There are no studies assessing the epidemiology and burden of decubitus ulcers at global, regional, and national levels. We aim to report this issue from 1990 to 2019 by extracting data from the Global Burden of Disease Study (GBD) 2019 and stratifying it by age, gender, and socio-demographic index (SDI). Globally, the number of prevalent cases of decubitus ulcers in 2019 is 0.85 (95% UI 0.78 to 0.94) million. The age-standardized rates of prevalence, incidence, and years lived with disability (YLDs) in 2019 are 11.3 (95% UI 10.2 to 12.5), 41.8 (37.8 to 46.2), and 1.7 (1.2 to 2.2) per 100,000 population, and compared with 1990, it has decreased by 10.6% (95% UI 8.7% to 12.3%), 10.2% (8.2 to 11.9%), and 10.4% (8.1 to 12.5%), respectively. In addition, the global prevalence rate of decubitus ulcers increases with age, peaking at the > 95 age group among men and women. At the regional and national levels, we observe a positive correlation between age-standardized YLDs and SDI. Malaysia, Saudi Arabia, and Thailand experienced the most significant increases in age-standardized prevalence rates at the national level. Finally, we concluded that the age-standardized prevalence, incidence, and YLDs rates of decubitus ulcer declined from 1990 to 2019, with significant regional differences. In order to monitor the dynamic changes of decubitus ulcers burden, it is recommended to improve the quality of decubitus ulcer health data in all regions and countries.
Terrestrial water storage anomaly (TWSA) from Gravity Recovery and Climate Experiment (GRACE) and GRACE Follow-on was first exacted by using the forward modeling (FM) method at three different scales over the Yangtze River basin (YRB): whole basin, three middle sub-basins, and eleven small sub-basins (total 15 basins). The spatiotemporal variability of eight hydroclimatic variables, snow water storage change (SnWS), canopy water storage change (CnWS), surface water storage anomaly (SWSA), soil moisture storage anomaly (SMSA), groundwater storage anomaly (GWSA), precipitation (P), evapotranspiration (ET), and runoff (R), and their contribution to TWSA were comprehensively investigated over the YRB. The results showed that the root mean square error of TWS change after FM improved by 17 %, as validated by in situ P, ET, and R data. The seasonal, inter-annual, and trend revealed that TWSA over the YRB increased during 2003-2018. The seasonal TWSA signal increased from the lower to the upper of YRB, but the trend, sub-seasonal, and inter-annual signals receded from the lower to the upper of YRB. The contribution of CnWS to TWSA was small over the YRB. The contribution of SnWS to TWSA occurs mainly in the upper of YRB. The main contributors to TWSA were SMSA (~36 %), SWSA (~33 %), and GWSA (~30 %). GWSA can be affected by TWSA, but other hydrological elements may have a slight impact on groundwater in the YRB. The primary driver of TWSA over the YRB was P (~46 %), followed by ET and R (both ~27 %). The contribution of SMSA, SWSA, and P to TWSA increased from the upper to the lower of YRB. R was the key driver of TWSA in the lower of YRB. The proposed approaches and results of this study can provide valuable new insights for water resource management in the YRB and can be applied globally.