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Previous studies reported higher lung cancer incidence in women than men among persons aged 35–54 years in the United States, a reversal of historically higher rates in men. We examined whether this pattern varies by state. Based on lung cancer incidence (2015–2019) data among adults aged 35–54 years from Cancer in North America database and historical cigarette smoking prevalence data (2004–2005) among adults 20–39 years from the Behavioral Risk Factor Surveillance System, incidence rates in women were equal to or higher than rates in their male counterparts in 40 of 51 states, with statistically significant differences in 20 states (two‐sided, p <.05). In contrast, current and ever smoking prevalence in women compared to men was statistically significantly lower (33 and 34 states, respectively) or similar. Furthermore, there was no association between differences in historical smoking prevalence and lung cancer incidence by sex. Lung cancer incidence rate is higher in young women than young men in most states and is unexplained by differences in smoking prevalence. [ABSTRACT FROM AUTHOR]

This study investigates trends and patterns in self-harm incidence rates among individuals aged 10–39 years in Iran from 1990 to 2019. Using Age-Period-Cohort (APC) analysis, it aims to identify significant age, period, and cohort effects, and to highlight gender-specific trends for effective prevention strategies. Utilizing data from the Global Burden of Disease (GBD) study, we performed an APC analysis to assess trends in self-harm incidence rates by gender. Data was stratified into six age groups and six five-year periods, and analyzed using the APC Web Tool from the National Cancer Institute. The average incidence rates of self-harm attempts and deaths among individuals aged 10–39 years were 93.87 and 7.55 per 100,000 individuals, respectively. Females had 1.75 times higher attempt rates than males, while males had 1.62 times higher death rates. The APC analysis revealed that males experienced stable self-harm rates over time, while females showed a significant decline. Peak incidence for both genders occurred at age 22.5 years. Self-harm incidence rates show younger females are more vulnerable to self-harm, but there has been a general decline in incidences over time, particularly for more recent cohorts but the stability of rates across ages and the lower rates in more recent cohorts highlighted in male. [ABSTRACT FROM AUTHOR]

Summary There is a growing consensus regarding the significant individual differences in responses to sleep inertia. However, little is known about the longitudinal trajectories of sleep inertia. Therefore, we aimed to investigate the incidence rates of sleep inertia, longitudinal trajectories, influencing factors and outcomes among intern nurses with shift work. A total of 1079 intern nurses with shift work completed online surveys at 2 weeks (T1) and 16 weeks (T2) after their clinical internship, respectively. The demographics and willingness to continue working as nurses, circadian type, sleep problems and emotional problems were measured. Hierarchical logistic regressions were used to examine predictors for the distinct longitudinal trajectory of sleep inertia, and binary logistic regressions were used to examine the predictive effects of trajectory memberships of sleep inertia on mental health problems (daytime sleepiness, anxiety, depression) at follow‐up. Overall, the incidence rates of severe sleep inertia increased significantly from 20.4% at T1 to 25.3% at T2 among intern nurses with shift work. All participants were classified into four trajectory memberships. Multiple factors were significant predictors of distinct trajectories of sleep inertia. Additionally, individuals with deteriorated and persistent‐high sleep inertia were more likely to develop mental health problems at the subsequent point. Sleep inertia is prevalent among intern nurses with shift work, and its distinct change patterns were associated with multiple risk factors and various adverse outcomes. Therefore, these factors should be considered when designing individualized and appropriate interventions for sleep inertia among medical staff. [ABSTRACT FROM AUTHOR]

Background: Thyroid cancer is the most prevalent malignant tumor within the endocrine system, accounting for 3%-4% of all cancer cases worldwide. A sharp increase in thyroid cancer cases has been observed, particularly after countries implemented population-based cancer registries that systematically collect standardized data on malignant diseases. In Georgia, the cancer registry was launched in 2015, addressing existing gaps in cancer data. This study aims to analyze secondary data from Georgia's population-based cancer registry concerning thyroid cancer. Aim: This study primarily aims to examine trends in thyroid cancer incidence and conduct a secondary analysis of thyroid cancer data from Georgia's registry. The study reviewed thyroid cancer prevalence trends among women and analyzed registry data for thyroid cancer cases reported in 2021, 2022, and 2023.. Methods: All variables in the cancer registry were analyzed, and correlations of interest were identified. Descriptive analysis was performed on both independent and dependent variables, with calculations of mean values, standard deviations, and confidence intervals. The relationships between independent variables (such as age, ethnicity, and location--region, city, or village) and dependent variables were assessed using SPSS 21 for data analysis. Results: According to the National Cancer Registry, the most frequent cancers among women include breast, thyroid, colorectal, uterine, and ovarian cancers. Data from the International Agency for Research on Cancer (IARC) indicate that Georgia's thyroid cancer incidence is unexpectedly high, surpassing rates in neighboring countries and the European Union. Data suggest a gender disparity in thyroid cancer prevalence, with a male-to-female ratio of roughly 1:3.3 globally, while in Georgia, it stands at 1:6. Experts suggest that the observed rise in thyroid cancer cannot be fully explained by advancements in diagnostic practices. This rise likely involves both improved detection and an actual increase in cases potentially linked to unidentified environmental carcinogens specific to thyroid cancer, though their identification remains elusive. If increased detection were the sole factor, incidence rates would rise evenly across all demographics, which is not the observed trend in thyroid cancer, where incidence varies by gender and age group. Conclusions:. As a result, the elevated prevalence of thyroid cancer in Georgia demands focused attention from both national and international experts and merits further study. [ABSTRACT FROM AUTHOR]

Increasing trends for prostate cancer incidence and mortality rates in many countries in Africa, Asia, and Latin America and the Caribbean probably reflect an increase in detection (incidence) and limited access to and availability of treatment (mortality). Our aim was to examine worldwide patterns and trends for prostate cancer (PC) incidence and mortality using high-quality, up-to-date, population-based data. We analyzed age-standardized PC incidence and mortality rates by country and region from the 2022 GLOBOCAN estimates and temporal trends in incidence (50 countries/territories) and mortality (59 countries/territories) rates using data from the Cancer Incidence in Five Continents series and the World Health Organization mortality database. Estimated PC rates across regions in 2022 varied 13-fold for incidence and 9.5-fold for mortality. The highest incidence rates were in Australia/New Zealand, North America, Northern Europe, and Latin America/Caribbean. The highest mortality rates were in sub-Saharan Africa and Latin America/Caribbean. During the most recent 5-yr period, incidence rates increased in 11 of the 50 countries included in the study and mortality rates increased in nine of 59 countries, mostly located in Africa, Asia, Latin America/Caribbean, and Central and Eastern Europe. Mortality rates decreased in 38 countries, largely located in Europe, Oceania, and Latin America/Caribbean. Limitations include the lack of data for low- and middle-income countries. The increase in PC incidence and mortality rates in many countries in Africa, Asia, and Latin America/Caribbean may be because of increases in detection (incidence) and limited access to and availability of treatments (mortality only). The findings reinforce the importance of improving the health care infrastructure in these countries to mitigate the rising burden of PC. [ABSTRACT FROM AUTHOR]

