The comparative burden of brain and central nervous system cancers from 1990 to 2019 between China and the United States and predicting the future burden

Comparison of different new ultrasonic technologies in resection assessment of neurosurgery

Background

New ultrasound (US) techniques, such as contrast-enhanced ultrasound (CEUS) and shear wave elastography (SWE), are being used to identify artifacts, guide the interventions and evaluate the extent of resection, as it is difficult for gray-scale ultrasound to distinguish the artifacts in intraoperative ultrasound (IOUS). However, to date, no comparative study has been conducted on the role of several new US technologies in guiding brain tumor resection. Thus, this study sought to compare the roles of various new US technologies in guiding brain tumor resection to find a convenient and useful guiding technology for brain tumor resection.

Methods

From July 2022 to July 2023, 64 brain tumor patients (33 men and 31 women), with ages ranging from 26 to 78 years (53.2±11.6 years), were included in the study. Before surgery, a planned resection (pRS) was determined for all of the included patients by a multidisciplinary neuro-oncology team. All patients underwent microsurgical resection of the lesion. After the craniotomy and before the dural opening, ultrasonic techniques, including B-mode, micro-flow imaging (MFI), CEUS, and SWE, were used to evaluate the features of the brain tumor and its surrounding structure. Then, those ultrasonic techniques were applied to each patient to confirm the microsurgical margin achieving the pRS at the end of the resection. Next, 3 days after surgery, a magnetic resonance imaging (MRI) scan was performed on each patient as the reference standard. The agreement between B-mode, color Doppler flow imaging (CDFI), MFI, CEUS, SWE, and MRI was measured by Fleiss' kappa agreement.

Results

In the evaluation of the surgical resection edges, all the included US technologies showed substantial agreement compared to the MRI results. The Kappa values were 0.717, 0.751, 0.714, and 0.892 for B-mode, MFI, SWE, and CEUS, respectively. CEUS and MRI showed the best diagnostic consistency. CEUS had the highest sensitivity, specificity, positive predictive value, and negative predictive value under the receiver operating characteristic (ROC) curve analysis (77.78%, 100%, 100%, and 86.05%, respectively), followed by MFI. B-mode and SWE showed similar accuracy in detecting tumor residue.

Conclusions

US is a convenient and cost-effective method for guiding the procedure and evaluating the extent of resection in neurosurgery. CEUS has the highest diagnostic accuracy for residual lesions among the new US technologies. Thus, MFI can be recommended as a technique for guiding and evaluating residues in neurosurgery in addition to CEUS.

A GBD 2021 study of Alzheimer's disease and other dementias attributable to metabolic risk factors and forecasts to 2045 in China

Background and aims

High fasting plasma glucose (FPG) and body mass index (BMI) are recognized as significant metabolic risk factors for Alzheimer's disease (AD) and other dementias. This study assesses the burden of AD and other dementias attributable to these risks in China using Global Burden of Disease (GBD) 2021 data.

Methods

We estimated deaths, disability-adjusted life-years (DALYs), years lived with disability (YLDs), and age-standardized rates of mortality (ASMR), DALYs (ASDR), and YLDs (ASYR) by age and sex. Temporal trends were analyzed via the average annual percentage change (AAPC), and Bayesian age-period-cohort (BAPC) models were applied to evaluate the effects of age, period, and cohort.

Results

In 2021, China recorded 76,239.36 deaths (95% UI: 2,528.26-259,225.86) from AD and other dementias due to metabolic risks, a 4.7-fold increase from 1990. Females experienced more metabolic risk-related deaths [51,844.08 (95% UI, 1,457.44, 177,037.05)] than males. The ASMR, ASDR, and ASYR showed continuous increases from 1990 to 2021, with AAPC values of 1.03, 1.31, and 1.98%, respectively. A significant increasing trend was observed across age groups from 40 to 95 years, with percentages above 0. Females presented relatively higher risks than males after 1997-2001 and within the birth cohort groups of 1957-1966. The disease burden due to HBMI is expected to rise, while that due to HFPG will decline, notable sex will persist until 2045.

Conclusion

Monitoring trends is crucial for interventions to reduce the future disease burden, particularly among women and older populations in China, to guide healthcare resource allocation effectively.

Comparison analysis of the burden and attributable risk factors of early-onset and late-onset colorectal cancer in China from 1990 to 2019

OBJECTIVES

The project intended to analyze the impact of burden and related risk factors of late-onset colorectal cancer (LOCRC) and early-onset colorectal cancer (EOCRC) in China, thus offering essential references for optimizing prevention and control strategies.

METHOD

Global Burden of Disease Study was employed to describe burden changes of EOCRC and LOCRC in China during 1990-2019, containing the numbers of incidence, deaths, prevalence, and disability-adjusted life years (DALYs), and to compare attributable deaths and DALYs risk factors in varying age and sex segments.

