Search

A bibliometric analysis (BA) is a knowledge synthesis methodology aimed at quantitively summarizing large amounts of bibliometric data. We aimed to summarize the performance of BAs in the health sciences. We searched Scopus for BAs in the health sciences published prior to May 10, 2023. All identified studies were included. We performed a BA on these studies in two steps: performance analysis and science mapping. For the performance analysis, various indicators of scientific production were calculated using the bibliometrix R package. For the science mapping, VOSviewer was used to generate a co-authorship network and a keyword co-occurrence network. In total, 5,828 BAs were analyzed. Scientific production has exploded in the last years, with more than 1,500 BAs published in 2022 alone. Scientific impact (i.e. citations) has also been rising, although at a lesser pace. The mean number of citations per year per BA was 1.78. China was the most productive country, publishing more BAs than the nine other most productive countries combined. China paradoxically had a lower number of citations per publication compared with the nine other most productive countries. International collaborations were rare. Common BA themes included oncology, public health, neurosciences, mental health, artificial intelligence, and COVID-19. BAs are increasingly common in the health sciences, but their performance remains limited. More international collaborations and standardized guidelines could help improve their performance, notably the frequency at which they are cited.

Aim: Although the number of global studies on ECMO, which is an important support system in the treatment of COVID-19 related respiratory failure, has increased in recent months, there is still no bibliometric study on the use of ECMO in COVID-19 in the literature. The aim of this study is to analyze the scientific articles on the use of ECMO in COVID-19 by statistical and bibliometric methods., Method: Articles published between 2019-2022 about the use of ECMO in COVID-19 were obtained from the Web of Science (WoS) database and analyzed using statistical and bibliometric methods. Spearman correlation coefficient was used for correlation studies. Network visualization maps were used to identify effe analysis and trending topics., Results: A total of 1197 publications were found. 758 (63.3%) of these publications were articles. The top 3 contributing countries to the literature were USA (257, 33.9%), Germany (102, 13.4%) and Japan (87, 11.5%). The top 3 most active institutions were League of European Research Universities (90), Harvard University (50), and Udice French Research Universities (39). The top 3 journals with the highest count of publications were ASAIO Journal ( n = 36), Frontiers in Medicine (22), and Perfusion-UK ( n = 20). According to the average count of citations per article, the most influential journals were JAMA (1319), Intensive Care Medicine (327), and Lancet (95.7), respectively. We have shared a summary of 758 articles in this comprehensive bibliometric study on the use of ECMO in COVID-19., Conclusion: It can be said that the use of ECMO in COVID-19 has been the trending topic recently and most of the studies are from countries in the ELSO Awards of Excellence list which indicates that the follow-up of ECMO in certain centers and teams can also be influencing the publications. This article can be a useful resource for clinicians, scientists, and students concerning global output for ECMO use in COVID-19.

Podcasts and other asynchronous remote learning pedagogies have become increasingly utilized in undergraduate and graduate medical education. They offer a convenient and accessible form of education for personalized learning and have been developed across multiple disciplines of medicine. This paper discusses the current literature on medical education podcasts, offers practical examples of existing free podcast content, and offers guidance on planning, designing, and executing the creation of a new educational podcast. It discusses best practices for the engagement of learners and logistical considerations for recording and hosting the material. These Twelve Tips hope to empower educators to utilize resources across the world to offer the highest quality opportunities for learners of all levels.

Abstract Children who do not consume enough iron have decreased growth, reduced immunity, and poor cognitive development. This study aimed to assess the pooled iron-rich food consumption, trends, and predictors among children aged 6–59 months old in Ethiopia. This study used Ethiopian demographic and health survey (EDHS-2005–2016) data with a total weighted sample size of 26,773 among children aged 6–59 months old. A multilevel mixed-effects logistic regression analysis was used to identify predictors of good iron-rich food consumption. The pooled proportion of iron-rich food consumed among children aged 6–59 months in Ethiopia was 11.77% (10.71, 12.92%). In Ethiopia, the proportion of iron-rich food intake by children aged 6–59 months was slightly increased from 9.25% (8.04, 10.62%) in EDHS 2005 to 10.86% (9.06, 12.95%) in EDHS 2011, and sharply increased to 17.49% (15.04, 20.24%) in EDHS 2016. The findings indicated that being children born to mothers aged 20 to 34 years old [AOR = 0.56, 95% CI: 0.35, 0.89], mothers aged ≥ 35 years old [AOR = 0.47, 95% CI: 0.28, 0.82], married parents [AOR = 1.68, 95% CI: 1.14, 2.48], completed primary education [AOR = 1.32, 95% CI: 1.02, 1.73], secondary education [AOR = 2.66, 95% CI: 1.53, 4.59], a higher education status of mother [AOR = 3.98, 95% CI: 1.92, 8.23], medium family [AOR = 1.39, 95% CI: 1.03, 1.89], rich family [AOR = 1.45, 95% CI: 1.09, 1.95], media exposure [AOR = 1.35, 95% CI: 1.06, 1.72], residents of the Tigray [AOR = 2.69, 95% CI: 1.51, 4.79], Oromia [AOR = 3.30, 95% CI: 1.30, 4.02], Benishangul [AOR = 2.12, 95% CI: 1.15, 3.88], Gambela [AOR = 5.85, 95% CI: 2.97, 11.50], and Dire Dawa region [AOR = 3.38, 95% CI: 1.76, 6.47], were significantly associated with good iron-rich food consumption among children aged 6–59 months old. The findings revealed that iron-rich food intake was considerably low among Ethiopian children aged 6–59 months. Increasing women’s literacy and economic empowerment improves iron-rich food consumption among children aged 6–59 months old.

Abstract Racial and ethnic disparities persist in cancer survival rates across the United States, despite overall improvements. This comprehensive analysis examines trends in 5-year relative survival rates from 2002–2006 to 2015–2019 for major cancer types, elucidating differences among racial/ethnic groups to guide equitable healthcare strategies. Data from the SEER Program spanning 2000–2020 were analyzed, focusing on breast, colorectal, prostate, lung, pancreatic cancers, non-Hodgkin lymphoma, acute leukemia, and multiple myeloma. Age-standardized relative survival rates were calculated to assess racial (White, Black, American Indian/Alaska Native, Asian/Pacific Islander) and ethnic (Hispanic, Non-Hispanic) disparities, utilizing period analysis for recent estimates and excluding cases identified solely through autopsy or death certificates. While significant survival improvements were observed for most cancers, notable disparities persisted. Non-Hispanic Blacks exhibited the largest gain in breast cancer survival, with an increase of 5.2% points (from 77.6 to 82.8%); however, the survival rate remained lower than that of Non-Hispanic Whites (92.1%). Colorectal cancer survival declined overall (64.7–64.1%), marked by a 6.2% point drop for Non-Hispanic American Indian/Alaska Natives (66.3–60.1%). Prostate cancer survival declined across all races, with Non-Hispanic American Indian/Alaska Natives showing a decrease of 7.7% points (from 96.9 to 89.2%). Lung cancer, acute leukemia, and multiple myeloma showed notable increases across groups. Substantial racial/ethnic disparities in cancer survival underscore the notable need for tailored strategies ensuring equitable access to advanced treatments, particularly addressing significant trends in colorectal and pancreatic cancers among specific minority groups. Careful interpretation of statistical significance is warranted given the large dataset.

Background Ischemic heart disease (IHD) is the second leading cause of disease burden in the Chinese population, and dietary factors are considered as effective and feasible approaches to reduce the disease burden. Objective To analyze the trends in the disease burden of IHD attributable to dietary factors from 1990 to 2021 and future trends in China, aiming to provide a reference basis for dietary prevention and treatment of IHD in China. Methods Data related to the disease burden of IHD attributable to dietary factors in China, worldwide, and regions with varied socio-demographic index (SDI) from 1990 to 2021 were extracted from the Global Burden of Disease 2021 (GBD 2021) database. Using the Joinpoint model, the annual percent change (APC) and average annual percent change (AAPC) were calculated to analyze the disease burden of IHD attributable to dietary factors in China, worldwide, and regions with varied SDI. Furthermore, the model evaluated the diet-ralated disease burden by gender and age groups in China, as well as the burden of disease attributable to specific dietary factors within the Chinese population from 1990 to 2021. Additionally, the Bayesian age-period-cohort (BAPC) model was used to predict the standardized mortality rate and the standardized disability-adjusted life year (DALY) rate of IHD attributable to dietary factors from 2022 to 2031. Results In 2021, the standardized mortality rate and standardized DALY rate of IHD attributable to dietary factors in China were 44.26/100 000 and 820.87/100 000, respectively, which were close to the global levels, but higher than those of high SDI regions and lower than the remaining four categories of SDI regions. From 1990 to 2021, the standardized mortality rate (AAPC=-0.17%, P

