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Great disparity is observed among studies investigating the prevalence of PTSD after burns. This systematic review and meta-analysis aimed to explore the pooled prevalence of PTSD in adult burn survivors over the first two years post-burn. Five electronic databases were searched for observational studies assessing the prevalence of PTSD symptoms after burns. Meta-analysis was performed using an auto-correlation and hierarchical effects model to estimate the course of PTSD prevalence rates over time and to establish point-prevalences. The effect of different moderators over time was tested with meta-regression. Thirty-two studies were included in the meta-analysis. The overall pooled prevalence of PTSD was 20.5% (95% CI 16.4–24.6) and the prevalence significantly decreased by about 0.37% per month post-burn over time. Questionnaire-based studies, and studies published from 2000 onwards, were more likely to show a decrease in PTSD prevalence over time compared to diagnostic studies and studies before 2000. A qualitative comparison revealed that inter-continental differences are likely to be complex and multi-factorial. PTSD affects about one in five burn survivors, with moderately decreasing rates from six months post-burn onwards. Early screening and identification of burn survivors who require specialist psychological care are vital for burns services. [ABSTRACT FROM AUTHOR]

Purpose: Due to overdiagnosis, the incidence of thyroid cancer (TC) has increased in high-income countries, including Italy. Efforts have been made to address this issue since the mid-2010s, but more information is needed about how TC incidence has changed. We aim to examine the trend in TC incidence in the Lazio Region (central Italy) and assess the impact of the 2014 Italian Consensus for the Classification and Reporting of Thyroid Cytology (ICCRTC) to identify potential changes in TC diagnosis. Methods: To identify TC cases, we conducted a population-based study (period 2007–2019) using the data from the Lazio Region Cancer Registry (5.8 million residents). We calculated the annual age-standardized incidence rates of TC for both sexes and analyzed the impact of ICCRTC on monthly incidence rates using segmented linear regression applied to interrupted time-series (ITS). Results: Throughout the 13 years, there was a significant decline in TC annual incidence rates, more pronounced in females. Our results are consistent with reports from outside Europe (United States and South Korea). Following ICCRTC implementation in 2014, a step-change reduction in both sexes was revealed. Conclusions: Our study indicates a significant decrease in the incidence of TC, particularly among females. The ITS analysis highlights the possible role of ICCRTC in reducing overdiagnosis. As the Lazio Region reflects the Italian population in terms of various demographic, health, and lifestyle indicators, our findings can be applicable at the national level. [ABSTRACT FROM AUTHOR]

Objective To analyze epidemiology of gastric cancer five-year survival distribution in Zhejiang population-based cancer registration. Methods The follow-up data of registrated gastric cancer cases diagnosed from 2008 to 2019 in 22 national cancer registry areas of Zhejiang Province were collected and divided into three diagnostic periods: 2008-2011, 2012-2015 and 2016-2019 to calculate five-year observed survival rates (OSRs), five-year relative survival rates (RSRs) and five-year age-standardized relative survival rates (ARSRs). The distribution of population characteristics (including gender, urban/rural, age group and occupation) and clinical characteristics (including the highest diagnostic institution, sub-site, pathological type and degree of differentiation) of gastric cancer survival rates in each period were analysed. Results 51 663 new cases of gastric cancer in 2008-2019 in the cancer registration area of Zhejiang Province were included in the analysis, and the ARSR of gastric cancer in 2008-2011, 2012-2015 and 2016-2019 showed an increasing trend (39.2%, 41.3% and 44.7%, respectively). In 2016-2019, the ARSR was similar across gender and urban and rural areas (44.4% for men and 45.7% for women; 44.9% in urban areas and 44.2% in rural areas); Among people with different occupations, the ARSR was highest among business and service workers (55.3%), the agriculture, forestry, animal husbandry and fisheries, water conservancy production workers and domestic workers were lower (41.5% and 43.2%, respectively). The highest diagnostic institution was the provincial hospital with a higher gastric cancer survival rate (47.0%) than the municipal (43.4%) and district (43.6%) levels. The ARSR for gastric cancer was relatively high in the lesser curvature (59.7%), pylorus (50.4%), antrum (49.3%), and greater curvature (48.7%), and lowest in cardia (38.9%). Among the major pathological types, adenocarcinoma (NOS) had an ARSR of 48.1%, mucinous adenocarcinoma 41.3%, imprinted cell carcinoma 39.4%, and squamous carcinoma 33.4%. The ARSR for highly differentiated, moderately differentiated, poorly differentiated and undifferentiated gastric cancers were 80.6%, 57.9%, 43.2% and 36.8%, respectively. Conclusion The 5-year survival rate of gastric cancer in Zhejiang Province is high and on the rise, with similar survival rates in different genders, urban and rural areas, and significant differences in the survival rates of gastric cancer patients with different occupational groups, highest diagnostic institutions, tumour sub-sites, pathological types and differentiation degrees. [ABSTRACT FROM AUTHOR]

Background: With increasing numbers of people seeking medical gender reassignment, the scientific community has become increasingly aware of the issue of detransitioning from social, hormonal or even surgical gender reassignment (GR). This study aimed to assess the proportion of patients who discontinued their established hormonal gender transition and the risk factors for discontinuation. Methods: A nationwide register-based follow-up was conducted. Data were analysed via cross-tabulations with chi-square statistics and t tests/ANOVAs. Multivariate analyses were performed via Cox regression, which accounts for differences in follow-up times. Results: Of the 1,359 subjects who had undergone hormonal GR in Finland from 1996 to 2019, 7.9% discontinued their established hormonal treatment during an average follow-up of 8.5 years. The risk for discontinuing hormonal GR was greater among later cohorts. The hazard ratio was 2.7 (95% confidence interval 1.1–6.1) among those who had accessed gender identity services from 2013 to 2019 compared with those who had come to contact from 1996 to 2005. Discontinuing also appeared to be emerging earlier among those who had entered the process in later years. Conclusions: The risk of discontinuing established medical GR has increased alongside the increase in the number of patients seeking and proceeding to medical GR. The threshold to initiate medical GR may have lowered, resulting in a greater risk of unbalanced treatment decisions. Trial registration number (TRN): Not applicable (the paper does not present a clinical trial). [ABSTRACT FROM AUTHOR]

• The last decade witnessed a rapid increase in epilepsy mortality. • Mortality from epilepsy was higher in Black individuals and men. • Similar upward trends in the last decade have been observed across ages, genders, and ethnicities. • A comprehensive assessment of long-term trends in mortality from epilepsy holds significance for healthcare prioritization. The analysis of long-term trends of mortality from epilepsy has not been conducted, which is crucial for estimating the future burden of epilepsy. We therefore aimed to investigate the long-term trends of mortality from epilepsy in the United States from 1979 to 2021. The cause-of-death and demographic data were from the National Center for Health Statistics (1979–2021) and population estimates were from the US Census Bureau. We used the joinpoint regression model to analyze secular trends in the mortality of epilepsy spanning from 1979 to 2021. Age-adjusted mortality from epilepsy was assessed based on the year 2000 U.S. population data, stratified by age, sex, and race. The age-adjusted mortality from epilepsy increased from 0.78 per 100,000 population in 1979 to 1.01 per 100,000 population in 2021, with an average annual percent change (AAPC) of 0.58% (95% confidence interval [CI]: 0.45% - 0.72%). The overall age-adjusted mortality of epilepsy had been on the rise between 2011 and 2021. The mortality rate generally increases with age. The mortality of epilepsy was higher in the Afro-American people and men. The mortality of epilepsy in both sexes declined first and then increased, with AAPC 1.02% (95% CI: 0.88%, 1.23%) in women and 0.10% (95% CI: -0.002%, 0.21%) in men. Mortality in all races including White, Afro-American people, and other races individuals fell first and then rose. The AAPC of mortality in White, other races, and Afro-American people were 0.89% (95% CI: 0.79%, 1.02%), -0.87% (95% CI: -1.84%, 0.88%), and -0.31% (95% CI: -0.48%, -0.13%), respectively. Although the mortality rate from epilepsy has experienced a period of decline, it is worth noting that the last decade has seen a rapid increase. A comprehensive assessment of long-term trends in mortality from epilepsy holds significance for healthcare prioritization. [ABSTRACT FROM AUTHOR]

