Despite the rising disease mortality rates, there is a dearth of studies on the incidence and trends of out-of-hospital cardiac arrests (OHCA) in China. This study aims to investigate the incidence and temporal trends of presumed cardiac origin OHCA in Guangzhou, Southern China, from 2011 to 2020.

In this population-based retrospective cohort study, pre-hospital data from the Guangzhou Emergency Medical Service (GZ-EMS) from 2011 to 2020 were analyzed. Crude incidence rates and age-standardized incidence rates (ASIRs) were calculated respectively. ASIRs were calculated using the 2000 national census population as the standard population. The Joinpoint software was used to calculate the Annual Percent Change (APC) and Average Annual Percent Change (AAPC) in the incidence of OHCA over the study period. From 2011 to 2020, 44,375 EMS-assessed OHCAs of presumed cardiac origin were recorded. Overall, the crude incidence rate of OHCA was 53.1 per 100,000 on average. AAPC was 7.0% (95% CI: 4.3%-9.8%). Age-standardized incidence rate(ASIR) was 38.4 per 100,000 on average, with an average annual increase of 4.8% (95% CI: 2.4%-7.3%). The crude and ASIR of OHCA increased in men, while the ASIR changed more moderately in women. The age group of ≥80 years had the highest rate of increase. The 20-29 and 70-79 age groups also demonstrated notable increases.

From 2011 to 2020, Guangzhou experienced a notable upward trend in both crude and ASIR of OHCA, with significant variations observed across gender and age demographics. This trend calls for a deeper investigation into the underlying factors.

Injuries from firearms and motor vehicle crashes (MVCs) are the leading causes of death among US children and youths aged 0 to 19 years. Examining the intersections of age group, sex, race, and ethnicity is essential to focus prevention efforts.

To examine firearm and motor vehicle fatality rates by population subgroups and analyze changes over time.

This cross-sectional study of firearm and MVC fatalities among US children and youths aged 0 to 19 years from the Centers for Disease Control and Prevention Web-Based Injury Statistics and Query Reporting System from 2011 to 2021. Participants included American Indian and Alaska Native; Asian, Hawaiian Native, and Pacific Islander; Black; Hispanic; and White youths. Data analysis was conducted from July 2023 to May 2024.

Firearm or MVC fatality.

Firearm and MVC fatality rates by year and over time, as measured by the Joinpoint regression annual percent change (APC).

From 2011 to 2021 there were 35 684 firearm and 40 735 MVC fatalities among US youths aged 0 to 19 years. For firearm fatalities, there were 21 332 homicides (59.8%), 12 113 suicides (33.9%), 1359 unintentional shootings (3.8%), 277 by legal enforcement (0.8%), and 603 from unknown intents (1.6%). When considering the intersections of age group, sex, race, and ethnicity, for firearm homicides among youths aged 15 to 19 years, the APCs were similar for Black (21.8%) and Hispanic (22.2%) males from 2018 to 2021, although with different peak rates (104.22 per 100 000 individuals and 17.80 per 100 000 individuals, respectively, in 2021). Black females aged 15 to 19 years demonstrated a dramatic APC increase of 40.7% from 2019 to 2021 (peak rate, 14.07 per 100 000 individuals). For firearm suicide in youths aged 10 to 19 years by sex, Black females had the greatest APC increase of 22.0% from 2016 to 2021. For MVC fatalities, the highest APC increase of 24.9% occurred among American Indian and Alaska Native females aged 15 to 19 years from 2018 to 2021. The highest MVC fatality rates occurred in 2021 among American Indian and Alaska Native males (38.16 per 100 000 individuals) and females (29.31 per 100 000 individuals) aged 15 to 19 years.

In this cross-sectional study, US youths aged 0 to 19 years experienced important disparities in firearm and MVC fatality rates and increases over time when considering the intersectionality by age group, sex, race, and ethnicity. These findings suggest that a multipronged strategy focused on individual, community, and policy level approaches for specific high-risk groups for each injury mechanism is necessary to address these leading causes of death in US youths.

Congenital syphilis (CS) case rates have increased significantly in the United States over the past 20 years, accelerating during the COVID-19 pandemic. Increasing rates may relate to access to care but have not been evaluated in a fully-insured population, such as the Military Health System.

We performed a repeated monthly cross-sectional study of CS cases and total encounters (care rates) using the queried Military Health System database. We defined CS by International Classifications of Diseases 10th Revision Clinical Modification diagnosis codes in beneficiaries  ≤ 2 years old. We evaluated pre-COVID-19 (March 2018 to February 2020), pandemic year 1 (March 2020 to February 2021), and pandemic year 2 (March 2021 to February 2022) periods. We performed change-point and trend analyses and Poisson regression to evaluate differences by sponsor rank, TRICARE region, and pandemic period. The Uniformed Services University Institutional Review Board approved the study.

A total of 69 unique CS cases were identified with a median monthly care rate of 0.90/100,000 eligible beneficiaries. The CS care rate showed a 5.8% average monthly percent increase throughout the study period (P < .001) and a 20.8% average monthly percent increase in year 2 (P < .05). Compared to the pre-pandemic era, CS care rates increased in pandemic years 1 and 2 (adjusted rate ratio [aRR] 2.76 [95% CI: 1.95-3.92], 5.52 [95% CI: 4.05-7.53], respectively). Congenital syphilis care rates were lower in children of senior enlisted sponsors versus junior enlisted, aRR 0.24 (95% CI: 0.17-0.33), and higher in the West and North regions versus South, aRR 2.45 (95% CI: 1.71-3.53) and aRR 2.88 (95% CI: 2.01-4.12), respectively.

Congenital syphilis care rates were substantially lower in this insured group than national rates but increased significantly during the COVID-19 pandemic. Higher care rates were seen in children of military members of lower rank. Regional trends differed from national data. These findings suggest that, even in a fully-insured population, income and regional differences impact CS, and the COVID-19 pandemic may have exacerbated differences in care delivery.

Background/Objectives: The Brazilian Constitution defines health as a universal right and a State responsibility, with the Unified Public Health System (SUS) ensuring free access to comprehensive care, including renal replacement therapies (RRTs) such as dialysis and kidney transplantation. This study aimed to analyze trends in peritoneal dialysis (PD) usage within Brazil's public health system over a 10-year period, focusing on geographic, demographic, and clinical changes. Methods: Using data from DATASUS and the Brazilian Society of Nephrology Dialysis Census, we analyzed PD usage and patient characteristics from 2014 to 2023. This methodology enabled an in-depth examination of shifts in RRT trends across regions and patient demographics. Results: PD usage declined from 6.5% in 2014 to 4.3% in 2023, with the steepest reductions observed in the North and Northeast regions. Usage increased in the Central-West region, while the Southeast and South experienced steady declines from 2016 to 2023. The proportion of centers offering PD decreased from 51.6% in 2014 to 37.9% in 2023. Over time, the average age of PD patients increased, as did the proportion of Brown/Black individuals receiving PD. Despite these shifts, patient serum levels of hemoglobin, parathyroid hormone, and phosphorus remained stable. Conclusions: This study highlights a relative decline in PD availability and use within Brazil's public health system, with notable regional disparities. These findings underscore the urgent need for targeted policies to support PD infrastructure, funding, and training to ensure equitable access to RRT across the country.

