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Aims Methods and results Conclusion Understanding the global burden of disease attributable to high body mass index (BMI) is essential for informing public health strategies and interventions to mitigate the impact of obesity‐related conditions.The global deaths and disability‐adjusted life years (DALYs) caused by high BMI were examined based on age, sex, year, and geographical location as well as socio‐demographic index. Globally in 2021, the deaths and DALYs attributable to high BMI have risen 2.54‐fold and 2.68‐fold for both sexes when compared to 1990. The number of global deaths linked to high BMI has risen for females from 828 147.16 (95% uncertainty interval [UI] 407 103.20–1 302 480.38) in 1990 to 2 013 089.03 (95% UI 979 000.37–3 076 044.71) in 2021, and for males from 631 386.07 (95% UI 315 452.97–988 213.75) in 1990 to 1 695 974.32 (95% UI 861 972.49–2 635 343.31) in 2021. The number of DALYs related to high BMI worldwide has risen for females from 26 097 463.34 (95% UI 11 042 501.33–42 206 794.07) in 1990 to 67 213 785.86 (95% UI 28 417 735.35–105 552 568.89) in 2021, and for males from 21 944 645.99 (95% UI 10 106 039.21–35 110 379.12) in 1990 to 61 306 297.23 (95% UI 27 566 755.49–94 931 874.52) in 2021. However, the age‐standardized rate of high‐BMI‐related deaths for females increased by 4.06% and 15.06% for males between 1990 and 2021, while the age‐standardized rate of high‐BMI‐related DALYs increased by 21.60% for females and 31.22% for males. Across the 21 Global Burden of Disease regions, in 2021, the highest age‐standardized rates of high‐BMI‐related deaths and DALYs were observed in Southern Sub‐Saharan Africa (125.12, 95% UI 71.21–183.13) and Oceania (3712.97, 95% UI 1666.49–5765.84), respectively.Efforts to promote healthy weight management, lifestyle modifications, and early intervention for obesity‐related health complications are essential in reducing the morbidity and mortality associated with obesity and improving overall population health. [ABSTRACT FROM AUTHOR]

Background: Cirrhosis continues to be the most common cause of chronic liver disease‐related deaths globally, which puts significant strain on global health. This report aims to investigate the patterns of cirrhosis in China, the United States, India and worldwide from 1990 to 2019 through an epidemiological analysis of the disease utilizing data from the Global Burden of Disease Study (GBD) 2019 database. Methods: Download the GBD database's statistics on liver cirrhosis deaths and Disability‐Adjusted Life Years for the years 1990–2019 worldwide as well as for China, the United States and India. Utilize techniques like age–period–cohort interaction, decomposition analysis, study of health inequities, Joinpoint model and Bayesian Average Annual Percentage Change model to process the data. Results: The main age group affected by cirrhosis disease, according to the results, is 50–69 years old. According to the Joinpoint model, there has been a negative worldwide Average Annual Percent Change (AAPC) in the burden of cirrhosis between 1990 and 2019. Only the USA's AAPC is positive out of the three nations that were evaluated (albeit its 95% confidence interval spans 0). These are China, India and the United States. Forecasting models indicate that the prevalence of cirrhosis will keep rising in the absence of government action. According to decomposition analysis, the main factors contributing to the rising burden of cirrhosis are population ageing and size, whereas changes in the disease's epidemiology slow the disease's growth. Research on health disparities indicates that, between 1990 and 2019, there was a downward trend in health disparities between various locations. Conclusion: Health organizations across different areas should take aggressive measures to address the worrisome prevalence of cirrhosis. [ABSTRACT FROM AUTHOR]

This study analyzes the epidemiology of pediatric drowning in Israel from 2010 to 2022, focusing on differences across age groups, sex, and regions. We conducted a retrospective cohort study using data from the Ministry of Health's administrative databases, covering all children aged 0–17 years who were seen in the emergency department, discharged after hospitalization, or died at the scene due to drowning, excluding cases of intentional harm or suicide. The primary outcome was the annual drowning rate per 100,000 children, categorized by age, sex, and region, along with hospitalization duration, intensive care unit admissions, and mortality rates. A total of 2101 drowning incidents were identified, with 9% resulting in death. Higher drowning rates were found in younger children (1–4 years) and teenagers (15–17 years), with notable differences by sex. Drowning rates were higher in coastal regions and more frequent during winter and spring. An increase in drowning rates was observed over the last 3 years of the study (2020–2022). Children hospitalized for more than 3 days had significantly higher mortality rates, both in general wards and intensive care units. Conclusions: Pediatric drowning is a persistent public health concern in Israel, with distinct seasonal, regional, age-specific, and sex-specific patterns in incidence and mortality. This study underscores the need for a comprehensive prevention strategy that includes year-round public education, environmental safety measures, and targeted interventions for high-risk groups to reduce drowning incidents and fatalities among children effectively. What is Known: • Pediatric drowning represents a significant public health challenge globally, with varying rates. • In Israel, pediatric drowning is the second leading cause of death from all injury-related deaths. Thus far, the measures and interventions to reduce fatalities were not proven effective enough. What is New: • Pediatric drowning in Israel, with a 9% mortality rate, revealed a biphasic rate varied by sex and is higher in coastal regions and during winter and spring. • There was a notable increase in drowning incidents during the last 3 years of the study period (2020–2022), coinciding with the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

This study investigates the projected impact of air pollution on mortality and Disability-Adjusted Life Years (DALYs) across SAARC countries. Utilizing Time Series and Machine Learning methodologies such as Autoregressive Integrated Moving Average, Exponential Smoothing, and Neural Network, the research aims to accurately forecast the mortality and DALYs attributed to air pollution from 2020 to 2030. Statistical analyses reveal a consistent upward trend in deaths and DALYs during the forecasting period, primarily driven by Ambient Particulate Matter Pollution (APM) and Ambient Ozone Pollution (AOP). Comparing the predictive accuracy of the models, Neural Network outperformed other methods, as indicated by Root Mean Square Error (RMSE) values. Specifically, the study finds that deaths and DALYs due to Ambient Particulate Matter pollution are least prevalent in the Maldives, while India and Pakistan exhibit the highest rates, and deaths and DALYs due to Ambient Ozone pollution are lowest in the Maldives and highest in Bangladesh and Pakistan. Moreover, deaths and DALYs attributed to Household Air Pollution (HAP) are lowest in Pakistan and highest in Nepal. These findings underscore the urgent need for air pollution control measures and informed policymaking in SAARC countries to mitigate the escalating health burden associated with air pollution. [ABSTRACT FROM AUTHOR]

Abstract This study investigates the projected impact of air pollution on mortality and Disability-Adjusted Life Years (DALYs) across SAARC countries. Utilizing Time Series and Machine Learning methodologies such as Autoregressive Integrated Moving Average, Exponential Smoothing, and Neural Network, the research aims to accurately forecast the mortality and DALYs attributed to air pollution from 2020 to 2030. Statistical analyses reveal a consistent upward trend in deaths and DALYs during the forecasting period, primarily driven by Ambient Particulate Matter Pollution (APM) and Ambient Ozone Pollution (AOP). Comparing the predictive accuracy of the models, Neural Network outperformed other methods, as indicated by Root Mean Square Error (RMSE) values. Specifically, the study finds that deaths and DALYs due to Ambient Particulate Matter pollution are least prevalent in the Maldives, while India and Pakistan exhibit the highest rates, and deaths and DALYs due to Ambient Ozone pollution are lowest in the Maldives and highest in Bangladesh and Pakistan. Moreover, deaths and DALYs attributed to Household Air Pollution (HAP) are lowest in Pakistan and highest in Nepal. These findings underscore the urgent need for air pollution control measures and informed policymaking in SAARC countries to mitigate the escalating health burden associated with air pollution.