Daily meteorological data from 1981 to 2022 and citrus growth periods data were used in this paper. The daily mean temperature, daily maximum temperature and their duration were selected as indicators of heat stress in citrus to clarify the spatial distribution characteristic and temporal variation trend of heat stress during citrus growth periods. The spatial and temporal differences of heat stress in different growing periods of citrus were compared using a paired t-test. The results show that (1) the average frequency, times and intensity of heat stress during flowering-fruit expanding stage of citrus are 87.73%, 2.23times•y-1 and 5.28d•times -1, respectively. High-value areas are mainly concentrated in the southeast of Jiangxi province. The average frequency, times and intensity of heat stress during the fruit expanding-fruit coloring stage of citrus are 56.43%, 1.15times•y-1 and 2.74d•times -1, respectively. High-value areas are mainly in the northern and central parts of Jiangxi province. (2) The station ratios, times and intensity of heat stress during the flowering-fruit expanding stage of citrus show a decreasing trend, with an average decrease of 0.90 percent points, 0.02 times and 0.06 d•time -1 every 10 years, respectively. The station ratios, times and intensity of heat stress during fruit expanding-fruit coloring stage of citrus show an increasing trend, with an average increase of 6.80 percent points, 0.26times and 0.50d•times -1 every 10 years, respectively. (3) The paired t-test results show that, the frequency, times and intensity of heat stress during flowering-fruit expanding stage of citrus are significantly higher than that during fruit expanding-fruit coloring stage of citrus. However, the climate tendency of times and intensity of heat stress during flowering-fruit expanding stage of citrus are significantly lower than that during fruit expanding-fruit coloring stage of citrus. The flowering-fruit expanding stage of citrus in Jiangxi province is the most frequent period of heat stress. For now, it is necessary to strengthen citrus defenses against heat stress during the flowering-fruit expanding stage. In the future, we should improve the prevention of heat stress in citrus during the fruit expanding-fruit coloring stage. [ABSTRACT FROM AUTHOR]

This study investigates the determinants and dynamics of the linguistic features of key audit matters (KAMs) in European countries. Using natural language processing algorithms, including FINBERT, I quantify stylistic and content‐based text characteristics at the KAM level and find that KAM length, readability, sentiment, quantitative density, specificity, the degree of forward‐looking statements, and the extent of boilerplate language are associated with the type of KAM topics, client attributes, and audit firm characteristics. In additional analyses, I also find early empirical evidence of a time trend in these linguistic features. Since their introduction in 2016, KAMs are becoming longer, more quantitative, more specific, but also include more boilerplate phrases. Collectively, the results of the study contribute to a more nuanced understanding of the determinants and dynamics of KAM disclosures. [ABSTRACT FROM AUTHOR]

Rare cancers collectively account for a significant proportion of the overall cancer burden in Japan. We aimed to describe and examine the incidence of each rare cancer and the temporal changes using the internationally agreed rare cancer classification. Cancer cases registered in regional population‐based cancer registries from 2011 to 2015 and the National Cancer Registry (NCR) from 2016 to 2018 were classified into 18 families, 68 Tier‐1 cancer groupings, and 216 single cancer entities based on the RARECAREnet list. Crude incidence rates and age‐standardized incidence rates (ASR) were calculated for Tier‐1 and Tier‐2 cancers. The annual percent change and the 95% and 99% confidence limits for annual ASR for each of the 68 Tier‐1 cancers were estimated using the log‐linear regression of the weighted least squares method. The differences in ASRs between 2011 and 2018 were evaluated as an absolute change. A total of 5,640,879 cases were classified into Tier‐1 and Tier‐2 cancers. The ASRs of 18 out of 52 Tier‐1 cancers in the rare cancer families increased, whereas the ASR for epithelial tumors of gallbladder decreased. The ASRs of 6 out of the 16 Tier‐1 cancers in the common cancer families increased, whereas those of epithelial tumors of stomach and liver decreased. There was no significant change in the incidence of the other 40 Tier‐1 cancers. The incidence of several cancers increased due to the dissemination of diagnostic concepts, improved diagnostic techniques, changes in coding practice, and the initiation of the NCR. [ABSTRACT FROM AUTHOR]

Objectives: To examine trends in incidence and mortality and evaluate overall survival (OS) of oral cancer in Singapore between 1968 and 2017. Methods: All diagnosed oral cancers by anatomical sites and population size were extracted from the Singapore Cancer Registry and the Department of Statistics Singapore. The trend of age‐standardized incidence rate (ASIR) and mortality rate (ASMR) (per 100 000 person‐years) of the lip, oral cavity and salivary gland cancers were evaluated by Prais‐Winsten regressions for each ethnicity and gender. Kaplan–Meier curves were performed to evaluate the OS by anatomical sites in each age group by ethnicity and sex. Results: Overall, 49, 3494 and 1066 people were diagnosed, and 28, 2310 and 476 died from lip, oral cavity and salivary gland cancers, respectively. The oral cavity cancer ASIR and ASMR reduced from 3.07 (1968–1972) to 2.01(2008–2012) and from 2.06 (1978–1982) to 1.21 (2013–2017) per 100 000 person‐years, respectively, with both highest in Indians throughout the whole period. Male:Female ratio ranged from 3.43 (1973–1977) to 1.75 (2013–2017) and from 3.41 (1978–1982) to 2.40 (2013–2017) for ASIR and ASMR, respectively. However, both salivary gland cancer ASIR and ASMR increased from 0.50 (1968–1972) to 0.80 (2008–2012) and from 0.18 (1968–1982) to 0.42 (1988–1992) per 100 000 person‐years, respectively, with both higher in males since 1993. Oral cavity cancer ASIR decreased for males aged ≥60, and Indian females ≥25, but increased among Chinese females aged ≥60. Oral cavity cancer ASMR decreased among Chinese aged 25–59, and among Malay males and Indian females. Salivary gland cancer ASIR increased among Chinese males aged ≥60 and Malay males aged 25–59; while ASMR increased among Chinese males aged ≥60. The median OS for oral cavity, lip and salivary gland cancers were 3.0, 9.3 and 18.1 years, respectively, with females surviving longer than males. Conclusions: Singapore has experienced a decline in the incidence and mortality of lip, oral cancer, an increase in in the incidence and mortality of salivary gland cancer, with an increase in the median overall survival rate. Monitoring the magnitude of oral cancer burden and the demographic, and temporal variations is necessary for tailoring health planning and setting priorities for future clinical care and research. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to describe caries prevalence and experience trends of permanent teeth among Singapore schoolchildren between 2007 and 2019. Methods: Anonymized records of all 6‐year‐old Primary 1 (P1), 11‐year‐old Primary 6 (P6) and 14‐year‐old Secondary 3 (S3) before the start of each school year were extracted from the Integrated Dental Electronic Assessment System (IDEAS) by school level, ethnicity and sex. Prais–Winsten regression was used to assess trends of mean decayed, missing and filled teeth (DMFT) and caries prevalence (% DMFT > 0) among the schoolchildren by school level, with reported Average Annual Percentage Change (AAPC) together with respective 95% confidence interval (CI). Results: In total, 519 471 P1, 566 573 P6 and 548 138 S3 were included during the above period, and the majority were comprised of Chinese children (P1: 67.2%, P6: 68.8% and S3: 71.0%, respectively). Overall, the prevalence of caries dropped from 6.9% in 2007 to 3.5% in 2019 among P1, from 34.5% in 2009 to 20.3% in 2019 among P6 and from 41.5% in 2007 to 33.5% in 2019 among S3 schoolchildren. The mean DMFT reduced from 0.11 to 0.05 among P1, 0.72 to 0.35 among P6 and 1.05 to 0.76 among S3 schoolchildren during the same period. Caries prevalence and mean DMFT were consistently higher among girls. On average, caries prevalence decreased 5% per year in P1 (AAPC −5.0 [95% CI: −6.1, −3.9]) and P6 (AAPC −4.9 [95% CI: −5.7, −4.1]) and 2% among S3 (AAPC −2.0 [95% CI: −3.5, −0.4]) schoolchildren. Caries prevalence decreased approximately 4% ~ 5% annually among P1 and P6 schoolchildren regardless of ethnicity. The average decrease in caries prevalence was lower (about 2%) among all ethnicities at S3 school level. Conclusion: Dental caries in permanent dentition of Singaporean schoolchildren had decreased from 2007 to 2019. However, the decrease observed among primary school students was more than double that among secondary schoolchildren. [ABSTRACT FROM AUTHOR]