Tobacco use remains a global challenge to public health, accounting for almost eight million deaths per year worldwide, with a significant portion attributable to tobacco-related cancers. Examining the epidemiology of tobacco-related cancers and assessing the trends in the incidence and mortality will allow for more effective prevention, treatment, and targeted strategies.

We assessed the trends in the incidence and mortality of tobacco-related cancers among adults in the United States using data from United States Cancer Statistics (USCS) 2001-2021 and mortality data 1975-2022 from the National Center for Health Statistics (NCHS). The incidence and mortality rates of tobacco-related cancers were calculated as cases per 1,000,000 persons and age-adjusted to the 2000 United States standard population.

There was a recent overall decreasing trend in both the incidence (2001-2021) and mortality rate (2001-2022). Among adults 20-49 years old, there was an increasing trend from 2001 to 2021 in the incidence among non-Hispanic American Indians/Alaska Natives (APC 2.6, 95% CI 2.1-3.0) and those in the West (APC 0.2, 95% CI 0.0-0.4); in Hispanics, the incidence rate increased most recently from 2013 to 2021 (APC 1.7, 95% CI 1.0-3.0). The mortality rate first increased from 1975 to 1990 among females 50-64 years old and males 65+ years old and from 1975 to 2000 among females 65+ years old, and then decreased thereafter.

The rising incidence in some younger groups highlights the need for targeted public health interventions to address disparities and improve cancer prevention in these vulnerable populations.

Heart failure (HF) and sepsis are significant causes of disease burden and mortality among the elderly population of the USA. HF causes fluid overload, which complicates the treatment approach when patients develop sepsis necessitating fluid resuscitation. While individual disease states have been studied extensively, the trends in mortality for concurrent sepsis and HF are not well known.

Mortality trends due to sepsis and HF in individuals aged 65 and older in the USA from 1999 to 2019 were analyzed using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. Differences in age-adjusted mortality rate (AAMR) and average annual percent change (AAPC) over the past two decades based on gender, race, region, and place of death were examined.

Between 1999 and 2019, there were a total of 5,887,799 deaths related to HF, 2,584,523 deaths related to sepsis, and 250,115 deaths related to both HF and sepsis. There was also a decrease in AAMR for HF-related (AAPC -0.80%) and sepsis-related (AAPC -0.28) deaths but an increase in combined HF and sepsis-related AAMR (AAPC 1.06%). Men had consistently higher AAMRs compared to women and a greater increase in mortality (AAPC in men 1.53% vs. women 0.56%). African American patients had a higher AAMR than White patients throughout the study period, though the difference narrowed. African Americans saw a decrease in overall HF and sepsis-related AAMR from 48.90 to 40.56 (AAPC -0.83), whereas AAMR for the White population increased from 27.26 to 33.81 (AAPC 1.37). Regionally, the Northeast had the highest AAMR in 1999 (32.32) but decreased to the lowest AAMR by 2019 (30.77). Totally, 203,368 (81.31%) of all deaths related to HF and sepsis were in medical facilities, 18,430 (7.37%) were in home/hospice facilities, and 24,713 (9.88%) in nursing homes.

HF and sepsis-related mortality in the elderly population increased over the past two decades, with men and African Americans at disproportionately higher risk.

This study investigated changes in life expectancy due to the COVID-19 pandemic by analyzing the contributions of age, sex, and cause of death in 2019 and 2022.

Korea's simplified life table and cause-of-death statistics from 2019 to 2022 were used to assess mortality changes by age, sex, and cause of death during the pandemic. Joinpoint regression analysis was applied to detect trends, and the Arriaga decomposition method was used to quantify the contributions of age, sex, and cause of death to life expectancy changes.

Joinpoint regression identified a slow increase in life expectancy in 2007 and a decline in 2020, coinciding with the COVID-19 pandemic. Life expectancy decreased markedly for men (-0.36 years per year, 95%CI: -0.68 to -0.03) and women (-0.45 years per year, 95%CI: -0.71 to -0.18). Age-specific contributions revealed declines across age groups, with the steepest reductions in the older population (80 years or older: -0.35 years for men; -0.52 years for women). Women (-0.68 years) contributed more to the decline in life expectancy than men (-0.41 years). COVID-19 ranked as the third leading cause of death in 2022, significantly contributing to the decline in life expectancy among the older population (aged 80 years or older: -0.306 years for men, -0.408 years for women). Women in Korea were more affected than men, reducing the sex-specific gap in life expectancy by 0.3 years.

The COVID-19 pandemic significantly impacted the life expectancy in Korea, particularly among older adults, with women experiencing a greater decline than men. These findings emphasize the need for targeted public health strategies to address age and sex disparities in future pandemics. Before the pandemic, non-communicable diseases such as malignant neoplasms, heart disease, and cerebrovascular disease dominated Korea's top 10 causes of death. During the pandemic, however, COVID-19 rose to third place by 2022. Notably, intentional self-harm (suicide) contributed to an increase in life expectancy, suggesting shifts in the relative impact of various causes of death.

The number of reported cases of human brucellosis significantly increased from 45,046 (3.25/100,000) in 2019 to 70,439 (4.99/100,000) in 2023.

Human brucellosis continued to spread and expand of in northern China, with the most cases reported in the Inner Mongolia Autonomous Region (n=87,961), Xinjiang Uygur Autonomous Region (n=27,845) and Shanxi Province (n=21,932). In southern China, reported cases increased substantially from 2,036 in 2019 to 5,128 in 2023. Joinpoint regression analysis revealed an upward trend in incidence rate across 29 provincial-level administrative divisions (PLADs), with an annual percent change (APC) of 12.86, (P<0.05), with particularly rapid increases observed in most southern PLADs. Spatiotemporal analysis identified high-risk clusters concentrated in the northwestern and northeastern regions.

With the continued worsening of human brucellosis over the past five years, implementing strict controls on the movement of infected animals is urgeent.

Childhood overweight and obesity pose significant risks to physical and mental health. The Nutrition Improvement Programme for Rural Compulsory Education Students (NIPRCES) has demonstrated effectiveness in reducing malnutrition.

From 2012 to 2023, obesity prevalence increased more rapidly (AAPC=10.6%) than overweight prevalence (AAPC=2.0%) among children aged 6-15 years in central and western rural China. A quicker increase in the trends of overweight and obesity was observed in rural western China (AAPC for overweight=3.0%, AAPC for obesity=11.8%), among males (AAPC for overweight=2.1%, AAPC for obesity=10.8%). Additionally, while the prevalence of overweight/obesity was lower in older age groups of children, these cohorts showed more rapid increases.

Continuous monitoring of prevalence and implementation of targeted interventions are essential to prevent and control the expansion of overweight and obesity.

Suspected occupational noise-induced deafness (ONID) represents the most prevalent suspected occupational disease in Guangdong Province and is among the most frequently reported nationwide. Given its public health significance, we conducted a systematic investigation of suspected ONID cases in Guangdong from 2014 to 2023, analyzing their epidemiological characteristics and diagnostic outcomes to inform evidence-based policies for ONID prevention and management.