Purpose: Although the Americas and Europe have historically dominated the global research landscape, emerging economies – Brazil, Russia, India, China, and South Africa (BRICS) have significantly increased their contributions in recent years. This article studies clinical trial trends in the BRICS nations between 2018 and 2022 and compares it with trends in the G7 nations (comprising Canada, France, Germany, Italy, Japan, the UK, the USA, and the European Union). This will help stakeholders in planning drug development strategies. Materials and Methods: Data were collected from the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and the World Bank database. An electronic search was done for the total number of trials registered between January 1, 2018, and March 15, 2023. Information was analyzed based on the year of registration, therapeutic area, type of intervention, sponsorship, and type of special population. The trial density indices (TDIs) were calculated based on population (Xi) and gross domestic product (GDP) (Yi) using author-derived formulae. Results: Altogether 2, 77, 536 trials from the BRICS and G7 were registered. China and the US had the most trials among the BRICS and G7, respectively. Between 2018 and 2022, the gap between the BRICS and G7 steadily reduced. The most common indication for clinical trials among the BRICS was cancer. Based on population, the TDI was the highest in China and the lowest in Russia. In proportion to the GDP, the TDI was maximum in Russia and minimum in India. Conclusion: There is a remarkable reduction in the gap in clinical trial trends between the BRICS and G7 nations. Among the BRICS, India and China are at the forefront in drug development. There is scope for improvement in trial density based on India’s population and GDP. Stakeholders are likely to utilize the strengths of the BRICS as an attractive destination for investment in this area.

Pediatric obesity has rapidly increased globally over the past few decades, including in Korea. We aimed to discuss trends in the prevalence of pediatric obesity and effective prevention strategies. Its prevalence has markedly increased in most high-income nations. According to recent reports, this increase has slowed in developed countries, but the levels remain alarmingly high. In Korea, the rate of pediatric obesity has surged notably since the 1990s; however, since the 2000s, this increase has become more gradual. According to recently published 2017 growth charts, the prevalence of pediatric obesity in Korea varies slightly depending on the data source. The National School Health Examination data showed that pediatric obesity gradually increase from 11.5% in 2014 to 15.1% in 2019, and after the coronavirus disease 2019 pandemic, it sharply increased to 19% in 2021. Based on data from the Korea National Health and Nutrition Examination Survey, the prevalence of pediatric obesity gradually increased from 10.8% in 2017 to 13.6% in 2019. This trend, which accelerated sharply to 15.9% in 2020 and 19.3% in 2021, was especially severe in boys and older children. Pediatric obesity not only affects health during childhood but also increases the risk of developing obesity and associated health conditions in adulthood. Despite ongoing research on treatment options, obesity prevention and control remain challenging. Hence, prioritizing early intervention and prevention of pediatric obesity through healthy eating habits and lifestyles is crucial. This requires intervention at the individual, family, school, and community levels.

Abstract The global incidence of gout has increased rapidly, likely secondary to the increase in the prevalence of conditions that predispose to gout, such as obesity. Depending on the population studied, the prevalence of gout ranges from less than 1 to 6.8%. Thus, gout can be a significant burden on healthcare systems. The objective of this study is to observe the trends in the incidence, prevalence, and disability-adjusted life years (DALYs) of gout between 1990 and 2019 globally and in the European Union (EU) 15+ nations. We extracted data from the Global Burden of Disease Study database based on the International Classification of Diseases (ICD) versions 10 and 9. Incidence, prevalence, and disability-adjusted life years (DALYs) were extracted for individual EU15+ countries and globally in males and females between 1990 and 2019. Joinpoint regression analysis was used to describe trends. Between 1990 and 2019, gout prevalence, incidence, and DALYs increased in both males (+ 21.42%, + 16.87%, + 21.49%, respectively) and females (+ 21.06%, + 18.75%, + 20.66%, respectively) globally. The United States of America had the highest increase in prevalence (males: + 90.6%; females + 47.1%), incidence (males: + 63.73%; females: + 39.11%) and DALYs (males: + 90.43%; females: + 42.75%). Incidence, prevalence, and DALYs from gout are increasing worldwide and in most of the EU15+ countries for males and females. Studies have reported the association of gout with comorbidities such as metabolic syndrome, diabetes mellitus, and cardiovascular disease. Health policies and resource allocation are required to increase awareness and modify risk factors globally.

Background: Virtual reality (VR), widely used in the medical field, may affect future medical training and treatment. Therefore, this study examined VR's potential uses and research directions in medicine. Methods: Citation data were downloaded from the Web of Science Core Collection database (WoSCC) to evaluate VR in medicine in articles published between 1 January 2012 and 31 December 2023. These data were analyzed using CiteSpace 6.2. R2 software. Present limitations and future opportunities were summarized based on the data. Results: A total of 2143 related publications from 86 countries and regions were analyzed. The country with the highest number of publications is the USA, with 461 articles. The University of London has the most publications among institutions, with 43 articles. The burst keywords represent the research frontier from 2020 to 2023, such as "task analysis", "deep learning", and "machine learning". Conclusion: The number of publications on VR applications in the medical field has been steadily increasing year by year. The USA is the leading country in this area, while the University of London stands out as the most published, and most influential institution. Currently, there is a strong focus on integrating VR and AI to address complex issues such as medical education and training, rehabilitation, and surgical navigation. Looking ahead, the future trend involves integrating VR, augmented reality (AR), and mixed reality (MR) with the Internet of Things (IoT), wireless sensor networks (WSNs), big data analysis (BDA), and cloud computing (CC) technologies to develop intelligent healthcare systems within hospitals or medical centers. [ABSTRACT FROM AUTHOR]

Abstract Background and Aims The coronavirus disease 2019 (COVID‐19) pandemic has affected the management of inflammatory bowel disease (IBD) patients. Elective operations and surveillance endoscopies were postponed for IBD patients to preserve healthcare resources and to prevent the spread of COVID‐19. This study aimed to describe the trends and outcomes of IBD surgery during the pandemic. Methods This was a retrospective propensity score‐matched analysis using data extracted from TriNetX, a multi‐institutional research database. IBD patients admitted for surgery were identified between March 2019 to February 2020 (prepandemic) and March 2020 to February 2023 (pandemic). The monthly volume of IBD surgical procedures was compared during the pandemic to the prepandemic period. After matching, the risk of adverse outcomes following IBD surgery was compared between the 3 years of the pandemic compared to the prepandemic cohort. Results There was a reduction in both elective and emergency IBD operations during the pandemic. These trends were not significant. After matching, the risks of returning to theaters and hospital readmission were comparable across the 3 years of the pandemic. In the first and second years of the pandemic, elective patients were at a greater risk of mortality (risk ratio [RR], 2; 95% confidence interval [CI], 1.160–3.448 and RR, 1.778; 95% CI, 1.003–3.150, respectively) and the emergency cohort had a higher risk of critical care admission (RR, 1.759; 95% CI, 1.126–2.747 and RR, 1.742; 95% CI, 1.131–2.682, respectively). Conclusion Our study highlights the impact of the COVID‐19 pandemic on the management of IBD patients undergoing surgery. These results provide insights into the management of IBD surgery during times of crisis and can help guide decision‐making and resource allocation for IBD patients requiring surgical intervention.

Abstract In the United States (US), chlamydia is the most frequently reported sexually transmitted infection that is nationally notifiable. We examined trends in chlamydia prevalence in the US in 2011–2016 compared with 2005–2010. Cross-sectional, nationally representative surveys, National Health and Nutrition Examination Surveys (NHANES), were used to compare national chlamydia prevalence estimates from 2011 to 2016 with those from 2005 to 2010, and changes in prevalence since 1999–2004 were also reviewed. Persons aged 18–39 years were included in these analyses. Prevalence of chlamydia was based on results from urine specimens. Results were weighted to represent the U.S. civilian, noninstitutionalized population. The baseline characteristics of the study population were similar in gender, age and race/ethnicity between the two groups (P > 0.05). The overall chlamydia prevalence was 1.88% (95% confidence interval [CI] 1.55–2.22%) in 2011–2016 and 1.57% (95% CI 1.27–1.87%) in 2005–2010, a relative increase of 19.7% (95% CI 0.2–39.2%; P high school educational level, never married, age at first sex 5 sexual partners. The chlamydia prevalence had an increasing trend from 2005–2010 to 2011–2016. Those with high chlamydia prevalence such as sexually active young adults and Non-Hispanic Black should be screened annually so that infected persons can be diagnosed and they and their sex partners can be treated promptly.

