
- Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA
| | - Lane Epps
- Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA
| | - Alex Mayah
- Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA
| | - Taylor W Burkholder
- Department of Emergency Medicine, University of Southern California, Los Angeles, California, USA
| | - Michael Senyu Jaung
- Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Ahson Haider
- San Francisco State University, San Francisco, California, USA
| | | | | | - Kayla Enriquez
- Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA
| | - Corey Bills
- Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USA
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21
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Cai Z, Chen M, Ye P, Yip PSF. Socio-economic determinants of suicide rates in transforming China: A spatial-temporal analysis from 1990 to 2015. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 19:100341. [PMID: 35024666 PMCID: PMC8671725 DOI: 10.1016/j.lanwpc.2021.100341] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background China has experienced dramatic social changes in the last three decades. This study aimed to investigate socio-economic factors related to suicide rates in China from 1990 to 2015, and examine how the impacts of these factors on suicide rates changed over time. Methods Suicide rates in 31 provinces in mainland China between 1990 and 2015 were obtained from the Global Burden of Disease (GBD) Study 2019. Temporal-spatial modelling was applied to assess the effects of GDP per capita, urbanization, migration, employment, divorce, proportions of children and older adults on provincial overall, male and female suicide rates. Findings The overall suicide rate in China declined from 18·1 /100,000 in 1990 to 8·6 /100,000 in 2015, with considerable spatial variation in the magnitude of decline across provinces. The protective effects of increasing in GDP per capita, and urbanization, on provincial suicide rate were strong in 1990 (log GDP: -3·56 [95% CI: -6·15, -0·96], urbanisation: -0·07 [-0·14, -0·01]), however these effects were negligible by 2015. The association between employment and suicide rates has shifted from positive to negative over the study period, while migration remained a constant risk factor for high suicide rates (0·04 [0.00, 0·09]). Interpretation This study highlighted the dynamic effects of economic and social factors on suicide rates in the context of transforming China. To maintain further reductions in suicide rates cannot rely simply on improving people's materialistic and economic conditions. A more holistic approach to improve overall population well-being is needed. Funding Humanities and Social Sciences Prestigious Fellowship (37000320) and the General Research Fund (17611619) at the University of Hong Kong.
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Affiliation(s)
- Ziyi Cai
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
| | - Mengni Chen
- Department of Sociology, University of Copenhagen, Denmark
| | - Pengpeng Ye
- National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Paul S F Yip
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China.,Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
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22
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Nardi PCC, Ribeiro EMS, Bueno JLO, Aggarwal I. The Influence of Cognitive Biases and Financial Factors on Forecast Accuracy of Analysts. Front Psychol 2022; 12:773894. [PMID: 35058844 PMCID: PMC8764190 DOI: 10.3389/fpsyg.2021.773894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/22/2021] [Indexed: 11/21/2022] Open
Abstract
The objective of this study was to jointly analyze the importance of cognitive and financial factors in the accuracy of profit forecasting by analysts. Data from publicly traded Brazilian companies in 2019 were obtained. We used text analysis to assess the cognitive biases from the qualitative reports of analysts. Further, we analyzed the data using statistical regression learning methods and statistical classification learning methods, such as Multiple Linear Regression (MRL), k-dependence Bayesian (k-DB), and Random Forest (RF). The Bayesian inference and classification methods allow an expansion of the research line, especially in the area of machine learning, which can benefit from the examples of factors addressed in this research. The results indicated that, among cognitive biases, optimism had a negative relationship with forecasting accuracy while anchoring bias had a positive relationship. Commonality, to a lesser extent, also had a positive relationship with the analyst's accuracy. Among financial factors, the most important aspects in the accuracy of analysts were volatility, indebtedness, and profitability. Age of the company, fair value, American Depositary Receipts (ADRs), performance, and loss were still important but on a smaller scale. The results of the RF models showed a greater explanatory power. This research sheds light on the cognitive as well as financial aspects that influence the analyst's accuracy, jointly using text analysis and machine learning methods, capable of improving the explanatory power of predictive models, together with the use of training models followed by testing.