Data on suspected ONID cases reported in Guangdong Province from 2014 to 2023 were extracted from the "Occupational Diseases and Health Hazard Factors Monitoring Information System." Cases were analyzed using descriptive epidemiological methods, with joinpoint regression analysis employed to assess long-term trends.

From 2014 to 2023, 16,987 suspected ONID cases were reported in Guangdong Province, comprising 65.22% of all suspected occupational disease cases (26,044). Cases exhibited a significant increasing trend (Average annual percentage change: 11.8%, 95% CI: 2.9%-22.3%, P = 0.013). The Pearl River Delta region accounted for 87.9% of all cases, with manufacturing being the predominant industry (90.1%). Within manufacturing, the metal products industry represented the highest proportion (15.2%). Males constituted 87.7% (14,905/16,987) of cases. Analysis of diagnostic outcomes from 2020 to 2023 revealed an overall diagnostic procedure initiation rate of 45.1%, with a subsequent confirmation rate of 48.9%.

Guangdong Province demonstrates high occurrence patterns of suspected ONID cases, particularly concentrated in the Pearl River Delta region and manufacturing sectors. The low rates of diagnostic procedure initiation and confirmation highlight the urgent need for enhanced regulatory oversight of diagnostic procedures and the development of expert consensus on suspected ONID identification criteria to improve diagnostic confirmation rates.

Since rubella was incorporated into the national disease surveillance system in 2004, rubella incidence has changed dramatically. This study analyzed the impact of immunization strategies on the age-specific and sex-specific incidence of rubella in China from 2004 to 2023 to inform efforts to accelerate rubella elimination.

Annual rubella-containing vaccine (RCV) coverage levels, reported rubella cases and incidence, and vaccination status of cases were obtained from the National Immunization Program Information Management System, the National Notifiable Diseases Reporting System, and the Measles Surveillance System, and used to describe temporal trends. Incidence trends and annual percent changes (APC) by age group and sex were estimated using joinpoint regression.

In 2008, RCV coverage was 51.5% for the first dose and 39.0% for the second dose, increasing to and stabilizing at 95% or above for both doses by 2012. There were 584,758 cases of rubella reported in China during 2004-2023. Joinpoint regression showed that rubella incidence initially increased, peaked in 2008, and then decreased (APC2004-2008=47.12%, APC2008-2023=-18.95%, P<0.05). Adolescents, aged 10-19 years, accounted for 67.8% of cases at a peak incidence in 2019 (APC2016-2019=103.70%, APC2016-2019=-89.76%, P<0.05); 77.8% of cases had no or unknown RCV history.

The decrease in rubella incidence is closely associated with vaccination. Nationwide inclusion of RCV significantly impacted on the prevention and control of rubella. Targeted measures to address immunization gaps and maintain high surveillance sensitivity are necessary to promote rubella elimination.

Certain causes of death can be avoided with access to timely prevention and treatment. We quantified trends in avoidable deaths from cardiovascular diseases for European Union (EU) countries from 1995 to 2020 and examined variations by demographics, disease characteristics, and geography.

Retrospective secondary data analysis of avoidable cardiovascular mortality using the WHO Mortality Database. Avoidable causes of death were identified from the OECD and Eurostat list (which uses an age threshold of 75 years). Regression models were used to identify changes in the trends of age-standardized mortality rates and potential years of life lost.

From 1995 to 2020, 11.4 million deaths from cardiovascular diseases in Europe were avoidable, resulting in 213.1 million potential life years lost. Avoidable deaths were highest among males (7.5 million), adults 65-74 years (6.8 million), and with the leading cause of death being ischemic heart disease (6.1 million). From its peak in 1995 until 2020, avoidable mortality from cardiovascular diseases has decreased by 57% across the EU. The difference in avoidable cardiovascular diseases mortality between females and males, and between Eastern and Western Europe has reduced greatly, however gaps continue to persist.

Avoidable mortality from cardiovascular diseases has decreased substantially among EU countries, although improvement has not been uniform across diseases, demographic groups or regions. These trends suggest additional policy interventions are needed to ensure that improvements in mortality are continued.

World Health Organization, Regional Office for Europe.

Antibiotics are the most prescribed drugs for children worldwide, but overuse and misuse have led to an increase in antibiotic resistance. Antimicrobial stewardship programmes (ASPs) have proven feasible in reducing inappropriate antimicrobial use. The study aimed at evaluating the impact and sustainability of an ASP with multiple interventions over 8 years.

This quasi-experimental study was conducted between 2014 and 2022 in the paediatric acute care unit of Padua University Hospital. Demographic and clinical data were retrieved from the electronic clinical records. Daily prescriptions were collected and analysed based on the AWaRe classification and using days of therapy (DOT) out of 1000 patient days (DOT/1000PDs). The primary outcome was to assess the change in overall antibiotic consumption and of access and watch antibiotics, stratifying patients with and without comorbidities. Trends in antibiotic consumption (DOTs/1000PD) were assessed using joinpoint regression analysis.

A total of 3118 children were included. Total antibiotic consumption remained stable and low in patients without comorbidities, ∼300 DOT/1000PDs, whereas a statistically significant constant reduction was observed in children with comorbidities, from almost 500 DOT/1000PPDs to <400 DOT/1000PDs. Access consumption increased in both groups of patients, whereas watch consumption constantly decreased, although statistically significant only in children with comorbidities.

Implementing a multistep ASP has proven feasible and sustainable in improving antibiotic prescriptions for previously healthy and fragile children. All the implemented interventions were low cost, and with efficient use of resources, ensuring an ASP that was effective, practical, and easily replicable and implementable in various healthcare settings.

This study aims to analyze the trend of Hepatitis B incidence in Xiamen City from 2004 to 2022, and to select the best-performing model for predicting the number of Hepatitis B cases from 2023 to 2027.

Data were obtained from the China Information System for Disease Control and Prevention (CISDCP). The Joinpoint Regression Model analyzed temporal trends, while the Age-Period-Cohort (APC) model assessed the effects of age, period, and cohort on hepatitis B incidence rates. We also compared the predictive performance of the Neural Network Autoregressive (NNAR) Model, Bayesian Structural Time Series (BSTS) Model, Prophet, Exponential Smoothing (ETS) Model, Seasonal Autoregressive Integrated Moving Average (SARIMA) Model, and Hybrid Model, selecting the model with the highest performance to forecast the number of hepatitis B cases for the next five years.

Hepatitis B incidence rates in Xiamen from 2004 to 2022 showed an overall declining trend, with rates higher in men than in women. Higher incidence rates were observed in adults, particularly in the 30-39 age group. Moreover, the period and cohort effects on incidence showed a declining trend. Furthermore, in the best-performing NNAR(10, 1, 6)[12] model, the number of new cases is predicted to be 4271 in 2023, increasing to 5314 by 2027.

Hepatitis B remains a significant issue in Xiamen, necessitating further optimization of hepatitis B prevention and control measures. Moreover, targeted interventions are essential for adults with higher incidence rates.

Occupational noise-induced deafness (ONID) has replaced occupational poisoning as the second most common occupational disease in China since 2015. However, there is a limited number of articles on epidemiological characteristics of legally diagnosed ONID.

