1,058 research outputs found
Surgical outcomes of gallbladder cancer: the OMEGA retrospective, multicentre, international cohort study
No full textBackground: Gallbladder cancer (GBC) is rare but aggressive. The extent of surgical intervention for different GBC stages is non-uniform, ranging from cholecystectomy alone to extended resections including major hepatectomy, resection of adjacent organs and routine extrahepatic bile duct resection (EBDR). Robust evidence here is lacking, however, and survival benefit poorly defined. This study assesses factors associated with recurrence-free survival (RFS), overall survival (OS) and morbidity and mortality following GBC surgery in high income countries (HIC) and low and middle income countries (LMIC). Methods: The multicentre, retrospective Operative Management of Gallbladder Cancer (OMEGA) cohort study included all patients who underwent GBC resection across 133 centres between 1st January 2010 and 31st December 2020. Regression analyses assessed factors associated with OS, RFS and morbidity. Findings: On multivariable analysis of all 3676 patients, wedge resection and segment IVb/V resection failed to improve RFS (HR 1.04 [0.84–1.29], p = 0.711 and HR 1.18 [0.95–1.46], p = 0.13 respectively) or OS (HR 0.96 [0.79–1.17], p = 0.67 and HR 1.48 [1.16–1.88], p = 0.49 respectively), while major hepatectomy was associated with worse RFS (HR 1.33 [1.02–1.74], p = 0.037) and OS (HR 1.26 [1.03–1.53], p = 0.022). Furthermore, EBDR (OR 2.86 [2.3–3.52], p < 0.0010), resection of additional organs (OR 2.22 [1.62–3.02], p < 0.0010) and major hepatectomy (OR 3.81 [2.55–5.73], p < 0.0010) were all associated with increased morbidity and mortality. Compared to LMIC, patients in HIC were associated with poorer RFS (HR 1.18 [1.02–1.37], p = 0.031) but not OS (HR 1.05 [0.91–1.22], p = 0.48). Adjuvant and neoadjuvant treatments were infrequently used. Interpretation: In this large, multicentre analysis of GBC surgical outcomes, liver resection was not conclusively associated with improved survival, and extended resections were associated with greater morbidity and mortality without oncological benefit. Aggressive upfront resections do not benefit higher stage GBC, and international collaborations are needed to develop evidence-based neoadjuvant and adjuvant treatment strategies to minimise surgical morbidity and prioritise prognostic benefit. Funding:Cambridge Hepatopancreatobiliary Department Research Fund. © 2023 The Author(s
Surgical outcomes of gallbladder cancer: the OMEGA retrospective, multicentre, international cohort study [Elektronisk resurs]
No full textBackground: Gallbladder cancer (GBC) is rare but aggressive. The extent of surgical intervention for different GBC stages is non-uniform, ranging from cholecystectomy alone to extended resections including major hepatectomy, resection of adjacent organs and routine extrahepatic bile duct resection (EBDR). Robust evidence here is lacking, however, and survival benefit poorly defined. This study assesses factors associated with recurrence-free survival (RFS), overall survival (OS) and morbidity and mortality following GBC surgery in high income countries (HIC) and low and middle income countries (LMIC). Methods: The multicentre, retrospective Operative Management of Gallbladder Cancer (OMEGA) cohort study included all patients who underwent GBC resection across 133 centres between 1st January 2010 and 31st December 2020. Regression analyses assessed factors associated with OS, RFS and morbidity. Findings: On multivariable analysis of all 3676 patients, wedge resection and segment IVb/V resection failed to improve RFS (HR 1.04 [0.84–1.29], p = 0.711 and HR 1.18 [0.95–1.46], p = 0.13 respectively) or OS (HR 0.96 [0.79–1.17], p = 0.67 and HR 1.48 [1.16–1.88], p = 0.49 respectively), while major hepatectomy was associated with worse RFS (HR 1.33 [1.02–1.74], p = 0.037) and OS (HR 1.26 [1.03–1.53], p = 0.022). Furthermore, EBDR (OR 2.86 [2.3–3.52], p < 0.0010), resection of additional organs (OR 2.22 [1.62–3.02], p < 0.0010) and major hepatectomy (OR 3.81 [2.55–5.73], p < 0.0010) were all associated with increased morbidity and mortality. Compared to LMIC, patients in HIC were associated with poorer RFS (HR 1.18 [1.02–1.37], p = 0.031) but not OS (HR 1.05 [0.91–1.22], p = 0.48). Adjuvant and neoadjuvant treatments were infrequently used. Interpretation: In this large, multicentre analysis of GBC surgical outcomes, liver resection was not conclusively associated with improved survival, and extended resections were associated with greater morbidity and mortality without oncological benefit. Aggressive upfront resections do not benefit higher stage GBC, and international collaborations are needed to develop evidence-based neoadjuvant and adjuvant treatment strategies to minimise surgical morbidity and prioritise prognostic benefit. Funding:Cambridge Hepatopancreatobiliary Department Research Fund. © 2023 The Author(s