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Affiliation(s)
- Paula Carolina Ciampaglia Nardi
- Accounting Department, School of Economics, Business Administration and Accounting, University of São Paulo, USP, Ribeirão Preto, Brazil
| | - Evandro Marcos Saidel Ribeiro
- Administration Department, School of Economics, Business Administration and Accounting, University of São Paulo, USP, Ribeirão Preto, Brazil
| | - José Lino Oliveira Bueno
- Department of Psychology, School of Philosophy, Science and Letters, University of São Paulo, USP, Ribeirão Preto, Brazil
| | - Ishani Aggarwal
- Brazilian School of Public and Business Administration, FGV, Rio de Janeiro, Brazil
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23
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Singh SP, Varghese KJ, Qureshi FM. Commentary: Meta-Analysis of 3D Printing Applications in Traumatic Fractures. Front Surg 2021; 8:783743. [PMID: 34859045 PMCID: PMC8631868 DOI: 10.3389/fsurg.2021.783743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 10/20/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- Som P Singh
- Department of Biomedical Sciences, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States
| | - Kevin J Varghese
- Department of Biomedical Sciences, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States
| | - Fahad M Qureshi
- Department of Biomedical Sciences, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States
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24
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Ye P, Er Y, Wang H, Fang L, Li B, Ivers R, Keay L, Duan L, Tian M. Burden of falls among people aged 60 years and older in mainland China, 1990-2019: findings from the Global Burden of Disease Study 2019. Lancet Public Health 2021; 6:e907-e918. [PMID: 34838197 PMCID: PMC8646839 DOI: 10.1016/s2468-2667(21)00231-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Falls in older people have become a major public health concern worldwide, but a comprehensive assessment of the burden of falls for older people in mainland China has not been done. We aimed to investigate the burden of falls among older people at the national and subnational level in mainland China, and explore the trends from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHOD Using data from GBD 2019, we estimated the burden of falls among people aged 60 years and older by sex and age group in terms of incidence, mortality, and disability-adjusted life-year (DALY) rates and assessed these indicators at the subnational level in 31 geographical units (hereafter called provinces). We investigated the overall trend in the burden of falls across these 31 provinces from 1990 to 2019, and assessed the change in the burden of falls by sex, age group (60-64, 65-69, 70-74, 75-79, and ≥80 years), and province between 1990 and 2019. FINDINGS In 2019, in mainland China, the incidence rate of falls among people aged 60 years and older was 3799·4 (95% uncertainty interval [UI] 3062·4-4645·0) new falls per 100 000 population, and 39·2 deaths (21·8-48·8) per 100 000 population and 1238·9 DALYs (920·5-1553·2) per 100 000 population were due to falls. We found no significant difference in the burden of falls between males and females. The incidence, mortality, and DALY rates of falls for people aged 80 years and older were significantly higher than those in the other age groups, except for incidence rate, which was non-significantly different between the age 75-79 years group and the oldest age group. Large variations in the incidence and DALY rates of falls were observed across 31 provinces. Although between 1990 and 2019 we found no significant changes in overall mortality due to falls in all provinces and in DALY rates for 23 provinces (DALY rates significantly decreased in two provinces and increased in six provinces), we found large increases in the incidence rate of falls in both males (percentage change between 1990 and 2019: 82·9% [67·4-100]) and females (77·0% [63·3-91·8]). The percentage change in incidence rate of falls between 1990 and 2019 varied from 50·0% (42·2-59·5) for people aged 60-64 years to 123·8% (105·4-141·9) for people aged 80 years and older. All provinces had significant increases in the incidence rate of falls between 1990 and 2019, with Sichuan having the greatest increase (148·5% [125·5-171·4]) and Jilin the smallest increase (14·7% [3·6-26·1]). INTERPRETATION Between 1990 and 2019, the incidence rate of falls increased substantially in older adults across mainland China, whereas the rates of mortality and DALY of falls among older people remained relatively stable, suggesting improvements in outcomes of falls. Nevertheless, falls remain an ongoing health burden for older people in mainland China, and there is an urgent need to introduce system-wide, integrated, and cost-effective measures to protect and support older people to minimise their risks and combat an increasing absolute burden as the population continues ageing. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Pengpeng Ye
- The George Institute for Global Health, UNSW Sydney, Sydney, NSW, Australia; National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Yuliang Er
- National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Haidong Wang
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Lijie Fang
- School of Sociology and Population Studies, Renmin University of China, Beijing, China
| | - Bingqin Li
- Faculty of Medicine and Health and Social Policy Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Rebecca Ivers
- The George Institute for Global Health, UNSW Sydney, Sydney, NSW, Australia; School of Population Health, UNSW Sydney, Sydney, NSW, Australia
| | - Lisa Keay
- The George Institute for Global Health, UNSW Sydney, Sydney, NSW, Australia; School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
| | - Leilei Duan
- National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Maoyi Tian
- The George Institute for Global Health, UNSW Sydney, Sydney, NSW, Australia; The George Institute for Global Health at Peking University Health Science Centre, Beijing, China; School of Public Health, Harbin Medical University, Harbin, China.