Abstract Observational and reanalysis datasets reveal a northward shift of the convective regions over northern Africa in summer and an eastward shift in winter in the last four decades, with the changes in the location and intensity of the thermal lows and subtropical highs also modulating the dust loading and cloud cover over the Middle East and North Africa region. A multi-model ensemble from ten models of the Coupled Model Intercomparison Project—sixth phase gives skillful simulations when compared to in-situ measurements and generally captures the trends in the ERA-5 data over the historical period. For the most extreme climate change scenario and towards the end of the twenty-first century, the subtropical highs are projected to migrate poleward by 1.5°, consistent with the projected expansion of the Hadley Cells, with a weakening of the tropical easterly jet in the summer by up to a third and a strengthening of the subtropical jet in winter typically by 10% except over the eastern Mediterranean where the storm track is projected to shift polewards. The length of the seasons is projected to remain about the same, suggesting the warming is likely to be felt uniformly throughout the year.

Background: Despite guideline recommendations, suboptimal prescription rates of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have been observed in patients with acute coronary syndrome. Objective: This study aimed to examine the temporal trends, variations, and mortality outcomes among acute coronary syndrome patients prescribed ACEIs/ARBs in the multi-ethnic population of Malaysia. Methodology: This retrospective study utilized data from the Malaysian National Cardiovascular Disease–Acute Coronary Syndrome registry, encompassing consecutive patient records from 2008 to 2017 (N = 60,854). Ten-year temporal trends of on-discharge ACEIs/ARBs prescription were examined. Demographics, clinical characteristics and 1-year all-cause mortality outcomes were compared between patients prescribed and not prescribed ACEIs/ARBs. Results: The 10-year prescription rate of on-discharge ACEIs/ARBs was 52.8% (n = 32,140), with a significant decline over the years [linear trend test, P = 0.008; SD = 0.03; SE = 0.001; 95% CI = 0.55-0.64]. Patients aged ≥65 years (aOR = 0.79; 95% CI = 0.73–0.86) were less likely to be prescribed ACEIs/ARBs than those aged

Background Colorectal cancer has become the third most prevalent malignant tumor in Jiading district of Shanghai, and its disease burden is still increasing. Objective To analyze the epidemic trend of colorectal cancer in Jiading district of Shanghai from 2003 to 2019 and provide scientific basis for the prevention and treatment of colorectal cancer. Methods Based on the cancer registration data from 2003 to 2019 in Jiading district of Shanghai, the statistical indicators such as crude incidence rate, crude mortality rate, standardized incidence rate and standardized mortality rate were calculated (the rate was standardized using the Chinese standard population of 2010). Joinpoint Regression Program 4.9.1.0 software was used to analyze the trends of incidence rate and mortality rate. Results From 2003 to 2019, there were 5 020 new cases of colorectal cancer in Jiading district of Shanghai, with a crude incidence rate of 52.12/100 000, a standardized incidence rate of 26.27/100 000; there were 2 419 deaths, with a crude mortality rate of 25.12/100 000, and a standardized mortality rate of 11.16/100 000; with males having higher crude incidence and crude mortality rates than females (P

Objective To analyze the epidemiological characteristics of notifiable infectious diseases in Tongzhou District of Nantong from 2017 to 2022, and provide scientific basis for developing targeted prevention and control strategies and measures. Methods Descriptive epidemiological methods were used to analyze the reported data of notifiable infectious diseases in Tongzhou District of Nantong from 2017 to 2022. Results From 2017 to 2022, a total of 25 379 cases of 26 types of notifiable infectious diseases were reported in Tongzhou District of Nantong, with an average annual incidence of 33.80 per 10 000. There were 27 deaths, with an average annual mortality rate of 0.04 per 10 000. Among the reported cases, the ratio of male to female reported incidence was 1.34∶1. The highest incidence of infectious diseases was observed in the age group under 10 years, mainly due to cases of varicella and hand-foot-mouth disease. The main occupational groups affected were farmers, preschool children, students, scattered children, and homemakers / unemployed individuals. Digestive tract infectious diseases such as hand-foot-mouth disease and other infectious diarrhea were mainly reported in summer, while respiratory tract infectious diseases such as varicella were more common in winter. The areas with the highest incidence were Xianfeng Street, Jinsha Street, and Xingren Town. The main types of infectious diseases reported were respiratory and intestinal tract infections. The top three reported diseases in terms of incidence rate were varicella, hand-foot-mouth disease, and syphilis. Conclusion In 2017—2022, the reported incidence of notifiable infectious disease in Tongzhou District of Nantong has showed a trend of fluctuating decline. However, it is still necessary to strengthen the monitoring and prevention of varicella and hand-foot-mouth disease, pay attention to the publicity and intervention of sexually transmitted diseases (such as syphilis), and maintain the incidence and mortality of notifiable infectious diseases at a low level compared to the national average.

Background: Bullying is a form of violence that is carried out repeatedly, with the intention of causing harm and with an imbalance of power between those involved. Bullying has serious negative effects on the mental health of adolescents and thus represents a significant health risk in childhood and adolescence. Methods: Based on data from the Health Behaviour in School-aged Children (HBSC) study from the survey year 2022 in Germany (N = 6,475), the prevalence of school bullying and cyberbullying among 11-, 13- and 15-year-olds in Germany was analysed. In addition, the prevalence of school bullying and cyberbullying was analysed as a trend from 2009/10 to 2022 (bullying) and from 2017/18 to 2022 (cyberbullying). Results: Around 14 % of the learners surveyed reported direct experience of bullying at school, and around 7 % reported cyberbullying experiences as bullied and/or bullying victims. Adolescents who identified as gender diverse were particularly likely to report bullying experiences. School bullying decreased over time, but remained stable between 2017/18 and 2022. Cyberbullying, on the other hand, increased in 2022 compared to 2017/18. Conclusions: Experiencing bullying at school and online is an everyday experience for many children and young people, so there is still a need for the broad implementation of effective anti-bullying measures in schools.

Background: Health Behaviour in School-aged Children (HBSC) is one of the largest international studies on child and adolescent health and cooperates with the World Health Organization (WHO). In Germany, adolescents aged 11, 13 and 15 are surveyed every four years about their health, health behaviour and social conditions. This article describes the HBSC study and in particular the methodology of the current 2022 survey and prior surveys conducted between 2009/10 and 2017/18. Method: 174 schools with a total of 6,475 students participated in the 2022 survey. The survey was conducted using questionnaires and covered a wide range of topics (including mental health, physical activity, bullying experiences, social determinants of health and experiences related to COVID-19). The 2022 survey was complemented by a school principal survey (N = 160). In addition to the current sample, the samples of the three previous surveys with representative data for Germany are presented: 2009/10 (N = 5,005), 2013/14 (N = 5,961) and 2017/18 (N = 4,347).: Discussion The health of children and adolescents is of great public health importance. The HBSC study makes a substantial contribution by providing internationally comparable results, analysing trends, and providing stakeholders with comprehensive and representative health monitoring data.

Abstract Globally, several children die shortly after birth and many more of them within the first 28 days of life. Sub-Sharan Africa accounts for almost half (43%) of the global neonatal death with slow progress in reduction. These neonatal deaths are associated with lack of quality care at or immediately after birth and in the first 28 days of life. This study aimed to determine the trends and risk factors of facility-based neonatal mortality in a major referral hospital in Lusaka, Zambia. We conducted retrospective analysis involving all neonates admitted in the University Teaching Hospital Neonatal Intensive Care Unit (UTH-NICU) in Lusaka from January 2018 to December 2019 (N = 2340). We determined the trends and assessed the factors associated with facility-based neonatal mortality using Generalized Linear Models (GLM) with a Poisson distribution and log link function. Overall, the facility-based neonatal mortality was 40.2% (95% CI 38.0–42.0) per 1000 live births for the 2-year period with a slight decline in mortality rate from 42.9% (95% CI 40.0–46.0) in 2018 to 37.3% (95% CI 35.0–40.0) in 2019. In a final multivariable model, home delivery (ARR: 1.70, 95% CI 1.46–1.96), preterm birth (ARR: 1.59, 95% CI 1.36–1.85), congenital anomalies (ARR: 1.59, 95% CI 1.34–1.88), low birthweight (ARR: 1.57, 95% CI 1.37–1.79), and health centre delivery (ARR: 1.48, 95% CI 1.25–1.75) were independently associated with increase in facility-based neonatal mortality. Conversely, hypothermia (ARR: 0.36, 95% CI 0.22–0.60), antenatal attendance (ARR: 0.76, 95% CI 0.68–0.85), and 1-day increase in neonatal age (ARR: 0.96, 95% CI 0.95–0.97) were independently associated with reduction in facility-based neonatal mortality. In this hospital-based study, neonatal mortality was high compared to the national and global targets. The improvement in neonatal survival observed in this study may be due to interventions including Kangaroo mother care already being implemented. Early identification and interventions to reduce the impact of risks factors of neonatal mortality in Zambia are important.