Abstract Atrial fibrillation (AF)/atrial flutter (AFL) is the most common cardiac tachyarrhythmia, with an increasing trend in its burden in recent years. However, the burden of AF/AFL in Iran remains unclear. This study aimed to estimate the burden of AF/AFL and its attributable risk factors from 1990 to 2019 at national and subnational levels. Using the comparative risk assessment method of the Global Burden of Disease (GBD) Study 2019, we extracted data on AF/AFL incidence, prevalence, deaths, disability-adjusted life years (DALYs), and their age-standardized rates from 1990 to 2019 and analyzed them based on by age, sex, and socio-demographic index (SDI). The percentage contribution of AF/AFL major risk factors was calculated. Moreover, the AF/AFL burden in 2050 was projected using the United Nations world population prospect data. In 2019, there were 339.1 (259.4–433.7) thousand AF/AFL patients in Iran, with 30.2 (23.2–38.5) thousand new cases, 1.7 (1.5–2) thousand deaths and 48 (37.7–60.5) thousand DALYs. Females and 50–69-year-old patients recorded a higher burden for AF/AFL; however, the increasing trend was more pronounced in males and more than 85-year-old patients. High systolic blood pressure and elevated body mass index (BMI) were the predominant attributable risk factors for AF/AFL-related deaths and DALYs. It is estimated that in 2050, the number of AF/AFL patients will increase to 1.1 million people, the incidence of AF/AFL will increase to 91 thousand patients, and the number of AF/AFL-related deaths and DALYs will surge to 7.2 and 170.8 thousand, respectively. Despite advancements in prevention and treatment, AF/AFL remains a major public health problem in Iran. Given its largely preventable and treatable nature, more cost-effective strategies are required to target modifiable risk factors, especially within susceptible age and sex groups.

Objective: Liver cancer is a major health concern globally and in China. This analysis investigated deaths and disability-adjusted life years (DALYs) with respect to etiologies and risk factors for liver cancer in China and worldwide. Methods: Global and China-specific data were collected on liver cancer deaths, DALYs, and age-standardized rates (ASRs) from the Global Burden of Disease Study 2019 database. Liver cancer etiologies were classified into five groups and risk factors were categorized into three levels. Each proportion of liver cancer burden was calculated in different geographic regions. The joinpoint regression model were used to assess the trends from 1990–2019. Results: Liver cancer accounted for 484,577 deaths worldwide in 2019 with an ASR of 5.9 per 100,000 population. China had an elevated liver cancer death ASR in 2019 and males had an ASR 1.7 times the global rate. The global ASR for DALYs peaked at 75–79 years of age but peaked earlier in China. Hepatitis B virus was the prominent etiology globally (39.5%) and in China (62.5%), followed by hepatitis C virus and alcohol consumption. In high sociodemographic index countries, non-alcoholic steatohepatitis has gained an increasing contribution as an etiologic factor. The liver cancer burden due to various etiologies has decreased globally in both genders. However, metabolic risk factors, particularly obesity, have had a growing contribution to the liver cancer burden, especially among males. Conclusions: Despite an overall decreasing trend in the liver cancer burden in China and worldwide, there has been a rising contribution from metabolic risk factors, highlighting the importance of implementing targeted prevention and control strategies that address regional and gender disparities.

Background: Paediatric deaths occurring within 24 hours of presentation to hospital contribute substantially to overall in-hospital mortality. The underlying contributors to these early deaths have not been well delineated. Objectives: To describe the characteristics (demographic features, ascribed aetiologies, predisposing factors) associated with deaths of paediatric patients within the first 24 hours of hospital presentation, and to determine modifiable factors that can be addressed to improve patient care and outcomes. Design: A secondary data analysis of deaths of paediatric patients within a metropolitan hospital system in South Africa. Data were obtained from the Child Healthcare Problem Identification Program (Child PIP) database for the time period 1 January 2005 through 31 December 2014. Setting: The three hospitals within a metropolitan hospital system, South Africa. Results: Of 2080 in-hospital deaths, 563(27%) occurred within 24 hours of hospital arrival. Almost half (48.3%) of these deaths occurred in infants aged 28 days to 1 year. The main causes of early mortality were sepsis (18.6%), acute respiratory illness(17.2%), and gastroenteritis with resultant hypovolemic shock(16.3%).During the initial 5-year time period, 30.5% of children who died were HIV positive. This percentage decreased to 14% in the latter 5-year time period. A majority of deaths were considered avoidable (89.5%). Potentially modifiable contributors to death included delay in seeking care (45.3% of deaths), poor assessment (36.9%), and inadequate management (29.3%) and monitoring (17.0%)of patients. Conclusions: Deaths within the first 24 hours after presentation to hospital were a major contributor to overall in-hospital mortality. Identified modifiable contributors to death can be addressed through improved education and training of both health care providers and family caregivers.

The reproduction number, R0, is an important parameter in epidemic models. It is interpreted as the average number of new cases resulted from each infected individual during the course of infection. In this paper, the R0 estimates since the outbreak of COVID-19 till 10 August 2020 for eight countries were computed using the package R{eSIR}. The computed values were examined and compared with the daily R0 estimates obtained by a static SIR model by aligning the days of infection, assuming a fixed number of days for the infected person to become confirmed/recover/die. The results showed that running R{eSIR} to obtain R0 estimates provided an easy mean of exploring epidemic data. Care must be taken in the interpretation of R0 as a measure of severity of the spread of an epidemic. Other factors, such as imported cases, need to be considered.

