METHODS: This study was conducted with GBD 2019 analytical and modelling strategies. Primary prevalence data came from claims from three countries and from hospital inpatient encounters from 45 locations. A Bayesian meta-regression modelling tool, DisMod-MR version 2.1, was used to estimate the age-specific, location-specific, and year-specific prevalence of benign prostatic hyperplasia. Age-standardised prevalence was calculated by the direct method using the GBD reference population. Years lived with disability (YLDs) due to benign prostatic hyperplasia were estimated by multiplying the disability weight by the symptomatic proportion of the prevalence of benign prostatic hyperplasia. Because we did not estimate years of life lost associated with benign prostatic hyperplasia, disability-adjusted life-years (DALYs) equalled YLDs. The final estimates were compared across Socio-demographic Index (SDI) quintiles. The 95% uncertainty intervals (UIs) were estimated as the 25th and 975th of 1000 ordered draws from a bootstrap distribution.
FINDINGS: Globally, there were 94·0 million (95% UI 73·2 to 118) prevalent cases of benign prostatic hyperplasia in 2019, compared with 51·1 million (43·1 to 69·3) cases in 2000. The age-standardised prevalence of benign prostatic hyperplasia was 2480 (1940 to 3090) per 100 000 people. Although the global number of prevalent cases increased by 70·5% (68·6 to 72·7) between 2000 and 2019, the global age-standardised prevalence remained stable (-0·770% [-1·56 to 0·0912]). The age-standardised prevalence in 2019 ranged from 6480 (5130 to 8080) per 100 000 in eastern Europe to 987 (732 to 1320) per 100 000 in north Africa and the Middle East. All five SDI quintiles observed an increase in the absolute DALY burden between 2000 and 2019. The most rapid increases in the absolute DALY burden were seen in the middle SDI quintile (94·7% [91·8 to 97·6]), the low-middle SDI quintile (77·3% [74·1 to 81·2]), and the low SDI quintile (77·7% [72·9 to 83·2]). Between 2000 and 2019, age-standardised DALY rates changed less, but the three lower SDI quintiles (low, low-middle, and middle) saw small increases, and the two higher SDI quintiles (high and high-middle SDI) saw small decreases.
INTERPRETATION: The absolute burden of benign prostatic hyperplasia is rising at an alarming rate in most of the world, particularly in low-income and middle-income countries that are currently undergoing rapid demographic and epidemiological changes. As more people are living longer worldwide, the absolute burden of benign prostatic hyperplasia is expected to continue to rise in the coming years, highlighting the importance of monitoring and planning for future health system strain.
FUNDING: Bill & Melinda Gates Foundation.
TRANSLATION: For the Amharic translation of the abstract see Supplementary Materials section.
METHODS: Studies published up to June 10, 2022, were searched in PubMed, Web of Science, Scopus, VIP, Wanfang, and China National Knowledge Infrastructure databases and screened for eligibility. Then, the combined odds ratio (OR) of the included studies was estimated based on five genetic models, i.e., homozygous (Met/Met vs. Thr/Thr), heterozygous (Thr/Met vs. Thr/Thr), dominant (Thr/Met + Met/Met vs. Thr/Thr), recessive (Met/Met vs. Thr/Thr + Thr/Met) and allele (Met vs. Thr). The study protocol was preregistered at PROSPERO (registration number: CRD42021235704).
RESULTS: Overall, our meta-analysis of 14 eligible studies involving 12,905 subjects showed that the p.Thr241Met polymorphism was significantly associated with increased glioma risk in both homozygous and recessive models (homozygous, OR = 1.381, 95% CI = 1.081-1.764, P = 0.010; recessive, OR = 1.305, 95% CI = 1.140-1.493, P<0.001). Subgroup analyses by ethnicity also revealed a statistically significant association under the two aforementioned genetic models, but only in the Asian population and not in Caucasians (P>0.05).
CONCLUSION: We demonstrated that the XRCC3 p.Thr241Met polymorphism is associated with an increased risk of glioma only in the homozygous and recessive models.
OBJECTIVES: The aim of this study was to assess the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during AGPs, and to examine the association between risk severity and the number of AGPs performed per day. The efficacy of personal protective equipment (PPE) was also assessed.