We conducted a comprehensive analysis of the epidemiological and spatiotemporal characteristics of ONID in Guangdong Province from 2006 to 2022, with the aim of providing a scientific foundation for policy formulation and health resource allocation.

Surveillance data of ONID cases in Guangdong Province from 2006 to 2022 were obtained from the "Occupational Diseases and Health Hazard Factors Monitoring Information System." Joinpoint regression analysis was applied to assess the long-term trends in cases of ONID from 2006 to 2022. Global spatial autocorrelation analysis was performed to measure the overall degree of similarity of the attribute values of spatially adjacent or neighboring regional units. The local indicators of spatial autocorrelation (LISA) plots were then used to identify the local clusters of ONID in Guangdong.

There were 3761 ONID cases in Guangdong Province from 2006 to 2022, showing a significantly increased trend in cases across the entire study period (average annual percentage change 21.9, 95% CI 18.7-35.1). The Moran's I values for the period of 2006 to 2022 ranged from 0.202 to 0.649 (all P<.001), indicating a positive spatial correlation of ONID across regions each year in Guangdong Province. A total of 15 high-high clusters were notably concentrated in specific counties within the Pearl River Delta.

Significant spatiotemporal patterns of ONID in Guangdong Province from 2006 to 2022 were identified, characterized by a dramatic increase followed by stabilization in case numbers. ONID predominantly occur in manufacturing industries, domestically funded enterprises, among males, individuals aged 40-49 years, and those with 5+ years of occupational noise exposure. Spatial analysis demonstrated significant clustering in the Pearl River Delta region, with consistent positive spatial autocorrelation across years. These results could help prioritize the allocation of resources for targeted prevention and control measures for ONID.

Suicide remains a leading cause of death in the United States, and recent data suggest suicide deaths involving opioids are increasing. Given unprecedented increases in drug-poisoning deaths, suicidality, and suicide deaths in recent years, an updated examination of the trends in suicide deaths involving opioids is warranted. In this descriptive epidemiologic analysis, we leverage final and provisional mortality data from the US Centers for Disease Control and Prevention's WONDER database to examine trends in suicide deaths involving opioid poisoning from 1999 to 2021 by biological sex. Results reveal complex changes over time: the number and age-adjusted rate of suicide deaths involving opioid poisoning among male and female residents tended to track together, and both increased through 2010, but then diverged, with the number and rate of suicide deaths involving opioid poisoning among female residents outpacing that of male residents. However, the number and rate of suicide deaths involving opioid poisoning among male residents then began to stabilize, while that of female residents declined, closing the sex-based gap. Across all years of data, the proportion of suicide deaths that involved opioid poisoning was consistently higher among female decedents (5.8%-11.0%) compared with male decedents (1.4%-2.8%). Findings have implications for improved suicide prevention and harm reduction efforts. This article is part of a Special Collection on Mental Health.

The rapid development of COVID-19 vaccines may have raised public concerns about their safety and side effects in the United States (US). This study aimed to assess trends in online searches related to the safety and side effects of COVID-19 vaccines in the US from 2021-2022.

Google COVID-19 Vaccination Search Insights was used to analyze searches about COVID-19 vaccine safety and side effects in the US from January 4, 2021, to November 21, 2022 (98 weeks). Data were scaled from 0 (low interest) to 100 (high interest) as a fixed scaling factor called scaled normalized interest (SNI) to indicate relative search interest over time and by location. A joinpoint regression analysis was used to determine the search trends during the study period.

Analysis included 709 counties across 38 US states. Searches of COVID-19 vaccine safety and side effects peaked in April 2021 in the District of Columbia (SNI: 35.8), Massachusetts (29.7), New Hampshire (27.4), Connecticut (27.3), and Maine (26.7), then decreased significantly by an average monthly percentage change (AMPC) of -16.6% (95% CI -19.9 to -13.3) until July 2022. Overall AMPC from January 2021 to November 2022 was -8.9% (95% CI -16.2 to -0.9; P<0.001).

Online searches related to COVID-19 vaccine safety and side effects decreased dramatically over time, supporting the utility of digital surveillance to track real-time vaccine safety concerns. This study provides insights into public interest in COVID-19 vaccine risks and can help monitor potential safety issues.

The aim of the study was to assess mortality and years of life lost from diabetes mellitus in Poland between 2000 and 2022.

The database was created from death cards made available for the purposes of this study by Statistics Poland. The study used data on deaths caused by type 1 diabetes mellitus, T1DM (N = 33,328), and type 2 diabetes mellitus, T2DM (N = 113,706). Standardized death rates (SDRs) and standard expected years of life lost per person (SEYLLp) and per death (SEYLLd) were calculated. A time trend analysis was performed using joinpoint models. The annual percentage change (APC) and the average annual percentage change (AAPC) were estimated.

Between 2000 and 2022, 33,328 people died from T1DM in Poland. The SDR rate increased from 6.0 to 8.8 per 100,000 population in the analyzed period. The APC was 1.3% (p < 0.05). SEYLLp rates per 100,000 population were 79.3 in 2000 and 109.2 in 2022. SEYLLd rates were 22.9 and 17.9 years, respectively (APC = -1.0%, p < 0.05). The mean age of those who died from T1DM increased from 66.1 in 2000 to 72.5 in 2022. Between 2000 and 2022, 113,706 people died from T2DM. The SDR increased from 12.5 to 37.7 per 100,00 (APC = 5.5%, p < 0.05). SEYLLp rates were 88.8 and 296.0 per 100,000 population (APC = 6.4%, p < 0.05). SEYLLd rates decreased from 16.9 in 2000 to 13.4 in 2022 (AAPC = -1.0%, p < 0.05). The mean age of those who died from T2DM increased from 73.1 to 78.1 years.

The study showed a growing problem of diabetes as a cause of death and years of life lost.

This study explored the incidence trends and spatial clustering of typhoid and paratyphoid fever (TPF) in Yunnan Province to provide scientific evidence for developing and improving prevention and control strategies.

Temporal trends were investigated by calculating the annual percent change (APC) and average annual percent change (AAPC), along with their 95% confidence intervals (CIs). The spatial clustering of TPF across Yunnan Province was examined using global Moran's I and local indicators of spatial association (LISA) statistics.

A total of 206,066 TPF cases were reported in Yunnan Province from 1989 to 2022, with an average annual incidence of 13.98 per 100,000 population and a case fatality rate of 2.5 per 1,000. The greatest number of cases was reported during July and August. The 25-34-year age group had the highest incidence, and farmers were prominently represented. TPF incidence in Yunnan Province showed a significant decrease and spatial clustering. From 2005 to 2022, 13 county-level cities/counties/municipal districts in 5 prefectures (cities) in Yunnan Province were identified as statistically significant H-H spatial clusters of TPF incidence. A total of 24 TPF outbreaks were reported in Yunnan Province from 2005 to 2022.

The incidence of TPF in Yunnan Province showed a significant decrease and spatial clustering. Control strategies should focus on high-incidence areas, seasons, and populations to reduce the incidence of TPF.

The influence of population aging on the disability-adjusted life years (DALYs) associated with cardiovascular disease (CVD) is acknowledged, yet the magnitude of this impact remains unclear.