Atrial fibrillation (AF)/atrial flutter (AFL) is the most common cardiac tachyarrhythmia, with an increasing trend in its burden in recent years. However, the burden of AF/AFL in Iran remains unclear. This study aimed to estimate the burden of AF/AFL and its attributable risk factors from 1990 to 2019 at national and subnational levels. Using the comparative risk assessment method of the Global Burden of Disease (GBD) Study 2019, we extracted data on AF/AFL incidence, prevalence, deaths, disability-adjusted life years (DALYs), and their age-standardized rates from 1990 to 2019 and analyzed them based on by age, sex, and socio-demographic index (SDI). The percentage contribution of AF/AFL major risk factors was calculated. Moreover, the AF/AFL burden in 2050 was projected using the United Nations world population prospect data. In 2019, there were 339.1 (259.4–433.7) thousand AF/AFL patients in Iran, with 30.2 (23.2–38.5) thousand new cases, 1.7 (1.5–2) thousand deaths and 48 (37.7–60.5) thousand DALYs. Females and 50–69-year-old patients recorded a higher burden for AF/AFL; however, the increasing trend was more pronounced in males and more than 85-year-old patients. High systolic blood pressure and elevated body mass index (BMI) were the predominant attributable risk factors for AF/AFL-related deaths and DALYs. It is estimated that in 2050, the number of AF/AFL patients will increase to 1.1 million people, the incidence of AF/AFL will increase to 91 thousand patients, and the number of AF/AFL-related deaths and DALYs will surge to 7.2 and 170.8 thousand, respectively. Despite advancements in prevention and treatment, AF/AFL remains a major public health problem in Iran. Given its largely preventable and treatable nature, more cost-effective strategies are required to target modifiable risk factors, especially within susceptible age and sex groups. [ABSTRACT FROM AUTHOR]

COVID-19 is putting a lot of strain on hospitals in order to stop SARS-CoV-2 from spreading. Stopping the COVID-19 outbreak requires equitable access to effective and safe COVID-19 vaccinations. The aim of this study was to study the global trend of deaths, cases, and vaccinations related to COVID-19. This was an ecological descriptive study that was conducted using publicly available data on deaths, cases, and vaccinations related to COVID-191 for the duration between February 2021 and February 2022 from the Our World in Data portal. A total of 437, 091, 587 COVID-19 cases were reported in the world until the 28th of February 2022. The prevalence rate of COVID-19 increased by 2.82-fold. The incidence rate of New COVID-19 cases increased by 4.15-fold. The overall COVID-19 mortality rate increased by 1.28-fold. The overall COVID-19 vaccination rate increased by 38.92-fold. The rate of COVID-19 vaccination increased during the study period. This was accompanied by a decrease in the rate of new COVID-19 cases and the rate of COVID-19-related mortality. Vaccination rates varied across continents and according to country income. COVID-19 vaccination must be made more acceptable by public awareness campaigns. This is likely to reduce the disease's incidence and related mortality. [ABSTRACT FROM AUTHOR]

Aim: Our study aims to provide an updated estimate of age‐ and sex‐specific deaths and disability‐adjusted life years (DALYs) associated with high body mass index (BMI) from 1990 to 2019 at the global, regional and national levels, and to forecast the global burden of disease attributed to high BMI from 2020 to 2035. Methods: We used the data for the number of deaths, DALYs, age‐standardized rate (per 100 000 population), percentage change and population attributable fraction from the Global Burden of Disease Study 2019 (GBD 2019) to examine the disease burden attributable to high BMI. We further applied an autoregressive integrated moving average (ARIMA) model to predict the disease burden for the period 2020‐2035. Results: From 1990 to 2019, the deaths and DALYs attributable to high BMI increased by 148% and 155.86% for men, and by 111.67% and 121.78% for women, respectively. In 2019, high BMI directly accounted for 8.52% [95% uncertainty intervals (UI) 0.05, 0.12] of all‐cause deaths and 5.89% (95% UI 0.04, 0.08) of global DALYs. The highest death rates were observed in men aged 65‐69 and women aged 75‐79. The highest DALY rates were observed in the age group of 60‐64 for both sexes. In 2019, the highest age‐standardized deaths and DALY rates were observed in the Central Asia region [163.15 (95% UI 107.72, 223.58) per 100 000 people] and the Oceania region [4643.33 (95% UI 2835.66, 6902.6) per 100 000 people], respectively. Fiji [319.08 (95% UI 213.77, 444.96) per 100 000 people] and Kiribati [10 000.58 (95% UI 6266.55, 14159.2) per 100 000 people] had the highest age‐standardized deaths and DALY rates, respectively. In 2019, the highest age‐standardized rates of high BMI‐related deaths and DALYs were observed in the middle‐high socio‐demographic index quintile and in the middle socio‐demographic index quintile. The age‐standardized deaths and DALY rates attributable to high BMI are projected to increase in both sexes from 2020 to 2035. The death rates are projected to rise from 62.79 to 64.31 per 100 000 people, while the DALY rates are projected to rise from 1946 to 2099.54 per 100 000 people. Conclusions: High BMIs significantly contribute to the global disease burden. The projected rise in deaths and DALY rates attributable to high BMI by 2035 highlights the critical need to address the impact of obesity on public health. Our study provides policymakers with up‐to‐date and comprehensive information. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, patients with Alzheimer's disease and related dementias (ADRD) were especially vulnerable, and modes of medical care delivery shifted rapidly. This study assessed the impact of the pandemic on care for people with ADRD, examining the use of primary, emergency, and long-term care, as well as deaths due to COVID and to other causes. Methods: Among 4.2 million beneficiaries aged 66 and older with ADRD in traditional Medicare, monthly deaths and claims for routine care (doctors' office and telehealth visits), inpatient/emergency department (ED) visits, and long-term care facility use from March or June 2020 through December 2022 are compared to monthly rates predicted from January–December 2019 using OLS and logistic/negative binomial regression. Correlation analyses examine the association between excess deaths — due to COVID and non-COVID causes — and changes in care use in the beneficiary's state of residence. Results: Increased telehealth visits more than offset reduced office visits, with primary care visits increasing overall (by 9 percent from June 2020 onward relative to the predicted rate from 2019, p <.001). Emergency/inpatient visits declined (by 9 percent, p <.001) and long-term care facility use declined, remaining 14% below the 2019 trend from June 2020 onward (p <.001). Both COVID and non-COVID deaths rose, with 231,000 excess deaths (16% above the prediction from 2019), over 80 percent of which were attributable to COVID. Excess deaths were higher among women, non-White patients, those in rural and isolated zip codes, and those with higher social deprivation index scores. States with the largest increases in primary care visits had the lowest excess deaths (correlation -0.49). Conclusions: Older adults with ADRD had substantial deaths above pre-pandemic projections during the COVID-19 pandemic, 80 percent of which were attributed to COVID-19. Routine care increased overall due to a dramatic increase in telehealth visits, but this was uneven across states, and mortality rates were significantly lower in states with higher than pre-pandemic visits. [ABSTRACT FROM AUTHOR]