RESULTS

The numbers and corresponding crude rates of incidence, deaths, prevalence, and DALYs of EOCRC and LOCRC in China during 1990-2019 demonstrated an upward trend across all age categories, with males being dramatically predominant. Overall, over time, the impact of a low-calcium diet and a low-fiber diet on mortality and DALY rates decreased, while the impact of other risk factors increased. In terms of gender, the risk factors affecting males changed greatly, with smoking, inadequate milk intake, and the low whole-grain diet being the main factors in 2019, while in 1990, the main factors were the low-calcium diet, smoking, and inadequate milk intake.

CONCLUSION

The burden of colorectal cancer in China is concerning. Patients grouped by diagnostic age exhibit different characteristics, indicating the need for high-quality research in the future to achieve personalized medicine tailored to different population characteristics.

The global burden, trends, and inequalities of individuals with developmental and intellectual disabilities attributable to iodine deficiency from 1990 to 2019 and its prediction up to 2030

Objective

The objective of this study was to assess the global burden of disease for developmental and intellectual disabilities caused by iodine deficiency from 1990 to 2019.

Methods

Using data from the global burden of disease (GBD) 2019, we conducted a cross-country inequity analysis to examine the worldwide burden of developmental and intellectual disabilities caused by the issue of iodine deficiency from 1990 to 2019. Absolute and relative inequality were assessed by the slope index of inequality and the concentration index, respectively. After summarising the latest evidence, we also projected the age-standardized prevalence and years lived with disability (YLD) rates up to 2030 using the BAPC and INLA packages in R statistical software.

Results

In 2019, the global age-standardized prevalence and YLD rates for developmental and intellectual disabilities due to iodine deficiency were 22.54 per 100,000 population (95% UI 14.47 to 29.23) and 4.12 per 100,000 population (95% UI 2.25 to 6.4), respectively. From 1990 to 2019, the age-standardized prevalence and YLD rates of developmental and intellectual disabilities due to iodine deficiency decreased significantly. Geographic distribution showed that areas with lower socio-demographic indices (SDI) were the most affected. The correlation between higher SDI and lower prevalence highlights the role of economic and social factors in the prevalence of the disease. Cross-national inequity analysis shows that disparities persist despite improvements in health inequalities. In addition, projections suggest that the disease burden may decline until 2030.

Conclusion

This research underscores the necessity for targeted interventions, such as enhancing iodine supplementation and nutritional education, especially in areas with lower SDI. We aim to provide a foundation for policymakers further to research effective preventative and potential alternative treatment strategies.

Global spatiotemporal distributions of lymphoma from 1990 to 2019: A Joinpoint regression analysis based on the global burden of disease study 2019, and projections until 2044

Lymphoma is a dissimilar collection of malignant neoplasms arising from the clonal propagation of lymphocytes. It is conventionally classified into two categories: Hodgkin lymphoma and non-Hodgkin lymphoma. The purpose of this study is to analyze the temporal patterns in the incidence of lymphoma worldwide over the past few decades and forecast the future trends from 2020 to 2044. Data on HL and NHL were obtained from the Global Burden of Disease Study 2019. In an effort to estimate the incidence rate trend, the Joinpoint regression analysis model was exploited. What's more, to project the disease burden by 2044, the Bayesian age-period-cohort analysis was employed. In 2019, higher incidence rates were observed in males and the elderly for both subtypes. Over the last three decades, a significant decline in the age-standardized incidence rate of HL was observed, while NHL has shown an increasing trend. By 2044, the age-standardized incidence rate of HL is anticipated to decrease in males and increase in females, while that of NHL is expected to rise. This study presents a new assessment of the spatiotemporal distributions of lymphoma. Significant emphasis should be placed on the effective management and long-term monitoring of patients to mitigate the potential future impact of the disease.

Type 1 and type 2 diabetes mortality burden: Predictions for 2030 based on Bayesian age-period-cohort analysis of China and global mortality burden from 1990 to 2019

AIMS

This study assessed diabetes (type 1 and type 2) mortality in China and globally from 1990 to 2019, predicting the next decade's trends.

MATERIALS AND METHODS

Data came from the Global Burden of Disease (GBD) database. The annual percentage change (AAPC) in age-standardized mortality rates (ASMR) for diabetes (type 1 and type 2) during 1990-2019 was calculated. A Bayesian age-period-cohort (BAPC) model predicted diabetes (type 1 and type 2) mortality from 2020 to 2030.

RESULTS

In China, type 1 diabetes deaths declined from 6,005 to 4,504 cases (AAPC -2.827), while type 2 diabetes deaths rose from 64,084 to 168,388 cases (AAPC -0.763) from 1990 to 2019. Globally, type 1 diabetes deaths increased from 55,417 to 78,236 cases (AAPC 0.223), and type 2 diabetes deaths increased from 606,407 to 1,472,934 cases (AAPC 0.365). Both China and global trends showed declining type 1 diabetes ASMR. However, female type 2 diabetes ASMR in China initially increased and then decreased, while males had a rebound trend. Peak type 1 diabetes deaths were in the 40-44 age group, and type 2 diabetes peaked in those over 70. BAPC predicted declining diabetes (type 1 and type 2) mortality burden in China and globally over the next 10 years.