Biomedicine is constantly evolving to ensure a significant and positive impact on healthcare, which has resulted in innovative and distinct requisites such as hydrogels. Chitosan-based formulations stand out for their versatile utilization in drug encapsulation, transport, and controlled release, which is complemented by their biocompatibility, biodegradability, and non-immunogenic nature. Stimuli-responsive hydrogels, also known as smart hydrogels, have strictly regulated release patterns since they respond and adapt based on various external stimuli. Moreover, they can imitate the intrinsic tissues' mechanical, biological, and physicochemical properties. These characteristics allow stimuli-responsive hydrogels to provide cutting-edge, effective, and safe treatment. Constant progress in the field necessitates an up-to-date summary of current trends and breakthroughs in the biomedical application of stimuli-responsive chitosan-based hydrogels, which was the aim of this review. General data about hydrogels sensitive to ions, pH, redox potential, light, electric field, temperature, and magnetic field are recapitulated. Additionally, formulations responsive to multiple stimuli are mentioned. Focusing on chitosan-based smart hydrogels, their multifaceted utilization was thoroughly described. The vast application spectrum encompasses neurological disorders, tumors, wound healing, and dermal infections. Available data on smart chitosan hydrogels strongly support the idea that current approaches and developing novel solutions are worth improving. The present paper constitutes a valuable resource for researchers and practitioners in the currently evolving field. [ABSTRACT FROM AUTHOR]

Abstract Background and Aims Given the significance of addressing neonatal mortality in pursuing the 2030 Sustainable Development Goal on child health, research focus on this area is crucial. Despite the persistent high rates of neonatal mortality rate (NMR) in Bangladesh, there remains a notable lack of robust evidence addressing inequalities in NMR in the country. Therefore, this study aims to fill the knowledge gap by comprehensively investigating inequalities in NMR in Bangladesh. Methods The Bangladesh Demographic and Health Survey (BDHS) data from 2000 to 2017 were analyzed. The equity stratifiers used to measure the inequalities were wealth status, mother's education, place of residence, and subnational region. Difference (D) and population attributable fraction (PAF) were absolute measures, whereas population attributable risk (PAR) and ratio (R) were relative measures of inequality. Statistical significance was considered by estimating 95% confidence intervals (CIs) for each estimate. Results A declining trend in NMR was found in Bangladesh, from 50.2 in 2000 to 31.9 deaths per 1000 live births in 2017. This study detected significant wealth‐driven (PAF: −20.6, 95% CI: −24.9, −16.3; PAR: −6.6, 95% CI: −7.9, −5.2), education‐related (PAF: −11.6, 95% CI: −13.4, −9.7; PAR: −3.7, 95% CI: −4.3, −3.1), and regional (PAF: −20.6, 95% CI: −27.0, −14.3; PAR: −6.6, 95% CI: −8.6, −4.6) disparities in NMR in all survey points. We also found a significant urban–rural inequality from 2000 to 2014, except in 2017. Both absolute and relative inequalities in NMR were observed; however, these inequalities decreased over time. Conclusion Significant variations in NMR across subgroups in Bangladesh highlight the need for comprehensive, and targeted interventions. Empowering women through improved access to economic resources and education may help address disparities in NMR in Bangladesh. Future research and policies should focus on developing strategies to address these disparities and promote equitable health outcomes for all newborns.

The goal of health systems implemented at international, national, or regional level is to improve health effectively and efficiently by all available means, including community efforts, special education, military, and government, thereby improving public health at all levels. Health issues as national issues need top priority. Inequalities in mortality risk are inseparable from issues surrounding the health policy debate. Public health level is assessed through several indicators. Health Policy in law regulates the right to health. Proposed health system goals at international, national, or regional levels are usually not measured by human rights standards and instruments. Universal Health Insurance is expected to provide benefits. Health services are provided as medicines and treatments. This review aimed to determine trends in number of publications and visualize linkages of health insurance topics through bibliometric analysis. This was a systematic review with steps following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram using 661 scientific articles published between 2004 and 2022, followed by inclusion and exclusion criteria from Dimensions database. Review of articles was by means of Vosviewer app. Our study results contributed to research roadmap development on health insurance. The limitation is that app.dimension.ai and google scholar databases are periodically updated, such that bibliometric analysis of health insurance should be repeated in the near future. Because this bibliometric analysis only extracted scientific article data from app.dimension.ai database, further research should add another database for broader and more comprehensive understanding of health insurance.

Background. Trends data up to 2018 suggest that tobacco smoking was increasing in South Africa (SA), but only limited information is available on the impact of the COVID-19 pandemic on the current pattern of use of tobacco and nicotine products (TNPs). Objectives. To assess trends in sociodemographic patterns in the use of TNPs and the extent to which sociodemographic factors and non-cigarette tobacco use may explain possible changes in rates of TNP use between 2017/18 and 2021. Methods. Data from three waves (2017, 2018 and 2021) of the South African Social Attitudes Survey (total N=8 140) were analysed. The sociodemographic correlates of current daily and non-daily use of factory-manufactured cigarettes (FMCs), roll-your-own (RYO) cigarettes, waterpipe/hubbly, electronic cigarettes (ECigs), snuff (a smokeless tobacco) and any combination of FMCs, RYO cigarettes and waterpipe/hubbly (‘current smoking’) in 2017/18 (pre-pandemic) were compared with those for 2021 (during the pandemic). Chi-square analyses and generalised linear models were used to compare the prevalence of TNP use between the two periods. A Blinda-Oaxaca decomposition analysis was also used to explore the roles of various sociodemographic factors, including any differences in the use of TNPs, that may explain any observed differences in smoking rates between 2017/18 and 2021. Results. Current smoking increased significantly from 22.4% (95% confidence interval (CI) 20.4 - 24.5) in 2017/18 to 27.6% (95% CI 24.3 - 31.1) in 2021 (p=0.009). Smoking of FMCs did not change significantly overall between these two periods (20.1% v. 22.1%; p=0.240), except for a significant increase among those who self-identified as black African and a decrease among those who self-identified as coloured and those currently employed. However, the use of waterpipe/hubbly, ECigs, RYO cigarettes and snuff increased significantly. Women, individuals aged

Background/Aim: Google Trends is a powerful tool for health information access and disease surveillance, including COVID-19 data forecasting. Cutaneous manifestations of COVID-19 include urticarial rash, which is multifactorial and may indicate a better prognosis. Aim of this study was to analyse the search queries for the term "urticaria" during the six years period (2017-2022) and assess the relationship between relative search volume (RSV) and a global rise in COVID-19 cases. Methods: This study examined search queries for "urticaria" from 2017 to 2022, exploring the relationship between RSV and global COVID-19 cases. Data on "urticaria" search volume in various countries were collected using Google Trends. Microsoft Excel and correlation analysis were used to analyse the data and investigate the association between search volume and monthly COVID-19 case rise. Results: During 2017-2019, the mean RSV for "urticaria" was 69.9 ± 10.1, which increased to 84.1 ± 8.6 during 2020-2022. The difference in means was statistically significant (p < 0.001). The mean RSV in 2022 (94.3) was the highest among all years studied. The increase in RSV from 2020 to 2022 moderately correlated (r = 0.56) with monthly COVID-19 case rise (p < 0.001). Nicaragua showed the highest search interest, while Africa, North America, Asia and Pacific, the Middle East and Europe had low search interest. Conclusions: This study identified a significant increase in search volume for "urticaria" during the COVID-19 pandemic. Nicaragua had the highest search interest, while English-speaking countries displayed low interest. Language variation, cultural differences and COVID-19-related health concerns may influence public interest in urticaria. These findings can aid public health officials in understanding public health concerns and tailoring effective health communication strategies.

Objective: To perform a bibliometric analysis of the scientific production related to intestinal microbiota and bariatric surgery between January 2016 and December 2022. Materials and Methods: A bibliographic search was performed in the Scopus database to identify published papers. Free and controlled terms (MeSH and Emtree) were used. The information collected was analyzed with SciVal. Results: A total of 518 published papers were included in the analysis. Carel Le Roux was the author with the highest scientific production; however, Edi Prifti had the highest impact. French National Institute of Health and Medical Research (Institut national de la santé et de la recherche médicale) was the institution with the highest number of published articles. Six of the 10 institutions with the highest production were in France, yet the United States had the highest volume of scientific production in this research topic. Most papers were published in first quartile journals. Articles with international collaboration had the highest impact. There is a sustained increase in the number of publications since 2019. Conclusions: The study found that the vast majority of research on gut microbiota changes following bariatric surgery are conducted in the United States and European countries. In addition, the sustained increase in production coupled with the articles being published in high-quality journals and having good citation impact are indictors of the current interest in this research field.