Objectives: In addition to harms caused to individuals who smoke, second-hand smoke (SHS or passive smoke) is an important public health issue. We aim to estimate the extent of preventable deaths due to tobacco and SHS exposure in Southeast Asia. Methods: Data were from the Global Burden of Disease Study 2019. We analysed data from Southeast Asia, including Cambodia, Indonesia, Laos, Malaysia, Maldives, Mauritius, Myanmar, Philippines, Seychelles, Sri Lanka, Thailand, Timor-Leste, and Vietnam. Results: In 2019, there were 728,500 deaths attributable to tobacco in Southeast Asia, with 128,200 deaths attributed to SHS exposure. The leading causes of preventable deaths were ischemic heart disease, stroke, diabetes mellitus, lower respiratory infections, chronic obstructive pulmonary disease, tracheal, bronchus, and lung cancer. Among deaths attributable to tobacco, females had higher proportions of deaths attributable to SHS exposure than males in Southeast Asia. Conclusion: The burden of preventable deaths in a year due to SHS exposure in Southeast Asia is substantial. The implementation and enforcement of smoke-free policies should be prioritized to reduce the disease burden attributed to passive smoking in Southeast Asia. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The reproduction number, R 0 , is an important parameter in epidemic models. It is interpreted as the average number of new cases resulted from each infected individual during the course of infection. In this paper, the R 0 estimates since the outbreak of COVID-19 till 10 August 2020 for eight countries were computed using the package R{eSIR}. The computed values were examined and compared with the daily R 0 estimates obtained by a static SIR model by aligning the days of infection, assuming a fixed number of days for the infected person to become confirmed/recover/die. The results showed that running R{eSIR} to obtain R 0 estimates provided an easy mean of exploring epidemic data. Care must be taken in the interpretation of R 0 as a measure of severity of the spread of an epidemic. Other factors, such as imported cases, need to be considered. [ABSTRACT FROM AUTHOR]

This paper examines the timing of one‐time fluctuations in births subsequent to the 1918 influenza pandemic in Madras (now Chennai), India. After seasonally decomposing key demographic aggregates, we identified abrupt one‐time fluctuations in excess births, deaths, and infant deaths. We found a contemporaneous spike in excess deaths and infant deaths and a 40‐week lag between the spike in deaths and a subsequent deficit in births. The results suggest that India experienced the same kind of short‐term postpandemic "baby bust" that was observed in the United States and other countries. Identifying the mechanisms underlying this widespread phenomenon remains an open question and an important topic for future research. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Pesticide poisoning kills hundreds of thousands of people in the Asia Pacific region each year. The majority are from deliberate self-poisoning with organophosphorus pesticides (OP), paraquat etc. It is a critical health problem in rural areas, where hazardous pesticides are easily available. Very few studies were present regarding this in India and research on anti-dotes to commonly available pesticides is very minimal. According to WHO report, it is the 2nd most common cause of death among people aged 15-29 years. Methodology: An observational study was conducted to study suicidal poisoning cases from Jan-June 2022 in a retrospective record-based manner. Qualitative variables were represented with graphs and tables. Quantitative variables were represented with mean and Standard deviation. Multinomial logistic regression was done to test the significance of poisoning agents with survival status. Nagelkerke R-squared mean regression model was considered in the analysis. p-value less than 0.05 was considered significant. Results: The incidence of suicidal poisoning was 696(~0.46%) during the study period. The mean age of the study population is 32.5±12.3 years. Majority of the cases were Organophosphorus compounds and paraquat comprising a total of about 26.11%. Fatality rate was 17.4% Multinomial logistic regression of various poisoning agents showed high significance of mortality OP poisoning (p=0.03), Paraquat poisoning (p<0.001) and Herbicides (p=0.02). Conclusion: Young populations were more prone to commit suicide suggesting increased recognition of the need for a coordinated response involving public health officials and psychiatric specialists to conduct mental health awareness camps and to provide counselling. Strengthening of translational research to develop anti-dotes for commonly available pesticides. [ABSTRACT FROM AUTHOR]

Introduction: The present study is an epidemiological study of the fatal cases of COVID-19 positive by Reverse Transcriptase Polymerase Chain Reaction in a tertiary care centre in West Bengal. The trace, track and treat mode of investigation has helped in the control and timely intervention in the disease pathogenesis. Objective: to analyse the epidemiological characteristics of COVID-19 related deaths in tertiary centre in Eastern India and comprehended the pattern of deaths due to COVID-19. This will help in understanding the gaps between infection and deaths. Methods: It was a cross sectional analytical study. The Medical certification of cause of death was studied and data was tabulated. We collected deaths due to COVID-19 in a tertiary set up in Eastern India from March'2020 to September'2020. Results: A total of sixty-one deaths were studied. Among the deaths with COVID-19, mild type accounted for the most followed by the severe type. The median age was 65 years50% of the deaths were distributed in 60-80 years age group. Additionally, the male to female ratio was 3:1. % of patients had underlying comorbidities. It was noted more amongst males. Most of the underlying diseases were hypertension, Diabetes Mellitus, cardiovascular diseases. Conclusion: COVID-19 posed a greater threat to the elderly people and men with fatal consequences. [ABSTRACT FROM AUTHOR]

Aims To devise effective preventive measures, a profound understanding of the evolving patterns and trends in atrial fibrillation (AF) and atrial flutter (AFL) burdens is pivotal. Our study was designed to quantify the burden and delineate the risk factors associated with AF and AFL across 204 countries and territories spanning 1990–2021. Methods and results Data pertaining to AF and AFL were sourced from the Global Burden of Disease Study 2021. The burden of AF/AFL was evaluated using metrics such as incidence, disability-adjusted life years (DALYs), deaths, and their corresponding age-standardized rates (ASRs), stratified by age, sex, socio-demographic index (SDI), and human development index (HDI). The estimated annual percentage change was employed to quantify changes in ASRs. Population attributable fractions were calculated to determine the proportional contributions of major risk factors to age-standardized AF/AFL deaths. This analysis encompassed the period from 1990 to 2021. Globally, in 2021, there were 4.48 million incident cases [95% uncertainty interval (UI): 3.61–5.70], 8.36 million DALYs (95% UI: 6.97–10.13) and 0.34 million deaths (95% UI: 0.29–0.37) attributed to AF/AFL. The AF/AFL burden in 2021, as well as its trends from 1990 to 2021, displayed substantial variations based on gender, SDI quintiles, and geographical regions. High systolic blood pressure emerged as the leading contributor to age-standardized AF/AFL incidence, prevalence, death, and DALY rate globally among all potential risk factors, followed closely by high body mass index. Conclusion Our study underscores the enduring significance of AF/AFL as a prominent public health concern worldwide, marked by profound regional and national variations. Despite the substantial potential for prevention and management of AF/AFL, there is a pressing imperative to adopt more cost-effective strategies and interventions to target modifiable risk factors, particularly in areas where the burden of AF/AFL is high or escalating. [ABSTRACT FROM AUTHOR]