Abstract Background In line with WHO guidelines for the implementation of public health prevention plans targeted at the impacts of high temperatures, a heat wave definition temperature (Tthreshold) was calculated for 182 so-called “isoclimatic zones” (IZ) in Spain. As the dependent variable for determining this Tthreshold, we analysed daily all-cause mortality data (ICD-10: A00-R99) for each IZ across the period 2009–2018. The independent variable used was the mean value of the maximum daily temperature of the summer months recorded at meteorological observatories in each IZ. We used Box–Jenkins models to ascertain mortality anomalies, and scatterplots to link these anomalies to the temperatures at which they occurred, thereby determining the Tthreshold for each IZ. We then calculated how many heat waves had occurred in each IZ, as well as their intensity, and analysed their time trend over this period. Results The results showed that in 52.5% of the IZ, the percentile of the maximum temperatures series of the summer months to which Tthreshold corresponded was below the 95th percentile of the meteorological heat wave definition in Spain: indeed, it only coincided in 30.7% of cases. The geographical distribution of these percentiles displayed great heterogeneity as a consequence of the local factors that influence the temperature–mortality relationship. The trend in the number of heat waves analysed indicated an overall increase in Spain at a rate of 3.9 heat waves per decade, and a similar rise in mean annual intensity of 9.5 °C/decade. These time-trend values were higher than those yielded by analysing the trend in meteorological heat waves based on the 95th percentile. Conclusions The results obtained in this study indicate the need to use a heat wave definition based on epidemiological temperature–mortality studies, rather than on values based on meteorological percentiles. This could be minimising estimated health impacts in analyses of future impacts attributable to heat.

Abstract Background The reduction of myocardial infarction (MI) and narrowing the gap between the populations with and without diabetes are important goals of diabetes care. We analyzed time trends for sex-specific incidence rates (IR) of first MI (both non-fatal MI and fatal MI) as well as separately for first non-fatal MI and fatal MI in the population with and without diabetes. Methods Using data from the KORA myocardial infarction registry (Augsburg, Germany), we estimated age-adjusted IR in people with and without diabetes, corresponding relative risks (RR), and time trends from 1985 to 2016 using Poisson regression. Results There were 19,683 people with first MI (34% fatal MI, 71% men, 30% with diabetes) between 1985 and 2016. In the entire study population, the IR of first MI decreased from 359 (95% CI: 345–374) to 236 (226–245) per 100,000 person years. In men with diabetes, IR decreased only in 2013–2016. This was due to first non-fatal MI, where IR in men with diabetes increased until 2009–2012, and slightly decreased in 2013–2016. Overall, fatal MI declined stronger than first non-fatal MI corresponding to IRs. The RR of first MI substantially increased among men from 1.40 (1.22–1.61) in 1985–1988 to 2.60 (2.26–2.99) in 1997–2000 and moderately decreased in 2013–2016: RR: 1.75 (1.47–2.09). Among women no consistent time trend for RR was observed. Time trends for RR were similar regarding first non-fatal MI and fatal MI. Conclusions Over the study period, we found a decreased incidence of first MI and fatal MI in the entire study population. The initial increase of first non-fatal MI in men with diabetes needs further research. The gap between populations with and without diabetes remained.

Objective To analyze the incidence trend of cancer from 2015 to 2020 in Sichuan Province and provide a reference for prevention and control of cancer. Methods Based on the cancer-related case information data on the Homepage of medical records in Sichuan Province from 2015 to 2020, the crude incidence rate was calculated, and the average annual change percentage (AAPC) of incidence rates was analyzed with Joinpoint 4.2.0.1. Results The new cancer cases in Sichuan Province increased from 181 490 in 2015 to 276 770 in 2020, and the incidence rate increased from 198. 57/105 in 2015 to 304.76/105 in 2020. From 2015 to 2020, the average annual percentage change (AAPC) was 7.514%, 6.751%, 8.611%, 4.713%, and 6.838%, respectively. The incidence of cancer in the Chengdu Plain Economic Zone and the Northwest Sichuan Ecological Economic Zone showed a rising trend, AAPC values with statistical significancebeing 7.549% and 9. 668%, respectively. From 2015 to 2020, the incidence rate of lung cancer, colorectal cancer, breast cancer, cervical cancer and prostate cancer in Sichuan Province showeda rising trend, with AAPC values of 11.220% (95% CI; 5.866-16.845), 6.606% (95% CI: l.395-13.202), 6.322% (95% CI: 1.411-11.472), 5.765% (95% CI: l.431-10.284) and 13. 222% (95% CI : 7.396-19.364), respectively. Conclusion The incidence of cancer in Sichuan Province shows a rising trend, and the prevention and control situation is grim. Lung cancer, digestive system cancer, breast cancer, cervical cancer and prostate cancer are the dominant cancer types in Sichuan Province, and specific prevention, control and screening should be strengthened. [ABSTRACT FROM AUTHOR]

Background: In line with WHO guidelines for the implementation of public health prevention plans targeted at the impacts of high temperatures, a heat wave definition temperature (Tthreshold) was calculated for 182 so-called "isoclimatic zones" (IZ) in Spain. As the dependent variable for determining this Tthreshold, we analysed daily all-cause mortality data (ICD-10: A00-R99) for each IZ across the period 2009–2018. The independent variable used was the mean value of the maximum daily temperature of the summer months recorded at meteorological observatories in each IZ. We used Box–Jenkins models to ascertain mortality anomalies, and scatterplots to link these anomalies to the temperatures at which they occurred, thereby determining the Tthreshold for each IZ. We then calculated how many heat waves had occurred in each IZ, as well as their intensity, and analysed their time trend over this period. Results: The results showed that in 52.5% of the IZ, the percentile of the maximum temperatures series of the summer months to which Tthreshold corresponded was below the 95th percentile of the meteorological heat wave definition in Spain: indeed, it only coincided in 30.7% of cases. The geographical distribution of these percentiles displayed great heterogeneity as a consequence of the local factors that influence the temperature–mortality relationship. The trend in the number of heat waves analysed indicated an overall increase in Spain at a rate of 3.9 heat waves per decade, and a similar rise in mean annual intensity of 9.5 °C/decade. These time-trend values were higher than those yielded by analysing the trend in meteorological heat waves based on the 95th percentile. Conclusions: The results obtained in this study indicate the need to use a heat wave definition based on epidemiological temperature–mortality studies, rather than on values based on meteorological percentiles. This could be minimising estimated health impacts in analyses of future impacts attributable to heat. [ABSTRACT FROM AUTHOR]

Background: The reduction of myocardial infarction (MI) and narrowing the gap between the populations with and without diabetes are important goals of diabetes care. We analyzed time trends for sex-specific incidence rates (IR) of first MI (both non-fatal MI and fatal MI) as well as separately for first non-fatal MI and fatal MI in the population with and without diabetes. Methods: Using data from the KORA myocardial infarction registry (Augsburg, Germany), we estimated age-adjusted IR in people with and without diabetes, corresponding relative risks (RR), and time trends from 1985 to 2016 using Poisson regression. Results: There were 19,683 people with first MI (34% fatal MI, 71% men, 30% with diabetes) between 1985 and 2016. In the entire study population, the IR of first MI decreased from 359 (95% CI: 345–374) to 236 (226–245) per 100,000 person years. In men with diabetes, IR decreased only in 2013–2016. This was due to first non-fatal MI, where IR in men with diabetes increased until 2009–2012, and slightly decreased in 2013–2016. Overall, fatal MI declined stronger than first non-fatal MI corresponding to IRs. The RR of first MI substantially increased among men from 1.40 (1.22–1.61) in 1985–1988 to 2.60 (2.26–2.99) in 1997–2000 and moderately decreased in 2013–2016: RR: 1.75 (1.47–2.09). Among women no consistent time trend for RR was observed. Time trends for RR were similar regarding first non-fatal MI and fatal MI. Conclusions: Over the study period, we found a decreased incidence of first MI and fatal MI in the entire study population. The initial increase of first non-fatal MI in men with diabetes needs further research. The gap between populations with and without diabetes remained. [ABSTRACT FROM AUTHOR]