Background and purpose: Ischemic heart disease (IHD) is a major public health problem and in 2019 it was the leading cause of years of life lost due to premature death. Knowing its incidence and mortality rates can help in designing and implementing preventive interventions in different regions of the country. In this study, the incidence and mortality pattern of IHD during the years 1990-2019 was investigated in the provinces of Iran. Materials and methods: In the current ecology study (ethics code IR.ZUMS.REC.1402.216), age-standardized incidence and mortality rate (per 100,000 population) of ischemic heart disease for 31 provinces of Iran from the Global Burden of Disease Database (GBD) in 1990, 1995, 2000, 2005, 2010, 2015 and 2019 were extracted. Also, the incidence and mortality rates in the age groups below 44, 45-54, 55-64, 65-74, 75-84, and above 85 years in the studied years were investigated. In men and women, in different age groups and overall, the mortality-incidence ratio (MIR) was also calculated. To identify provinces with similar trends in incidence, mortality, and MIR in the studied years, model-based clustering analysis was used. A finite mixture of multivariate t-distributions was used in the clustering method. Bayesian Information Criterion (BIC) was used to determine the number of clusters (number of different trends). To determine the number of clusters, different clusters were considered and BIC was calculated. The number of clusters with the lowest BIC value was considered as the final number of clusters in each index. Analyzes were performed in R 4.2.0 software. Results: During the years 1990 to 2019, the incidence rate of IHD in women has decreased by 6% and men by 4%, the mortality rate of IHD in women by 35% and men by 40%, and MIR in women by 69% and men by 62%. The results showed that from 1990 to 2019, in Khorasan Razavi province, we saw a 13% decrease in the total incidence of the disease, and in Ardabil province, we saw only a 1% decrease in the total incidence of the disease. The lowest rate of IHD in 2019 was in Tehran province. Also, in both genders, Tehran province had the lowest mortality rate and the lowest MIR. North Khorasan province has the highest incidence and Golestan province has the highest mortality rate and the highest MIR of the disease in 2019. Based on the results of clustering analysis, the incidence rate is 3, the mortality rate is 2 and MIR has 2 trends (clusters) in 31 provinces. The IHD incidence rate in Ardabil, Golestan, South Khorasan, Qazvin, Qom, Sistan, and Baluchistan, Tehran, and Yazd, the mortality rate in Ardabil, Bushehr, Chaharmahal and Bakhtiari, Hormozgan, Ilam, Kurdistan, Lorestan, Qazvin and Semnan, and MIR in West and East Azerbaijan, Bushehr, Chaharmahal and Bakhtiari, Fars, Gilan, Golestan, Hormozgan, Ilam, Isfahan, Kerman, Kermanshah, Khorasan Razavi, Khuzestan, Kurdistan, Lorestan, Markazi, Mazandaran, Semnan and Yazd had a similar trend and a higher value than other provinces. Conclusion: The incidence and mortality rate and MIR have decreased during the 30 years of study in Iran, but this decrease in the incidence rate was less than the decrease in the other two indices. This shows the need for health system planners to pay attention and focus on first-level preventive programs. Also, the observed difference in incidence and mortality rate according to different provinces, and planning according to different regions is noted.

Abstract Background Aggregate trends can be useful for summarizing large amounts of information, but this can obscure important distributional aspects. Some population subgroups can be worse off even as averages climb, for example. Distributional information can identify health inequalities, which is essential to understanding their drivers and possible remedies. Methods Using publicly available Demographic and Health Survey (DHS) data from 41 sub-Saharan African countries from 1986 to 2019, we analyzed changes in coverage for eight key maternal and child health indicators: first dose of measles vaccine (MCV1); Diphtheria-Pertussis-Tetanus (DPT) first dose (DPT1); DPT third dose (DPT3); care-seeking for diarrhea, acute respiratory infections (ARI), or fever; skilled birth attendance (SBA); and having four antenatal care (ANC) visits. To evaluate whether coverage diverged or converged over time across the wealth gradient, we computed several dispersion metrics including the coefficient of variation across wealth quintiles. Slopes and 5-year moving averages were computed to identify overall long-term trends. Results Average coverage increased for all quintiles and indicators, although the range and the speed at which they increased varied widely. There were small changes in the wealth-related gap for SBA, ANC, and fever. The wealth-related gap of vaccination-related indicators (DPT1, DPT3, MCV1) decreased over time. Compared to 2017, the wealth-gap between richest and poorest quintiles in 1995 was 7 percentage points larger for ANC and 17 percentage points larger for measles vaccination. Conclusions Maternal and child health indicators show progress, but the distributional effects show differential evolutions in inequalities. Several reasons may explain why countries had smaller wealth-related gap trends in vaccination-related indicators compared to others. In addition to service delivery differences, we hypothesize that the allocation of development assistance for health, the prioritization of vaccine-preventable diseases on the global agenda, and indirect effects of structural adjustment programs on health system-related indicators might have played a role.

Total knee and hip arthroplasty (TKA and THA respectively) is frequently used in severe structural changes in patients with osteoarthritis (OA) and rheumatoid arthritis (RA).Objective: to evaluate the dynamics of the number of TKA of THA in patients with OA and RA treated in the Department of Traumatology and Orthopedics of V.A. Nasonova Research Institute of Rheumatology.Material and methods. The analysis of 11-year period (from 2012 to 2022) of surgical activity of the Department of Traumatology and Orthopedics of V.A. Nasonova Research Institute of Rheumatology.Results and discussion. Within the mentioned period, 2955 TKA and THA were performed in 1590 patients with OA and 1365 with RA. From 2012 to 2018, the number of surgeries in patients with OA and RA was approximately the same, but since 2019 there has been a significant increase in the number of total arthroplasties (TA) in OA. The median delta (Δ) of the number of TKA and THA performed annually over 11 years was 13.5 [-17.5; 75.7] in patients with OA and 2.5 [-10.25; 25.0] in patients with RA (p=0.032).Conclusion. In the last 11 years there was no significant dynamics in the number of TKA and THA in patients with RA. At the same time, there is a statistically significant increase in the number of TA in patients with OA, which is in line with the global trend.

Achtergrond: Het aantal ouderen in Nederland neemt toe en daarmee het aantal oudere gebruikers van de geestelijke gezondheidszorg (GGz). Om toekomstig beleid te kunnen bepalen, is het belangrijk te weten hoe het GGz-gebruik zich in het verleden heeft ontwikkeld. Deze studie brengt veranderingen in het GGz-gebruik van ouderen in de periode 1990-2004 in beeld. Methode: Er is gebruik gemaakt van data uit de psychiatrische casusregisters. Zo kon rekening gehouden worden met inwoneraantal per onderscheiden leeftijdsgroep en konden de kosten per geproduceerde eenheid worden berekend voor de onderscheiden categorieën van zorg. Resultaten: Er was een stijging in het aantal ouderen dat gebruik maakte van de GGz in genoemde periode. De kosten daarentegen daalden, door een afname van dure klinische zorg en een toename van goedkopere ambulante zorg en verblijf in een RIBW. Dit gold met name voor de periode tot en met 2002. Vanaf dat jaar stabiliseert de verhouding tussen intra- en extramurale zorg. Conclusie: De periode 1990-2002 wordt gekenmerkt door extramuralisering van de GGz voor ouderen, waardoor meer ouderen in zorg zijn zonder stijging in de kosten. Met het oog op verdere toename van het GGz-gebruik door ouderen, zal naar alternatieve vormen van extramurale zorg moeten worden gezocht.

In this retrospective study, we measured enterovirus D68 (EV-D68) genomic RNA in wastewater solids longitudinally at 2 California, USA, wastewater treatment plants twice per week for 26 months. EV-D68 RNA was undetectable except when concentrations increased from mid-July to mid-December 2022, which coincided with a peak in confirmed EV-D68 cases.

Abstract Improved sanitation is indispensable to human health. However, lack of access to improved sanitation remains one of the most daunting public health challenges of the twenty-first century in Bangladesh. The aim of the study was to describe the trends in access to improved sanitation facilities following the inequity gap among households in different socioeconomic groups in Bangladesh. Data from the Bangladesh Demographic and Health Survey (BDHS) 2007, 2011, 2014, and 2017-18 were extracted for this study. Inequity in access to improved sanitation was calculated using rich-poor ratio and concentration index to determine the changes in inequity across the time period. In Bangladesh, the proportion of households with access to improved sanitation increased steadily from 25.4% to 45.4% between 2007 and 2014, but slightly decreased to 44.0% in 2017-18. Age, educational status, marital status of household head, household wealth index, household size, place of residence, division, and survey year were significantly associated with the utilisation of improved sanitation. There is a pro-rich situation, which means that utilisation of improved sanitation was more concentrated among the rich across all survey years (Concentration Index ranges: 0.40 to 0.27). The government and other relevant stakeholders should take initiatives considering inequity among different socioeconomic groups to ensure the use of improved sanitation facilities for all, hence achieving universal health coverage.