Background: No studies have updated the epidemiologic changes in non-rheumatic degenerative mitral valve disease (DMVD) since 2019, thus this study utilized data from the Global Study of Diseases, Injuries, and Risk Factors 2019 (GBD2019) to assess the burden of DMVD in 204 countries and territories over the period 1990–2019, as well as changes in the prevalence, incidence, deaths and changes in disability-adjusted life years (DALYs). Methods: Using the results from the GBD2019, analyzing the incidence, prevalence, deaths, and DALYs rates, as well as their age-standardized rates (ASR). Based on the human development index (HDI), the socio-demographic index (SDI), age, and sex. Results: In 2019, there were 24.229 million (95% uncertainty interval (UI) 23.081–25.419 million) existing cases of DMVD worldwide, with 1.064 million (95% UI 1.010–1.122 million) new cases and 0.034 million (95% UI 0.028–0.043 million) deaths, and 0.883 million (95% UI 0.754–1.092 million) disability-adjusted life years. The incidence, prevalence, deaths, and DALYs of DMVD and their ASR showed significant differences across sex, age groups, regions, and countries from 1990 to 2019. It is projected that by 2030, the incidence of DMVD in females will be 0.72 million with an ASR of 15.59 per 100,000 population, 0.51 million in males with an ASR of 11.75 per 100,000 population, and a total incidence of 1.23 million with an ASR of 14.03 per 100,000 population. Conclusions: DMVD remains a significant public health problem that cannot be ignored, despite a decreasing trend in the ASR of global incidence, prevalence, deaths and DALYs from 1990 to 2019. However, we note an adverse development trend in countries with low socio-demographic indexes and seriously aging societies, and sex inequality is particularly prominent. This indicates the need to reposition current prevention and treatment strategies, with some national health administrations developing corresponding strategies for preventing an increase in DMVD based on local health, education, economic conditions, sex differences, and age differences. [ABSTRACT FROM AUTHOR]

Abstract Objective: To investigate factors associated with tuberculosis deaths in Mato Grosso state, Brazil, from 2011 to 2020. Methods: Retrospective cohort study with data obtained from the Notifiable Health Conditions Information System and the Mortality Information System. Deaths were qualified using probabilistic linkage and analyzed using Poisson regression. Results: 12,331 cases and 525 deaths were identified over 10 years. The factors associated with death were: age ≥60 years (RR: 7.70; 95%CI 1.91;31.04), incomplete elementary and high school education (RR: 3.66; 95%CI 1.34;9.96), illiteracy (RR: 4.50; 95%CI 1.60;12.66), homeless population (RR: 2.41; 95%CI 1.34;4.35), alcohol use (RR: 1.45; 95%CI 1.04;2.02), male sex (RR: 1.48; 95%CI 1.04;2.09) and tobacco use (RR: 1.32; 95%CI 0.98;1.77). Laboratory confirmation was a protective factor. Conclusion: Risk of death was higher in men over 60 years old, with low education levels, in vulnerable situations, and who used alcohol/tobacco.

BackgroundMaternal sepsis and other maternal infections (MSMIs) are major public health concerns worldwide. However, comprehensive data on their global burden and evolving trends remain sparse. This study aims to explore the epidemiological trends of MSMIs in women of childbearing age (WCBA) from 1990 to 2019, investigate the relationship between disease burden and age, period, and birth cohorts, and then provide a prediction of MSMIs incidence and deaths.MethodsThe estimates and 95% uncertainty intervals (UIs) for the incidence and death number of MSMIs in seven age groups (15–19, 20–24, 25–29, 30–34, 35–39, 40–44, 45–49 years) were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. The age-standardized incidence and mortality rates of MSMIs in WCBA were estimated utilizing the age standardization by direct method. Joinpoint regression analysis was employed to investigate the changing trends of age-standardized incidence and mortality rates from 1990 to 2019. Age-period-cohort analysis was utilized to estimate the independent effects of age, period, and birth cohorts. Furthermore, a Nordpred age-period-cohort analysis was implemented to predict the global epidemiological trends through 2044.ResultsIn 2019, the estimated global age-standardized incidence and mortality rates of MSMIs in WCBA were 1072.90 (95% UI: 725.93 to 1483.46) and 0.86 (95% UI: 0.69 to 1.05), respectively. The highest disease burden existed in the African Region. From 1990 to 2019, the estimated global age-standardized incidence and mortality rates of MSMIs (AAPC: -1.32, 95% CI: −1.34 to −1.30; AAPC: -3.39, 95% CI: −4.28 to −2.48) in WCBA both demonstrated significant declining trends. The changing trends varied significantly across 6 regions and 204 countries. The effects of age, period, and cohort on incidence and mortality rates differed. From 2020 to 2044, the global age-standardized incidence rate of MSMIs in WCBA was predicted to decrease whereas the case number increases slowly.ConclusionThe global trends in MSMIs incidence and mortality generally showed a decline with considerable heterogeneity, indicating both the effectiveness and unevenness of global management of MSMIs. Moreover, the predicted increased case number highlights prominent challenges in the control of MSMIs.

ContextSegregation has been linked to unequal life chances. Individuals from marginalized communities experience more crime, higher levels of poverty, poorer health, and less civic engagement. In addition, segregated metropolitan regions have been found to display inequality in access to basic services. This article builds on these findings by linking segregation to infection and deaths from COVID-19.MethodsUsing census data matched to COVID infection and death statistics at the county level, this article offers a theoretical basis for the researchers' choice of segregation measures and predictions for different racial groups. It analyzes the relationship between two dimensions of segregation-racial isolation and racial unevenness-and COVID outcomes for different racial and ethnic groups.FindingsIn counties where Black and Latino residents lived in more racially isolated neighborhoods, they were much more likely to contract COVID-19. This pattern was exacerbated in counties with a high proportion of frontline workers. In addition, racial segregation increased COVID-19 death rates for Black, Latino, and white residents.ConclusionsThese findings suggest that devastating outcomes of the coronavirus pandemic were linked to a long history of racial marginalization and entrenched discrimination produced by structural inequalities embedded in our geographies. This knowledge should be used to inform public health planning.

Abstract Background In response to the harm caused by tobacco use worldwide, the World Health Organization (WHO) World Health Assembly actioned the WHO Framework Convention on Tobacco Control (FCTC) in 2005. To help countries meet their FCTC obligations, the WHO introduced in 2008 the MPOWER policy package and by 2020 the FCTC had been ratified by 182 parties. The package consists of six evidence-based demand reduction smoking cessation policies to assist countries to achieve best practice. We used published evaluation results and replicated the published model to estimate current policy achievement and demonstrate the impact and equity of the MPOWER policy package in reducing the global number of smokers and smoking-attributable deaths (SADs) between 2007 and 2020. Methods We replicated an evaluation model (the Abridged SimSmoke model) used previously for country impact assessments and validated our replicated reduction in SADs for policies between 2014 and 2016 against the published results. The replicated model was then applied to report on the country level SADs averted from achieving the highest level of implementation, that is best practice in MPOWER policies, between 2016 and 2020. The latest results were then combined with past published results to estimate the reduction in SADs since the commencement of the MPOWER policy package. Country level income status was used to investigate the equity in the uptake of MPOWER policies worldwide. Results Identical estimates for SADs in 41 out of 56 MPOWER policies implemented in 43 countries suggested good agreement in the model replication. The replicated model overestimated the reduction in SADs by 159,800 (1.5%) out of a total of 10.5 million SADs with three countries contributing to the majority of this replication discrepancy. Updated analysis estimated a reduction of 8.57 million smokers and 3.37 million SADs between 2016 and 2020. Between 2007 and 2020, 136 countries had adopted and maintained at least one MPOWER policy at the highest level which was associated with a reduction in 81.0 million smokers and 28.3 million SADs. Seventy five percent of this reduction was in middle income countries, 20% in high income and less than 5% in low income countries. Conclusions Considerable progress has been made by MPOWER policies to reduce the prevalence of smokers globally. However, there is inequality in the implementation and maintenance, reach and influence, and the number of SADs averted. Future research to modify the model could provide a more comprehensive evaluation of past and future progress in tobacco control policies, worldwide.