Types of Scientific Collaborators: A Perspective of Author Contribution Network
No full textThe purpose of this study is to investigate interaction between collaborators within individual studies by measuring how they made contributions to their studies. Author contribution network is constructed based on the author contribution statements of 140,000 full-text articles in PloS by viewing every collaborator as a node and a shared contribution as an edge. Three types of contributors are identified: general team-players, factotums, and mavericks. The preliminary result suggests that division of labor widely exists in scientific re-search and the latter two types of collaborators are common in small teams.Made available in DSpace on 2018-07-12T15:28:19Z (GMT). No. of bitstreams: 2
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Previous issue date: 201
Hospital-based caregiver intervention for people following hip fracture surgery (HIP HELPER) : multicentre randomised controlled feasibility trial with embedded qualitative study in England
No full textObjectives: To assess the feasibility of conducting a pragmatic, multi-centre randomised controlled trial (RCT) to test the clinical and cost-effectiveness of an informal caregiver training programme to support the recovery of people following hip fracture surgery.
Design: Two-arm, multi-centre, pragmatic, open, feasibility RCT with embedded qualitative study.
Setting: National Health Service (NHS) providers in five English hospitals.
Participants: Community-dwelling adults, aged 60 years and over, who undergo hip fracture surgery and their informal caregivers.
Intervention: Usual care: usual NHS care.
Experimental: usual NHS care plus a caregiver-patient dyad training programme (HIP HELPER). This programme comprised of three, one-hour, one-to-one training sessions for a patient and caregiver, delivered by a nurse, physiotherapist or occupational therapist in the hospital setting pre-discharge. After discharge, patients and caregivers were supported through three telephone coaching sessions. Randomisation and blinding: Central randomisation was computer generated (1:1), stratified by hospital and level of patient cognitive impairment. There was no blinding.
Main outcome measures: Data collected at baseline and four months post-randomisation included: screening logs, intervention logs, fidelity checklists, acceptability data and clinical outcomes. Interviews were conducted with a subset of participants and health professionals.
Results: 102 participants were enrolled (51 patients; 51 caregivers). Thirty-nine percent (515/1311) of patients screened were eligible. Eleven percent (56/515) of eligible patients consented to be randomised. Forty-eight percent (12/25) of the intervention group reached compliance to their allocated intervention. There was no evidence of treatment contamination. Qualitative data demonstrated the trial and HIP HELPER programme was acceptable.
Conclusions: The HIP HELPER programme was acceptable to patient-caregiver dyads and health professionals. The COVID-19 pandemic impacting on site’s ability to deliver the research. Modifications are necessary to the design for a viable definitive RCT.
Trial registration number: ISRCTN13270387 Data availability statement: The data that support the findings of this study are available from the corresponding author (TS) upon reasonable request. This includes access to the full protocol, anonymised participant-level dataset and statistical code.
STRENGTHS AND LIMITATIONS OF THIS STUDY
• Mixed-method approach provided useful feasibility and acceptability data.
• Assessment of diverse measures allowed evaluation of data collection for key outcome domains.