In Australia, Aboriginal and Torres Strait Islander peoples are much more likely to be arrested, charged with criminal offences and imprisoned than other Australians. Aboriginal and Torres Strait Islanders comprise 49% of young people in detention but only 5.8% of the Australian population aged 10–17. This study investigated changes between 1997 and 2019 in the interaction of Aboriginal and non‐Aboriginal young people with the justice system in the Northern Territory (NT) of Australia. The prevalence of young people being charged with an alleged offence decreased by more than 60% between 1999 and 2001, co‐incident with the introduction of the Juvenile Diversion Scheme in August 2000. Thereafter, for non‐Aboriginal young people there was a small and temporary increase, but for Aboriginal young people prevalence increased almost back to pre‐2000 levels by 2015 before starting to decrease. Aboriginal young people comprised 57% of those charged with any offence in 1997, rising to 88% in 2019. Further investigation is needed to understand the reasons for divergent trends in the prevalence of alleged offending for Aboriginal and non‐Aboriginal young people, which may include the role of diversion, differences in the nature of offences and systemic bias and racism. [ABSTRACT FROM AUTHOR]

Objective: To determine the temporal trend and epidemiology of animal bite cases in Gerash City, Iran. Methods: This retrospective cross-sectional study analyzed 630 cases of people with animal bites between 2011 and 2021 in Gerash City. The collected data were analyzed using Chi-square test. Results: The mean age of victims was (30.9±17.5) years. 80.54% Of victims were male, 39.70% were self-employed, and 64.60% were adults (≥18 years). Most cases of bites occurred in 2019 (91 cases), 2020 (74 cases) and 2021 (87 cases), and most of the bites were related to the upper limbs (62.70%). Most of the wounds were superficial (78%), most of the biting animals were domestic animals (91.74%), and most of the victims had Iranian nationality (97.62%). Conclusions: Given the increasing trend of animal bites in Gerash City, health authorities should carry out basic measures such as education and awareness among the public, especially at-risk groups such as adult males. Additionally, since most cases of bites are due to dogs, it seems necessary to plan for vaccination of dogs, especially those with owners.

Transjugular intrahepatic portosystemic shunt (TIPS) is an established treatment for portal hypertension and its' complications in liver cirrhosis, yet the development of hepatic encephalopathy (HE) remains a significant concern. This review covers the reported incidence, risk factors, and management strategies for post-TIPS HE over the past decade. Incidence varies widely (7–61%), with factors like age, liver function, hyponatremia, and spontaneous portosystemic shunts influencing risk. Procedural aspects, including TIPS timing, indication, and stent characteristics, also contribute. Pharmacological prophylaxis with lactulose and rifaximin shows promise, but current evidence is inconclusive. Procedural preventive measures, such as shunt embolization and monitoring portal pressure gradients, are explored. Treatment involves pharmacological options like lactulose and rifaximin, and procedural interventions like stent diameter reduction. Ongoing studies on novel predictive markers and emerging treatments, such as faecal microbiota transplant, reflect the evolving landscape in post-TIPS HE management. This concise review provides clinicians with insights into the multifaceted nature of post-TIPS HE, aiding in improved risk assessment, prophylaxis, and management for patients undergoing TIPS procedures. [ABSTRACT FROM AUTHOR]

Purpose: Social anxiety disorder (SAD) is prevalent in adolescents. Increase in levels of general anxiety since 2010's has been observed in young people. Little is known of time trends in symptoms of social anxiety during 2010's, of pre- to during-COVID-19 era changes, or of associations between social anxiety symptoms and pandemic severity, distance education, and COVID-19-related experiences in young people. Methods: We examined social anxiety symptoms, their temporal changes, and their associations with COVID-19 related factors in a sample of 450 000 13-to-20-year-old Finns in 2013–2021. Data from nationwide School Health Promotion study was used. Social anxiety symptoms were assessed with the Mini-SPIN using cut-off score ≥ 6 as indicator of high social anxiety. Multivariate logistic regression analyses were used, controlling for gender, age, family SES, and symptoms of general anxiety and depression. Results: High-level social anxiety symptoms increased markedly from 2013/2015 to 2021 among both sexes. A steeper increase was found among females. In 2021, 47% of females self-reported high social anxiety, a two-fold increase relative to 2013/2015. No association between regional COVID-19 incidence and change in social anxiety symptoms was found. No clear associations between time spent in distance education and social anxiety symptoms were found. Fears of getting infected or transmitting coronavirus, and reports of not getting needed support for schoolwork during distance education were all associated with high social anxiety. Conclusion: Prevalence of high social anxiety in young people aged 13–20 has increased considerably from 2013 to 2021, especially among girls. During COVID-19 pandemic, socially anxious young people report a need for educational support and suffer from infection-related fears. [ABSTRACT FROM AUTHOR]

AIM: To investigate time trends in myopia and high myopia prevalence over 6y among young university adults in China. METHODS: This is a 6-year series cross-sectional study from 2016 to 2021. Totally 4910 freshmen were enrolled and completed a questionnaire concerning age, gender, and disease history. Students with eye diseases were excluded after a detailed eye examination. The refractive status was measured by non-cycloplegic objective refraction and ocular parameters were measured by Lenstar 900. The examination followed the same protocol each year. Trends over time in myopia and high myopia prevalence, as well as ocular biometry parameters, were analyzed. RESULTS: From 2016 to 2021, the axial length (AL) and corneal radius (CR) increased significantly (P=0.002 for AL; P=0.04 for CR). However, the spherical equivalent (SE) and the ratio of axial length to the corneal radius (AL/CR) did not change significantly (P=0.59 for SE; P=0.24 for AL/CR). The frequency of AL ≥26.0 mm increased from 26.6% in 2016 to 29.3% in 2021 (P=0.05 for trend). The prevalence of myopia and high myopia did not change significantly in our study (P≥0.18). Compared to a similar cross-sectional study conducted 10 years ago, the prevalence of myopia decreased significantly (94.9% vs 91.8%, P

Background: The study aimed to characterize patients with leprosy admitted to Fontilles throughout the 20th and 21st centuries, focusing on differences across three periods (I, II, and III). It also explored variables linked to patient survival. Methods: This was a retrospective descriptive study analyzing the medical records of Fontilles patients from 1909 to 2020. It assessed 26 clinical, sociodemographic, and temporal variables (n = 2652). Results: Most patients were male, single, multibacillary (MB), and farmers, from Andalusia and the Valencian Community. The origin of patients shifted over time towards being mostly foreign-born in period III. More than a half were previously admitted and had family members with leprosy. While leprosy reactions decreased over time, neurological symptoms were increasingly diagnosed. The age at onset, admission, and death increased progressively over time. The survival of patients with leprosy at Fontilles depended on the age at admission and the period. Conclusions: Improved knowledge, services, and awareness regarding leprosy led to increased age at onset and more favorable outcomes. The prolonged time between symptom onset and diagnosis indicates that leprosy is still a neglected disease. Although MB forms are more severe, leprosy classification did not significantly impact the survival rates of patients at Fontilles.

ABSTRACT: We develop a linear corporate tax function where taxes paid are regressed on pre-tax income and an intercept. We show that if the intercept is positive, cash ETRs are a convex function of pre-tax income. We present large-sample evidence consistent with this ETR convexity. Thus, although firms may have stable linear tax functions (i.e., constant parameters in the linear tax model) representing stable tax avoidance behavior, ETRs can change over time because of growth in pre-tax income. Consequently, simply examining changes (or differences) in cash ETRs is nondiagnostic about whether tax avoidance has changed over time (or differs across firms). We illustrate our argument by showing that all of the observed downward trend in cash ETRs documented by Dyreng et al. (2017) can be explained by growth in pre-tax income. The wholesale concern about increased tax avoidance over time might be overstated. Data Availability: Data are available from the public sources cited in the text. JEL Classifications: G39; H20; H25; H26.