This research quantified the influence of population aging on CVD DALYs from 1990 to 2021 through decomposition analysis. The findings revealed that the proportion of DALYs attributable to aging varied widely, ranging from ‒77.0% to 148.9% across 204 countries. There was significant variation in the attributed DALY proportions among different countries or territories and types of CVD. Ischemic heart disease and stroke emerged as the leading contributors to DALYs influenced by aging.

Globally, the association of population aging with increased CVD DALYs underscores the critical need for enhancing health systems to cater to the needs of older adults. Mitigating the burden of CVD DALYs linked to demographic aging can be achieved by investing in resources and adjusting fertility policies.

The Asia-Pacific region is the most populous and diverse globally, encompassing nations with both the longest and shortest life expectancies (LE). However, less is known about the health-adjusted life expectancy (HALE) situation in this region.

This study found diversity in the levels and trends of HALE among countries in the Asia-Pacific region, with HALE in 2021 ranging from 49.87 years in Afghanistan to 74.96 years in Singapore. The largest HALE increase from 1990 to 2021 was observed in the Lao People's Democratic Republic and the smallest in Fiji. HALE continually increased as SDI increased, but different patterns of HALE across countries varied by SDI level.

The diversity among these countries provides a prerequisite and scientific basis for promoting the achievement of health goals in the Asia-Pacific region through multilateral and bilateral cooperation.

Stroke is the second leading cause of death and disability in Latin America; however, few epidemiological studies have been conducted in South America. An observational study was conducted to analyze trends in stroke mortality in South American (SA) countries. Age-standardized mortality rates and proportional mortality due to stroke in the populations of SA countries between 1990 and 2019 were assessed by extracting data from the Global Burden of Disease 2019 study. Joinpoint regression models were employed to identify trends in the annual percentage change in mortality rates for each segment. Considering the data collected over the 30 years that were studied, the age-standardized stroke mortality trend decreased in Argentina (-1.6%), Uruguay (-0.6%), Brazil (-0.5%), Guyana (-0.5%), and Bolivia (-0.4%), while Venezuela (+1.6%) and Suriname (+1.0%) showed an increasing trend. The proportional stroke mortality trend decreased in Argentina (-1.7%), Paraguay (-0.9%), Uruguay (-0.7%), Guyana (-0.7%), Brazil (-0.5%), and Chile (-0.5%), whereas Bolivia (+1.0%), Suriname (+0.6%), and Peru (+0.4%) exhibited an increasing trend. The trends in stroke mortality between 1990 and 2019 demonstrated considerable variability. While most SA countries experienced significant decreases in stroke mortality trends, Venezuela and Suriname showed increases in age-standardized mortality rates, and Bolivia, Suriname, and Peru exhibited increases in proportional mortality rates. No decreasing stroke mortality trend was observed in the segment after the last joinpoint, highlighting the need for improvement in prevention and treatment.

Background and Objectives: Despite a global decrease in HIV incidence, recent trends in Türkiye indicate a concerning rise, particularly among younger populations and women. This study investigates the local and regional dynamics influencing these trends using advanced epidemiological methodologies. Material and Methods: Utilizing Age-period-cohort analysis and joinpoint regression, we analysed HIV incidence and prevalence data from the Global Burden of Disease study for Türkiye. These methods allowed for a detailed examination of changes over time, identifying specific age groups and periods with significant shifts in incidence rates. Results: Key findings include a 13.03% increase in annual percentage change among males aged 15-19 and an 11.37% increase among females in the same age group. Additionally, the incidence rates among females have shown a significant rise after 2008. Conclusions: The rising HIV incidence in Türkiye reflects complex socio-economic, cultural, and biological factors, with significant increases among young people and women. Addressing these challenges requires targeted interventions, comprehensive educational programs, and inclusive healthcare services to align with global efforts and commitments. The study underscores the importance of incorporating young people in decision-making processes to effectively combat HIV in Türkiye.

Background: Inflammatory bowel disease (IBD) prevalence in Eastern Europe is increasing. The 30-day readmission rate is a crucial quality metric in healthcare, reflecting the effectiveness of initial treatment and the continuity of care post-discharge; however, such parameters are rarely analyzed. The aim of this study was to explore the trends in 30-day readmissions among patients with inflammatory bowel disease in Latvia between 2014 and 2020. Methods: This is a retrospective trends study in IBD-ulcerative colitis and Crohn's disease (UC and CD)-patients in Latvia between 2014 and 2020, involving all IBD patients identified in the National Health service database in the International Classification of Diseases-10 (ICD) classification (K50.X and K51.X) and having at least one prescription for IBD diagnoses. We assessed all IBD-related hospitalizations (discharge ICD codes K50X and K51X), as well as hospitalizations potentially related to IBD comorbidities. We analyzed hospitalization trends and obtained the 30 day all-cause readmission rate, disease specific readmission rate and readmission proportion for specific calendar years. Trends in readmissions and the mean length of stay (LOS) for CD and UC were calculated. Results: Despite a decrease in admission rates observed in 2020, the total number of readmissions for CD and UC has increased. Female patients prevailed through the study period and were significantly older than male patients in both the CD and UC groups, p < 0.05. We noted that there was no trend for 30 day all-cause readmission rate for CD (p > 0.05); however, there was a statistically significant trend for 30 day all-cause readmission for UC patients (p-trend = 0.018) in the period from 2014 to 2019. There was a statistically significant trend for CD-specific readmission rate (p < 0.05); however, no statistically significant trend was observed for UC-specific readmission (p > 0.05). An exploratory analysis did not reveal any statistically significant differences between treated and not-treated IBD patients (p > 0.05). The increasing trend is statistically significant over the period 2014-2018 (p < 0.05); however, the trend interrupts in 2020, which can be associated with the COVID-19 global pandemic and the related changes in admission flows where the gastroenterology capacity was reallocated to accommodate increasing numbers of COVID-19 patients. More studies are needed to evaluate the long-term impact of COVID-19 pandemic and 30-day readmissions. No significant dynamics were observed in the mean total hospitalization costs over the 2014-2020 period.

Sex is a crucial factor in the development, progression, and treatment of cancer, making it vital to examine cancer incidence trends by sex for effective prevention strategies.

This study aimed to assess the incidence of cancer in China between 2007 and 2021, with a focus on sex-based trends.

A population-based cancer registry comprising 14.14 million individuals was maintained between 2007 and 2021 by the Beijing Municipal Health Big Data and Policy Research Center. The age-standardized rates (ASRs) of cancers were calculated using the Segi population. The average annual percentage of change (AAPC) was evaluated using the joinpoint regression model, while the Bayesian age-period-cohort model was used to predict cancer incidence in the next 10 years.

From 2007 to 2021, the study included 651,342 incident patients with cancer, of whom 51.2% (n=333,577) were women. The incidence indicated by the ASR for all cancers combined was 200.8 per 100,000 for women and 184.4 per 100,000 for men. The increase in incidence indicated by AAPC for all malignancies combined significantly increased in women between 2007 and 2021 (AAPC=3.1%; P<.001), whereas it remained constant in men (AAPC=0.3%; P=.30). Although the overall incidence of all cancers indicated by AAPC increased in young men (AAPC=3.2%; P=.01), the greatest increase was observed among young women (AAPC=6.1%; P<.001). The incidence rate ratio for cancer in women increased among subsequent younger generations compared with patients born in the 1962-1966 cohort. The ASR in women will increase 1.6-fold over the next 10 years, with women having twice the incidence rate of men by 2031.