MATERIAL AND METHODS: This cross-sectional cohort study was based on an online questionnaire form completed by 629 general and specialized dentists between January 1 and February 28, 2021. The collected data referred to the sources of COVID-19 infection, the type of PPE used and the number of AGPs performed each day by dental healthcare professionals (DHCPs). For each question, the absolute numbers of responses as well as percentages were calculated.
RESULTS: Among the 629 DHCPs, 113 (17.97%) contracted COVID-19. The risk of contracting COVID-19 during AGPs was the same as in the case of non-AGPs, and the infection risk was not associated with the number of AGPs performed per day. The efficacy of a surgical mask with a face shield/eye goggles was higher in comparison with all other types of PPE. Differences in the infection risk across the different types of PPE used were statistically significant (p < 0.001).
CONCLUSIONS: The risk of COVID-19 transmission during AGPs is the same as in the case of non-AGPs. Thus, restrictions on the performance of elective AGPs should be lifted. On the other hand, the best protection during AGPs is provided by a surgical mask with a face shield/eye goggles.
OBJECTIVE: With the growing body of evidence supporting the use of eHealth interventions, the intention is to conduct a meta-analysis on various health outcomes of eHealth interventions among ischaemic heart disease (IHD) patients.
METHODS: Based on PRISMA guidelines, eligible studies were searched through databases of Web of Science, Scopus, PubMed, EBSCOHost, and SAGE (PROSPERO registration CRD42021290091). Inclusion criteria were English language and randomised controlled trials published between 2011 to 2021 exploring health outcomes that empower IHD patients with eHealth interventions. RevMan 5.4 was utilised for meta-analysis, sensitivity analysis, and risk of bias (RoB) assessment while GRADE software for generating findings of physical health outcomes. Non-physical health outcomes were analysed using SWiM (synthesis without meta-analysis) method.
RESULTS: This review included 10 studies, whereby, six studies with 895 participants' data were pooled for physical health outcomes. Overall, the RoB varied significantly across domains, with the majority was low risks, a substantial proportion of high risks and a sizeable proportion of unclear. With GRADE evidence of moderate to high quality, eHealth interventions improved low density lipoprotien (LDL) levels in IHD patients when compared to usual care after 12 months of interventions (SMD -0.26, 95% CI [-0.45, -0.06], I2 = 0%, p = 0.01). Significance appraisal in each domain of the non-physical health outcomes found significant findings for medication adherence, physical activity and dietary behaviour, while half of the non-significant findings were found for other behavioural outcomes, psychological and quality of life.
CONCLUSIONS: Electronic Health interventions are found effective at lowering LDL cholesterol in long-term but benefits remain inconclusive for other physical and non-physical health outcomes for IHD patients. Integrating sustainable patient empowerment strategies with the advancement of eHealth interventions by utilising appropriate frameworks is recommended for future research.
OBJECTIVE: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019.
EVIDENCE REVIEW: The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs).
FINDINGS: In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles.
CONCLUSIONS AND RELEVANCE: The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.
METHODS: This study proposed a deterministic, compartmental model with contact tracing and vaccination components. We defined contact tracing effectiveness as the proportion of contacts of a positive case that was successfully traced and the vaccination rate as the proportion of daily doses administered per population in Malaysia. Sensitivity analyses on the untraced and infectious populations were conducted.
RESULTS: At a vaccination rate of 1.4%, contact tracing with an effectiveness of 70% could delay the peak of untraced asymptomatic cases by 17 d and reduce it by 70% compared with 30% contact tracing effectiveness. A similar trend was observed for symptomatic cases when a similar experiment setting was used. We also performed sensitivity analyses by using different combinations of contact tracing effectiveness and vaccination rates. In all scenarios, the effect of contact tracing on COVID-19 incidence persisted for both asymptomatic and symptomatic cases.
CONCLUSIONS: While vaccines are progressively rolled out, efficient contact tracing must be rapidly implemented concurrently to reach, find, test, isolate and support the affected populations to bring COVID-19 under control.
METHODS: We estimated population-level distributions of haemoglobin concentration by age and sex for each location from 1990 to 2021. We then calculated anaemia burden by severity and associated years lived with disability (YLDs). With data on prevalence of the causes of anaemia and associated cause-specific shifts in haemoglobin concentrations, we modelled the proportion of anaemia attributed to 37 underlying causes for all locations, years, and demographics in the Global Burden of Disease Study 2021.