Scientific relevance. The quality of medicinal products, particularly vaccines, is contingent on the stability of the manufacturing process at all stages, which can be evaluated using Shewhart charts for data obtained by monitoring the quality attributes of interest.Aim. This study evaluated the stability of the quality and manufacturing processes of the BCG and BCG-M tuberculosis vaccines using Shewhart charts.Materials and methods. This study focused on samples of the BCG tuberculosis vaccine and the BCG-M tuberculosis vaccine, a less reactogenic alternative for primary immunisation. Both vaccines were released to the market in 2019–2022. The quality of samples was assessed for stability based on their potency and total bacterial count, which are the key parameters for immunogenicity evaluation. These quality parameters were compared using test results submitted by the manufacturer and obtained at the testing centre. The authors plotted individuals charts (X-charts) and moving range charts (R-charts) in accordance with national standards GOST R 50779.42-99 and GOST R ISO 7870-2-2015.Results. The quality of the BCG and BCG-M vaccines remained stable during the entire follow-up period (2019–2022). For some periods, the retrospective analysis of R- and X-charts revealed characteristic trends meeting special cause criteria. The Pearson correlation coefficient (r) between the data submitted by the manufacturer and the data obtained at the testing centre ranged from 0.2 to 0.8.Conclusions. The Shewhart charts demonstrated that the quality parameters of the BCG and BCG-M tuberculosis vaccines tested in 2019–2022 were stable. These vaccines had stable manufacturing processes, as shown by the R- and X-charts. However, the warning signs indicated that additional measures should be taken to standardise the manufacturing processes. The findings suggest that Shewhart charts may be recommended for monitoring the production and quality of tuberculosis vaccines.

Background Scientometric analyses of specific topics in geriatrics and gerontology have grown robustly in scientific literature. However, analyses using holistic and interdisciplinary approaches are scarce in this field of research. This article aimed to demonstrate research trends and provide an overview of bibliometric information on publications related to geriatrics and gerontology. Methods We identified relevant articles on geriatrics and gerontology using the search terms “geriatrics,” “gerontology,” “older people,” and “elderly.” VOSviewer was used to perform bibliometric analysis. Results A total of 858 analyzed articles were published in 340 journals. Among the 10 most contributory journals, five were in the United States, with the top journal being the Journal of the American Geriatrics Society. The United States was the leading country in research, followed by Japan, Canada, and the United Kingdom. A total of 5,278 keywords were analyzed. In the analysis of research hotspots, the main global research topics in geriatrics and gerontology were older adults (n=663), education and training (n=471), and adults aged 80 years (n=461). These were gradually expanded to include areas related to caring for older adults, such as geriatric assessments (n=395). Conclusion These results provide direction for fellow researchers to conduct studies in geriatrics and gerontology. In addition, they provide government departments with guidance for formulating and implementing policies that affect older adults, not only in setting academic and professional priorities but also in understanding key topics related to them.

Background: Virtual reality (VR), widely used in the medical field, may affect future medical training and treatment. Therefore, this study examined VR’s potential uses and research directions in medicine. Methods: Citation data were downloaded from the Web of Science Core Collection database (WoSCC) to evaluate VR in medicine in articles published between 1 January 2012 and 31 December 2023. These data were analyzed using CiteSpace 6.2. R2 software. Present limitations and future opportunities were summarized based on the data. Results: A total of 2143 related publications from 86 countries and regions were analyzed. The country with the highest number of publications is the USA, with 461 articles. The University of London has the most publications among institutions, with 43 articles. The burst keywords represent the research frontier from 2020 to 2023, such as “task analysis”, “deep learning”, and “machine learning”. Conclusion: The number of publications on VR applications in the medical field has been steadily increasing year by year. The USA is the leading country in this area, while the University of London stands out as the most published, and most influential institution. Currently, there is a strong focus on integrating VR and AI to address complex issues such as medical education and training, rehabilitation, and surgical navigation. Looking ahead, the future trend involves integrating VR, augmented reality (AR), and mixed reality (MR) with the Internet of Things (IoT), wireless sensor networks (WSNs), big data analysis (BDA), and cloud computing (CC) technologies to develop intelligent healthcare systems within hospitals or medical centers.

With a rapidly aging global population, comprehending the risks associated with older people’s activities of daily living is increasingly important; yet, interdisciplinary analyses remain rare. By providing a bibliometric overview of the capability risks associated with older people’s activities of daily living, in order to identify prevailing trends and future directions in the field, the study aims to fill this gap. Using CiteSpace software to analyze data from 928 articles published between 2004 and 2023, the study results demonstrate the growing interest in the capability risks of older people’s activities of daily living, with the United States leading in the number of publications, and geriatrics emerging as the dominant discipline. Notably, Institut National de la Sante et de la Recherche Medicale (Inserm) in France emerges as a pivotal contributor in the field. Key research topics encompass risk factors associated with a decline in daily activities and disease-related studies, with emerging trends in cognitive function and instrumental activity research. Future research should prioritize the development of predictive mechanisms for daily living trends, exploration of caregiving solutions, and promotion of interdisciplinary collaboration. This study highlights promising avenues for further research, emphasizing the importance of predictive modeling, innovative caregiving strategies, and interdisciplinary cooperation in addressing capability risks in the activities of daily living of older people.

Fitness in Portugal results from a set of historical intersections marked by various influences and personalities. To a large extent, knowledge of this path is essential to understanding the current reality and some of the problems the area faces. The present study intends to situate and summarize the main national and international events and influences, as well as some time frames, which led to the development of the intervention area commonly called fitness. For this purpose, the work is structured in three parts: i) the beginnings of fitness, where some of the international influences that were at the origin of this area will be presented; ii) some of the main influences and factors that allowed the growth of fitness in Portugal; and iii) the effect of the historical trajectory of fitness in the current context and future considerations about the area. Given the scarcity of records on the subject, the present work, as an opinion article, will also be a self-report of the authors, who, having experienced different moments of this history, intend to leave a contribution to this record and for future reflections of its impact on the development of the area, professionals, and respective practices.

ABSTRACTInjuries are responsible for a high premature mortality and disability. They are poorly explored in low and middle income-countries. We aimed to estimate the burden of hospitalized injuries in the Monastir governorate (Tunisia) according to the nature of the injury, trends and projections of hospitalizations for injuries up until 2024, and to identify the distribution of this disease burden based on age and sex. We performed a descriptive study from 2002 to 2012 including all hospitalizations for injuries. Data were collected from morbidity and mortality register of the University Hospital of Monastir (Tunisia). We estimated the burden of injuries using the Disability Adjusted Life Years (DALYs). We described injuries (crude prevalence rate (CPR) and age standardized prevalence rate (ASR)), related mortality (lethality and standardized mortality ratio (SMR)), trends and prediction for 2024. A total of 18,632 hospitalizations for injuries representing 10% of all hospitalizations during study period were recorded. Per 1000 inhabitants per year, CPR was 3.36 and the ASR was 3.44. The lethality was of 17.5 deaths per 1000 injured inpatients per year and the SMR was of 2.95 (Confidence Interval of 95%: 2.64–3.29). Burden related to injuries was 2.36 DALYs per 1000 population per year, caused mainly by Years of Life Lost (83.4%), most frequent among men aged under 40 years. The predicted ASR for 2024 was 4.46 (3.81–5.23) per 1000 person-years. Injuries to the head was the most prevalent (20.7%) causing 67.7% of DALYs; and increasing by 226% through 2024. Injuries had a high prevalence and an important burden in a Tunisian university hospital. Prediction showed increased prevalence for 2024. Preventive measures and a trauma surveillance register should be implemented soon.

Resumen: Propósito: Analizar las tendencias a largo plazo por edad y sexo de la mortalidad por diabetes mellitus (DM) en Chile, durante los años 1990–2020. Material y método: Mediante la elaboración de un estudio de cohorte retrospectivo se analizó la tasa de mortalidad estandarizada por DM, según edad y sexo. Se examinó la tendencia de la tasa de mortalidad ajustada por edad, utilizando un análisis de regresión joinpoint para estimar el porcentaje de cambio anual y evaluar su significancia estadística. Resultados: Un total de 97.939 defunciones fueron registradas en Chile entre 1990–2020 (49.273 hombres y 48.666 mujeres). La tasa de mortalidad bruta fue levemente más alta en hombres y un 60% de los fallecimientos se produce en mayores de 80 años. El análisis de la tendencia evidenció un aumento estadísticamente significativo del porcentaje de cambio anual en un 3,16% anual hasta 2002 y luego un constante descenso de -1,25% anual. En el análisis por sexo, en hombres evidenció un aumento del porcentaje de cambio anual de un 0,99%, mientras que en mujeres destaca una disminución de -0,92% anual. Conclusiones: La tendencia de la mortalidad por DM ha mantenido una disminución constante desde 2002. Sin embargo, cuando se analizan los datos por sexo, los hombres poseen una mayor tasa de mortalidad y su tendencia va al alza a través de los años estudiados. Es importante realizar un estudio de otras variables que expliquen los resultados, para llegar a una conclusión que impacte en el desenlace de los pacientes con DM. Abstract: Purpose: To analyze the long-term trends by age and sex of mortality from diabetes mellitus (DM) in Chile, during the years 1990–2020. Material and method: The standardized mortality rate for DM was analyzed, according to age and sex, through the elaboration of a retrospective cohort study. The age-adjusted mortality rate trend was examined, using joinpoint regression analysis to estimate the annual percentage change and to assess its statistical significance. Results: A total of 97,939 deaths were registered between 1990–2020 (49,273 men and 48,666 women) in Chile. The crude mortality rate was slightly higher in men and 60% of deaths occur in people over 80 years of age. The trend analysis showed a statistically significant increase in annual percentage change of 3.16% until 2002 and then a constant decrease of -1.25% per year. In the analysis by sex, in men there was an increase in annual percentage change of 0.99% per year, while in women there was a decrease of -0.92% per year. Conclusions: Mortality from DM has sustained a constant decrease since 2002. However, when the data is analyzed by sex, men have a higher mortality rate with and upwards trend throughout the years studied. It is important to carry out a study of other variables that might explain these results, in order to reach a conclusion that could impact on the outcomes of patients with DM.