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25
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Borges G, García-Pacheco JÁ, Familiar-Lopez I. Global estimates of the attributable risk of alcohol consumption on road injuries. Alcohol Clin Exp Res 2021; 45:2080-2089. [PMID: 34748239 DOI: 10.1111/acer.14689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/19/2021] [Accepted: 07/29/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Alcohol consumption is one of the main risk factors for death by road injuries, but little is known about the global distribution of the population-attributable risk (PAR) of alcohol use for death by road injuries. METHODS We used publicly available data from the 2019 Global Burden of Disease Study (GBD) to estimate the PAR of alcohol use for 5 types of road injury, globally and individually for available countries, by socio-demographic index (SDI), and by age, sex, and year from 1990 to 2019. RESULTS 6.6% of all road injuries in 2019 were attributable to alcohol consumption, with large variations worldwide; the highest burden was in Europe and among countries classified in the high-middle SDI. PAR was higher in men than in women, and among younger individuals. Important variations in PAR of alcohol were also observed by road injury type, with motorcyclist road injuries having the highest PAR. Overall, PAR showed a small increase during 1990-2019; younger (<39 years old) men showed an increasing trend during this period, while older women had a decreasing trend in PAR. CONCLUSIONS PAR for alcohol and road injuries is not homogenous. Large PAR for alcohol and road deaths was found in Europe, among men, young adults, and motorcyclists. These results could help public health agencies, law enforcement, and the public guide efforts to reduce these deaths.
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Affiliation(s)
- Guilherme Borges
- Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Ciudad de México, Mexico
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26
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Yang S, Lin H, Luo C. Meta-Analysis of 3D Printing Applications in Traumatic Fractures. Front Surg 2021; 8:696391. [PMID: 34532337 PMCID: PMC8439573 DOI: 10.3389/fsurg.2021.696391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/27/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Traumatic fracture is a common orthopaedic disease, and application of 3D printing technology in fracture treatment, which entails utilisation of pre-operative printed anatomic fracture model, is increasingly gaining popularity. However, effectiveness of 3D printing-assisted surgery lacks evidence-based findings to support its application. Materials and Methods: Embase, PubMed and Cochrane Library databases were systematically searched until October, 2020 to identify relevant studies. All randomised controlled trials (RCTs) comparing efficacy of 3D printing-assisted surgery vs. conventional surgery for traumatic fractures were reviewed. RevMan V.5.3 software was used to conduct meta-analysis. Results: A total of 12 RCTs involving 641 patients were included. Pooled findings showed that 3D printing-assisted surgery had shorter operation duration [standardised mean difference (SMD) = −1.52, 95% confidence interval (CI) – 1.70 ~ −1.34, P < 0.00001], less intraoperative blood loss (SMD = 1.34, 95% CI 1.74 ~ 0.94, P < 0.00001), fewer intraoperative fluoroscopies (SMD = 1.25, 95% CI 1.64 ~ 0.87, P < 0.00001), shorter fracture union time (SMD = −0.15, 95% CI −0.25 ~ −0.05, P = 0.003), and higher rate of excellent outcomes (OR = 2.40, 95% CI 1.07 ~ 5.37, P = 0.03) compared with conventional surgery. No significant differences in complication rates were observed between the two types of surgery (OR = 0.69, 95% CI 0.69 ~ 1.42, P = 0.32). Conclusions: Indicators including operation duration, intraoperative blood loss, number of intraoperative fluoroscopies, fracture union time, and rates of excellent outcomes showed that 3D printing-assisted surgery is a superior alternative in treatment of traumatic fractures compared with conventional surgery. Moreover, the current study did not report significant differences in incidence of complications between the two approaches. Systematic Review Registration: CRD42021239507.