Introduction: The anatomical proximity of urinary and genital organs in females increases the risk of ureteral and bladder injuries during pelvic surgeries. Ureteral injuries occur in approximately 0.43% of gynaecological procedures, while bladder injuries range from 0.5% to 1%. Obstetric operations report incidences of 0.25% and 0.3%, respectively. Aims: This audit evaluates bladder and ureteric injuries in obstetric and gynaecological surgeries at Raipur Institute of Medical Sciences (RIMS) over two years, given its role as a tertiary referral centre with significant surgical workloads. The goal is to reduce iatrogenic injuries and enhance patient safety. Materials and Methods: A retrospective analysis of 1408 obstetric surgeries (LSCS, hysterotomies, laparotomies, etc.) and 464 gynaecological surgeries (387 open, 77 laparoscopic) performed from January 2022 to January 2024 was conducted. Documented urological injuries were further analysed, with cystograms performed for suspected bladder injuries. Results: The mean age for bladder injuries was 34.8 years, with a mean parity of 2.4, whereas the mean age for ureteric injuries was 35 years with a mean parity of 3. Among obstetric procedures, bladder injuries occurred in 0.7% (10 cases), while there were no ureteric injuries. In gynaecological procedures, bladder injuries were found in 7.5% (35 cases), ureteric injuries in 2.8% (13 cases), and concurrent injuries in 0.8% (2 cases). The overall bladder injury rate was 2.4% (45 cases), and ureteric injury was 0.7% (13 cases). Most bladder injuries were located at the dome (35 cases), posterior wall (7), and lateral wall (3); no injuries were reported at the bladder neck. Repair methods included triple-layer Vicryl with suprapubic catheter (SPC) insertion-20 cases, without SPC-9 cases, and through catheterization alone-13 cases; 3 patients were lost to follow-up. 5 Ureteral mucosal injuries were managed by Oversewing/conservative, 6 cases by DJ stent +/- repair, 1 fistula repair, while 3 were lost to follow up. Conclusion: The incidence of bladder injury was 2.4%, and ureteric injury was 0.7%, with concurrent bladder and ureteric injury noted in 0.1%. Timely detection and management can reduce associated morbidity. Surgeons should maintain awareness of potential urological injuries to improve outcomes during obstetric and gynaecological surgeries. [ABSTRACT FROM AUTHOR]

Data description is the first step for understanding the nature of the problem at hand. Usually, it is a simple task that does not require any particular assumption. However, the interpretation of the used descriptive measures can be a source of confusion and misunderstanding. The incidence rate is the quotient between the number of observed events and the sum of time that the studied population was at risk of having this event (person-time). Despite this apparently simple definition, its interpretation is not free of complexity. In this piece of research, we revisit the incidence rate estimator under right-censorship. We analyze the effect that the censoring time distribution can have on the observed results, and its relevance in the comparison of two or more incidence rates. We propose a solution for limiting the impact that the data collection process can have on the results of the hypothesis testing. We explore the finite-sample behavior of the considered estimators from Monte Carlo simulations. Two examples based on synthetic data illustrate the considered problem. The R code and data used are provided as Supplementary Material. [ABSTRACT FROM AUTHOR]

Dementia incidence is lower among Asian Americans than among Whites, despite higher prevalence of type 2 diabetes, a well-known dementia risk factor. Determinants of dementia, including type 2 diabetes, have rarely been studied in Asian Americans. We followed 4846 Chinese, 4129 Filipino, 2784 Japanese, 820 South Asian, and 123 360 non-Latino White members of a California-based integrated health-care delivery system from 2002 to 2020. We estimated dementia incidence rates by race/ethnicity and type 2 diabetes status, and we fitted Cox proportional hazards and Aalen additive hazards models for the effect of type 2 diabetes (assessed 5 years before baseline) on age of dementia diagnosis, controlling for sex/gender, educational attainment, nativity, height, race/ethnicity, and a race/ethnicity × diabetes interaction. Type 2 diabetes was associated with higher dementia incidence in Whites (hazard ratio [HR] = 1.46; 95% CI, 1.40-1.52). Compared with Whites, the estimated effect of diabetes was larger in South Asians (HR = 2.26; 95% CI, 1.48-3.44), slightly smaller in Chinese (HR = 1.32; 95% CI, 1.08-1.62) and Filipino (HR = 1.31; 95% CI, 1.08-1.60) individuals, and similar in Japanese individuals (HR = 1.44; 95% CI, 1.15-1.81). Heterogeneity in this association across Asian subgroups may be related to type 2 diabetes severity. Understanding this heterogeneity may inform prevention strategies to prevent dementia for all racial and ethnic groups. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and Aims Even though aging is a known risk factor for prostate cancer incidence and mortality, there has been an increase in incidence among young men since the late 1980s with notably lower survival rates than those among older men. However, there is insufficient knowledge about recent trends in the incidence and survival of this disease. Methods We analyzed prostatic cancer incidence trends in men under 50 from 1975 to 2020 using Surveillance, Epidemiology, and End Results (SEER) 8 registries data. We further studied frequency, incidence rate, and survival rates in this group across SEER 22 registries, which cover around 41.9% of the US population. We analyzed the data by age, stage, and race subgroups and identified potential risk factors affecting survival prognosis using multivariable Cox proportional hazards regression models. Results Our results revealed that prostate cancer incidence rates in men under 50 have increased from 1975 to 2020. There was a significant decline from 2009 to 2014, followed by a gradual decrease. Between 2004 and 2020, 35,670 new cases were diagnosed. 76.10% of these cases were localized, 15.10% were regional, 4.20% were distant, and 4.60% were unstaged. Certain factors can negatively impact the prognosis, including age at diagnosis under 30, advanced stages of the disease, and non‐Hispanic black race. Conclusion Early‐onset prostate cancer has distinct epidemiological and clinical characteristics, and more research is required to gain a better understanding of the biological, genetic, and environmental factors that contribute to its development. This understanding will assist in the creation of more suitable management plans that can enhance survival rates.

ObjectiveTo provide the first estimates of dementia incidence rates among elderly in Lebanon.MethodsThe cohort established in 2013 consisted of 470 elderly from Beirut and Mount Lebanon, who consented to be followed-up. In 2017, we reached 341 participants/informants, achieving a response rate of 72.6%. The validated Arabic version of the 10/66 Dementia Research Group diagnostic tool was administered through face-to-face interviews. Direct age standardization was applied to the data using the Western European population distribution. Age-, sex- and location-specific incidence rates were estimated.ResultsAfter 3.5 years of follow up, 19 new cases of dementia were identified among 229 surviving participants. The crude incidence rate was 16.8 per 1,000 p-y, and the age standardized rate was 20.5 per 1,000 p-y. The incidence rate increased with age, going from 6.5 for those aged 65–74 years to 54.0 for those aged 85–89 years. Incidence rate was higher among females than males (20.7 vs.12.0), and higher in Mount Lebanon, as compared to the capital city Beirut (19.5 vs.14.9).ConclusionDementia incidence rate was close to European and North American countries' estimates. The use of validated tools increased the internal validity of our results. A large cohort study is warranted to confirm these results.