The rising incidence of cancer among women in China has become a growing concern, emphasizing the need for increased efforts in cancer prevention and early screening, especially among young women.

Background and Objectives: Clostridioides difficile infection is a major public health issue, being among the main causes of mortality due to healthcare-associated diarrhea. This study aimed to assess the trends in mortality attributable to Clostridioides difficile infections in European countries over a period of 30 years. Materials and Methods: A descriptive epidemiological study was conducted, with the application of an ecological study design, to evaluate the trends in mortality due to Clostridioides difficile infection in the Central, Eastern, and Western European sub-regions from 1990 to 2019. The Global Burden of Disease study database was used. Trends were evaluated with the joinpoint regression analysis. Results: In both sexes, about 76% of all deaths attributable to Clostridioides difficile infections were recorded in the Western European sub-region in 2019. The age-standardized rates of the burden of Clostridioides difficile infection in 2019 were the highest in the Central European sub-region, followed by the Western European sub-region, while the lowest rates were observed in the Eastern European sub-region. A significantly increasing trend in mortality attributable to Clostridioides difficile infection from 1990 to 2019 was recorded both in males (by +2.1% per year) and females (by +2.8% per year). The burden of Clostridioides difficile infection showed increasing trends in most of the European countries, significantly correlating with the country's development, according to the Human Development Index. Conclusions: The rising burden of Clostridioides difficile infection in European countries in the last few decades suggests a need for improving public health measures, with a focus both on the hospital setting and community.

To identify the epidemiological, spatial, and temporal pattern of TB-HIV coinfection in Brazil during the period from 2001 to 2020.

Ecological study using space-time analysis techniques. It included cases of TB-HIV coinfection registered in Brazil from 2001 to 2020. The temporal trend analysis was performed using segmented regression by Joinpoint regression. For spatial analysis, Moran indices were calculated and choropleth maps were produced using TerraView and QGIS software.

A stable temporal trend was observed in the incidence rates of TB-HIV coinfection in Brazil during the analyzed period. In addition, high-risk areas for coinfection located in states in the North, Southeast, South, and Midwest regions were identified.

There was stability in the incidence of TB-HIV coinfection in Brazil over the last 20 years and heterogeneous geographic distribution of risk areas for the condition.

In recent years, the incidence of measles in China has consistently remained below 1 per 100,000 population, yet the disease has not been eliminated. This study aims to comprehensively analyze the epidemiological characteristics of measles from 2005 to 2022, identify high-risk populations and areas, and propose targeted interventions.

We utilized data from the China Disease Prevention and Control Information System for our comprehensive analysis. Spatial autocorrelation was employed to examine the spatial clustering of measles, while spatiotemporal scanning analysis was used to detect spatiotemporal clustering to describe measles epidemiology during the study period.

Between 2005 and 2022, 732,218 measles cases were reported in China. Overall, the incidence of measles exhibited a downward trend, particularly during the periods of 2008-2011 and 2015-2022. In 2022, the incidence rate reached its historical low at 0.039 per 100,000 population. Measles predominantly affects young children. Since 2017, global spatial clustering has diminished, although hotspot areas persist in the western provinces. Spatial-temporal scanning identified a high-incidence cluster from 2005 to 2008, comprising 15 provinces in the western, central, and northern regions of China. Conversely, from 2016 to 2022, a low-incidence cluster was detected in the southern and central provinces.

China has made significant progress in measles prevention and control. The recent low incidence and absence of substantial spatiotemporal clustering indicate that China is nearing measles elimination. However, there is a continuing need to enhance prevention and control efforts among very young children and in historic incidence hotspots in western provinces. Additionally, improving the diagnosis of vaccine-associated rash illnesses is essential.

Gastric cancer exerts a significant healthcare burden worldwide and is highly geographically heterogeneous. This study investigates the burden of gastric cancer in China from 1990 to 2019 and compares it with Japan, South Korea, and the United States. The results indicated a declining trend in ASIR and ASDR in four countries. However, the incidence and death rates in China remain disproportionately high. Significant gender disparities exist in the incidence and death rates, with males experiencing significantly higher rates than females. Incidence and death rates were found to increase with age in all studied countries. In China, a transient upward trend was observed in the period effect, whereas the cohort effect has been declining. In contrast, the remaining countries showed decreasing patterns in both period and cohort effects. The burden of disease remains high in China, therefore, broaden the scope of gastroscopy screening and concentrate on high-risk groups is vital.

Gastric signet ring cell carcinoma (GSRC) represents a specific subtype of gastric cancer renowned for its contentious epidemiological features, treatment principles, and prognostic factors.

To investigate the epidemiology of GSRC and establish an improved model for predicting the prognosis of patients with locally advanced GSRC (LAGSRC) after surgery.

The annual rates of GSRC incidence and mortality, covering the years 1975 to 2019, were extracted from the Surveillance, Epidemiology, and End Results (SEER) database to explore the temporal trends in both disease incidence and mortality rates using Joinpoint software. The clinical data of 3793 postoperative LAGSRC patients were collected from the SEER database for the analysis of survival rates. The Cox regression model was used to explore the independent prognostic factors for overall survival (OS). The risk factors extracted were used to establish a prognostic nomogram.

The overall incidence of GSRC increased dramatically between 1975 and 1998, followed by a significant downward trend in incidence after 1998. In recent years, there has been a similarly optimistic trend in GSRC mortality rates. The trend in GSRC showed discrepancies based on age and sex. Receiver operating characteristic curves, calibration curves, and decision curve analysis for 1-year, 3-year, and 5-year OS demonstrated the high discriminative ability and clinical utility of this nomogram. The area under the curve indicated that the performance of the new model outperformed that of the pathological staging system.

The model we established can aid clinicians in the early prognostication of LAGSRC patients, resulting in improved clinical outcomes by modifying management strategies and patient health care.

Silicosis is an occupational respiratory disease linked to silica dust inhalation. The main driver was traditional coal mining, but in recent decades, new sources of exposure have emerged. Our aim in this study was to assess the temporal and spatial distribution of mortality due to this disease over a 22-year period in Spain.

Silicosis records, as an Underlying Cause of Death, were extracted from the National Institute of Statistics from 1999 to 2020 using the International Classification of Diseases 10th revision (code J62.8). Age- and sex-adjusted mortality rates per 1,000,000 inhabitants were calculated for the territory and by province. A geographic analysis was performed, and clusters of deaths were identified at the municipal level, and then the outcomes were compared in two periods of 11 years.

There were 2618 deaths due to silicosis in Spain. The mean age of death increased significantly by 0.66% annually from 1999 to 2013. The age-adjusted mortality rate decreased by 7.30% per year, falling from 3.00 to 0.65 per 1,000,000 inhabitants. The temporal pattern showed a significant decrease of mortality rate in 31% of the provinces (16 out of 52), while it increased in Pontevedra. Regarding the spatial analysis, 11 clusters were found in both periods, but some variations were observed in terms of their distribution in the Spanish territory, as well as in the affected municipalities.