CONCLUSIONS

Type 2 diabetes mortality remained high in China and globally despite decreasing type 1 diabetes mortality over 30 years. Predictions suggest a gradual decrease in diabetes mortality over the next decade, highlighting the need for continued focus on type 2 diabetes prevention and treatment.

Diagnostic Accuracy of Intraoperative Brain Smear: A Meta-Analysis of Studies from Resource-Limited Settings

BACKGROUND

Intraoperative brain smear is an easy, rapid, and cost-effective technique for immediate diagnosis of brain tumors. Earlier studies have gauged its application on limited number of samples, but its diagnostic accuracy especially in low-resource settings, where its practice would be extremely helpful, is still undetermined. To investigate the diagnostic accuracy of intraoperative brain smear in resource-limited settings for diagnosis of brain tumors.

METHODS

A systematic search was conducted on PubMed, Google Scholar, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Embase for all articles utilizing intraoperative brain smears that were extracted. Studies from low- and middle-income countries (LMICs) with test performance characteristics were selected and subsequent values were summarized using a hierarchical summary receiver operating characteristic (ROC) curve via STATA and pooled using a random-effects model on MetaDiSc 2.0.

RESULTS

Twelve studies consisting of 1124 patients were identified. Six studies included both adult and pediatric population groups, while 4 investigated adults and 2 included pediatric patients. The pooled diagnostic odds ratio (OR) was calculated to be 212.52 (CI: [104.27-433.13]) of Bivariable pooled specificity and sensitivity were 92% (CI: [86%-96%]) and 96% (CI: [93%-98%]), respectively.

CONCLUSIONS

Our study shows that intraoperative brain smear is not only an accurate and sensitive diagnostic modality in resource-rich settings, but it is also equally useful in resource-limited settings, making it an ideal method for rapid diagnosis.

Increasing Burden of Osteoarthritis in China: Trends and Projections from the Global Burden of Disease Study 2019

BACKGROUND This study aimed to evaluate the epidemiology of osteoarthritis in China in a comprehensive and reliable way, to project its future epidemiological patterns, and to mitigate its health hazards. MATERIAL AND METHODS Data were extracted and analyzed from the Global Burden of Diseases Study 2019. Trends in osteoarthritis epidemiology were explored using joinpoint regression analysis. Additionally, we analyzed dynamic trends using the sociodemographic index (SDI) of China. To assess and predict the epidemiology of osteoarthritis from 2020 to 2039, we used both the Bayesian age-period-cohort model and Nordpred model. RESULTS The number of prevalent cases, incident cases, and years lived with disability (YLDs) for osteoarthritis in China increased from 51.8, 4.6, and 1.8 million, respectively, in 1990, to 132.8, 10.7, and 4.7 million, respectively, in 2019, and the average annual percentage changes were 3.286, 2.938, and 3.324, respectively. The prevalence and YLDs peaked in the population aged over 90 years old, while the incidence peaked in the population aged around 50 years old. A significant positive correlation was found between osteoarthritis burden and SDI. Osteoarthritis burden is expected to continue to increase. In the population studied here, it was higher in women than in men, but this may invert by 2039. CONCLUSIONS The prevalence, incidence, and YLDs of osteoarthritis had significantly increased and may continue to increase during the next 2 decades. Prevention and treatment strategies should target women, middle-aged individuals, and the elderly.

National situation, trends, and predictions of disease burden of atopic dermatitis in Chinese children and adolescents

Background

Atopic dermatitis (AD) is an important global health problem affecting children and adolescents and detailed national information of disease burden in China is lacking. We aimed to evaluate the national disease burden of AD in Chinese children and adolescent, to provide the temporal trends over the past 30 years and to predict the burden for the next 10 years.

Methods

The data of AD in China, including incidence, prevalence, and DALY, and population data were obtained from the Global Burden of Disease Study 2019 (GBD study 2019), which were estimated using the DisMod-MR 2.1. We analyzed the three measures by age and sex; the age groups were <5 years, 5-9 years, 10-14 years, and 15-19 years. The joinpoint regression analyses was conducted to assess the temporal trends from 1990 to 2019. The Bayesian age-period cohort (BAPC) model was used to predict measures from 2020 to 2030.

Results

In 2019, the highest incidence case and rate were observed in <5 years group; for prevalence and disability adjusted life year (DALY), the groups of <5 years and 5-9 years showed similar higher levels and the groups of 10-14 years and 15-19 years had similar relatively lower levels. Overall, the male-to-female ratios were >1 in <5 years group and <1 in 10-14 and 15-19 age groups. The trend analyses found an overall trend of decrease in cases of the three measures; in recent about 3 years, slight increase trends were shown in cases and rates of the three measures in <5 years group. The prediction analyses found a slight decreasing trend for cases of these measures and a slight increasing trend for rates of these measures in the <5 years group in the next 10 years; the 5-9 years group was predicted to increase slightly in rates of the three measures.

Conclusion

In conclusion, the groups of <5 years and 5-9 years are two important populations that need targeted measures to reduce disease burden of AD in China. Regarding sex disparity, we should pay more attention to males in <5 years group and to females in 10-19 years group.