BackgroundThis study aimed to describe the temporal trends in the age and sex burdens of lower respiratory infections (LRIs) in China and globally from 1990 to 2021 and to analyze their epidemiological characteristics to formulate corresponding strategies to control LRIs.MethodsThis study utilized open data from the Global Burden of Disease (GBD) database from 1990 to 2021 to assess the burden of disease based on the prevalence, incidence, mortality, years lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) of LRIs in China and globally. Moreover, a comprehensive comparative analysis of the epidemiological characteristics of LRIs in China and globally was conducted via the Joinpoint regression model, age-period-cohort model (APC model), and stratified analysis of the study method from multiple dimensions, such as age, sex, and period. Finally, we used an autoregressive integrated moving average (ARIMA) model to predict the disease burden in LRIs over the next 15 years.ResultsFrom 1990 to 2021, China's age-standardized incidence, deaths, and disability-adjusted life year (DALY) rates per 100,000 people decreased from 5,481.13 (95% CI: 5,149.05, 5,836.35) to 2,853.81 (95% CI: 2,663.94, 3,067.55), from 60.65 (95% CI. 52.96, 66.66) to 14.03 (95% CI: 11.68, 17) and from 3,128.39 (95% CI: 2,724.11, 3,579.57) to 347.67 (95% CI: 301.28, 402.94). The global age-standardized incidence, deaths, and DALY rates per 100,000 people, on the other hand, decreased from 6,373.17 (95% CI: 5,993.51, 6,746.04) to 4,283.61 (95% CI: 4,057.03, 4,524.89) and from 61.81 (95% CI: 56.66, 66.74) to 28.67 (95% CI: 25.92, 31.07) and from 3,472.9 (95% CI: 3,090.71, 3,872.11) to 1,168.8 (95% CI: 1,016.96, 1,336.95). The decline in the aforementioned indicators is greater in the female population than in the male population, and the decrease in China is more pronounced than the global trend. In China, the age-standardized incidence and mortality rates of LRIs showed an annual average percentage change (AAPC) of −2.12 (95% CI: −2.20, −2.03) and −4.77 (95% CI: −5.14, −4.39), respectively. Globally, the age-standardized incidence and mortality rates for LRIs decreased by −1.28 (95% CI: −1.37, −1.18) and −2.47 (95% CI: −2.61, −2.32). By 2036, the incidence of lower respiratory infections (LRI) among men and women in China is projected to decrease by 36.55 and 46.87%, respectively, while the mortality rates are expected to decline to 12.67% for men and increase by 71.85% for women. In comparison, the global decline in LRI incidence is lower than that observed in China, yet the reduction in mortality rates is greater globally than in China.ConclusionsAge-standardized incidence, mortality and disability-adjusted life years (DALYs) decreased more in China than at the global level between 1990 and 2021. Compared with the previous period, the COVID-19 pandemic has led to a significant decrease in the disease burden of LRIs. As the population continues to age, the disease burden of LRIs in the old adult population will become a major new public health challenge.

INTRODUCTION: Mild cognitive impairment (MCI) is a significant public health concern and a potential precursor to Alzheimer's disease (AD). This study leverages electronic health record (EHR) data to explore rural‐urban differences in MCI incidence, risk factors, and healthcare navigation in West Michigan. METHODS: Analysis was conducted on 1,528,464 patients from Corewell Health West, using face‐to‐face encounters between 1/1/2015 and 7/31/2022. MCI cases were identified using International Classification of Diseases (ICD) codes, focusing on patients aged 45+ without prior MCI, dementia, or AD diagnoses. Incidence rates, cumulative incidences, primary care physicians (PCPs), and neuropsychology referral outcomes were examined across rural and urban areas. Risk factors were evaluated through univariate and multivariate Cox regression analyses. The geographic distribution of patient counts, hospital locations, and neurology department referrals were examined. RESULTS: Among 423,592 patients, a higher MCI incidence rate was observed in urban settings compared to rural settings (3.83 vs. 3.22 per 1,000 person‐years). However, sensitivity analysis revealed higher incidence rates in rural areas when including patients who progressed directly to dementia. Urban patients demonstrated higher rates of referrals to and completion of neurological services. While the risk factors for MCI were largely similar across urban and rural populations, urban‐specific factors for incident MCI are hearing loss, inflammatory bowel disease, obstructive sleep apnea, insomnia, being African American, and being underweight. Common risk factors include diabetes, intracranial injury, cerebrovascular disease, coronary artery disease, stroke, Parkinson's disease, epilepsy, chronic obstructive pulmonary disease, depression, and increased age. Lower risk was associated with being female, having a higher body mass index, and having a higher diastolic blood pressure. DISCUSSION: This study highlights rural‐urban differences in MCI incidence and access to care, suggesting potential underdiagnosis in rural areas likely due to reduced access to specialists. Future research should explore socioeconomic, environmental, and lifestyle determinants of MCI to refine prevention and management strategies across geographic settings. Highlights: Leveraged EHRs to explore rural‐urban differences in MCI in West Michigan.Revealed a significant underdiagnosis of MCI, especially in rural areas.Observed lower rates of neurological referrals and completions for rural patients.Identified risk factors specific to rural and urban populations. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the leading cause of death in the United States, and rates of CVD incidence vary widely by race and ethnicity. Cigarette smoking is associated with increased risk of CVD. The purpose of the study was: 1) to examine smoking prevalence over time across Asian and Pacific Islander (API) and multi-race API subgroups; 2) to determine whether the CVD risk associated with smoking differed among these subgroups. Methods: We identified patients belonging to 7 single race/ethnicity groups, 4 multi-race/ethnicity groups, and a non-Hispanic White (NHW) comparison group at two large health systems in Hawaii and California. We estimated annual smoking prevalence from 2011 through 2018 by group and gender. We examined incidence of CVD events by smoking status and race/ethnicity, and computed hazard ratios for CVD events by age, gender, race/ethnicity, census block median household income, census block college degree, and study site using Cox regression. Results: Of the 12 groups studied, the Asian Indian and Chinese American groups had the lowest smoking prevalence, and the Asian + Pacific Islander multiracial group had the highest smoking prevalence. The prevalence of smoking decreased from 2011 to 2018 for all groups. Multi-race/ethnicity groups had higher risk of CVD than the NHW group. There was no significant interaction between race/ethnicity and smoking in models predicting CVD, but the association between race/ethnicity and CVD incidence was attenuated after adjusting for smoking status. Conclusions: There is considerable heterogeneity in smoking prevalence and the risk of CVD among API subgroups.

Abstract Introduction Alopecia areata (AA) is an autoimmune skin disease presenting as nonscarring hair loss. Information on the epidemiology of AA, especially the occurrence of AA and its subtypes within the general population, is scarce. The study aimed to estimate the incidence rates and prevalence of hospital-treated AA and its subtypes in Denmark and to examine the demographic and clinical characteristics of patients with AA, including comorbidities and use of prescription medications. Methods This was a cohort study based on data from administrative and health registers in Denmark in 1995–2016. The study included individuals who were (1) registered with a hospital inpatient or hospital-based outpatient clinic diagnosis of AA between 1995 and 2016 in the Danish National Patient Registry covering encounters at all Danish hospitals, (2) alive and resided in Denmark anytime between 1995 and 2016, (3) aged ≥ 12 years, and (4) resided uninterrupted in Denmark during the 12 months before the first AA diagnosis during the study period. Results During the study period, 2778 individuals with an incident hospital-based diagnosis of AA were identified; 63.1% were female and 28.7% of the patients were aged ≥ 50 years. Over the study period, the overall incidence rate for any hospital-treated AA per 100,000 person-years was 2.62 (95% confidence interval [CI], 2.53–2.72), and the overall prevalence in 2016 was 71.7 (95% CI 69.4–74.1) per 100,000 persons. Both incidence rate and prevalence increased over time. Prevalence of most hospital-treated comorbidities or history of medication use was below 10% and was similar in the alopecia totalis (AT)/alopecia universalis (AU) and non-AT/AU subtypes of AA. Conclusion This cohort study reported incidence rates and prevalence over time and characteristics of individuals with hospital-treated AA in Denmark, which are in agreement with those previously reported in this population.