• Participant experiences and acceptability data suggest perceived value in the HIP HELPER programme. • 10% of the cohort were living with cognitive impairment; none were recruited to the qualitative sub-study. • COVID-19 pandemic affected NHS services, which impacted on study delivery
Publisher Correction: Global estimates on the number of people blind or visually impaired by cataract: a meta-analysis from 2000 to 2020
No full textFully disaggregated data is not available publicly due to data sharing agreements with some principal investigators yet requests for summary data can be made to the corresponding author.” Furthermore, the information in the “Funding” section was incomplete. The following information was added: “This study was funded by Brien Holden Vision Institute, Fondation Thea, Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation (LCIF), Sightsavers International, and University of Heidelberg.” The “Competing interests” section has been corrected from “The authors declare no competing interests” to the following detailed information: GBD 2019 Blindness and Vision Impairment Collaborators Declarations N S Bayileyegn reports participation on a Data Safety Monitoring Board or Advisory Board with Jimma University, and leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with Jimma University as a discipline committee member; outside the submitted work. S Bhaskar reports grants or contracts from the Japan Society for the Promotion of Science (JSPS), JSPS International Fellowship, Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT), the Australian Academy of Science, Grant-in-Aid for Scientific Research (KAKENHI); leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with Rotary District 9675 as the District Chair of Diversity, Equity, and Inclusion; the Global Health & Migration Hub Community and the Global Health Hub Germany (Berlin, Germany) as the Chair and Manager; PLOS One, BMC Neurology, Frontiers In Neurology, Frontiers in Stroke, Frontiers in Public Health and BMC Medical Research Methodology as an Editorial Board Member; and with the College of Reviewers, Canadian Institutes of Health Research (CIHR), and the Government of Canada as a Member; outside the submitted work. X Dai reports support for the present manuscript from the Institute for Health Metrics and Evaluation and the University of Washington. M Cenderadewi reports grants or contracts from James Cook University (International Research Training Program Scholarship for doctoral study), and support for attending meetings and travel from James Cook University; all outside the submitted work. M Foschi reports consulting fees from Roche; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Sanofi, Merck, and Novartis; support for attending meetings and travel from Novartis and Roche; leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with MSBase as a scientific leadership board member, and Cochrane Review Group for Multiple Sclerosis and other rate diseases of the CNS as a member; all outside the submitted work. F Ghassemi reports support for the present manuscript from medical writing. B N G Goulart reports stock or stock options with Bristo Myers-Squibb and Pfizer; outside the submitted work. V B Gupta reports grants or contracts from the National Health and Medical Research Council (NHMRC); outside the submitted work. S Hallaj reports support for the present manuscript from the National Institute of Health, Bridge to AI common fund (grant number: OT2 OD032644). I M Ilic reports support for the present manuscript from the Ministry of Education, Science and Technological development, Republic of Serbia (project No 175042, 2011-2023). S Islam reports support for the present manuscript from the National Health and Medical Research Council (NHMRC) Investigator Grant and the Heart Foundation Vanguard Grant. J H Kempen reports support for the present manuscript from Sight for Souls and Mass Eye and Ear Global Surgery Program; and leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with Sight for Souls as the President. K Krishan reports other non-financial support from the UGC Centre of Advanced Study, CAS II, awarded to the Department of Anthropology, Panjab University (Chandigarh, India); outside the submitted work. O P Kurmi reports grants or contracts from the British Council India paid to Coventry University; outside the submitted work. V C Lansingh reports consulting fees from HelpMeSee, and financial support for attending meetings and travel from HelpMeSee; outside the submitted work. J L Leasher leadership or fiduciary roles in board, society, committee or advocacy groups, unpaid with the National Eye Institute as a member and the National Eye Health Education Program as a planning committee member; outside the submitted work. M Lee reports support for the present manuscript from the Ministry of Education of the Republic of Korea, and the National Research Foundation of Korea (NRF-2021R1I1A4A01057428) and Bio-convergence Technology Education Program through