Background: The purpose of this study is to assess the burden of thyroid cancer over the course of 30 years in 204 countries and territories. Methods: Data from the Global Burden of Disease (GBD) 2019 database was analyzed to extract information on prevalence, deaths, DALYs(disability-adjusted life-years), YLL(years of life los), YLD(years lived with disability), and their corresponding age-standardized rates at global, regional, and national levels. The primary focus of the study was to examine trends in thyroid cancer from 1990 to 2019, specifically looking at the Estimated Annual Percentage Change (EAPC) for ASPR, ASDR, and ASDR. Additionally, the study investigated the relationship between cancer burden and the Socio-Demographic Index (SDI). Results: Globally, there will be approximately 18.3 million thyroid cancer (TC) cases in 2019; China and the USA are projected to be the most significant with 310,327 and 220,711 cases (16.17 and 14.82 cases per 100,000 people, respectively).Over the period from 1990 to 2019, age-standardized prevalence rates exhibited a global rise, whereas deaths and DALYs saw a decrease(EAPC:1.63, –0.15- –0.14, respectively). Significantly, the age-standardized prevalence rate increased in 21 GBD regions, affecting 195 out of 204 countries or territories. Over the studied period, thyroid cancer cases, deaths, and DALYs were consistently higher among females than males. Furthermore, a higher Socio-demographic Index was associated with increased age-standardized prevalence rates. [ABSTRACT FROM AUTHOR]

For more than two decades there has been a continuous rise in opioid overdose related deaths. The majority of the deaths include the age range when, traditionally, individuals are likely to attend college or university. As a result, Vassar College has taken the important initiative and created and implemented a new opioid overdose intervention strategy and action plan called AED+. AED+ expands on the Model of Greater Awareness, Training and Increased Availability of and Accessibility to Life Saving Intervention Devices; a model that was created based on AED devices improving outcomes of out-of-hospital cardiac arrest emergencies. Similar to AED's improving out-of-hospital cardiac arrest outcomes, the + component of the AED+ initiative increases awareness and provides basic, targeted education about naloxone and its use. Furthermore, the education includes information about naloxone's greater availability and its more immediate access across the campus by students, staff, faculty, administrators, and visitors in the event of a suspected opioid overdose. Starting in May 2023, members of the school's Health Service and senior administrative leaders identified it necessary to be proactive and not reactive to managing an opioid overdose in the campus community. Although Vassar College has not recently experienced an opioid overdose, it is confidently projected that these targeted actions will proactively and positively reduce the likelihood of opioid-related fatalities on campus. Furthermore, it is the purpose of this article to share the AED+ model so other colleges and universities can modify it to best fit their unique setting in order to improve opioid overdose outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Coroners' Prevention of Future Death (PFDs) reports are an under-utilized resource to learn about preventable deaths in England and Wales. We aimed to identify sepsis-related PFDs and explore the causes and concerns in this subset of preventable sepsis deaths. Methods: Four thousand three hundred five reports were acquired from the Courts and Tribunals Judiciary website between July 2013 and November 2022, which were screened for sepsis. Demographic information, coroners concerns and responses to these reports were extracted and analyzed, including a detailed paediatric subgroup analysis. Results: Two hundred sixty-five reports (6% of total PFDs) involved sepsis-related deaths. The most common cause of death in these reports was "sepsis without septic shock" (42%) and the most common site of infection was the respiratory system (18%) followed by gastrointestinal (16%) and skin (13%) infections. Specific pathogens were named in few reports (27%). Many deaths involved multimorbid patients (49%) or those with recent surgery (26%). Coroners named 773 individual concerns, the most frequent were: a failure to keep accurate records or notes (28%), failure in communication or handover (27%) or failure to recognize risk factors or comorbidities (20%). Paediatric cases frequently reported issues with sepsis screening tools (26%). Sepsis PFDs resulted in 421 individual reports being sent, of which 45% received no response. Most organisations who did respond acknowledged concerns and initiated a new change (74%). Conclusion: Sepsis-related PFDs provide valuable insights into preventable causes of sepsis and identify important sources of improvement in sepsis care. Wider dissemination of findings is vital to learn from these reports. [ABSTRACT FROM AUTHOR]

Background: In response to the harm caused by tobacco use worldwide, the World Health Organization (WHO) World Health Assembly actioned the WHO Framework Convention on Tobacco Control (FCTC) in 2005. To help countries meet their FCTC obligations, the WHO introduced in 2008 the MPOWER policy package and by 2020 the FCTC had been ratified by 182 parties. The package consists of six evidence-based demand reduction smoking cessation policies to assist countries to achieve best practice. We used published evaluation results and replicated the published model to estimate current policy achievement and demonstrate the impact and equity of the MPOWER policy package in reducing the global number of smokers and smoking-attributable deaths (SADs) between 2007 and 2020. Methods: We replicated an evaluation model (the Abridged SimSmoke model) used previously for country impact assessments and validated our replicated reduction in SADs for policies between 2014 and 2016 against the published results. The replicated model was then applied to report on the country level SADs averted from achieving the highest level of implementation, that is best practice in MPOWER policies, between 2016 and 2020. The latest results were then combined with past published results to estimate the reduction in SADs since the commencement of the MPOWER policy package. Country level income status was used to investigate the equity in the uptake of MPOWER policies worldwide. Results: Identical estimates for SADs in 41 out of 56 MPOWER policies implemented in 43 countries suggested good agreement in the model replication. The replicated model overestimated the reduction in SADs by 159,800 (1.5%) out of a total of 10.5 million SADs with three countries contributing to the majority of this replication discrepancy. Updated analysis estimated a reduction of 8.57 million smokers and 3.37 million SADs between 2016 and 2020. Between 2007 and 2020, 136 countries had adopted and maintained at least one MPOWER policy at the highest level which was associated with a reduction in 81.0 million smokers and 28.3 million SADs. Seventy five percent of this reduction was in middle income countries, 20% in high income and less than 5% in low income countries. Conclusions: Considerable progress has been made by MPOWER policies to reduce the prevalence of smokers globally. However, there is inequality in the implementation and maintenance, reach and influence, and the number of SADs averted. Future research to modify the model could provide a more comprehensive evaluation of past and future progress in tobacco control policies, worldwide. [ABSTRACT FROM AUTHOR]