The objectives of the study were to examine the incident rate (IR), characteristics, and mechanisms of muscle injuries of 121 men amateur soccer players that voluntarily participated in this project. Sixty-five muscle injuries with an overall IR of 3.62/1000 h, 95% CI 2.7–4.5, were reported. The most frequently injured muscle groups were the hamstrings (IR 1.78/1000 h, 95% CI 1.1–2.3), followed by the adductors (IR 1.5/1000 h, 95% CI 0.93–2.06). Most muscle injuries were characterized as mild (IR 2.3/1000 h, 95% CI 1.53–2.92) or minimal (IR 1.28/1000 h, 95% CI 1.16–2.39. Higher incidence of injury sustained during matches (IR 14.09 injuries/1000 h, 95% CI 9.49–18.7), than in training (IR 1.88 injuries/1000 h, 95% CI 1.19–2.56). The most frequent injury mechanisms were high-speed running (84.4%) and change of direction (44.4%), for hamstring and adductors-related groin injuries, respectively. Players aged over 24 years had a 7-fold increased risk to sustain a hamstring injury but a lower risk to sustain an adductor-related groin injury. Injury prevention and rehabilitation management strategies may reduce muscle injury rates in amateur soccer. [ABSTRACT FROM AUTHOR]

Context: Shoulder dislocation < are the most commonly treated joint dislocation in the emergency department. Zacchilli and Owens previously reported on the epidemiology of shoulder dislocations presenting to the einergency department in the United States from 2002 to 2006. At the time of data collection and analysis, no epidemiological report had been published to update these findings. Purpose: The purpose of our study was to provide an updated epidemiological report from 2007 to 2020. Results : A total of 26,203 shoulder dislocations were recorded in the National Electronic Injury Surveillance System database from 2007 to 2020. The highest rates occurred in males (71.4%. n = 18,722) and patients aged 20-29 years old (28.2%, n = 7,292). The most common mechanism of injury was sports involvement (48.6%. n = 12,735). Interpretation : Our findings suggest that rates of shoulder dislocations have remained consistent with previous research on this topic, indicating no significant changes over the past 19 years. More effective prevention strategies are needed, especially for at-risk populations. [ABSTRACT FROM AUTHOR]

Introduction: Alopecia areata (AA) is an autoimmune skin disease presenting as nonscarring hair loss. Information on the epidemiology of AA, especially the occurrence of AA and its subtypes within the general population, is scarce. The study aimed to estimate the incidence rates and prevalence of hospital-treated AA and its subtypes in Denmark and to examine the demographic and clinical characteristics of patients with AA, including comorbidities and use of prescription medications. Methods: This was a cohort study based on data from administrative and health registers in Denmark in 1995–2016. The study included individuals who were (1) registered with a hospital inpatient or hospital-based outpatient clinic diagnosis of AA between 1995 and 2016 in the Danish National Patient Registry covering encounters at all Danish hospitals, (2) alive and resided in Denmark anytime between 1995 and 2016, (3) aged ≥ 12 years, and (4) resided uninterrupted in Denmark during the 12 months before the first AA diagnosis during the study period. Results: During the study period, 2778 individuals with an incident hospital-based diagnosis of AA were identified; 63.1% were female and 28.7% of the patients were aged ≥ 50 years. Over the study period, the overall incidence rate for any hospital-treated AA per 100,000 person-years was 2.62 (95% confidence interval [CI], 2.53–2.72), and the overall prevalence in 2016 was 71.7 (95% CI 69.4–74.1) per 100,000 persons. Both incidence rate and prevalence increased over time. Prevalence of most hospital-treated comorbidities or history of medication use was below 10% and was similar in the alopecia totalis (AT)/alopecia universalis (AU) and non-AT/AU subtypes of AA. Conclusion: This cohort study reported incidence rates and prevalence over time and characteristics of individuals with hospital-treated AA in Denmark, which are in agreement with those previously reported in this population. [ABSTRACT FROM AUTHOR]

Abstract INTRODUCTION Mild cognitive impairment (MCI) is a significant public health concern and a potential precursor to Alzheimer's disease (AD). This study leverages electronic health record (EHR) data to explore rural‐urban differences in MCI incidence, risk factors, and healthcare navigation in West Michigan. METHODS Analysis was conducted on 1,528,464 patients from Corewell Health West, using face‐to‐face encounters between 1/1/2015 and 7/31/2022. MCI cases were identified using International Classification of Diseases (ICD) codes, focusing on patients aged 45+ without prior MCI, dementia, or AD diagnoses. Incidence rates, cumulative incidences, primary care physicians (PCPs), and neuropsychology referral outcomes were examined across rural and urban areas. Risk factors were evaluated through univariate and multivariate Cox regression analyses. The geographic distribution of patient counts, hospital locations, and neurology department referrals were examined. RESULTS Among 423,592 patients, a higher MCI incidence rate was observed in urban settings compared to rural settings (3.83 vs. 3.22 per 1,000 person‐years). However, sensitivity analysis revealed higher incidence rates in rural areas when including patients who progressed directly to dementia. Urban patients demonstrated higher rates of referrals to and completion of neurological services. While the risk factors for MCI were largely similar across urban and rural populations, urban‐specific factors for incident MCI are hearing loss, inflammatory bowel disease, obstructive sleep apnea, insomnia, being African American, and being underweight. Common risk factors include diabetes, intracranial injury, cerebrovascular disease, coronary artery disease, stroke, Parkinson's disease, epilepsy, chronic obstructive pulmonary disease, depression, and increased age. Lower risk was associated with being female, having a higher body mass index, and having a higher diastolic blood pressure. DISCUSSION This study highlights rural‐urban differences in MCI incidence and access to care, suggesting potential underdiagnosis in rural areas likely due to reduced access to specialists. Future research should explore socioeconomic, environmental, and lifestyle determinants of MCI to refine prevention and management strategies across geographic settings. Highlights Leveraged EHRs to explore rural‐urban differences in MCI in West Michigan. Revealed a significant underdiagnosis of MCI, especially in rural areas. Observed lower rates of neurological referrals and completions for rural patients. Identified risk factors specific to rural and urban populations.

In 2021, in the Russian Federation, malignant neoplasms (MN) of the trachea, bronchi, lungs (ICD – C33, C34) occupied the first place in the structure of MN in men accounting for 16.4 %. Many studies show the existence of a potential connection between impacts of occupational factors and MN development; however, in Russia, the occupational genesis of MN is rarely recognized. The aim of this study was to identify a relationship between working conditions, volumes of pollutants emitted into ambient air and the incidence of tracheal, bronchial, and lung MN in men. The data were obtained from Form No. 7 "Information on malignant neoplasms", the Report "The state of working conditions for workers employed by economic entities operating in the Russian Federation as per specific types of economic activity", and Form No. 2-TP (air) "Information on the protection of ambient air" of Rosstat. We analyzed incidence rates of malignant neoplasms of the trachea, bronchi, and lungs among working age males, as well as males aged between 40 and 65 years in 2011–2021. The study involved quartile analysis (incidence rates were standardized with the direct method); correlation analysis (Kendall rank correlation); as well as multiple regression analysis. The latter was carried out to study effects of predictors (volumes of pollutants emitted into ambient air) on the selected criterion (MN incidence). The research data were statistically analyzed using MS Office Excel 2019, IBM SPSS Statistics 26. A downward trend was established for the analyzed incidence rates in Russia. A moderate positive correlation (τ = +0.31) was obtained between the proportion of workers employed in harmful or hazardous working conditions and the incidence of MN of the specified localization. A predictive regression model was developed. The obtained results of the correlation analysis require more in-depth consideration in subsequent studies. In our opinion, oncologists need to study occupational routes of their patients. Employers should focus on primary MN prevention within corporate practices of enterprises.

Objective: Background incidence rates are routinely used in safety studies to evaluate an association of an exposure and outcome. Systematic research on sensitivity of rates to the choice of the study parameters is lacking. Materials and Methods: We used 12 data sources to systematically examine the influence of age, race, sex, database, time-at-risk, season and year, prior observation and clean window on incidence rates using 15 adverse events of special interest for COVID-19 vaccines as an example. For binary comparisons we calculated incidence rate ratios and performed random-effect meta-analysis. Results: We observed a wide variation of background rates that goes well beyond age and database effects previously observed. While rates vary up to a factor of 1,000 across age groups, even after adjusting for age and sex, the study showed residual bias due to the other parameters. Rates were highly influenced by the choice of anchoring (e.g., health visit, vaccination, or arbitrary date) for the time-at-risk start. Anchoring on a healthcare encounter yielded higher incidence comparing to a random date, especially for short time-at-risk. Incidence rates were highly influenced by the choice of the database (varying by up to a factor of 100), clean window choice and time-at-risk duration, and less so by secular or seasonal trends. Conclusion: Comparing background to observed rates requires appropriate adjustment and careful time-at-risk start and duration choice. Results should be interpreted in the context of study parameter choices.