the Korea Institute for Advancement Technology (KIAT) funded by the Ministry of Trade, Industry and Energy (No. P0017805). C McAlinden reports grants or contracts from the Welsh Government on the following study: Feasibility of an alternative pathway for hospital referrals from Diabetic Eye Screening Wales (DESW) for people suspected with sight-threatening diabetic eye disease (diabetic maculopathy). No funds will be received from the author’s institution or personally related to this study. Any work conducted as part of this study is as an unpaid collaborator; consulting fees from Acufocus (Irvine, California, USA), Atia Vision (Campbell, California, USA), Bausch and Lomb (Bridgewater, New Jersey, USA), BVI / PhysIOL (Liège, Belgium), Coopervision (Pleasanton, California, USA), Cutting Edge (Labége, France), Fudan University (Fudan, China), Hoya (Frankfurt, Germany), Knowledge Gate Group (Copenhagen, Denmark), Johnson & Johnson Surgical Vision (Santa Ana, California, USA), Keio University (Tokyo, Japan), Ludwig-Maximilians-University (München, Germany), Medevise Consulting SAS (Strasbourg, France), Novartis (Basel, Switzerland), Ophtec BV (Groningen, The Netherlands), Sun Yat-sen University (Guangzhou, China), SightGlass vision (Menlo Park, California, USA), Science in Vision (Bend, Oregan, USA), SpyGlass (Aliso Viejo, California, USA), Targomed GmbH (Bruchsal, Germany), University of São Paulo (São Paulo, Brazil), and Vold Vision (Arkansas, USA); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Scope (Crawley, UK), Bausch and Lomb (Bridgewater, New Jersey, USA), and Thea pharmaceuticals (Clemont-Ferrand, France); support for attending meetings and/or travel from Royal College of Ophthalmologists (London, UK), Scope (Crawley, UK), Portuguese Society of Ophthalmology (Portugal), British Society of Refractive surgery (BSRS), Thea pharmaceuticals (Clemont-Ferrand, France), Bausch and Lomb (Bridgewater, New Jersey, USA); leadership or fiduciary roles in board, society, committee or advocacy groups, paid or unpaid with the British Society of Refractive Surgery (BSRS) as an unpaid council member, and the Royal College of Ophthalmologists (London, UK) as an unpaid PROM advisor; other financial interests from the Quality of Vision (QoV) Questionnaire tool, the Orthokeratology and Contact Lens Quality of Life Questionnaire (OCL-QoL), and paid peer reviews for Research Square; outside of the submitted work. Finally, the section “Author Contributions” has been added and an Appendix with more detailed information for individual author contributions has been included in the form of electronic supplementary material. The original article has been corrected
Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
No full textBackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378-521), affecting 3·40 billion (3·20-3·62) individuals (43·1%, 40·5-45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7-26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6-38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5-32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7-2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed.FundingBill & Melinda Gates Foundation
Utilization of mechanical power and associations with clinical outcomes in brain injured patients : a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial
No full textFunding Information: The authors received no direct funding for this work. SW is supported by institutional research grants and the National Institutes of Health. MS receives support from NIMH K01MH115789. ST is supported by the Eliot Phillipson Clinician Scientist Training Program and Clinician Investigator Program at the University of Toronto. RDS is supported on NIA R33AG071744. Publisher Copyright: © 2023, The Author(s).Peer reviewe
Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050 : a systematic analysis for the Global Burden of Disease Study 2021
No full textFunding Information: This study is funded by the Bill & Melinda Gates Foundation. A Ahmad acknowledges support from the Deanship of Scientific Research at Shaqra University for supporting this work. S M Aljunid acknowledges support from the Department of Community Medicine, School of Medicine, International Medical University, Malaysia and Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. T Astell-Burt acknowledges support from an Australian Research Council (ARC) Future Fellowship (FT220100857). A Badawi acknowledges support from the Public Health Agency of Canada. R Bai acknowledges support in part by the National Natural Science Foundation of China (grant number 72204112) and the Social Science Fund of Jiangsu Province (grant number 21GLD008). O C Baltatu acknowledges support by the National Council for Scientific and Technological Development (CNPq, 304224/2022-7) and Anima Institute - AI (research professor fellowship). L Belo acknowledges support from from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. D A Bennett acknowledges support from the Medical