Introduction The expansion of higher education is a worldwide phenomenon. To our knowledge, there are no studies analyzing the trends in demands of enrollment in health-related studies in Spain. Therefore, the objective was to analyze the change in demand (the number of requests for enrollment divided by the number of offered places) for undergraduate health-related studies in Spain during the period 2015–2021 as well as compare the change by region in the pre (2015–2019) and pandemic (2020–2021) period. Methods This is an observational (ecological type) study with temporal series analyses using data from public (non-for-profit) higher education institutions from the Integrated University Information System. For the analysis by region, we calculated the demand of all twelve undergraduate health-related degrees and the percentages of change between both periods using the Wilcoxon test. The Joinpoint Regression program was used to analyze the trends in demand for each degree during the 7-year period. Results Significant (p < 0.001) increases in demand during the pandemic period were observed in all regions. During the pandemic, medicine, biomedicine, nursing, odontology and pharmacy presented a higher demand in comparison with data collected before the pandemic started. In contrast, this pattern was not confirmed in the following cases: physiotherapy, occupational therapy, podiatry, psychology, social work, human nutrition and dietetics. By regions, Navarra, Asturias, and La Rioja presented the most drastic changes. In regions with the biggest number of universities, such as Catalonia, Andalusia and Madrid, the change observed was smaller.

Introduction: Respiratory infections caused by viruses are becoming a global concern, especially in the aftermath of COVID-19 pandemic. Due to massive impact of COVID-19 in the past 3 years globally, other viruses causing respiratory illnesses have largely been ignored. But as the COVID-19 pandemic declined, changing trends were seen in the pattern of respiratory viral infections in Pakistan. Aims & Objectives: To study the trends of respiratory viral infections in Pakistan in the winter of 2022/2023 after the decline of Covid-19 pandemic. Material & Methods: A total of 454 samples were evaluated for viral pathogens (Influenza A, Influenza B and Respiratory syncytial virus) by running them on Multiplex Polymerase chain reaction. We received 373 samples from Lahore,46 from Multan,24 from Islamabad,6 from Rawalpindi,4 from Okara and 1 from Sheikhupura. Data was analyzed by applying descriptive statistics using SPSS version 23, a p-value of ?0.05 was considered significant. Results: The prevalence of Influenza A virus was 26.4% (120/454 cases), followed by RSV which showed the prevalence of 10% (46/454 cases) whereas Influenza B showed a prevalence of 6%(27/454cases). Conclusion: Influenza A and RSV incidence has surged in the year 2022/2023 which is the post Covid -19 period. There is an increased incidence of Influenza A in the elderly population whereas RSV in children.

In recent years, wearable sensors and mHealth applications are becoming an important part for recording and monitoring health parameters. The aim is to characterize bibli-ometric indicators on scientific productivity in the use of smart bracelets according to scientific journal, study topic and publication trend. A bibliometric study was per-formed. The data extracted from the articles were: year of publication, name of the journal, language of publication, country, type of study and subject matter. A total of 45 studies were identified (21 cross-sectional and 24 experimental), of which 43 were published in English, one in Spanish and one in German. A total of 32 scientific journals published eight research topics related to smartwatch use [active living with 17 studies (37.8%), followed by stress and anxiety with 7 studies (15.6%), nanogenerators (batteries) with 6 studies (13.3%), computing with 5 studies (11.1%), chronic diseases 4 studies (8.9%), COVID propagation 3 studies (6.7%), energy expenditure 2 studies (4.4%) and occupational health 1 study (2.2%)]. The journal Sensors (Basel) published the most articles in the last 6 years (n=7, 16%). The scientific productivity of both study types reflects a positive trend (cross-sectional studies R2= 0.82 and in experimental studies R2= 0.76). A total of 45 cross-sectional and experimental studies using smart-watches were verified in eight different study topics. The most investigated category was active living and the journal that published the highest number of articles was the journal Sensors (Basel).

Background Protein-energy malnutrition (PEM) is a common nutritional deficiency. With the change of lifestyle and eating habits, people pay increasing attention to nutritional health problems, and PEM may have different effects on the health of different age groups. Objective To analyze the overall and age-specific trends of PEM incidence in 1990-2019 and to predict its incidence in 2020-2029 in China. Methods The data of this study were derived from the Global Burden of Disease Study 2019, involving mortality indicators, and incidence indicators in 18 age groups (ranged from 0 to over 85 years grouped by an interval of 5 years) of PEM in China from 1990 to 2019. The age-standardized rates were calculated using the world standard population. Joinpoint regression analysis was used to calculate the annual percentage change (APC) and annual average percentage change (AAPC) of the incidence rate and 95% confidence interval, and to describe the temporal trend. The autoregressive integrated moving average (ARIMA) model was used to predict the incidence of PEM in China from 2020 to 2029. Results (1) In 2019, the standardized incidence ratio (SIR) of PEM in the whole population of China was 1 996.5/100 000, and that in males (2 444.7/100 000) was higher than that in females (1 536.0/100 000) . The SIR of PEM in the whole population in China was lower than that of the world standard population (2 099.4/100 000) , and that of PEM in Chinese males was higher than that in the world standard male population (2 304.0/100 000) . The incidence of PEM was highest in

Objectives: To describe the trends and characteristics of the worldwide scientific production on the use of artificial pancreas (AP) in the management of diabetes mellitus (DM). Materials and Methods: Scientific papers published between 2017 and 2022 were retrieved from the Scopus database using relevant keywords. Only original articles, reviews, and short surveys were included. The metadata were exported to the SciVal software for retrieving quantitative data and the main characteristics such as journals, authors, institutions, journal metrics by quartiles, subcategories, and collaborative networks were extracted. Results: A total of 642 articles were included after applying the inclusion/exclusion criteria: original articles, 489; reviews, 151; and short surveys, 2. The most common type of collaboration was at the national level (38.3%; citations per publication: 22.3; field-weighted citation index [FWCI]: 2.2) followed by international collaboration (29.4%; citations per publication: 19.6; FWCI: 1.94). More than 70% of articles in each year were published in journals listed in Q1. Two journals, Diabetes Technology and Therapeutics and Journal of Diabetes Science and Technology, accounted for about 22% of all publications. Six of the top 10 universities were from the United States, with The University of Virginia having the most publications (n = 54; 59 authors; citations per publication: 38.4; FWCI: 3.73). Conclusions: The findings of this study highlight that most research on this topic is published in high-quality journals and has a good citation impact. Notably, most research has been conducted in developed countries, thereby indicating the need for research efforts in this field from developing countries.

Background: A high seroprevalence of various transfusion-transmitted infections (TTIs) in donated blood is the main safety concern, especially in low- and middle-income countries. As per the World Health Organization (WHO) recommendation, all blood donations must be tested for human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), Treponema pallidum infection, and malaria, which mainly comprises the major bulk of TTIs. Aims: The purpose of this study is to observe the seroprevalence of hepatitis C virus and Treponema pallidum infection over the period of 5 years in blood donors of our blood center along with their epidemiological determinants with respect to age, sex, residence, occupation, and type of donors. Materials and Methods: Retrospective study was conducted for the period of 5 years, from 1st January 2017 to December 2021, estimating the seroprevalence of hepatitis C and Treponema pallidum infection in the blood donors along with their epidemiological determinants. Results: Out of 19,689 donations in 5 years, 690 (3.50%) units were positive for transfusion-transmissible infections with 1.67% donors seropositive for HCV, 1.23% for Treponema pallidum infection, 0.42% for HBV, and 0.18% for HIV. The prevalence of TTIs was found to be highest in 2020 (4.52%) and least in 2017 (2.57%). Out of a total of 330 HCV cases detected in 5 years, 84.85% of cases were seen in voluntary donors. Rural donors constituted 71.21% of cases. The majority of cases were seen in the age group of 18–30 years, i.e., 61.82%, and a maximum number of cases were seen in the farmers (31.21%), followed by laborers and construction workers (21.21%). Out of a total of 242 cases of Treponema pallidum infection, 84.29% were seen in voluntary blood donors. Demographic data showed 70.24% of cases in rural donors. Occupational data revealed a maximum number of cases in farmers (34.29%), followed by laborers (21.90%). Conclusion: Higher seroprevalence of HCV and Treponema pallidum infection in our region as compared with other areas is a matter of great concern about the growing infection rate of these in our area. Stringent use of donor selection criteria and more vigorous donor screening is utmost need of the hour for reducing the burden of TTIs in blood transfusion services.