Ahmed Saad AL-Zomia, Ibrahim Ali AL-Zehefa, Abdulrhman Mohammed Alqarni, Abdulaziz Mohammed Al Muidh, Abdulmajeed Mesfer Almousa, Abdullah Faez Al-Qaed, Abdullrahman Saeed Alshahrani, Bandar Mohammed Asiri, Ghufran Badr Asiri, Lama Ali Lahiq, Mohammed Abdulaziz Al-Amri, Mohammed Saeed Al-Nujimi, Saud Mamdoh Alfaisal, Ibrahim Tawhari Faculty of Medicine, King Khalid University, Abha, Saudi ArabiaCorrespondence: Ahmed Saad AL-Zomia, Medical Intern Faculty of Medicine, King Khalid University, Abha, Aseer, 61421, Saudi Arabia, Email Ahmedszomia@gmail.comBackground: Ocular malignancies are uncommon among eye diseases; however, they jeopardize both vision and life. The main objective of this study was to use to describe the epidemiology of eye and ocular adnexa malignancies across different ages and sex.Methods: The King Khaled University institutional review board approved this study. Data on ocular cancer were retrieved from the Saudi Cancer Registry between 1994 and 2018. The registry collected important patient information such as demographic information (age, gender, and nationality), clinical details, and tumor classification.Results: The total number of cases with ocular cancer diagnosed was 1051 cases. The highest number was recorded in Riyadh (35.39%, n=372), followed by Makkah (16.93%, n=178). The incidence was higher in the 0– 4 years’ age group (55.21%), and it got down as people got older. The data also revealed differences in the number of reported cases over time, as well as in the representation of eye cancer cases by gender and nationality. While many ocular cancer pathologies were seen, with “Retinoblastoma, not otherwise specified” being the most common (53.32%), the incidence rates for males and females remained largely stable over time.Conclusion: The study emphasizes the need for continued monitoring, research, and analysis of potential of epidemiology of ocular cancer occurrence in Saudi Arabia. Identifying the geographical distribution and age pattern of Ocular malignancies have the potential to assist healthcare authorities and policymakers in developing precise strategies to reduce, recognize at an early stage, and successfully manage this condition.Keywords: ocular neoplasms, clinicopathologic characteristics, incidence rates, targeted strategies, retinoblastoma, Saudi Arabia

Abstract Background There is a concern that exposure to psychosocial stressors during the COVID-19 pandemic may have led to a higher incidence of mental disorders. Thus, this study aimed to compare trends in incidence rates of depressive disorder, anxiety disorders, obsessive–compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and eating disorders in primary- and specialist health care before (2015–2019) and during the COVID-19 pandemic (2020–2021). Methods We used aggregated population registry data to calculate incidence rates of mental disorders from primary- (The Norwegian Control and Payment of Health Reimbursements Registry (KUHR)) and specialist (The Norwegian Patient Registry (NPR)) health care. The analyses included all Norwegian residents aged 18–65 during the study period. Incident cases were defined as having no previous registration with the same mental disorder in KUHR (from 2006) or NPR (from 2008). We used linear prediction models and mean models to compare incidence rates and test trends before and during the pandemic. Results During the pandemic, the incidence rates among women were higher or as predicted for OCD in specialist health care and for eating disorders in both primary- and specialist health care. These findings were strongest among women aged 18–24 years. Incidence rates for depression and phobia/OCD among both genders in primary health care and phobic anxiety disorders among both genders in specialist health care were lower or as predicted. Conclusion The COVID-19 pandemic may have led to more women needing treatment for OCD and eating disorders in the Norwegian population. The decreased incidence rates for some disorders might indicate that some individuals either avoided seeking help or had improved mental health during the pandemic.

Background: Cervical Cerclage may be an effective treatment option in true cervical insufficiency. Cervical function plays a crucial role to protect growing fetus in utero in maintaining successful pregnancy. As the gestational weeks progress, the cervix undergoes dynamic changes, including softening and shortening, to accommodate fetal growth. Objective: The objective of this study is to evaluate the effectiveness and outcome of cervical cerclage placement as a preventive measure against recurrent pregnancy loss and preterm delivery and its complications, to analyze pregnancy outcomes among participants who received cervical cerclage and to investigate the relationship between cervical cerclage and pregnancy outcome based on gestational age. Method and Materials: The study was conducted over three years at CMH, Jashore and Ibn Sina Hospital Jashore, utilizing a retrospective and longitudinal interventional approach. Ethical approval was obtained before commencing the study, which involved 92 cases undergoing mid-trimester cervical cerclage. Cervical length measurements, cervical cerclage using the McDonald technique, and subsequent medical management were performed with outcome analyzed using descriptive statistics and odds ratio. Data were analyzed retrospectively through SPSS data analysis tool. Result: 45.65% of patients experienced term deliveries, while 33.70% had preterm deliveries, with 20.65% facing abortions. Distinct inclusion criteria unveiled diverse outcomes, such as recurrent pregnancy loss cases showing 40.82% preterm and 38.78% term deliveries. Odds ratios highlighted cervical length's significance, with a 0.25 ratio indicating reduced preterm risk. Interestingly, 61.69% of preterm births occurred between 34 and 36 weeks. Maternal outcomes indicated low incidence rates of hemorrhage (4.8%), infections (1.1%) and cervix laceration (2.4%). Conclusion: The study underscores cervical cerclage's potential in enhancing full-term pregnancies, particularly for patients with cervical incompetence. While highlighting its success, the study also acknowledges associated risks and complications. [ABSTRACT FROM AUTHOR]