Siloxanes, widely used in various consumer and industrial products, are emerging concerns of contaminants. Despite this, limited studies have been conducted on contamination and time trends on siloxanes in coastal environments. In the present study, four cyclic and 15 linear siloxanes were measured in sediments collected from an artificial saltwater lake in Korea during 2001–2016 to investigate contamination, time trends, and ecotoxicological concerns. Cyclic siloxanes were detected in all sediment samples, whereas linear siloxanes were not frequently detected. The highest siloxane concentrations were observed in creeks passing through various industrial complexes, indicating that industrial activities predominantly contributed to siloxane contamination in coastal environments. Decamethylcyclopentasiloxane (D5) and dodecylcyclohexasiloxane (D6) were predominant siloxanes in sediments over the last two decades. Siloxane concentrations significantly increased in creek sediments from 2008 to 2016, whereas those in inshore and offshore regions significantly decreased due to a strong dilution effect by the operation of tidal power plant. This suggests that consumption patterns and coastal development activities are crucial factors determining the contamination and time trends in the sedimentary siloxanes. The sedimentary concentrations of octamethylcyclotetrasiloxane (D4) and D5 exceeded several thresholds, raising the potentials for ecological risks to aquatic organisms.

The UV filters octocrylene (OC) and 2-ethylhexyl salicylate (EHS) are commonly used in sunscreens and frequently detected in environmental media. However, knowledge on human exposures is scarce.In this human biomonitoring (HBM) study, we analyzed concentrations of exposure biomarkers specific to OC (CPAA, DOCCA, 5OH-OC) and EHS (5OH-EHS, 5oxo-EHS, 5cx-EPS) in 24-h urine samples (n = 420) from the German Environmental Specimen Bank (ESB). These samples were collected from German students (20–29 years; 30 males/30 females per year) between 1996 and 2020 (4-year intervals; collection in winter).We found continuously increasing OC and EHS exposures (Jonckheere-Terpstra; p LOQ) and 0.060 µg/L 5cx-EPS (88 %>LOQ). This general trend was confirmed by the other biomarkers, however at lower detection rates. Based on metabolite excretion in the 24-h urine samples and human toxicokinetic data, we calculated maximum daily intakes (DI) of 17 µg/(kg bw * d) OC and 59 µg/(kg bw * d) EHS. Based on a derived no-effect level (DNEL) of 0.8 mg/(kg bw * d), the OC exposures of individuals in our study did not indicate any health risk. Similarly, for EHS all biomarker concentrations were well below the HBM-I values of 12 µg/L 5OH-EHS and 11 µg/L 5cx-EPS.Our data proves the general applicability of specific OC and EHS metabolites for HBM in the general population and shows clearly increasing exposures. Higher (co-)exposures must be expected in populations with increased sunscreen use such as (summer) vacationers, children and outdoor workers.

Purpose: Antidepressant use has increased in many European countries, mostly driven by longer treatment duration. The aim of this study was to provide prevalence rates of long-term users of antidepressants for the Swiss population over the last decade and to investigate associated factors for longer use. Methods: We examined the prevalence rates of individuals with at least one prescription for antidepressants using longitudinal health claims data for 2013 to 2021. We defined short- (< one year), medium- (one–two years), and long-term users (> two years) for 2015 to 2019. We applied a binary logistic regression model to investigate the effects of population (gender, age, area of living, language, health insurance plan, and nursing home) and treatment characteristics (psychiatric or psychotherapeutic care) on long-term compared to short- and medium-term users in 2019. Results: In 2021, 9% of the Swiss population (n = 770,698) received at least one antidepressant prescription, which remained stable since 2013. In 2019, the proportion of long-term users was 57.4%, with steady increase since 2015. The proportion of medium- and short-term users has decreased. Older age, being a woman, living in an urban area, living in a nursing home, being enrolled in a standard care plan, and receiving psychiatric or psychotherapeutic care were factors positively associated with being a long-term user. Conclusion: The proportion of long-term users in Switzerland is high and steadily increasing. Given the ongoing debate about the confounding effects of relapse and withdrawal, more research is needed to investigate longer use of antidepressants that could indicate overprescribing. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To determine the global prevalence of nursing burnout syndrome and time trends for the last 10 years. Background: The prevalence of burnout syndrome varied greatly in different regions in the last 10 years, so the average prevalence and time trends of nursing burnout syndrome for the last 10 years were not completely clear. Design: A meta‐analysis conducted in the PRISMA guidelines. Methods: CINAHL, Web of Science, and PubMed were searched for trials on the prevalence of nursing burnout syndrome from 2012 to 2022 systematically. Hoy's quality assessment tool was used to evaluate the risk of bias. The global prevalence of nursing burnout syndrome was estimated, and subgroup analysis was used to explore what caused heterogeneity. Time trends for the last 10 years were evaluated by meta‐regression using Stata 11.0. Results: Ninety‐four studies reporting the prevalence of nursing burnout were included. The global prevalence of nursing burnout was 30.0% [95% CI: 26.0%–34.0%]. Subgroup analysis indicated that the specialty (p <.001) and the region (p <.001) and the year (p <.001) were sources of the high heterogeneity. Meta‐regression indicated that it tended to increase gradually for the last 10 years (t = 3.71, p =.006). The trends increased in Europe (t = 4.23, p =.006), Africa (t = 3.75, p =.006) and obstetrics (t = 3.66, p =.015). However, no statistical significance was found in ICU (t = −.14, p =.893), oncology (t = −0.44, p =.691) and emergency department (t = −0.30, p =.783). Conclusions: A significant number of nurses were found to have moderate‐high levels of burnout syndrome for the last 10 years. The meta‐analysis also indicated an increased trend over time. Therefore, more attention to the prevalence of nursing burnout syndrome is urgently required. Relevance to Clinical Practice: High prevalence of nursing burnout may attract more attention from the public. This analysis may serve as an impetus for relevant policy to change nurses' working conditions and reduce the occurrence of burnout. [ABSTRACT FROM AUTHOR]

Background: The study of recognized occupational diseases trend is important to understand the preventive approach needed in the future, however, while numbers of occupational diseases are available on web, data on incidence are missing. The aim of our study was to analyze the trend and the incidence rate ratio (IRR) of recognized occupational diseases in Italy, in Friuli-Venezia Giulia region (FVG) and Liguria region from 2010 to 2021. Methods: Numbers of recognized occupational diseases by the Italian National Insurance for Occupational Diseases (INAIL) were analyzed and incidence were calculated considered the total number of workforces in the area. A Poisson regression model was used to estimate incidence trends. Results: FVG region presented a higher incidence of all occupational diseases compared to Italy and to Liguria in the period considered. The overall incidence in 2019 was 175, 91.8 and 108 cases for 100,000 workers, for FVG, Liguria and Italy respectively. Musculoskeletal disorders (MSDs) were the majority of occupational diseases with 100, 51 and 82.8 cases per 100,000 workers, in FVG, Liguria and Italy, respectively. Incidence of occupational cancers was 16, 10 and 4.9 cases per 100,000 workers, in FVG, Liguria and Italy, respectively. The annual change of incidence from 2010 to 2019 was positive for MSDs (IRR 1.06; 95%CI 1.06 to 1.07) and decreasing for the other causes in Italy. In FVG region the trend was positive for MSDs (IRR 1.05; 95%CI 1.04 to 1.06), for respiratory diseases (IRR 1.03; 95%CI 1.00 to 1.05) and pleural plaques (IRR 1.03; 95%CI 1.00 to 1.06). In Liguria the trend was positive for MSDs (IRR 1.17; 95%CI 1.15-1.19) and for pleural plaques (IRR 1.07; 95%CI 1.03-1.12). Stable trends were found for cancers. Declining trend was shown for noise induced hearing loss and skin diseases. Conclusions: FVG region presented a higher incidence of recognized occupational diseases compared to Liguria region and Italian data. Results that can be explained by a higher propensity of claiming for occupational diseases in workers, mainly for MSDs disorders. For cancers and asbestos-related diseases the higher incidence can be attributable to high exposure to asbestos in FVG and Liguria workers mainly in shipyard and dock activities. [ABSTRACT FROM AUTHOR]