Background: Fast-food culture is an uprising trend among the younger age groups. Stressful life due to increased study load, staying away from home, peculiar working hours, etc., negatively influences the food choices of medical students. Hence, this study was conducted to describe the prevalence, pattern, and preferences of fast-food consumption and also to determine the relationship of frequency of fast food with body mass index (BMI) of students of a medical college in Western Maharashtra. Methods: A cross-sectional study was done among 398 students of a medical college in Pune for 6 months. The data collection was done using a self-administered pretested structured questionnaire and analyzed using Microsoft Excel and SPSS version 20 software. Results: Three hundred and ninety-eight medical students responded. We found a 100% prevalence of fast-food consumption with different frequencies. 13.8% of the students were found to be overweight. Pizza was the most frequently consumed fast food. The taste factor was the most common reason to consume fast food among both sexes. The majority of the study participants (98.5%) were aware that fast foods are hazardous to health. A statistically significant association was found between the frequency of consumption of fast food with the type of diet (P = 0.008) and BMI (P = 0.023). Conclusion: High prevalence and preference for fast-food consumption can result in various noncommunicable diseases among students of the medical profession and is a major concern. Thus, there is a need for educating the students regarding nutritional information and counseling to bridge the gap between their knowledge and practice about healthy eating behavior.

Frailty is an age-related clinical state associated with deterioration across multiple physiological systems and a leading cause of morbidity and mortality later in life. To understand how frailty develops and what causes its progression, longitudinal data with repeated frailty measurements are required. This review summarizes evidence from longitudinal studies on frailty trajectories, transitions, and trends. We identified several consistent findings: frailty increases with aging and is a dynamic condition, and more recent generations of older adults have higher frailty levels. These findings have both clinical and public health relevance, including the provision of healthcare and aged care services in the coming years. Further studies are required, particularly those conducted in low- and middle-income countries and those investigating factors associated with changes in frailty. The latter may help develop better-targeted interventions to reverse or slow the progression of frailty.

Background Clostridioides difficile (formerly known as Clostridium difficile) infection (CDI) is one of the most prevalent healthcare-associated infections in the United States (US). In the early 2000s, CDI emerged as a great threat with increasing prevalence, mortality, and severity, especially in advanced age. We investigated the US national trends in in-hospital CDI prevalence, mortality, severity, and age composition from 2003 to 2014.Methods We identified the patients with CDI using the national inpatient sample data from 2003 to 2014. We performed Poisson regression model and Kendall’s tau-b correlation test for our analyses.Results Adjusted overall CDI prevalence did not significantly change during 2003–2014. In-hospital mortality of overall CDI did not significantly change during 2003–2008, then significantly decreased during 2008–2014. Severity of overall CDI significantly increased during 2003–2008, then decreased during 2008–2014. The proportions of patients with age [Formula: see text] 65 years decreased in CDI prevalence, mortality, and severity during 2003–2014.Conclusions Compared to the earlier years 2003–2008, overall CDI outcome improved in the later years 2008–2014. Younger patients increasingly contributed to CDI prevalence, mortality, and severity during 2003–2014. More studies to understand underlying driving forces of changes in CDI trends are warranted to mitigate CDI.

Background: Leishmaniasis is one of the endemic diseases in Iran and Isfahan province. This study was conducted to investigate the trend of cutaneous leishmaniasis in 6 main centers of Isfahan province during the years 2007 to 2018. Methods: This research is a cross-sectional descriptive-analytical study that was conducted based on the data available in the Zoonosis Diseases Unit located in the Isfahan Health Vice-Chancellor. The data related to the new cases of cutaneous leishmaniasis that were reported by the detection laboratories as well as the data related to the control measures and the fight against the reservoir were collected. The trend of disease incidence was analyzed separately by foci, year and the relationship between disease incidence and control measures. Findings: The results showed that during this 11-year period, the incidence of leishmaniasis is decreasing, but some centers, such as the number 1 Isfahan region, have had severe fluctuations in some years. The relationship between the average incidence of the disease and the total number of poisons consumed using the Pearson Correlation statistical test was linear and significant. In other words, in the centers where the highest amount of poison has been consumed, the incidence rate of leishmaniasis is also reported to be higher. Conclusion: Considering the fluctuations of the disease in some years, and the number 1 Isfahan region has the highest rate of incidence despite the highest amount of poisons consumed compared to the Shahin-shahr region, the effectiveness of this type of intervention in the long term is doubtful.

Abstract Background Smokeless tobacco use is popular in some regions worldwide, but it receives less attention compared to cigarette smoking. We aimed to estimate the recent prevalence of, and trends in, smokeless tobacco use and to examine its associated factors among adolescents aged 12–16 years in 138 countries/territories (hereafter “countries”) from 1999 to 2019. Methods Data from the Global Youth Tobacco Survey conducted in 138 countries in 2010–2019 and the National Youth Tobacco Survey conducted in the United States in 2019 were used to calculate the prevalence of current smokeless tobacco use and investigate its associated factors among adolescents aged 12–16 years. We also assessed the trend in the prevalence of smokeless tobacco use in 100 countries that had conducted more than one survey from 1999 to 2019. Results The overall prevalence of current smokeless tobacco use was 4.4% (95% confidence interval [CI] 4.0–4.9), with 5.7% (5.1–6.3) for boys, 3.1% (2.6–3.5) for girls, 3.9% (3.5–4.4) for adolescents aged 12–14 years and 5.4% (4.8–5.9) for those aged 15–16 years. The prevalence was highest in the South-East Asian region (6.1%, 4.4–7.7) and lowest in the Western Pacific region (2.0%, 1.7–2.4). The prevalence of smokeless tobacco use decreased in 57 of 100 countries, increased in 32 countries, and remained unchanged in 11 countries. Current cigarette smoking (odds ratio [OR]=2.00, 95% CI=1.68–2.39), other tobacco product use (OR=6.03, 95% CI=4.92–7.40), tobacco advertisement exposure (OR=1.44, 95% CI=1.19–1.74), being offered free tobacco products (OR=2.01, 95% CI=1.66–2.42), and not being taught about dangers of smoking (OR=1.28, 95% CI=1.09–1.50) were all positively associated with current smokeless tobacco use. Conclusions Smokeless tobacco use among adolescents remains a public health concern worldwide. Although the prevalence among adolescents decreased in most countries, it remains high especially in the South-East Asian region. More strict and effective strategies and measures are needed to further curb the smokeless tobacco use among adolescents.

Introduction: the relevance of determining national trends in prevalence of diseases among the adult population in Ukraine is high, as it solves several important medical, social and economic problems of society. The aim: to determine national trends in prevalence of diseases among the adult population in Ukraine and Kharkiv region. Materials and methods: data from official sources of statistical information of Ukraine (State Institution "Center for Medical Statistics of the Ministry of Health of Ukraine") were used to determine national trends in prevalence of diseases among the adult population in Ukraine and Kharkiv region. A systematic analysis and generalization of the obtained data was performed and trends in prevalence of diseases among the adult population in Ukraine and Kharkiv region. Results: a decrease in the prevalence of diseases among the adult population of Ukraine over the 2010-2017 years with trends of -18.3% (general morbidity) and -25.9% (diseases detected for the first time in life) has been determined. Over the 2010-2019 years, the dynamics of reducing the prevalence of diseases and morbidity of adult residents of the Kharkiv region with trends of -12.6% and -23.0% has been established. For 2018-2019, progressive trends in reducing the prevalence of most diseases were noted, except for eating disorders and metabolic disorders (trends of increase, respectively, + 2.2% and + 2.9%) and symptoms, signs and deviations from the norm, which were found in clinical and laboratory studies (trends + 2.8% and + 3.5%) and neoplasms (only in terms of 100 thousand people) — + 0.1%. Discussion: the obtained results of the general dynamics of trends in the prevalence of diseases of the population in Ukraine completely coincide with the data of other world studies. Conclusions: there was a significant decrease in the spread of prevalence of diseases and morbidity among the mature population of Ukraine and the Kharkiv region.