Objective: To estimate the incidence rates (IR) of prespecified outcomes of interest in pediatric patients (1 month to < 1 year) treated with intravenous (IV) pantoprazole using Optum's longitudinal electronic health records database (Optum Market Clarity) from the United States (US). Methods: This real-world, non-interventional, retrospective cohort study was conducted from 01 January 2007 to 31 December 2020 in patients who received IV pantoprazole. Premature patients and those weighing < 2.36 kg were excluded. Patients were categorized based on diagnosis of gastroesophageal reflux disease (GERD) and erosive esophagitis (EE) into: Subgroup 1 (GERD and EE), Subgroup 2 (GERD and no EE), and Subgroup 3 (absence of GERD and EE). Overall IRs (per 1000 person-years [PY]) and 95% confidence intervals (CI) of outcomes were estimated (overall and subgroups) and stratified by duration of IV pantoprazole treatment (< 4 days versus ≥ 4 days). Results: Of 1879 eligible patients, none were identified in Subgroup 1; 851 (45.3%) and 1028 (54.7%) patients were identified in Subgroups 2 and 3, respectively. IRs of outcomes of interest ranged from 0.0 to 742.8 per 1000 PY. IRs were highest for vomiting (742.80), diarrhea (377.77), abdominal distension (214.31), hyponatremia (204.99), and hypokalemia (203.49). IRs were comparable between Subgroups 2 and 3. For most outcomes, IRs were higher among patients treated with IV pantoprazole for ≥ 4 days versus those treated for < 4 days. Conclusion: These results are consistent with the known safety profile of pantoprazole and emphasize the utility of using real-world data from pediatric populations for assessment of safety outcomes. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has sharpened the focus on health care safety and quality, underscoring the importance of using standardized metrics such as the International Classification of Diseases, Tenth Revision (ICD-10). In this regard, the ICD-10 cluster Y62-Y69 serves as a proxy assessment of safety and quality in health care systems, allowing researchers to evaluate medical misadventures. Thus far, extensive research and reports support the need for more attention to safety and quality in health care. The study aims to leverage the pandemic's unique challenges to explore health care safety and quality trends during prepandemic, intrapandemic, and postpandemic phases, using the ICD-10 cluster Y62-Y69 as a key tool for their evaluation. Objective: This research aims to perform a comprehensive retrospective analysis of incidence rates associated with ICD-10 cluster Y62-Y69, capturing both linear and nonlinear trends across prepandemic, intrapandemic, and postpandemic phases over an 8-year span. Therefore, it seeks to understand how these trends inform health care safety and quality improvements, policy, and future research. Methods: This study uses the extensive data available through the TriNetX platform, using an observational, retrospective design and applying curve-fitting analyses and quadratic models to comprehend the relationships between incidence rates over an 8-year span (from 2015 to 2023). These techniques will enable the identification of nuanced trends in the data, facilitating a deeper understanding of the impacts of the COVID-19 pandemic on medical misadventures. The anticipated results aim to outline complex patterns in health care safety and quality during the COVID-19 pandemic, using global real-world data for robust and generalizable conclusions. This study will explore significant shifts in health care practices and outcomes, with a special focus on geographical variations and key clinical conditions in cardiovascular and oncological care, ensuring a comprehensive analysis of the pandemic's impact across different regions and medical fields. Results: This study is currently in the data collection phase, with funding secured in November 2023 through the Ricerca Corrente scheme of the Italian Ministry of Health. Data collection via the TriNetX platform is anticipated to be completed in May 2024, covering an 8-year period from January 2015 to December 2023. This dataset spans pre-pandemic, intra-pandemic, and early post-pandemic phases, enabling a comprehensive analysis of trends in medical misadventures using the ICD-10 cluster Y62-Y69. The final analytics are anticipated to be completed by June 2024. The study's findings aim to provide actionable insights for enhancing healthcare safety and quality, reflecting on the pandemic's transformative impact on global healthcare systems. Conclusions: This study is anticipated to contribute significantly to health care safety and quality literature. It will provide actionable insights for health care professionals, policy makers, and researchers. It will highlight critical areas for intervention and funding to enhance health care safety and quality globally by examining the incidence rates of medical misadventures before, during, and after the pandemic. In addition, the use of global real-world data enhances the study's strength by providing a practical view of health care safety and quality, paving the way for initiatives that are informed by data and tailored to specific contexts worldwide. This approach ensures the findings are applicable and actionable across different health care settings, contributing significantly to the global understanding and improvement of health care safety and quality. International Registered Report Identifier (IRRID): PRR1-10.2196/54838 [ABSTRACT FROM AUTHOR]

Osteonecrosis (ON) is a common disabling complication of treatment for patients with acute lymphoblastic leukaemia (ALL). Reported incidence rates range from 1% to 61% and multiple possible risk factors have been identified. This review explored existing evidence to provide new perspectives and recommendations for future interdisciplinary research. PEDro, CINAHL, AMED, EMBSAE, OVID, EMCARE databases were systematically searched from their inception to March 2022. Published original research reporting the incidence rates of osteonecrosis in patients aged 10–25 with ALL were included. Study reporting quality was assessed against appropriate reporting guidelines (STROBE, CONSORT and CROSS). All relevant data reporting incidence rates and risk factors were extracted for narrative synthesis. 3146 report titles were screened, with 34 studies included (n = 12,056) (30 observational cohort studies, three randomised trials, and one questionnaire study). The median study quality reporting score was 68% (IQR 64–82%). Median overall incidence rate of ON was 51.8% (IQR 41.4–58.9%) and 15.65% (IQR 9.2–24.2%) for asymptomatic and symptomatic patient screening respectively. Five possible risk factor categories were identified: sex assigned at birth, age, ethnicity, steroid regimen, and genotype. The female sex and white ethnicity were consistently reported as risk factors independently associated with an increased risk of osteonecrosis in all studies. A heterogenous body of literature with moderate reporting quality identified a high incidence rate of osteonecrosis in patients with ALL. Future research investigating the efficacy of stratified treatments that focus on reducing the risk of osteonecrosis through modification of steroid regimen particularly in females of white ethnicity is needed. Obtaining multidisciplinary consensus with regards to screening methodologies and intervention outcomes may also help to improve evidence synthesis in this area. This may in turn facilitate early diagnosis and improve long term patient outcomes through treatment regimen modification and possible prevention of ON progression.

Objective of this study was to use to describe the epidemiology of eye and ocular adnexa malignancies across different ages and sex.Methods: The King Khaled University institutional review board approved this study. Data on ocular cancer were retrieved from the Saudi Cancer Registry between 1994 and 2018. The registry collected important patient information such as demographic information (age, gender, and nationality), clinical details, and tumor classification.Results: The total number of cases with ocular cancer diagnosed was 1051 cases. The highest number was recorded in Riyadh (35.39%, n=372), followed by Makkah (16.93%, n=178). The incidence was higher in the 0– 4 years' age group (55.21%), and it got down as people got older. The data also revealed differences in the number of reported cases over time, as well as in the representation of eye cancer cases by gender and nationality. While many ocular cancer pathologies were seen, with "Retinoblastoma, not otherwise specified" being the most common (53.32%), the incidence rates for males and females remained largely stable over time.Conclusion: The study emphasizes the need for continued monitoring, research, and analysis of potential of epidemiology of ocular cancer occurrence in Saudi Arabia. Identifying the geographical distribution and age pattern of Ocular malignancies have the potential to assist healthcare authorities and policymakers in developing precise strategies to reduce, recognize at an early stage, and successfully manage this condition. [ABSTRACT FROM AUTHOR]

Background: There is a concern that exposure to psychosocial stressors during the COVID-19 pandemic may have led to a higher incidence of mental disorders. Thus, this study aimed to compare trends in incidence rates of depressive disorder, anxiety disorders, obsessive–compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and eating disorders in primary- and specialist health care before (2015–2019) and during the COVID-19 pandemic (2020–2021). Methods: We used aggregated population registry data to calculate incidence rates of mental disorders from primary- (The Norwegian Control and Payment of Health Reimbursements Registry (KUHR)) and specialist (The Norwegian Patient Registry (NPR)) health care. The analyses included all Norwegian residents aged 18–65 during the study period. Incident cases were defined as having no previous registration with the same mental disorder in KUHR (from 2006) or NPR (from 2008). We used linear prediction models and mean models to compare incidence rates and test trends before and during the pandemic. Results: During the pandemic, the incidence rates among women were higher or as predicted for OCD in specialist health care and for eating disorders in both primary- and specialist health care. These findings were strongest among women aged 18–24 years. Incidence rates for depression and phobia/OCD among both genders in primary health care and phobic anxiety disorders among both genders in specialist health care were lower or as predicted. Conclusion: The COVID-19 pandemic may have led to more women needing treatment for OCD and eating disorders in the Norwegian population. The decreased incidence rates for some disorders might indicate that some individuals either avoided seeking help or had improved mental health during the pandemic. [ABSTRACT FROM AUTHOR]