BACKGROUND Hexabromocyclododecanes (HBCDs) have been identified as organic pollutants with the properties of persistence, long-distance migration, bioaccumulation, and biological toxicity. HBCDs have been detected in all kinds of biological and abiotic samples around the world, and have adverse effects on the environment and human body. As a non-invasive biological sample, human milk is a good medium for evaluating the exposure of HBCDs in the human body, and is widely used in the study of the exposure level of HBCDs in various countries, especially in nursing infants and young children. According to the survey, the production and use of HBCDs in Beijing has continued to rise since the use and production restriction of HBCDs in 2016, and the total use of HBCDs in 2019 increased by 60.8% compared with 2018. Therefore, in recent years in Beijing, especially before and after the use and production restriction of HBCDs, the residual characteristics and change trend of HBCDs in breast milk have attracted much attention. OBJECTIVES To investigate the residual characteristics and trends of HBCDs in breast milk in Beijing from 2010 to 2018, evaluate the health risks for infants to intake HBCDs via breastfeeding, and provide basic data support for the scientific use, management, control, and human exposure risk assessment of HBCDs. METHODS Breast milk samples (n=233) were obtained from 85 volunteer donors living in Beijing from 2010 to 2018. All volunteers have been living in Beijing for more than 5 years, are healthy, and do not directly engage in HBCDs production, processing, and other related occupations. Each sample was about 30mL, which was manually collected by volunteers into a 30mL clean glass bottle with a Teflon lined screw cap, and then transferred to a laboratory refrigerator for cryopreservation at -20℃. All volunteers were informed of the objective of this study. Pretreatment was conducted by liquid-liquid extraction and ammonia, ethanol, ether and n-hexane were added in turn. After liquid-liquid extraction, concentrated sulfuric acid sulfonation was combined with solid phase extraction (SPE) to purify the samples. Finally, 200μL methanol was added for constant volume. After centrifugation, the upper layer solution was transferred to a brown sample bottle (including lined tube) for storage. The qualitative and quantitative analysis of HBCDs was performed by Waters UPLC CLASS ultra-high performance liquid phase tandem API 4000 triple quadrupole mass spectrometry(LC-MS/MS). The isotope internal standard method was used for quantitative analysis to reduce the matrix effect. RESULTS The detection rate of HBCDs in breast milk was 100%, indicating that HBCDs have been widespread in the human body. The concentration range of HBCDs was 0.46-93.5ng/g lw (lipid weight), with the average and median values of 7.27ng/g lw and 5.77ng/g lw, respectively. The 95th percentile of high-end exposure was 15.6ng/g lw. There were individual differences in the milk samples. The detection rates of α, β and γ-HBCD in all breast milk samples were 100%, 35.6% and 70.8%, respectively. α-HBCD had the most abundant diastereomers in breast milk samples, accounting for 80.1%, followed by γ-HBCD and β-HBCD in order. There were also a small number of breast milk samples that were dominated by γ-HBCD, accounting for 52.2%-83.5%. Even samples taken by the same volunteer in different months had different major diastereomers. The median EDI of HBCDs via human milk for infant was 20.5ng/kg bw/day, and the 95th percentile value was 71.4ng/kg bw/day, which was comparable to the previous research in Beijing, but higher than Japan, Ghana and other cities in China. CONCLUSIONS Compared with the HBCDs in breast milk from other regions at home and abroad, the level of HBCDs in breast milk in this study is close to the previous research data in Beijing, but higher than that of Shanghai, Shenzhen and other cities in China, as well as higher than the results of recent studies in Japan, the United Kingdom, the United States, Canada, India, the Philippines and some African countries, which may be related to the continuous use of HBCDs in China and the large amount of use. In human breast milk, α-HBCD is the main diastereomers, while in a small number of samples, γ-HBCD is the main diastereomers. The differences in the distribution characteristics of these diastereomers may be due to the differences in the absorption, metabolism and excretion mechanisms among individuals, and the transformation of HBCDs among different isomers in vivo, and the differences in the main external exposure pathways. The level of HBCDs showed an obvious upward trend from 2010 to 2013, reached the highest value of 6.84ng/g lw in 2013, and then decreased slightly and remained constant, which may be related to the production, use and prohibition of HBCDs globally and domestically. The time trend of α-HBCD and HBCDs is basically the same, while the content of β-HBCD and γ-HBCD in breast milk is low, and the change trend is stable with time. The concentration of HBCDs in breast milk changed slowly from 2014 to 2018 but did not show a significant downward trend after the initial ban of HBCDs in China in 2016, which may indicate that there are still a large number of HBCDs in production and use on the market, and human intake of HBCDs through air, dust, diet and other ways does not decrease. The risk assessment results indicate that the Hazard Quotient (HQ) of 99% breast milk samples is less than 1, which indicates that the intake of HBCDs through breast-feeding during lactation would not bring significant health risk to infants, but the HQ value of 1% breast milk samples is greater than 1, which suggests that breastfeeding may bring health risks to infants. More research is needed to further investigate the major sources of exposure and the effect of each potential factor.

Abstract Purpose To report the time trends in basic patient characteristics and the number of specimens received at a national referral center for ophthalmic pathology. Methods Data on patient sex, age at surgical resection and geographical location of the referring unit were obtained for all specimens received at the St. Erik Ophthalmic Pathology laboratory, Stockholm, Sweden, between January 1st, 1959, and December 31st, 2021. Results A total of 33 057 specimens had been received, of which 14 560 (44%) came from men and 18 477 (56%) from women (for 20 patients, the sex was not specified). The average annual percent change (AAPC) in the number specimens received was + 10.5%, whereas the Swedish population increased with 0.5% per year. Patients became older throughout the period, with an average yearly increase of patient age at surgery of 0.3 years (AAPC 0.2%). Overall, women were three years older than men at surgery (59.4 versus 56.4 years, P

Siloxanes and synthetic musk compounds (SMCs) have been widely used as additives in household and personal care products. Humans are easily exposed to siloxanes and SMCs originating from these products through ingestion and dermal absorption of indoor dust. In the present study, indoor dust samples were analyzed for 19 siloxanes (cyclic and linear) and 12 SMCs (polycyclic, macrocyclic, and nitro musks) to assess their occurrence, time trends over time, source, and health risks. A total of 18 siloxanes and 10 SMCs were detected in all indoor dust samples obtained from 2011⎯2021, indicating widespread and long-term contamination. Higher detection frequencies and concentrations were associated with siloxanes and SMCs with higher use and strong resistance against degradation processes. Indoor dust samples were dominated by linear siloxanes (L11–L13), 1,3,4,6,7,8-hexahydro-4,6,6,7,8,8-hexamethylcyclopenta-(g)-2-benzopyran (HHCB), musk ketone (MK), and 7-acetyl-1,1,3,4,4,6-hexamethyl-1,2,3,4-tetrahydronaphthalene (AHTN). The frequent use of household and personal care products is likely an important source of siloxane and SMC contamination in indoor environments. The concentrations of siloxanes and SMCs in indoor dust increased from 2011 to 2021, particularly, those of linear siloxanes, reflecting the impact of regulatory actions addressing cyclic siloxanes. The profiles of siloxanes remained stable throughout the study period, whereas those of SMCs shifted from nitro to polycyclic musks. The estimated daily intakes (EDIs) of siloxanes and SMCs arising from ingestion were greater than from dermal absorption of indoor dust. The EDIs of siloxanes and SMCs associated with indoor dust indicated that children are exposed to these pollutants.