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Affiliation(s)
- Sha Yang
- Department of Orthopaedics, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Engineering Research Center of Stem Cell Therapy, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Huapeng Lin
- Department of Intensive Care Unit, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Cong Luo
- Department of Orthopaedics, Children's Hospital of Chongqing Medical University, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Engineering Research Center of Stem Cell Therapy, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
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27
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The global burden of fractures. THE LANCET HEALTHY LONGEVITY 2021; 2:e535-e536. [DOI: 10.1016/s2666-7568(21)00183-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 12/25/2022]
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28
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Wu AM, Bisignano C, James SL, Abady GG, Abedi A, Abu-Gharbieh E, Alhassan RK, Alipour V, Arabloo J, Asaad M, Asmare WN, Awedew AF, Banach M, Banerjee SK, Bijani A, Birhanu TTM, Bolla SR, Cámera LA, Chang JC, Cho DY, Chung MT, Couto RAS, Dai X, Dandona L, Dandona R, Farzadfar F, Filip I, Fischer F, Fomenkov AA, Gill TK, Gupta B, Haagsma JA, Haj-Mirzaian A, Hamidi S, Hay SI, Ilic IM, Ilic MD, Ivers RQ, Jürisson M, Kalhor R, Kanchan T, Kavetskyy T, Khalilov R, Khan EA, Khan M, Kneib CJ, Krishnamoorthy V, Kumar GA, Kumar N, Lalloo R, Lasrado S, Lim SS, Liu Z, Manafi A, Manafi N, Menezes RG, Meretoja TJ, Miazgowski B, Miller TR, Mohammad Y, Mohammadian-Hafshejani A, Mokdad AH, Murray CJL, Naderi M, Naimzada MD, Nayak VC, Nguyen CT, Nikbakhsh R, Olagunju AT, Otstavnov N, Otstavnov SS, Padubidri JR, Pereira J, Pham HQ, Pinheiro M, Polinder S, Pourchamani H, Rabiee N, Radfar A, Rahman MHU, Rawaf DL, Rawaf S, Saeb MR, Samy AM, Sanchez Riera L, Schwebel DC, Shahabi S, Shaikh MA, Soheili A, Tabarés-Seisdedos R, Tovani-Palone MR, Tran BX, Travillian RS, Valdez PR, Vasankari TJ, Velazquez DZ, Venketasubramanian N, Vu GT, Zhang ZJ, Vos T. Global, regional, and national burden of bone fractures in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. THE LANCET. HEALTHY LONGEVITY 2021; 2:e580-e592. [PMID: 34723233 PMCID: PMC8547262 DOI: 10.1016/s2666-7568(21)00172-0] [Citation(s) in RCA: 243] [Impact Index Per Article: 81.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Bone fractures are a global public health issue; however, to date, no comprehensive study of their incidence and burden has been done. We aimed to measure the global, regional, and national incidence, prevalence, and years lived with disability (YLDs) of fractures from 1990 to 2019. METHODS Using the framework of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we compared numbers and age-standardised rates of global incidence, prevalence, and YLDs of fractures across the 21 GBD regions and 204 countries and territories, by age, sex, and year, from 1990 to 2019. We report estimates with 95% uncertainty intervals (UIs). FINDINGS Globally, in 2019, there were 178 million (95% UI 162-196) new fractures (an increase of 33·4% [30·1-37·0] since 1990), 455 million (428-484) prevalent cases of acute or long-term symptoms of a fracture (an increase of 70·1% [67·5-72·5] since 1990), and 25·8 million (17·8-35·8) YLDs (an increase of 65·3% [62·4-68·0] since 1990). The age-standardised rates of fractures in 2019 were 2296·2 incident cases (2091·1-2529·5) per 100 000 population (a decrease of 9·6% [8·1-11·1] since 1990), 5614·3 prevalent cases (5286·1-5977·5) per 100 000 population (a decrease of 6·7% [5·7-7·6] since 1990), and 319·0 YLDs (220·1-442·5) per 100 000 population (a decrease of 8·4% [7·2-9·5] since 1990). Lower leg fractures of the patella, tibia or fibula, or ankle were the most common and burdensome fracture in 2019, with an age-standardised incidence rate of 419·9 cases (345·8-512·0) per 100 000 population and an age-standardised rate of YLDs of 190·4 (125·0-276·9) per 100 000 population. In 2019, age-specific rates of fracture incidence were highest in the oldest age groups, with, for instance, 15 381·5 incident cases (11 245·3-20 651·9) per 100 000 population in those aged 95 years and older. INTERPRETATION The global age-standardised rates of incidence, prevalence, and YLDs for fractures decreased slightly from 1990 to 2019, but the absolute counts increased substantially. Older people have a particularly high risk of fractures, and more widespread injury-prevention efforts and access to screening and treatment of osteoporosis for older individuals should help to reduce the overall burden. FUNDING Bill & Melinda Gates Foundation.