Research Council Population Research Unit at the University of Oxford. A N Bhat acknowledges support from the Manipal Academy of Higher Education. M Carvalho acknowledges support from FCT in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of UCIBIO and the project LA/P/0140/2020 of i4HB. S B Chidambaram acknowledges the administrative support provided by JSS Academy of Higher Education & Research, Mysuru, India. S Cuschieri acknowledges support from the University of Malta. B B Duncan acknowledges support in part by the Brazilian National Council for Scientific and Technological Development (CNPq, research fellowship), and the Institute for Health Technology Assessment (IATS; 465518/2014-1). H A Edinur acknowledges support from the Ministry of Higher Education Malaysia (Fundamental Research Grant Scheme: FRGS/1/2020/STG03/USM/03/5). A Fatehizadeh acknowledges support from the Department of Environmental Health Engineering of Isfahan University of Medical Sciences, Isfahan, Iran. S Gaihre acknowledges support from the Institute of Applied Health Sciences (IAHS), School of Medicine, Medical Sciences and Nutrition (SMMSN), University of Aberdeen for providing time and necessary resources to work on this manuscript. R K Gautam acknowledges the work to their organization Department of Pharmacology, Indore Institute of Pharmacy, IIST Campus, Rau, Indore, 453331 (M.P.), India. V K Gupta acknowledges funding support from National Health and Medical Research Council (NHMRC), Australia. S Haque acknowledges support from Jazan University, Saudi Arabia for providing the access of Saudi Digital Library for this study. J Haubold acknowledges support from The Clinician Scientist Program of the Clinician Scientist Academy (UMEA) of the University Hospital Essen, funded by the German Research Foundation (DFG) (FU 356/12-2), provided Johannes Haubold with financial support. B-F Hwang acknowledges support from China Medical University, Taiwan (province of China) (CMU111-MF-55). N Ikeda acknowledges support from the National Institutes of Biomedical Innovation, Health and Nutrition, Japan. I M Ilic acknowledges support from project No 175042 supported by Ministry of Education, Science and Technological Development, Republic of Serbia, 2011-2023. M D Ilic acknowledges support from the Ministry of Science, and Technological Development and Innovation of the Republic of Serbia (no. 451-03-47/2023-01/200111). S M S Islam acknowledges support from the National Health and Medical Research Council of Australia (NHMRC) and has received funding from the National Heart Foundation of Australia. N E Ismail acknowledges AIMST University, Malaysia for institutional support. N Joseph acknowledges support from Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India in this research work. H Kandel acknowledges support from a Kornhauser Research Fellowship at the University of Sydney. M Kivimäki acknowledges support from the Wellcome Trust (221854/Z/20/Z), Medical Research Council (R024227), National Institute on Aging (R01AG062553), and Academy of Finland, Finland (350426). K Krishan acknowledges non-financial support from UGC Centre of Advanced Study, Phase II, awarded to the Department of Anthropology, Panjab University, Chandigarh, India, outside the submitted work. K Latief received funding from Taipei Medical University for Doctoral Education during the conduct of this review. M Lee acknowledges support from the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2021R1I1A4A01057428) and Bio-convergence Technology Education Program through the Korea Institute for Advancement Technology (KIAT) funded by the Ministry of Trade, Industry and Energy (No. P0017805). M-C Li acknowledges support from the National Science and Technology Council in Taiwan (province of China) (NSTC 111-2410-H-003-100-SSS). G Lopes acknowledges support from national funds through the Fundação para a Ciência e a Tecnologia (FCT) under the Scientific Employment Stimulus - Individual Call (CEECIND/01768/2021). S Lorkowski acknowledges institutional support from the Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig (Germany; German Federal Ministry of Education and Research; grant agreement number 01EA1808A). G Lucchetti is a Research Productivity Grantee of the Brazilian National Council for Scientific and Technological Development (CNPq) - type 1C. M A Mahmoud acknowledges the support from Taibah University to participate in this research project. D C Malta acknowledges support from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), FAPEMIG - Fundação de Amaparo a Pesquisa de Minas Gerais. H R Marateb acknowledges support from the Beatriu de Pinós post-doctoral programme from the Office of the Secretary of Universities and Research from the Ministry of Business and Knowledge of the Government of Catalonia program (#2020 BP 00261). E Mathews acknowledges support from the DBT/Wellcome Trust India Alliance Fellowship (grant number IA/CPHE/17/1/503345) and would like to thank Central University of Kerala, India. L