The objective of this experiment was to evaluate the spatial pattern and temporal trend of colorectal cancer (CRC) burden attributed to dietary risk factors in China from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. Numbers and age-standardised rates of deaths, disability-adjusted life years (DALYs) and corresponding average annual percentage change (AAPC) were determined. The joinpoint regression analysis was used to assess the temporal trends of CRC deaths and DALYs from 1990 to 2019. In China, the number of diet-attributable CRC deaths and DALYs in 2019 were 90.41 (95% uncertainty interval: 65.69, 114.67) and 2234.06 (1609.96, 2831.24) per-1000 population, marking 2.05% and 1.68% annual increases since 1990, respectively. The region with the highest increase in age-standardised rates (ASRs) of diet-related CRC deaths and DALYs was in Taiwan with an AAPC of 2.00% (1.51, 2.48), whereas the highest decline in ASRs of CRC deaths and DALYs was observed in Hong Kong with an AAPC of −0.63% (−0.90, −0.35) (all P < 0.05). Nationally, men suffered higher CRC deaths and DALY burdens attributable to dietary risks than did women. Regarding the specific diet group, diets low in calcium, milk, and whole grains contributed to CRC deaths and DALYs the most. Diet is an important contributor to increasing CRC burden in China. Necessary measures should be taken to kerb the growing burden attributed to dietary factors, particularly in males and in regions with middle Socio-demographic Index or lower. [ABSTRACT FROM AUTHOR]

Objective: This study was undertaken to characterize changes in health care utilization and mortality for people with epilepsy (PWE) during the COVID‐19 pandemic. Methods: We performed a retrospective study using linked, individual‐level, population‐scale anonymized health data from the Secure Anonymised Information Linkage databank. We identified PWE living in Wales during the study "pandemic period" (January 1, 2020–June 30, 2021) and during a "prepandemic" period (January 1, 2016–December 31, 2019). We compared prepandemic health care utilization, status epilepticus, and mortality rates with corresponding pandemic rates for PWE and people without epilepsy (PWOE). We performed subgroup analyses on children (<18 years old), older people (>65 years old), those with intellectual disability, and those living in the most deprived areas. We used Poisson models to calculate adjusted rate ratios (RRs). Results: We identified 27 279 PWE who had significantly higher rates of hospital (50.3 visits/1000 patient months), emergency department (55.7), and outpatient attendance (172.4) when compared to PWOE (corresponding figures: 25.7, 25.2, and 87.0) in the prepandemic period. Hospital and epilepsy‐related hospital admissions, and emergency department and outpatient attendances all reduced significantly for PWE (and all subgroups) during the pandemic period. RRs [95% confidence intervals (CIs)] for pandemic versus prepandemic periods were.70 [.69–.72],.77 [.73–.81],.78 [.77–.79], and.80 [.79–.81]. The corresponding rates also reduced for PWOE. New epilepsy diagnosis rates decreased during the pandemic compared with the prepandemic period (2.3/100 000/month cf. 3.1/100 000/month, RR =.73, 95% CI =.68–.78). Both all‐cause deaths and deaths with epilepsy recorded on the death certificate increased for PWE during the pandemic (RR = 1.07, 95% CI =.997–1.145 and RR = 2.44, 95% CI = 2.12–2.81). When removing COVID deaths, RRs were.88 (95% CI =.81–.95) and 1.29 (95% CI = 1.08–1.53). Status epilepticus rates did not change significantly during the pandemic (RR =.95, 95% CI =.78–1.15). Significance: All‐cause non‐COVID deaths did not increase but non‐COVID deaths associated with epilepsy did increase for PWE during the COVID‐19 pandemic. The longer term effects of the decrease in new epilepsy diagnoses and health care utilization and increase in deaths associated with epilepsy need further research. [ABSTRACT FROM AUTHOR]

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IntroductionWe described how COVID-19 fatality and symptoms varied by dominant variant and vaccination in the US.MethodsUsing the Restricted Access Dataset from the US CDC (1/1/2020–10/20/2022), we conducted a cross-sectional study assessing differences in COVID-19 deaths, severity indicators (hospitalization, ICU, pneumonia, abnormal X-ray, acute respiratory distress syndrome, mechanical ventilation) and 12 mild symptoms by dominant variant/vaccination periods using logistic regression after controlling for confounders.ResultsWe found the highest fatality during the dominant periods of Wild (4.6%) and Delta (3.4%). Most severe symptoms appeared when Delta was dominant (Rate range: 2.0–9.4%). Omicron was associated with higher mild symptoms than other variants. Vaccination showed consistent protection against death and severe symptoms for most variants (Risk Ratio range: 0.41–0.93). Boosters, especially the second, provided additional protection, reducing severe symptoms by over 50%.DiscussionThis dataset may serve as a useful tool to monitor temporospatial changes of fatality and symptom for case management and surveillance.

ObjectivesIn addition to harms caused to individuals who smoke, second-hand smoke (SHS or passive smoke) is an important public health issue. We aim to estimate the extent of preventable deaths due to tobacco and SHS exposure in Southeast Asia.MethodsData were from the Global Burden of Disease Study 2019. We analysed data from Southeast Asia, including Cambodia, Indonesia, Laos, Malaysia, Maldives, Mauritius, Myanmar, Philippines, Seychelles, Sri Lanka, Thailand, Timor-Leste, and Vietnam.ResultsIn 2019, there were 728,500 deaths attributable to tobacco in Southeast Asia, with 128,200 deaths attributed to SHS exposure. The leading causes of preventable deaths were ischemic heart disease, stroke, diabetes mellitus, lower respiratory infections, chronic obstructive pulmonary disease, tracheal, bronchus, and lung cancer. Among deaths attributable to tobacco, females had higher proportions of deaths attributable to SHS exposure than males in Southeast Asia.ConclusionThe burden of preventable deaths in a year due to SHS exposure in Southeast Asia is substantial. The implementation and enforcement of smoke-free policies should be prioritized to reduce the disease burden attributed to passive smoking in Southeast Asia.

Introduction: The COVID-19 pandemic caused a significant mortality in the world and in Ecuador. This research aimed to analyze the excess mortality due to the COVID-19 pandemic in Ecuador. Method: An observational, longitudinal, quantitative and descriptive study, classified as an ecological study in the field of epidemiology. This study focuses on measuring excess mortality during the years 2020, 2021 and 2022, using the average number of deaths that occurred in the period from 2015 to 2019 as the baseline. Results: From January 2020 to October 2022, Ecuador accumulated a total excess of deaths of 98,915. In 2020, the excess mortality was higher at 46,374, with the highest value occurring in April at 15,484. In 2021, the excess deaths amounted to 35,859, with April having the highest excess of 7,330. In 2022, the excess mortality was 16,682, with January recording the highest excess at 4,204. Conclusion: Evidence of underreporting of deaths, as well as temporal and geographical variations in excess mortality, was observed. The province with the highest number of deaths and excess mortality was Guayas, followed by Pichincha. The results provide an analysis of the situation during the health emergency, emphasizing the importance of evaluating the healthcare system's capacity to respond during times of crisis and the imperative need to implement corrective measures for the future.