FINDINGS: In 2021, the global prevalence of anaemia across all ages was 24·3% (95% uncertainty interval [UI] 23·9-24·7), corresponding to 1·92 billion (1·89-1·95) prevalent cases, compared with a prevalence of 28·2% (27·8-28·5) and 1·50 billion (1·48-1·52) prevalent cases in 1990. Large variations were observed in anaemia burden by age, sex, and geography, with children younger than 5 years, women, and countries in sub-Saharan Africa and south Asia being particularly affected. Anaemia caused 52·0 million (35·1-75·1) YLDs in 2021, and the YLD rate due to anaemia declined with increasing Socio-demographic Index. The most common causes of anaemia YLDs in 2021 were dietary iron deficiency (cause-specific anaemia YLD rate per 100 000 population: 422·4 [95% UI 286·1-612·9]), haemoglobinopathies and haemolytic anaemias (89·0 [58·2-123·7]), and other neglected tropical diseases (36·3 [24·4-52·8]), collectively accounting for 84·7% (84·1-85·2) of anaemia YLDs.
INTERPRETATION: Anaemia remains a substantial global health challenge, with persistent disparities according to age, sex, and geography. Estimates of cause-specific anaemia burden can be used to design locally relevant health interventions aimed at improving anaemia management and prevention.
FUNDING: Bill & Melinda Gates Foundation.
METHODS: The present study was a descriptive-analytical study in which the records of 1361 patients who underwent cardiovascular surgery and were on a mechanical ventilator during 2019-2020 at the Imam Ali Heart Center in Kermanshah city were examined. The data collection tool was a three-part researcher-made questionnaire including demographic characteristics, health records, and clinical variables. Data analysis was done using descriptive and inferential statistical tests and SPSS Version 25 software.
RESULTS: In this study, of the 1361 patients, 953 (70%) were male. The results indicated that 78.6% of patients had short-term mechanical ventilation, and 21.4% had long-term mechanical ventilation. There was a statistically significant relationship between the history of smoking, drug use, and baking bread with the type of mechanical ventilation (P
METHODS: This descriptive cross-sectional study aimed to assess Al Ain University students' knowledge of Human Monkeypox. A validated questionnaire was distributed to students between lectures. The respondents' knowledge of human Monkeypox was assessed by 21 questions that examined the participants' knowledge of Monkeypox as follows: 5 items examined knowledge of the source, definition, and incubation time; 2items assessed the mechanism of transmission of human Monkeypox, 7 items assessed the signs and symptoms; 7 items assessed the preventative measures; and 6 items assessed the treatment modalities. A multivariate logistic regression model was used to identify the factors influencing respondents' knowledge of human Monkeypox among university students.
RESULTS: A total of five hundred and fifty-eight (558) students participated in the study. The average knowledge score was 70.1%, with a 95% confidence interval (CI) of 68.9 - 71.3. Of the total participants, 111 (19.9%) had poor knowledge about human Monkeypox, 320 (57.3%) had moderate knowledge, and 127 (22.8%) had good knowledge. The results of the statistical modelling showed that Old age (OR 0.681; 95% CI 1.005-1.016), female gender (OR 1.26; 95% CI 0.813 -0.961), participants from medical colleges (OR 1.22; 95% CI 1.13 -1.32) having a history of human chickenpox infection (OR 2.6; 95% CI 2.3-2.9) and receiving information on human Monkeypox during education (OR 1.14; 95% CI 1.05-1.2) were strong determinants for good knowledge about human Monkeypox.
CONCLUSION: knowledge of Monkeypox among the participants is relatively low, particularly regarding the epidemiology, symptoms and treatments. Therefore, increasing knowledge of Monkeypox will be key to enhancing the capacity to respond to human monkeypox cases and to relay pertinent data to a disease surveillance system.
METHODS AND RESULTS: A multidisciplinary panel of fifty-two international experts comprising Hepatologists, Endocrinologists, Diabetologists, Cardiologists and Family Physicians from six continents (Asia, Europe, North America, South America, Africa and Oceania) participated in a formal Delphi survey and developed consensus statements on the association between MAFLD and the risk of CVD. Statements were developed on different aspects of CVD risk, ranging from epidemiology to mechanisms, screening, and management.
CONCULSIONS: The expert panel identified important clinical associations between MAFLD and the risk of CVD that could serve to increase awareness of the adverse metabolic and cardiovascular outcomes of MAFLD. Finally, the expert panel also suggests potential areas for future research.