Monasta acknowledges support from the Italian Ministry of Health (Ricerca Corrente 34/2017), payments made to the Institute for Maternal and Child Health IRCCS Burlo Garofolo. U Mons acknowledges support from Marga and Walter Boll Foundation, Kerpen, Germany. U O Mueller acknowledges funding by the German National Cohort Study. A Ortiz acknowledges Comunidad de Madrid en Biomedicina P2022/BMD-7223, CIFRA_COR-CM. Instituto de Salud Carlos III (ISCIII) RICORS program to RICORS2040 (RD21/0005/0001) funded by European Union – NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia (MRR). J R Padubidri acknowledges Manipal Academy of Higher Education, Manipal and Kasturba Medical College, Mangalore for their support towards collaborative research. V C F Pepito acknowledges institutional support from the Ateneo de Manila University. I Qattea acknowledges support from Nassau University Medical Centers and Cleveland Clinic Foundation. E M M Redwan acknowledges support from King Abdulaziz University (DSR), Jeddah, and King Abdulaziz City for Science & Technology (KACSAT), Saudi Arabia; and Science & Technology Development Fund (STDF), and US-Egypt Science & Technology joint Fund, The Academy of Scientific Research & Technology (ASRT), Egypt. L F Reyes acknowledges support from Universidad de La Sabana. M Rodrigues was supported by the Centre of Studies in Geography and Spatial Planning, funded by national funds through the Foundation for Science and Technology (FCT) under the reference UIDB/04084/2020. U Saeed acknowledges support from The International Center of Medical Sciences Research (ICMSR), Islamabad (44000), Pakistan. A Schuermans acknowledges support from the Belgian American Educational Foundation. N S Shah was supported by National Heart, Lung, and Blood Institute grant number K23HL157766. L M L R Silva was supported by the project code CENTRO-04-3559-FSE-000162, Fundo Social. M Tabish acknowledges support from the Deanship of Scientific Research at Shaqra University for this work. M Tonelli acknowledges support from the David Freeze Chair in Health Services Research. M R Tovani-Palone acknowledges Saveetha Institute of Medical and Technical Sciences for supporting this study. Z Wang acknowledges financial support from Fonds de recherche du Québec - Santé, China Scholarship Council, and McGill University Global Health Scholars Program. Mr Wang has also received consulting fees from the Fred Hollows Foundation. X Xu is supported by Heart Foundation Post-doctoral Fellowship funded by the Heart Foundation of Australia (Award No. 102597), and Scientia Program at the University of New South Wales, Australia. S B Zaman acknowledges receiving a scholarship from the Australian Government Research Training Program (RTP) in support of his academic career. A Zumla acknowledges support from the Pan African Network for Rapid Research, Response, and Preparedness for Infectious Diseases Epidemics Consortium (PANDORA-ID-NET), European and Developing Countries Clinical Trials Partnership the EU Horizon 2020 Framework Programme (EDCTP-RIA2016E-1609). Publisher Copyright: © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licensePeer reviewe
Global, regional, and national burden of stroke and its risk factors, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021
No full textBackground: Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990-2021.
Methods: We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age-standardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline.
Findings: In 2021, stroke was the third most common GBD level 3 cause of death (7·3 million [95% UI 6·6-7·8] deaths; 10·7% [9·8-11·3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160·5 million [147·8-171·6] DALYs; 5·6% [5·0-6·1] of all DALYs). In 2021, there were 93·8 million (89·0-99·3) prevalent and 11·9 million (10·7-13·2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65·3% (62·4-67·7), intracerebral haemorrhage constituted 28·8% (28·3-28·8), and subarachnoid haemorrhage constituted 5·8% (5·7-6·0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88·2% [53·4-117·7]), high ambient temperature (72·4% [51·1 to 179·5]), high fasting plasma glucose (32·1% [26·7-38·1]), diet high in sugar-sweetened beverages (23·4% [12·7-35·7]), low physical activity (11·3% [1·8-34·9]), high systolic blood pressure (6·7% [2·5-11·6]), lead exposure (6·5% [4·5-11·2]), and diet low in omega-6 polyunsaturated fatty acids (5·3% [0·5-10·5]).
Interpretation: Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden
Correction to: MASK 2017: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity using real-world-evidence
No full textFollowing publication of the original article [1], the authors reported that one of the collaborators’ names was spelled incorrectly. In this Correction the incorrect and correct author name are shown. In the author list of this Correction article, only the corresponding author and institutional author are presented
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