At least 10% of lung cancers arise in adults who have never used tobacco. Data remain inconclusive on whether lung cancer incidence has been increasing among adults who have never used tobacco. How have age-adjusted incidence rates of lung cancer changed temporally, especially among adults who have never used tobacco? Trends in lung cancer incidence were examined using linked electronic health record and cancer registry data on a dynamic cohort of adults ≥ 30 years of age at risk of incident lung cancer between January 1, 2007, and December 31, 2018, from an integrated health-care system in northern California. Truncated age-adjusted lung cancer incidence rates and average annual percentage change (AAPC) in rates were estimated, overall and separately for adults who have ever and never used tobacco by age, sex, and race or ethnicity. The cohort included 3,751,348 adults (52.5% female, 48.0% non-Hispanic White, 63.1% have never used tobacco), among whom 18,627 (52.7% female, 68.6% non-Hispanic White, 15.4% have never used tobacco) received a diagnosis of lung cancer. The overall lung cancer incidence rate declined from 91.1 to 63.7 per 100,000 person-years between 2007 and 2009 and between 2016 and 2018 (AAPC, –3.9%; 95% CI, –4.2% to –3.6%). Among adults who have ever used tobacco, incidence rates declined overall from 167.0 to 113.4 per 100,000 person-years (AAPC, –4.2%; 95% CI, –4.4% to –3.9%) and, to varying degrees, within all age, sex, and racial or ethnic groups. Among adults who have never used tobacco, incidence rates were relatively constant, with 3-year-period estimates ranging from 19.9 to 22.6 per 100,000 person-years (AAPC, 0.9%; 95% CI, –0.3% to 2.1%). Incidence rates for adults who have never used tobacco seemed stable over time, within age, sex, and racial or ethnic groups, except for those of Asian and Pacific Islander (API) origin (AAPC, 2.0%; 95% CI, 0.1%-3.9%), whose rates were about twice as high compared with their counterparts. These observed trends underscore the need to elucidate further the cause of lung cancer in adults who have never used tobacco, including why incidence is higher and rising in API adults who have never used tobacco. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Marginal ulcer (MU) is an uncommon but significant complication following one-anastomosis gastric bypass (OAGB). Our study aims to understand the incidence rates, risk factors, and management of MU following OAGB. Methods: MEDLINE, Scopus, and Cochrane Library databases were examined to identify all studies on OAGB where authors had reported on MU. Data were collected on basic demographics, incidence rates, risk factors, and management of this condition. Results: Thirty-two studies involving 8868 patients were analysed. The mean age and body mass index (BMI) of patients in these studies were 40.9 ± 4.5 years and 47.6 ± 5.6 kg/m2, respectively. Among the patient cohort, approximately 72% were female, and 20.6% had preoperative gastroesophageal reflux disease (GERD). The authors described prescribing proton-pump inhibitors (PPI) prophylaxis to 14.1% of patients after surgery. Two hundred twenty-eight patients were reported to have MU. The incidence of MU was 2.59% (95% CI 1.89–3.52), of which 53 patients presented within 12 months, 24 patients presented after 31 months, and five patients after 6 years. One hundred forty-six patients did not have presentation time documented. Sixty-five patients were described to have MU diagnosed on endoscopy, of which 54 were symptomatic and 11 were asymptomatic. The authors were, however, not specific on the choice of investigation for the remaining 163 patients. Of patients, 89.7% were treated conservatively with PPIs, whilst 10.3% had surgery to treat MU. Conclusions: Marginal ulcer is an uncommon complication following OAGB. The majority of patients are treated conservatively with PPIs. Larger, well-designed studies reporting on risk factors, investigation, and management of MU following OAGB are warranted. [ABSTRACT FROM AUTHOR]

Abstract Background Pneumonia is the most serious form of acute respiratory infection and Streptococcus pneumoniae is a leading cause of pediatric bacterial pneumonia. Pneumococcal conjugate vaccines were introduced in the United States (US) in 2000 (7-valent [PCV7]) and 2010 (13-valent [PCV13]). This study estimated annual incidence rates (IRs) of all-cause pneumonia (ACP) among US children aged

Abstract Background Little is known about stage 1 and 2 pressure injuries that are health care‐acquired. We report incidence rates of health care‐acquired stage 1 and stage 2 pressure injuries, and, estimate the excess length of stay using four competing analytic methods. We discuss the merits of the different approaches. Methods We calculated monthly incidence rates for stage 1 and 2 health care‐acquired pressure injuries occurring in a large Singapore acute care hospital. To estimate excess stay, we conducted unadjusted comparisons with a control cohort, performed linear regression and then generalized linear regression with a gamma distribution. Finally, we fitted a simple state‐based model. The design for the cost attribution work was a retrospective matched cohort study. Results Incidence rates in 2016 were 0.553% (95% confidence interval [CI] 0.55, 0.557) and 0.469% (95% CI 0.466, 0.472) in 2017. For data censored at 60 days’ maximum stay, the unadjusted comparisons showed the highest excess stay at 17.68 (16.43‐18.93) days and multi‐state models showed the lowest at 1.22 (0.19, 2.23) days. Conclusions Poor‐quality methods for attribution of excess length of stay to pressure injury generate inflated estimates that could mislead decision makers. The findings from the multi‐state model, which is an appropriate method, are plausible and illustrate the likely bed‐days saved from lowering the risk of these events. Stage 1 and 2 pressure injuries are common and increase costs by prolonging the length of stay. There will be economic value investing in prevention. Using biased estimates of excess length of stay will overstate the potential value of prevention.

Objective of the study: to analyze cataract incidence rates over the period from 1955 through 2019 in the cohort of the population exposed in the Southern Urals and to analyze radiation risk of cataract incidence.Methods. For the first time cataract incidence was assessed over a long- term period from 1955 through 2019 in people who were chronically exposed in a low-to-moderate dose range. The registry of eye pathologies created in the URCRM was used as the basis for the study. Analysis of incidence rates was conducted with account of the individualized doses to the lens. The incidence rates were calculated using the methods of medical statistics per 1,000 people. The odds ration (OR) of cataract development was also evaluated using the case-control study.Results. In total the studied group consisted of 14,751 people (1955–2019) who underwent examinations in the outpatient department of the URCRM. As of December 2020 4,658 patients with cataract were registered. According to the findings of the study (1955–2019) it has been stated that cataract incidence increases with age and thus with the aging of the cohort, improvement of the quality of the diagnosing procedures and examination of the patients. The number of cataracts in women significantly exceeds that in men (3,169 and 1,489, respectively). Standardized incidence rate of cataract over all the years of the follow-up is 172.94 (95 % CI: 168.10–177.78). In the course of the study of the cataract incidence dependence on the dose to the lens, it has been revealed that cataract incidence tends to increase with the increasing dose. Risk value of cataract development (OR) depending on the dose to the lens obtained as a result of the case-control study made up 1.10 (95 % CI: 1.00–1.21).Conclusion. The incidence of cataract in the studied cohort increases with the follow-up periods. The number of cataracts in women is greater than that in men, the age characteristics are approximately the same. A trend of increased effect of the dose on the increase in the risk of cataracts was established based on the results of the performed analysis.

[Display omitted] Descriptive epidemiological data on incidence rates (IRs) of asthma with recurrent exacerbations (ARE) are sparse. This study hypothesized that IRs for ARE would vary by time, geography, age, and race and ethnicity, irrespective of parental asthma history. The investigators leveraged data from 17,246 children born after 1990 enrolled in 59 US with 1 Puerto Rican cohort in the Environmental Influences on Child Health Outcomes (ECHO) consortium to estimate IRs for ARE. The overall crude IR for ARE was 6.07 per 1000 person-years (95% CI: 5.63-6.51) and was highest for children aged 2-4 years, for Hispanic Black and non-Hispanic Black children, and for those with a parental history of asthma. ARE IRs were higher for 2- to 4-year-olds in each race and ethnicity category and for both sexes. Multivariable analysis confirmed higher adjusted ARE IRs (aIRRs) for children born 2000-2009 compared with those born 1990-1999 and 2010-2017, 2-4 versus 10-19 years old (aIRR = 15.36; 95% CI: 12.09-19.52), and for males versus females (aIRR = 1.34; 95% CI 1.16-1.55). Black children (non-Hispanic and Hispanic) had higher rates than non-Hispanic White children (aIRR = 2.51; 95% CI 2.10-2.99; and aIRR = 2.04; 95% CI: 1.22-3.39, respectively). Children born in the Midwest, Northeast and South had higher rates than those born in the West (P <.01 for each comparison). Children with a parental history of asthma had rates nearly 3 times higher than those without such history (aIRR = 2.90; 95% CI: 2.43-3.46). Factors associated with time, geography, age, race and ethnicity, sex, and parental history appear to influence the inception of ARE among children and adolescents. [ABSTRACT FROM AUTHOR]

Agricultural activity employs an estimated 1.3 billion workers worldwide, which is half of the world's labour force. In terms of fatalities, injuries and work-related ill-health, it is one of the four most hazardous sectors of activity (along with construction, transportation and storage and manufacturing). According to International Labour Organization (ILO) estimates, at least 170000 agricultural workers are dying each year. In this paper, the statistical indicators concerning non-fatal and fatal accidents at work in agriculture, forestry and fishing activity and an incidence rate in the Member State of the European Union (EU-27) and in the R.N. Macedonia during 2017÷2021 were presented. The performed statistical analysis shows that the number of non-fatal and fatal accidents at work in agriculture, forestry and fishing activity in EU-27, in 2020 was decreased in comparison with 2017. In the R.N. Macedonia in 2021, there was a decrease in the number of non-fatal accidents at work in comparison with 2017. During 2021 in the R.N. Macedonia, there were no recorded fatal accidents at work. This fact categorizes the R.N. Macedonia in the category of EU-27 Member States with zero fatal accidents at work.