Background: Comparing the distribution of all cause or cause-specific child mortality in countries by income and its progress over time has not been rigorously monitored, and hence remains unknown. We therefore aimed to analyze child mortality disparities between countries with respect to income level and progression for the period 2000–2015, and further explored the convergence of unequal income levels across the globe. Methods: Four types of measures were used to assess the degree of inequality across countries: difference and ratio of child mortality rate, the concentration index, and the Erreygers index. To assess the longitudinal trend of unequal child mortality rate by wealth ranking, hierarchical mixed effect analysis was used to examine any significant changes in the slope of under-5 child mortality rate by GDP per capita between 2000 and 2015. Results: All four measures reveal significant inequalities across the countries by income level. Compared with children in the least deprived socioeconomic quintile, the mortality rate for children in the most deprived socioeconomic quintile was nearly 20.7 times higher (95% Confidence Interval: 20.5–20.8) in 2000, and 12.2 times (95% CI: 12.1–12.3) higher in 2015. Globally, the relative and absolute inequality of child mortality between the first and fifth quintiles have declined over time in all diseases, but was more pronounced for infectious diseases (pneumonia, diarrhea, measles, and meningitis). In 2000, post-neonatal children in the first quintile had 105.3 times (95% CI: 100.8–110.0) and 216.3 times (95% CI: 202.5–231.2) higher risks of pneumonia- and diarrhea-specific child mortality than children in the fifth quintile. In 2015, the corresponding rate ratios had decreased to 59.3 (95% CI: 56.5–62.1) and 101.9 (95% CI: 94.3–110.0) times. However, compared with non-communicable disease, infectious diseases still show a far more severe disparity between income quintile. Mixed effect analysis demonstrates the convergence of under-5 mortality in 194 countries across income levels. Conclusion: Grand convergence in child mortality, particularly in post neonatal children, suggests that the global community has witnessed success to some extent in controlling infectious diseases. To our knowledge, this study is the first to assess worldwide inequalities in cause-specific child mortality and its time trend by wealth. [ABSTRACT FROM AUTHOR]

Background: There is a paucity of data on occupational disease incidence in Italy, and we analyzed the trend on time as an incidence rate ratio (IRR). Methods: Occupational diseases reported to the Italian National Insurance for Occupational Diseases (INAIL) in industrial and services sectors from 2006 to 2019 were considered and analyzed. Annual case counts were analyzed using a Poisson regression model to estimate incidence trends. Results: The incidence of occupational diseases in the industrial and services sectors in 2019 was 261 cases for 100,000 workers, with musculoskeletal disorders (MSDs) representing 65% of the total cases, their incidence being 169.5 cases per 100,000 workers. The incidence of ear diseases (ED) decreased to 20.8 cases for 100,000 workers. The annual change in incidence (IRR) was 1.08 (CI 95% 1.07-1.11) for MSDs, 1.08 (CI 95% 1.06-1.10) for cancers, and 1.04 (CI 95% 1.03-1.06) for respiratory diseases. The trend was significantly negative for ear diseases, 0.96 (CI 95% 0.96-0.97), and skin diseases 0.93 (CI 95% 0.92-0.93). No changes were found for asbestos and mental disorders. Conclusions: During the study period, occupational diseases increased in Italy, mainly for MSDs, due to a changeover in eligibility criteria from 2008. However, the overall incidence was lower than in other EU Countries. More efforts are needed to harmonize the legislation for joint action in preventing and recognizing occupational diseases. [ABSTRACT FROM AUTHOR]

Summary: This article describes the recent prevalence and trend in weight status in young men over three and half decades among Austrian conscripts overall and by subgroups defined by education and smoking behavior. We extracted medical record data from six medical examination stations across the country of all Austrian military conscripts (aged 17–19 years) recruited between 1983 and 2017 (n = 1.5 million). Weight and height were measured to calculate body mass index (BMI). Mean BMI increased from 22.7 to 24.3 kg/m2 between 1983 and 2017. Over time, the prevalence of obesity (BMI ≥ 30 kg/m2) increased from 1.6% (95% CI 1.6–1.7%) to 8.2% (95% CI 8.1–8.3%). The prevalence of obesity among Austrian young men increased remarkably in the past 35 years. Higher levels of education appeared to be associated with lower prevalence of obesity, particularly among the non-smokers. [ABSTRACT FROM AUTHOR]

Alarming levels of emotional symptoms among youth were reported during the COVID-19 pandemic. Studies assessing these figures against the pre-pandemic developments are rare. We examined the trend of generalized anxiety (GA) in adolescents in the 2010s and the effect of the COVID-19 pandemic against this trend. Data from the Finnish School Health Promotion study with 750,000 participants aged 13–20 between 2013 and 2021 was analyzed using GAD-7 to measure self-reported GA (cut-off ≥10). Inquiries were made about remote learning arrangements. Effects of time and COVID-19 were analyzed with logistic regression. Among females, an increasing trend in GA between 2013 and 2019 was found (OR per year 1.05), and the prevalence increased from 15.5 % to 19.7 %. Among males, the trend was decreasing (OR = 0.98), with prevalence from 6.0 % to 5.5 %. Increase in GA from 2019 to 2021 was stronger in females (19.7 % to 30.2 %) than males (5.5 % to 7.8 %), while the effect of COVID-19 on GA was equally strong (OR = 1.59 vs. OR = 1.60) against the pre-pandemic trends. Remote learning was associated with elevated levels of GA, especially among those with unmet needs for learning support. The design of repeated cross-sectional surveys doesn't allow analyses of within individual changes. Given the pre-pandemic trends of GA, the COVID-19 effect on it appeared equal in both sexes. The increasing pre-pandemic trend among adolescent females and the strong effect of COVID-19 on GA among both sexes warrants constant monitoring of mental health of the youth in the aftermath of the COVID-19 pandemic. • Prevalence of generalized anxiety (GA) increased among females during the 2010s. • Among males the trend in GA was almost flat, while slightly decreasing. • Against these trends, the effect of COVID-19 on GA in adolescents was very strong. • Considering the trends the effect of COVID-19 was equally strong for both sexes. • Monitoring adolescent mental health is warranted during the post-COVID-19 era. [ABSTRACT FROM AUTHOR]

Background: The increasing trends in Diabetes prevalence and its attributed burden emphasized as an important issue that needs serious and urgent attention, all over the word. We estimated the mean Fasting Plasma Glucose (FPG) and the prevalence of Diabetes in aged 25 years or older Iranian adults, by sex, age, province, and year through the time period of 1990 to 2016. Methods: In order to access the most comprehensive relevant data at the same time the systematic data searched added to the data of 5 national surveys and 7 sub-national population based investigations. Two round of modeling, including the Age-Spatio-Temporal and Gaussian Process Regression were used for estimation of mean FPG trend and uncertainties. To estimate Diabetes estimations in target groups, a crosswalk model was applies to the FPG estimates. The model reiterated separately for women and men. All of estimations standardized based on the Iran national census population of 2016 by year, age groups and sexes at national and sub-national levels. Results: In 2016, the number of the diabetic population was 4.43 (3.93–4.99) million (2.38 million women). Between 1990 and 2016, the age-standardized mean of FPG increased from 84.69 mg/dl (79.8–89.8) to 100.5 mg/dl (97.9–103.3) in women and from 82.7 mg/dl (78.3–87.5) to 98.8 mg/dl (96.2–101.4) in men. Simultaneously, with considerable difference, the Diabetes prevalence, has increased from 6.1% (4.7–7.8) to 9.8% (8.7–11.1) in women and from 5.0% 18 (3.8–6.3) to 8.1% (7.2–9.2) in men (75% attributed to population growth). Considering the geographical patterns, the greatest increment in the prevalence of Diabetes detected in the northwestern and the central provinces. Conclusion: Significant increasing trends of Diabetes led to alarming threat, which can make the strategies and goals of our prevention programs out of control. We should plan for more effective communicative interventions for prevention and management of Diabetes, to be designed, implemented and monitored based on the updated scientific evidence. [ABSTRACT FROM AUTHOR]