METHODS AND ANALYSIS: Scopus, PubMed, Cochrane, Web of Science and ProQuest will be searched from database inception to February 2023 using PEO search strategy (Population: adults with COPD; Exposure: inflammatory markers; Outcomes: lung function, muscle force and exercise capacity). Four reviewers working in pairs will independently screen articles for eligibility and extract data that fulfilled the inclusion criteria. Depending on the design of the included studies, either Cochrane risk-of-bias version 2 or the Newcastle-Ottawa Scale tools will be used to rate the methodological quality of the included studies. Effect sizes reported in each individual study will be standardised to Cohen's d and a random effects model will be used to calculate the pooled effect size for the association.
ETHICS AND DISSEMINATION: Ethical approval is unnecessary as this study will only use publicly available data. The findings will be disseminated through publication in peer-reviewed journals and conferences.
PROSPERO REGISTRATION NUMBER: CRD42022284446.
METHODS: This was a retrospective cohort study involving two hepatobiliary centres from January 1, 2012, to June 30, 2018. Medical records were analysed for sociodemographic, clinical characteristics, laboratory testing, and HCC treatment information. Survival outcomes were examined using the Kaplan-Meier and log-rank test. Prognostic factors were determined using multivariate Cox regression.
RESULTS: A total of 212 patients were included in the study. The median survival time was 22 months. The 1-, 3-, and 5-year survival rates were 64.2%, 34.2%, and 18.0%, respectively. Palliative treatment (adjusted hazard ratio [AHR] = 2.82, 95% confidence interval [CI] 1.75-4.52), tumour size ≥ 5 cm (AHR = 2.02, 95%CI: 1.45-2.82), traditional medication (AHR = 1.94, 95%CI: 1.27-2.98), raised alkaline phosphatase (AHR = 1.74, 95%CI: 1.25-2.42), and metformin (AHR = 1.44, 95%CI: 1.03-2.00) were significantly associated with poor prognosis for HCC survival. Antiviral hepatitis treatment (AHR = 0.54, 95% CI: 0.34-0.87), nonalcoholic fatty liver disease (NAFLD) (AHR = 0.50, 95% CI: 0.30-0.84), and family history of malignancies (AHR = 0.50, 95%CI: 0.26-0.96) were identified as good prognostic factors for HCC survival.
DISCUSSION: Traditional medication, metformin treatment, advanced stage and raised alkaline phosphatase were the poor prognostic factors, while antiviral hepatitis treatment, NAFLD, and family history of malignancies were the good prognostic factors for our HCC cases comorbid with T2D.
METHODS: This study was a two-arm parallel randomized controlled trial. Twenty-eight patients with coronary heart disease were randomly assigned to either the intervention group, receiving a 12-week technology-assisted intervention (n = 14), or the control group (n = 14), receiving usual care. Guided by the Health Belief Model, the intervention group received three center-based, supervised exercise training sessions, a fitness watch that served as a cue to action, six educational videos, and a weekly video call. The Self-efficacy for Exercise, exercise capacity, and Health Promoting Lifestyle Profile II were assessed at baseline and immediately post-intervention (12-weeks).
RESULTS: Among the 28 patients who participated in this study, 85.7% completed the program, with a relatively low attrition rate (14.3%). The number of exercise training sessions accomplished by the participants in the intervention group was 51.27 ± 19.41 out of 60 sessions (85.5%) compared to 36.46 ± 23.05 (60.8%) in the control group. No cardiac adverse events or hospitalizations were reported throughout the study. Participants in the intervention group showed greater improvement in health-promoting behaviors when compared with the control group at 12 weeks. Within-group effects demonstrated improvement in exercise self-efficacy and exercise capacity among participants in the intervention group. A participant satisfaction survey conducted immediately post-intervention revealed that participants were "very satisfied" (23.1%) and "satisfied" (76.9%) with the technology-assisted intervention.
CONCLUSIONS: The findings demonstrated that technology-assisted intervention in a hybrid cardiac rehabilitation program was feasible and suggested to be beneficial in improving exercise self-efficacy, exercise capacity, and health promoting behavior among patients with coronary heart disease. A full-scale study is needed to determine its effectiveness in the long term.
TRIAL AND PROTOCOL REGISTRATION: ClinicalTrials.gov NCT04862351. https://clinicaltrials.gov/ct2/show/NCT04862351.