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Background & aims: Cirrhosis was the leading cause of morbidity and mortality in adults, but data on the burden and trends were sparse in children and adolescents. We aimed to assess the trends in 204 countries and territories over the past 30 years in children and adolescents aged 0–19 years. Methods: Data on cirrhosis was collected by the Global Burden of Disease (GBD) 2019 database from 1990 to 2019. We reported on the number, rates, and average annual percentage changes (AAPCs) of incidence and disability-adjusted life-years (DALYs) of cirrhosis at global, regional, and national level. Results: Globally, the incident numbers of cirrhosis in children and adolescents increased from 204,767 in 1990 to 241,364 in 2019, an increase of 17.9%, with an AAPC 0.13(0.10 to 0.16). Prevalence (AAPC = − 2.27[− 2.39 to − 2.15]), mortality (AAPC = − 1.68 [− 1.86 to − 1.5]), and DALYs rate (AAPC = − 1.72[− 1.88 to − 1.56]) of cirrhosis have decreased significantly. Cirrhosis incident rates varied between different ages. Cirrhosis caused by alcohol use (AAPC = 1[0.8 to 1.1]; incidence cases increased 48%), hepatitis C (AAPC = 0.4 [0.4 to 0.5]), NAFLD (AAPC = 0.5 [0.3 to 0.6]) have been increasing, while only hepatitis B (− 0.3[− 0.4 to − 0.2]) decreasing. Incidence cases of cirrhosis were increased in low (101.6%) and low-middle sociodemographic index (SDI 21.1%) areas, while decreasing in middle and above SDI areas. At the regional level, the largest increases count was observed in Sub-Saharan Africa. Conclusions: Global incidence rate of cirrhosis has been increasing, while the DALYs rate has been decreasing in children and adolescents. Morbidity of cirrhosis caused by hepatitis B declined, while hepatitis C, NAFLD, and alcohol use increased. [ABSTRACT FROM AUTHOR]

In this ecological study, we aim to establish the role vaccines play in bringing the pandemic under control, as well as the impact of pathogen variants, vaccine hesitancy, and medical resource availability during the process by utilizing publicly available data. The study spans a three-year data collection period for daily hospital admissions due to COVID-19 and the daily reported cases of COVID-19 across all 50 states in the USA. In doing so, we aim to demonstrate the difference in severity of the SARS-CoV-2 pathogen among vaccinated and unvaccinated populations in the USA. The study assesses the correlation of COVID-19 vaccines (e.g., Pfizer, Moderna, and Janssen) and disease outcomes (transmissibility, severity, and deaths) caused by different strains of SARS-CoV-2 and establishes a negative correlation between COVID-19 vaccine and disease outcomes. By considering potential confounders in vaccine hesitancy, medical resource availability and vaccine dosage, we demonstrate the aforementioned to be insubstantial in predicting disease outcomes while the latter displays a contrasting significance in terms of disease outcomes. Between all the major variants of concern, the Delta and Omicron variants in particular have been associated with higher virulence and transmissibility factors respectively. Hence, the CDC continues to encourage the US population to get vaccinated since vaccines are one of the most effective ways to protect the community from potential outbreaks and prevent severe disease manifestations. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the worldwide burden of leukemia owing to occupational exposure to formaldehyde (OEF) from 1990 to 2019. Data on leukemia due to OEF were obtained from the Global Burden of Disease Study (GBD) 2019. By region, age, sex, and disease subtype, the numbers and age-standardized rates (ASRs) associated with deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) were analyzed. Annual average percentage change (AAPC) was used to estimate disease burden trends from 1990 to 2019. To measure the risk of leukemia due to OEF, the population attributable fraction (PAF) was introduced. From 1990 to 2019, the number of deaths, DALYs, YLLs, and YLDs for leukemia caused by OEF increased by 44%, 34%, 33%, and 124%, respectively. Regarding the change in ASRs, the age-standardized YLDs (ASYLDs) rate of leukemia due to OEF, which was 38.03% (AAPC = 1.17 [95% confidence interval [CI] 1.11, 1.23]), indicated an increased trend. But the age-standardized mortality rate (ASMR), age-standardized DALY (ASDALY) rate, and age-standardized YLL (ASYLL) rate showed decline trends, with − 11.90% (AAPC = − 0.41 [95% CI − 0.45, − 0.37]), − 14.19% (AAPC = − 0.5 [95% CI − 0.55, − 0.45]), and − 14.97% (AAPC = − 0.53 [95% CI − 0.58, − 0.48]), respectively. In terms of PAFs, there were increasing trends in PAFs of age-standardized deaths, ASDALYs, ASYLLs, and ASYLDs for leukemia caused by OEF, with 20.15% (95% uncertainty interval [UI] 11.76%, 30.25%), 36.28% (95% UI 21.46%, 53.42%), 51.91% (95% UI 35.05%, 72.07%), and 36.34% (95% UI 21.58%, 53.63%), respectively. Across the socio-demographic index (SDI) regions, the leukemia burden caused by OEF was concentrated in middle and high-middle SDI regions. Besides, OEF poses a more serious risk for acute leukemia among the leukemia subtype. Globally, leukemia caused by OEF remains a public health burden. Policies must be developed to avoid the burden of leukemia caused by OEF. [ABSTRACT FROM AUTHOR]

Background: Low‐Risk Alcohol Drinking Guidelines (LRDGs) aim to reduce the harms caused by alcohol. However, considerable discrepancies exist in the 'low‐risk' thresholds employed by different countries. Argument/analysis: Drawing upon Canada's LRDGs update process, the current paper offers the following propositions for debate regarding the establishment of 'low‐risk' thresholds in national guidelines: (1) as an indicator of health loss, years of life lost (YLL) has several advantages that could make it more suitable for setting guidelines than deaths, premature deaths or disability adjusted years of life (DALYs) lost. (2) Presenting age‐specific guidelines may not be the most appropriate way of providing LRDGs. (3) Given past overemphasis on the so‐called protective effects of alcohol on health, presenting cause‐specific guidelines may not be appropriate compared with a 'whole health' effect derived from a weighted composite risk function comprising conditions that are causally related to alcohol consumption. (4) To help people reduce their alcohol use, presenting different risk zones associated with alcohol consumption instead of a single low risk threshold may be advantageous. Conclusions: National LRDGs should be based on years of life lost and should be neither age‐specific nor cause‐specific. We recommend using risk zones rather than a single drinking threshold to help people assess their own risk and encourage the adoption of behaviours with positive health impacts across the alcohol use spectrum. [ABSTRACT FROM AUTHOR]