We evaluated spatiotemporal changes in the mean and variation in largemouth bass (Micropterus salmoides) mercury concentrations over three discrete time periods (1995, 2005–2006, and 2019–2021) across 56 Connecticut waterbodies. We detected largemouth bass raw mercury concentrations that exceeded the US Environmental Protection Agency (USEPA) Fish Tissue Residue Criterion (≥ 0.30 µg g−1 ww) in 75.1%, 63.3%, and 47.7% of all fish sampled during 1995, 2005–2006, and 2019–2021, respectively. Total length (TL)-adjusted largemouth bass mercury concentrations declined across all ecoregions in Connecticut between subsequent sampling periods but increased between 2005–2006 and 2019–2021 in the Northwest Hills/Uplands ecoregion. The coefficient of variation (CV) of largemouth bass TL-adjusted mercury concentrations increased through time, increasing from 25.78% during 1995 to 36.47% during 2019–2021. The probability of a largemouth bass having a raw mercury concentration > 0.30 µg g−1 ww increased with total length (TL), but the TL with a 50% probability varied across ecoregions and periods. The variation in largemouth bass mercury concentrations highlights the roles that changes to individual behaviors, food web structure, lake properties, and legacy mercury may play in shaping broad patterns and trends in mercury consumption risks. [ABSTRACT FROM AUTHOR]

Wenzhou has improved its environmental quality because of comprehensive environmental remediation; nevertheless, the semen quality of infertile males remains unclear. This study determined whether better environmental quality improved semen quality in this region. We recorded semen quality data from 22 962 infertile males from January 2014 to November 2019 at the Center for Reproductive Health of The First Affiliated Hospital of Wenzhou Medical University (Wenzhou, China). Patients were predominantly 30–35 years old (33.1%) and workers (82.0%), with high school education or lower (77.6%); more than a half of the patients (52.6%) were Wenzhou household registration; and most patients (77.5%) had abnormal semen quality. Patients who were older than 40 years and workers, and those with Wenzhou household registration, had significantly worse semen quality (all P < 0.05). From 2014 to 2019, progressive sperm motility, total sperm motility, and semen volume showed increasing linear trends in all patients (P = 0.021, 0.030, and 0.005, respectively), yet normal sperm morphology showed a linearly decreasing trend (P = 0.046). Sensitivity analyses for subgroups yielded similar results. In conclusion, the improvement of environmental quality and better function of the accessory glands are associated with progressive sperm motility, total sperm motility, and semen volume. Normal sperm morphology is influenced by occupational exposures and personal lifestyle and does not improve with environmental quality.

Abstract Background Millions of tons of lead were added to gasoline worldwide beginning in 1922, and leaded gasoline has been a major source of population lead exposure. In 1960s, lead began to be removed from automotive gasoline. Removal was completed in 2021. Objectives To determine whether removal of lead from automotive gasoline is associated with declines in population mean blood lead levels (BPb). Methods We examined published studies that reported population blood leaded levels for two or more years, and we calculated average concentrations of lead in gasoline corresponding to the years and locations of the blood lead level measurements. Results Removal of lead from gasoline is associated with declines in BPb in all countries examined. In some countries, BPb continues to fall after lead has been eliminated from gasoline. Following elimination of lead from gasoline, BPb less than 1 μg/dL have been observed in several European and North American countries, and BPb less than 3 μg/dL have been documented in several studies from South America. Discussion There remain many countries for which no multi-year studies of populations BPb have been identified, including all of Central America, high population countries including Pakistan and Indonesia, and major lead producers including Australia and Russia. Conclusion Removal of lead from gasoline has been a public health success. Elimination of lead from gasoline has enabled many countries to achieve population mean BPb levels of 1 μg/dL or lower. These actions have saved lives, increased children’s intelligence and created great economic benefit in countries worldwide.

OBJECTIVE: This study investigated time trends in occupational exposure to various chemicals in Sweden and the distribution across demographic and labor market sectors. METHODS: Exposure to six chemicals was investigated from 1980 to 2013 by application of a job exposure matrix to national population registers. Respirable crystalline silica (RCS), diesel engine exhaust, welding fumes, wood dust, chlorinated hydrocarbon solvents, and lead were selected to represent different groups of chemicals. Trends in exposure prevalence were investigated by linear regression and compared to the occupationally active population. Confidence intervals for the rate of change over time were obtained by bootstrapping. RESULTS: The proportion of workers born outside the Nordic countries increased over time in those exposed to RCS, diesel exhaust and wood dust. There was a shift of exposed jobs to small companies (

Polychlorinated biphenyls (PCBs) are industrial products extensively used in the past. Because of their widespread presence and toxic effects, the international community adopted control measures to reduce their release into the environment. Currently, PCB concentrations are decreasing, but humans are still exposed. In this paper, we reported the results of a study concerning PCB concentrations in human serum samples collected in Italy over two decades. The aim of the study was to investigate the trend of major determinants of PCB human exposure, several decades after the end of their production. PCB concentrations ranged over three orders of magnitude (from 0.4 to 958 ng/g lipid), with a median value of 85 ng/g lipid. We identified age, sampling year, body mass index, sex, and living near hot spots or being occupationally exposed as relevant factors in determining body burden. Our results can give indications to refine regulatory policies on PCBs in Italy, with particular attention to the disposal of residue PCB-containing products. To improve control measures can further decrease the exposure of citizens to PCBs, limit health implications, and improve citizens' perception about chemical risk management. [ABSTRACT FROM AUTHOR]

Purpose: To report the time trends in basic patient characteristics and the number of specimens received at a national referral center for ophthalmic pathology. Methods: Data on patient sex, age at surgical resection and geographical location of the referring unit were obtained for all specimens received at the St. Erik Ophthalmic Pathology laboratory, Stockholm, Sweden, between January 1st, 1959, and December 31st, 2021. Results: A total of 33 057 specimens had been received, of which 14 560 (44%) came from men and 18 477 (56%) from women (for 20 patients, the sex was not specified). The average annual percent change (AAPC) in the number specimens received was + 10.5%, whereas the Swedish population increased with 0.5% per year. Patients became older throughout the period, with an average yearly increase of patient age at surgery of 0.3 years (AAPC 0.2%). Overall, women were three years older than men at surgery (59.4 versus 56.4 years, P < 0.0001) The number of specimens increased with patient age from the first to the 8th decade, after which it decreased to zero in the 11th decade. The largest portion of patients had undergone their surgery in one of the hospitals or clinics in the capital region, with four of the five largest sources corresponding to the most populous counties in the country. Conclusions: During six decades, the growth in number of specimens sent to our national referral center for ophthalmic pathology has greatly outpaced the growth of the population, indicating an increasing demand for subspecialized services. Throughout the period, patients have become older, and a higher number of specimens have been submitted from female patients. [ABSTRACT FROM AUTHOR]

Background: Adherence to evidence-based hospital stroke care is variable and may change over time. It is important to determine which process measures are associated with variation in outcome. In a large dataset, we analyzed the association between process and outcome and the fluctuations of indicators over time, and identified quality indicators (QIs) that should be prioritized for improving the quality of stroke care. Methods: We analyzed data from 123,259 patients diagnosed with acute ischemic stroke (AIS) who were treated at 109 large tertiary hospitals in China between January 2011 and May 2017. In total, 12 stroke treatment indicators were selected to calculate the hospital process composite performance (HPCP). Hospitals were divided into subgroups according to the time trend of HPCP estimated by the Group-Based Model. We analyzed the influence of hospital subgroups on the patient outcomes using a multi-level model and explored the QIs that led to variation. Results: The HPCP trends for stroke indicators of 109 hospitals over 7 years were divided into two groups (Group 1, low-HPCP; Group 2, high-HPCP). After adjusting for patient age, medical insurance, comorbidities, patterns of admission, and NIHSS-scores, patients in the high-HPCP group presented higher rate of independence and longer length of stay compared to the low-HPCP group. The multi-level model showed that there was a statistically significant difference in the utilization rate between the two groups, with most marked differences seen in emergency assessment and function evaluation indicators. Conclusion: Variation in the quality of stroke care exists across hospitals, and better adherence to guideline-based care is associated with improved outcomes. We found that QIs related to emergency examination and functional assessment were the main factors differing between good and poor adherers to stroke indicators, suggesting that quality improvement in stroke care could prioritize these QIs. [ABSTRACT FROM AUTHOR]