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Fine particulate matter (PM 2.5) exposure is associated with stroke incidence and mortality. However, the global distribution and trends of stroke burden and mortality attributable to PM 2.5 are rarely studied. We estimated the spatial patterns and temporal trends of PM 2.5 -attributable stroke burden in 195 countries and territories from 1990 to 2017. Detailed data on stroke burden attributable to PM 2.5 were extracted from the Global Burden of Disease Study (GBD) 2017. The numbers and age-standardized rates of stroke disability-adjusted life years (DALYs) and mortality (ASDR and ASMR) were estimated by age, sex, subtype, region, and country. Temporal trends in ASDR and ASMR were analyzed using estimated annual percentage change (EAPC). Globally, in 2017, 10.5 million DALYs and 0.4 million deaths related to stroke were attributable to PM 2.5. The corresponding ASDR and ASMR increased with age, were highest in males and for intracerebral hemorrhage, and varied greatly across countries, with the largest burden in high-middle sociodemographic index (SDI) regions and East Asia. The global ASDR and ASMR decreased by 7.2% and 12.2% from 1990 to 2017, with EAPCs of −0.42 (95% confidence interval [CI]: -0.55, −0.28) and −0.57 (95% CI: -0.72, −0.42), respectively. Age-specific stroke burden rates declined significantly, except in the middle-aged population. The decrease was more pronounced in women and for subarachnoid hemorrhage, while proportions of ischemic stroke burden increased globally and in all SDI regions. Most geographic regions achieved significant declines in ASDR and ASMR since 1990; however, Asia and approximately 30% of countries and territories, especially in low-income countries, showed undesirable increasing trends. The patterns and trends were heterogeneous across countries. Strengthened and tailored approaches for stroke prevention and air pollution management are still needed to reduce the disease burden associated with PM 2.5 , particularly in males, middle-age populations, and low-income countries and for ischemic stroke. • Stroke burden attributable to PM 2.5 varied greatly across countries. • The age-standardized rate (ASR) of PM 2.5 -attributable stroke burden were decreased in most regions. • The reduction in the ASR was more pronounced in women and for subarachnoid hemorrhage. • Ischemic stroke burden attributable to PM 2.5 significantly increased since 1990. • Asia and about 30% of countries showed increased trends in ASR, especially in low-income countries. [ABSTRACT FROM AUTHOR]

Smoking is a well-defined modifiable risk factor for dementia. Understanding national temporal trends of dementia deaths due to smoking is critical for prioritizing action for the global prevention of dementia, as well as smoking prevention. We aimed to estimate the patterns and temporal trends of smoking-attributable dementia-related deaths for 195 countries from 1990 to 2017. Detailed data on dementia deaths attributable to smoking were obtained from the Global Burden of Disease Study 2017. The estimated annual percentage change (EAPC) was used to quantify the temporal trends in the age-standardized mortality rate (ASMR) of dementia attributable to smoking by age, sex, region, and country. In 2017, approximately 2.51 million deaths attributable to dementia occurred globally; among them, 317,747 dementia-related deaths were attributable to smoking. The corresponding ASMR decreased by 31.1% from 6.33 per 100,000 population in 1990 to 4.36 per 100,000 population in 2017, with an EAPC of −1.43 (95% CI -1.48, −1.37). The reduction in the ASMR in women (EAPC = −2.13; 95% CI -2.18, −2.08) was more pronounced than that in men (EAPC = −1.26; 95% CI -1.32, −1.20). Most geographic region have achieved significant declines in ASMRs since 1990; however, Central Asia and 24 countries and territories showed increased trends in ASMRs over the same period. Despite large reductions in the ASMRs of dementia attributable to smoking over the past three decades, the corresponding number of deaths has steadily increased due to population growth and aging. The ASMR trend patterns were heterogeneous across countries, and there were undesirable increases in the dementia ASMR in some countries. Strengthened efforts for tobacco prevention are still needed to reduce the disease burden due to smoking, particularly in countries where the dementia ASMR is increasing. • Trends of dementia deaths attributable to smoking for 195 countries were estimated. • Globally, the ASMR of dementia attributable to smoking were decreased. • The reduction in the ASMR in women was more pronounced than that in men. • Most geographic region have achieved significant declines in ASMRs since 1990. • Central Asia and 24 countries and territories showed increased trends in ASMRs. [ABSTRACT FROM AUTHOR]

Background: Liver cancer is a commonly diagnosed malignancy in China. The etiologies of liver cancer are widely known, although studies on temporal trends in liver cancer caused by specific etiologies are rare. Methods: Data on the incidence and mortality of liver cancer were retrieved from the Global Burden of Diseases Study 2017. The estimated annual percentage change (EAPC) was used to quantify temporal trends in the age‐standardized incidence rate (ASIR) and the age‐standardized mortality rate (ASMR) of liver cancer from 1990 to 2017. Results: Nationwide, the number of incident cases of liver cancer increased from 258 000 in 1990 to 515 900 in 2017. The ASIR decreased from 27.16 per 100 000 to 26.04 per 100 000 during this period, with an EAPC of −0.64 (95% confidence interval [CI] −0.84, −0.44). The number of deaths increased from 245 300 in 1990 to 418 200 in 2017, and the ASMR decreased from 26.72 to 21.30 (EAPC = −1.16, 95% CI −1.35, −0.97). The most pronounced decreases in the ASIR and ASMR were observed in liver cancer due to hepatitis B and in people aged 15‐49 years. Conclusions: Since the extensive efforts for prevention of hepatitis B virus infection, the incidence of liver cancer due to hepatitis B has significantly decreased. However, liver cancer due to hepatitis C, NASH, and other causes remains a major public health concern. Additional preventive strategies tailored to liver cancer are needed to further reduce its disease burden in China. [ABSTRACT FROM AUTHOR]

Aim: We assessed the correlations between non‐invasive fibrosis scores and mortality in both the general population and non‐alcoholic fatty liver disease (NAFLD) patients. Methods: We used data from the US National Health and Nutrition Examination Survey 1988–2014. The NAFLD fibrosis score (NFS), Fibrosis‐4 index (FIB‐4) score, aspartate aminotransferase to platelet ratio index (APRI) score, and Forns index score were calculated at baseline. The associations of these scores with the risk of mortality were determined using additive Cox proportional hazard models. The area under the receiver operating characteristic curve (AUROC) was used to study the predictive capacity of each scoring system. Results: A total of 44 508 participants were included; among them, 9721 deaths occurred during a mean follow‐up of 12.5 years. A "J"‐shaped correlation pattern was observed for both the FIB‐4 and APRI scores. A "U"‐shaped correlation pattern was observed for both the Forns index and NFS. Similar correlation patterns were observed in 1955 NAFLD patients. For overall mortality, the AUROC values of the selected fibrosis scores were comparable between general population and NAFLD patients. The superior predictive capacity was found for FIB‐4, with AUROC of 75.03% (95% confidence interval, 70.91% to 79.82%) in general population and 75.32% (95% confidence interval, 69.43% to 80.11%) in NAFLD patients, respectively. Conclusions: Non‐linear associations were shown between the fibrosis scoring systems and mortality risk. These scores could serve as indicators for mortality in people with or without NAFLD. [ABSTRACT FROM AUTHOR]