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Dzobo K. What to Do for Increasing Cancer Burden on the African Continent? Accelerating Public Health Diagnostics Innovation for Prevention and Early Intervention on Cancers. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2021; 25:567-579. [PMID: 34399067 DOI: 10.1089/omi.2021.0098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
No other place illustrates the increasing burden of cancer than in Africa and in particular, sub-Saharan Africa. Many of the individuals to be diagnosed with cancer will be in low-resource settings in the future due to, for example, an increase in populations and aging, and high co-morbidity with infections with viruses such as human immunodeficiency virus (HIV) and human papillomavirus (HPV), as well as the presence of infectious agents linked to cancer development. Due to lack of prevention and diagnostic innovation, patients present with advanced cancers, leading to poor survival and increased mortality. HIV infection-associated cancers such as B cell lymphomas, Kaposi's sarcoma, and HPV-associated cancers such as cervical cancer are particularly noteworthy in this context. Recent reports show that a host of other cancers are also associated with viral infection and these include lung, oral cavity, esophageal, and pharyngeal, hepatocellular carcinoma, and anal and vulvar cancers. This article examines the ways in which diagnostic innovation empowered by integrative biology and informed by public health priorities can improve cancer prevention or early intervention in Africa and beyond. In addition, I argue that because diagnostic biomarkers can often overlap with novel therapeutic targets, diagnostics research and development can have broader value for and impact on medical innovation.
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Affiliation(s)
- Kevin Dzobo
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town Component, Cape Town, South Africa.,Institute of Infectious Disease and Molecular Medicine, Division of Medical Biochemistry, Department of Integrative Biomedical Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Detecting subtle mobility changes among older adults: the Quantitative Timed Up and Go test. Aging Clin Exp Res 2021; 33:2157-2164. [PMID: 33098079 DOI: 10.1007/s40520-020-01733-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/01/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The Quantitative Timed Up and Go (QTUG) test uses wearable sensors, containing a triaxial accelerometer and an add-on triaxial gyroscope, to quantify performance during the TUG test with potential to capture more minor changes in mobility. AIMS To examine the responsiveness, minimum detectable change (MDC) and observed effect size of QTUG in a cohort of socially active adults aged 50 years and over participating in a structured community exercise program. METHODS 54 participants (91% females, mean age 63.6 ± 6.5 years) completed repeated QTUG testing under single- and dual-task conditions. Responsiveness of the QTUG was assessed by correlation of change in standard TUG with QTUG change (Pearson's correlation coefficient). MDC and effect sizes (standardized mean difference and Cohen's d) were also calculated for QTUG. RESULTS There was a strong positive correlation between change in the standard TUG and change in QTUG (single task r = 0.91, p < 0.001). MDC in QTUG was calculated as 0.77 (Sd, 1.39; ICC 0.96) seconds (single task) and 2.33 (Sd 2.18; ICC 0.85) seconds (dual task). Several QTUG parameters showed improvements in mean values with small effect sizes (sit -to-stand transition time d = 0.418; walk time d = 0.398; cadence d = 0.306, swing time d = 0.314; step time d = 0.479; gait velocity d = 0.365; time to reach turn d = 0.322) under single-task conditions and with a moderate effect size (d = 0.549) in time taken to turn under the dual-task condition. CONCLUSION Initial evidence of QTUG's responsiveness to change in mobility in active middle to older age adults has been demonstrated with small to moderate effect sizes observed in specific QTUG parameters.
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