Background: Pneumonia is the most serious form of acute respiratory infection and Streptococcus pneumoniae is a leading cause of pediatric bacterial pneumonia. Pneumococcal conjugate vaccines were introduced in the United States (US) in 2000 (7-valent [PCV7]) and 2010 (13-valent [PCV13]). This study estimated annual incidence rates (IRs) of all-cause pneumonia (ACP) among US children aged < 18 years before and after the introduction of PCV7 and PCV13. Methods: ACP episodes were identified in the IBM MarketScan Commercial and Medicaid Databases using diagnosis codes. Annual IRs were calculated overall and by inpatient and outpatient settings as the number of episodes per 100,000 person-years (PY) for all children aged < 18 years and by age group (< 2, 2–4, and 5–17 years). National estimates of annual pneumonia IRs were extrapolated using Census Bureau data. Interrupted time series (ITS) analyses were used to assess immediate and gradual changes in monthly pneumonia IRs, adjusting for seasonality. Results: In the commercially-insured population, ACP IRs declined between the pre-PCV7 period (1998–1999) and late PCV13 period (2014–2018) from 5,322 to 3,471 episodes per 100,000 PY for children aged < 2 years, from 4,012 to 3,794 episodes per 100,000 PY in children aged 2–4 years but increased slightly from 1,383 to 1,475 episodes per 100,000 PY in children aged 5–17 years. The ITS analyses indicated significant decreases in monthly ACP IRs in the early PCV7 period (2001–2005) among younger children and in the early PCV13 period (2011–2013) among all children. Increases were observed in the late PCV7 period (2006–2009) among all age groups, but were only significant among older children. IRs of inpatient ACP decreased across all age groups, but outpatient pneumonia IRs remained stable during the study timeframe, even increasing slightly in children aged 5–17 years. More prominent declines were observed for Medicaid-insured children across all age groups; however, Medicaid IRs were higher than IRs of commercially-insured children during the entire study timeframe. Conclusions: ACP disease burden remains high in US children of all ages despite overall reductions in incidence rates during 1998–2018 following the introduction of PCV7 and PCV13. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to investigate the overall survival (OS) of young women with endometrial cancer (EC) in Bulgaria and the impact of histological type on survival. Material and methods: This is a population-wide retrospective study of patients with EC (≤ 40 years at diagnosis) registered at Bulgarian National Cancer Registry (BNCR) between 1993 and 2020. Patients were re-classified according to the 8th edition of the TNM classification. Results: In total, 30 597 patients were registered and histologically confirmed with malignant tumors of the uterine body. From that, 29 065 of them (95%) had ECs, and the rest had sarcomas. Around 1.64% of all malignant tumors of the uterine body are diagnosed in women under the age of 40. Most of them are diagnosed in the early stage. There was no significant difference in median OS for patients diagnosed before or after 2003. In recent years there was a slight improvement in survival and patients from the last cohort of this study had a 5-year survival rate of 92.5%. Patients with favorable pathology (T1, G1/2) had no lymph node involvement at the time of diagnosis and their 10-year survival rate was 94%. Conclusions: EC in young women is a rare disease. In most cases, patients are diagnosed in early stageT1, G1/2, N0 and their prognosis is excellent. However, the lack of improvement of OS of young patients with EC in the last three decades shows the need for treatment optimization. [ABSTRACT FROM AUTHOR]

Abstract Background Invasive meningococcal disease (IMD) causes high fatality in untreated patients alongside long-term sequelae in 20% survivors. For a comprehensive assessment of epidemiology, an analysis of these sequelae is required. This study aims to investigate the epidemiology of disease between 2008 and 2017 including a description of the sequelae, through the analysis of data collected from the UK Clinical Practice Research Datalink (CPRD) linked with data from the Hospital Episode Statistics (HES), and Office for National Statistics (ONS) mortality registry data. Methods This was a 10-year retrospective observational cohort study designed to describe the incidence, case-fatality rate (CFR) and occurrence of sequelae due to meningococcal disease, in the UK between 2007 and 2017 using data from the UK CPRD-HES-ONS. Cases were identified and matched on age, gender, date of diagnosis of IMD and followed-up-time with a control group without IMD. Demographics, clinical characteristics, mortality, and IMD-related sequelae were examined for IMD cases and compared with matched controls for a more comprehensive assessment. Results The study analysed 640 IMD patients with majority of the cases diagnosed (76.9%) in a hospital setting. Age-group analysis showed a decrease in the incidence rate of IMD in patients aged 50 years (10.4 – 27.8%). CFR was slightly higher among females, toddlers, and adults >50 years. No significant change in CFR was observed over study period. Case-control study showed a higher number of IMD sequelae among cases compared to age- and gender-matched controls, especially in those ≥ 50 years. Conclusion The study showed that, despite a relatively low incidence rate, IMD is responsible for a high CFR, namely in older age groups and by a high number of IMD sequelae. The study showed that leveraging data from existing databases can be used to complement surveillance data in truly assessing the epidemiology of IMD. Despite the availability of routine vaccination programs, IMD still poses a significant burden in the healthcare system of the UK. Optimization of vaccination programs may be required to reduce the disease burden.

Intimate partner homicide (IPH) is an extreme outcome of intimate partner violence (IPV). It is a societal challenge that needs to be investigated over time to see whether changes occur concerning the incidence of IPH, IPH characteristics, socioeconomic factors, and contact with service providers. This study includes the total Norwegian cohort of IPHs between 1990 and 2019 with a final conviction (N = 224). Poisson regression was applied to model the incidence rate of homicide and IPH between 1990 and 2020 as well as the incidence rates of immigrant perpetrators and victims. Multivariate logistic regression analyses were used to test the association between characteristics and period 1990–2012 compared to after 2012 as dependent variable. The results show that though homicide incidence rates in Norway declined steadily and significantly after 1990, IPH rates did not begin to decline until 2015. The following IPH characteristics showed reduced incidence after 2012: IPH-suicide, perpetrators with a criminal record, and IPHs perpetrated subsequent to preventive interventions towards the perpetrator. Sentence length in IPH cases had increased. Changes were not observed for any of the other IPH characteristics investigated. IPH is often the culmination of long-term violence and can be prevented, even if risk assessment is challenging due to the low base rates. [ABSTRACT FROM AUTHOR]

Incidence rates are popular summary measures of the occurrence over time of events of interest. They are also called mortality rates or failure rates, depending on the context. The incidence rate is defined as the ratio between the total number of events and total follow-up time and can be estimated with the strate command. When the event of interest can occur multiple times on any given subject over a time period, like infections, the incidence rate represents an average count per unit of time, such as the average number of infections per year. When the event of interest can occur only once, such as death, an alternative summary measure is the risk, or probability, of occurrence per unit time, such as the risk of dying in one year. In this article, I present the stprisk command, which estimates risks, and illustrate its use and interpretation through a data example. [ABSTRACT FROM AUTHOR]