The decrease in mortality due to Silicosis could be related to less exposure to silica dust over the years and an improvement in the survival of those affected. It is thus essential to analyze the role of preventive measures for this occupational disease.

China accounts for nearly half of liver cancer deaths globally. A better understanding of the current liver cancer mortality will be helpful to establishing priorities for intervention and to decreasing the disease burden of liver cancer. The study aimed to explore and predict the mortality burden of liver cancer in China.

Data were extracted from the Disease Surveillance Point system of the Chinese Center for Disease Control and Prevention from 2008 to 2020. Crude and age-standardized liver cancer mortality rates were reported by sex, urban or rural residence, and region. Trends in liver cancer mortality rates from 2008 to 2020 were estimated as average annual percentage change (AAPC). The changing trend of live cancer mortality in the future is also predicted.

In 2020, the crude mortality of liver cancer was 25.57/100,000, and males and people lived in rural areas had higher age-standardized liver cancer mortality rates than females and people lived in people in urban areas. Crude mortality and age-standardized mortality rates in southwest provinces (Guangxi, Sichuan, Tibet) and in a northeast province (Heilongjiang) were higher than that in other provinces, and age-specific mortality rates increased with age. From 2008 to 2020, liver cancer mortality rates decreased, but people under 50 years of age had a higher AAPC than those over 50 years of age, possibly because of the adoption of hepatitis B virus vaccination in newborns and children. Furthermore, the mortality of liver cancer in 2021-2030 is predicted to have a downward trend.

Liver cancer mortality rates declined in China from 2008 to 2020. Future interventions to control liver cancer mortality need to focus on people of male sex, older age, and living in rural areas or less developed provinces.

Malaria is a major global public health issue with varying epidemiologies across countries. In Colombia, it is a priority endemic-epidemic event included in the national public health policy. However, evidence demonstrating nationwide variations in the disease behavior is limited. This study aimed to analyze changes in the levels and distribution of endemic-epidemic malaria transmission in the eco-epidemiological regions of Colombia from 1978 to 1999 and 2000 to 2021.

We conducted a comprehensive time-series study using official secondary data on malaria-associated morbidity and mortality in Colombia from 1978 to 2021. Temporal-spatial and population variables were analyzed, and the absolute and relative frequency measures of general and regional morbidity and mortality were estimated.

We observed an 18% reduction in malaria endemic cases between the two study periods. The frequency and severity of the epidemic transmission of malaria varied less and were comparable across both periods. A shift was observed in the frequency of parasitic infections, with a tendency to match and increase infections by Plasmodium falciparum. The risk of malaria transmission varied significantly among the eco-epidemiological regions during both study periods. This study demonstrated a sustained decrease of 78% in malarial mortality.

Although the endemic components of malaria decreased slightly between the two study periods, the epidemic pattern persisted. There were significant variations in the risk of transmission across the different eco-epidemiological regions. These findings underscore the importance of targeted public health interventions in reducing malarial morbidity and mortality rates in Colombia.

To identify trends in motorcycle road deaths in Colombia between 2008 and 2021.

An observational and descriptive study of trends in motorcycle road deaths was conducted using official death records from 2008 to 2021. Jointpoint Poisson regression analysis was performed to detect inflection points in mortality rates specific to age, sex, and area of residence.

A total of 28 200 motorcycle road deaths were identified during the period; 24 271 men and 3 929 women died. Of the deaths, 74.1% occurred in urban areas and 25.9% in rural areas. In rural areas, there was an increasing trend in fatalities in young adults of both sexes during the period. The same occurred in men over 65 years of age. In urban areas, there was an upward trend in fatalities in the age group from 45-64 for both sexes during the period. Only one inflection point was detected, in 2015, showing a downward trend in adolescent females.

The trend in motorcycle road deaths in Colombia continued to rise during the 2008-2021 period, both in rural areas for young adults and in urban areas for middle-aged adults.

Hepatitis A virus (HAV) is the most common cause of acute viral hepatitis, which is preventable by vaccination. This study analyzed trends of HAV infections in Poland according to socio-demographic features in the years 2009-2022 and assessed the potential impact of the COVID-19 pandemic (2020-2023) and the migration of war refugees from Ukraine (since February 2022). In 2009-2022, 7115 new cases of HAV infection were diagnosed in Poland, especially among men (66.4%) and in urban areas (77.4%). Infections among men were most common at the age of 25-34 (median rate 0.43 per 105) and in women aged 15-24 (median rate 0.39 per 105). Analysis of the 14-year frequency of HAV infections exhibited three trends, regardless of gender, age, and residence. The infections revealed a downward trend in 2009-2014, increased significantly in 2014-2018, and decreased again after 2018. A particularly rapid increase in HAV infections occurred between March 2017 and February 2018 (median rate 0.79 per 105). The high level of new infections persisted until the beginning of the COVID-19 pandemic, at which point it dropped significantly but did not reach the level recorded before March 2017. During the Omicron SARS-CoV-2 dominance period, the median rate of HAV infections was 0.053 per 105, with a four-fold increase being observed from February 2022 (when the migration of war refugees from Ukraine began) to August 2022. The presented results can serve as a reference point for further observations in Central Europe. The HAV epidemiological situation is unlikely to escalate in Poland but requires further monitoring.

This study aimed to investigate mortality and years of life lost (YLL) due to suicide and homicide in children aged 10-19 years in southern Iran from 2004 to 2019. Study Design: A cross-sectional study.

The data on all deaths due to suicide and homicide in Fars province were obtained from the population-based electronic death registration system (EDRS). Crude mortality rate and YLL were calculated. The joinpoint regression method was used to examine the trend.

During the study period, 563 cases of suicide and 218 cases of homicide in children aged 10-19 have occurred. The total number of YLL due to suicide was 9766 in men and 6261 in women. According to the joinpoint regression analysis, the trend of YLL due to suicide was increasing in males. In other words, the annual percent change (APC) was 4.8% (95% CI 0.4 to 9.5, P=0.036). Additionally, there was a constant trend in females, and APC was 2.7% (95% CI -2.0 to 7.7, P=0.241). The number of YLL due to homicide was 4890 in males and 1294 in females. The trend of YLL due to homicide was stable in males and females. In other words, APC was -1.6% (95% CI -5.6 to -2.6, P=0.422) in males and -2.7% (95% CI -10.0 to 5.2, P=0.467) in females.

Based on the findings of this study, the trend of mortality rate and YLL due to suicide in men has been increasing and it has been stable in women. Moreover, the trend of mortality due to homicide was stable for both males and females. Therefore, it is necessary to take preventive actions.

Background and Objectives: Dengue is an important public health concern that warrants an examination of the longer-term global trends of its disease burden. The aim of this study was to assess the trends in dengue incidence and mortality worldwide over the last three decades. Materials and Methods: A descriptive epidemiological study was carried out, investigating the trends in the incidence and mortality of dengue from 1990 to 2019. The dengue incidence and mortality data were obtained from the Global Burden of Disease study database. Trends were examined using joinpoint regression analysis. Results: Globally, there were 56.7 million new cases of dengue reported in 2019: the disease was diagnosed in 27.4 million males and 29.3 million females. A total of 36,055 (18,993 males and 17,032 females) related deaths were reported worldwide in 2019. In both sexes, about 60% of new cases were recorded in the South-East Asia region (16.3 million in males and 17.4 million in females). Globally, the incidence of dengue exhibited an increasing tendency from 1990 to 2019 in both sexes (equally, by 1.2% per year). A significantly decreasing trend in the mortality of dengue was recorded only in females (by -0.5% per year), while an increasing trend was observed in males (by +0.6% per year). Conclusions: The rise in the number of new dengue cases and deaths in the world in the last several decades suggests a need for implementing more effective prevention and management measures.

There are limited published data on mortality trends in pulmonary hypertension (PH) worldwide. The objective of this study was to assess the PH-related mortality and time trends in the general population over the past 20 years.

We used country-level PH mortality data from the World Health Organization (WHO) mortality database (2000-19), using the International Classification of Diseases, tenth revision (ICD-10) codes (I27.0, I27.2, I27.8, or I27.9). The average annual percentage changes (AAPCs) were calculated to describe mortality trends.

Fifty-four countries were included in this study. Between 2017 and 2019, the average age-standardized death rates (per 100,000) were 0.80 and 0.87 for males and females, respectively. Joinpoint analyses revealed a decreasing PH mortality trend for the overall population from 2000 to 2019 (AAPC -3.2 [95% confidence interval (CI) -4.1 to -2.4]), which was consistent between males and females (males: AAPC -5.3 [95% CI -6.2 to -4.4], females: AAPC -1.7 [95% CI -2.4 to -0.9]). When the estimates were stratified by etiology, we found that the mortality rates from idiopathic pulmonary arterial hypertension (I27.0) and pulmonary heart disease (unspecified, I27.9) had decreased significantly, while the mortality rates in other secondary PH (I27.2) and other specified pulmonary heart diseases (I27.8) had significantly increased. In addition, there were substantial differences in mortality rates and time trends across countries.

Although an overall decrease in PH mortality trends over the past two decades, there were substantial differences across countries. For countries with high or rising mortality rates, more efforts are needed to reduce the mortality.

Incidence of anal squamous cell carcinoma is increasing, but vaccination against human papillomavirus (HPV) and removal of precancerous anal lesions could prevent new cases. The overall HPV-associated cancer incidence is reported to be higher in rural populations and in counties with lower economic status. We assessed these differences specifically for HPV-associated anal squamous cell carcinoma and described the geographic, county-level economic, and sociodemographic variations in incidence rates and trends.

We analyzed data from the US Cancer Statistics to assess age-standardized incidence rates of HPV-associated squamous cell carcinomas among adults aged 18 years and older from 2001 to 2019. We calculated rate ratios and 95% confidence intervals to examine differences in incidence rates. We also quantified changes in incidence rates over time using joinpoint regression.

From 2001 to 2019, 72 421 new cases of HPV-associated anal squamous cell carcinoma were diagnosed among women (2.8 per 100 000) and 37 147 among men (1.7 per 100 000). Age-standardized incidence rates were higher in the South compared with other census regions and in counties ranked in the bottom 25% and 25%-75% economically than in the top 25%. The overall incidence rate increased in women but remained stable in men during 2009-2019. Incidence rates increased in adults aged 50 years and older but decreased among those aged 40-44 years from 2001 to 2019 in women and from 2007 to 2019 in men.

There were inequities in HPV-associated anal squamous cell carcinoma incidence by geographic and county-level economic characteristics. Failure to improve vaccine and treatment equity may widen existing disparities.

The COVID-19 pandemic resulted in a decline in outpatient attendance. Therefore, this study aimed to clarify long- and short-term clinic attendance trends by speciality in Japan between 2009 and 2021. A retrospective observational study of Japan's claims between 2009 and 2021 was conducted using the Estimated Medical Expenses Database. The number of monthly outpatient claims in clinics was used as a proxy indicator for monthly outpatient attendance, and specialities were categorised into internal medicine, paediatrics, surgery, orthopaedics, dermatology, obstetrics and gynaecology, ophthalmology, otolaryngology, and dentistry. The annually summarised age-standardised proportions and the percentage of change were calculated. Joinpoint regression analysis was used to evaluate long-term secular trends. The data set included 4,975,464,894 outpatient claims. A long-term statistically significant decrease was observed in outpatient attendance in internal medicine, paediatrics, surgery, ophthalmology, and otolaryngology during the pandemic. From March 2020 to December 2021, which includes the COVID-19 pandemic period, outpatient attendance in paediatrics, surgery, and otolaryngology decreased in all months compared with that of the corresponding months in 2019. For some specialities, the impact of the pandemic was substantial, even in the context of long-term trends. Speciality-specific preparedness is required to ensure essential outpatient services in future public health emergencies.

Cancer is the second leading cause of death. It is thus essential to examine cancer trends in all regions. In addition, trend data after 2019 and on cancer 1-year mortality are scarce. Our aim was to analyze incidence and 1-year mortality cancer trends in northeastern Spain during 2005-2020. We used the Osona Tumor Registry, which registers cancer incidence and mortality in Osona. The mortality information came from the Spanish Death Index. We analyzed age-standardized incidence rates and 1-year mortality by sex in the population aged > 17 years during 2005-2020. Trends were examined with negative binomial and joinpoint regression. Incidence rates of colorectal, lung and bronchus, and urinary bladder cancer increased annually in females by 2.86%, 4.20%, and 4.56%, respectively. In males, the incidence of stomach and prostate cancer decreased annually by 3.66% and 2.05%, respectively. One-year mortality trends decreased annually for endometrium cancer (-9.0%) and for colorectal cancer in males (-3.1%). From 2019 to 2020, the incidence of cancer decreased, while 1-year mortality increased in both sexes. In a North-Eastern Spanish county, 1-year mortality decreased for endometrium cancer in females and for colorectal cancer in males. Our results suggest a trend of decreasing cancer incidence and increasing cancer mortality as a result of the COVID-19 pandemic.

The expansion of higher education is a worldwide phenomenon. To our knowledge, there are no studies analyzing the trends in demands of enrollment in health-related studies in Spain. Therefore, the objective was to analyze the change in demand (the number of requests for enrollment divided by the number of offered places) for undergraduate health-related studies in Spain during the period 2015-2021 as well as compare the change by region in the pre (2015-2019) and pandemic (2020-2021) period.

This is an observational (ecological type) study with temporal series analyses using data from public (non-for-profit) higher education institutions from the Integrated University Information System. For the analysis by region, we calculated the demand of all twelve undergraduate health-related degrees and the percentages of change between both periods using the Wilcoxon test. The Joinpoint Regression program was used to analyze the trends in demand for each degree during the 7-year period.

Significant (p < 0.001) increases in demand during the pandemic period were observed in all regions. During the pandemic, medicine, biomedicine, nursing, odontology and pharmacy presented a higher demand in comparison with data collected before the pandemic started. In contrast, this pattern was not confirmed in the following cases: physiotherapy, occupational therapy, podiatry, psychology, social work, human nutrition and dietetics. By regions, Navarra, Asturias, and La Rioja presented the most drastic changes. In regions with the biggest number of universities, such as Catalonia, Andalusia and Madrid, the change observed was smaller.