Whole-Genome Sequencing Reveals Temporal Trends in Antibiotic Resistance Genes in Escherichia coli Causing Pediatric Urinary Tract Infections in Central Vietnam.

(1) Background: Pediatric urinary tract infections (UTIs) pose significant challenges due to drug-resistant Escherichia coli (E. coli) strains. This study utilizes whole-genome sequencing to analyze temporal trends in antibiotic resistance genes (ARGs) in clinical E. coli isolates from pediatric UTI cases in central Vietnam. (2) Methods: We conducted whole-genome sequencing on 71 E. coli isolates collected from pediatric UTI patients between 2018 and 2020. ARGs were identified, and their prevalence over time was analyzed. Statistical tests were used to correlate ARG presence with antibiotic resistance. (3) Results: Of the 47 E. coli isolates with complete data, 40 distinct ARGs were identified, with a median of 10 resistance genes per isolate. A significant increase in the total number of ARGs per isolate was observed over time, from an average of 8.88 before June 2019 to 11.63 after. Notably, the prevalence of the aadA2 gene (aminoglycoside resistance) rose from 0% to 26.7%, and that of the blaNDM-5 gene (beta-lactam and carbapenem resistance) increased from 0% to 23.3%. Key correlations include blaEC with cephalosporin resistance, blaNDM-5 with carbapenem resistance, and sul2 with sulfamethoxazole/trimethoprim resistance. (4) Conclusions: Whole-genome sequencing reveals complex and evolving antibiotic resistance patterns in pediatric E. coli UTIs in central Vietnam, with a marked increase in ARG prevalence over time. Continuous surveillance and targeted treatments are essential to address these trends. Understanding genetic foundations is crucial for effective intervention strategies.

Airborne particulate matter integral assessment in Magdalena department, Colombia: Patterns, health impact, and policy management.

The relevance of atmospheric particulate matter (PM) to health and the environment is widely known. Long-term studies are necessary for understanding current and future trends in air quality management. This study aimed to assess the long-term PM concentration in the Magdalena department (Colombia). It focused on the following aspects: i) spatiotemporal patterns, ii) correlation with meteorology, iii) compliance with standards, iv) temporal trends over time, v) impact on health, and vi) impact of policy management. Fifteen stations from 2003 to 2021 were analyzed. Spearman-Rho and Mann-Kendall methods were used to correlate concentration with meteorology. The temporal and five-year moving trends were determined, and the trend magnitude was calculated using Teil-Sen. Acute respiratory infection odd ratios and risk of cancer associated with PM concentration were used to assess the impact on health. The study found that the maximum PM10 concentration was 194.5 µg/m3, and the minimum was 3 µg/m3. In all stations, a negative correlation was observed between PM10 and atmospheric water content, while the wind speed and temperature showed a positive correlation. The global trends indicated an increasing value, with five fluctuations in five-year moving trends, consistent with PM sources and socio-economic behavior. PM concentrations were found to comply with national standard; however, the results showed a potential impact on population health. The management regulation had a limited impact on increasing concentration. Considering that national regulations tend to converge towards WHO standards, the study area must create a management program to ensure compliance.

Secular Trends in Gross Motor Coordination: A Study of Peruvian Children Living at High Altitude.

PURPOSE: To (1) describe secular trends in gross motor coordination (GMC) scores by sex and age; (2) investigate GMC trends adjusted for concomitant secular trends in height, weight, and overall physical fitness; and (3) examine trends in children's frequencies within different GMC categories. METHOD: The sample comprises 1562 Peruvian children (690 in 2009 and 872 in 2019), aged 6-11 years, from Junín (a high-altitude region). GMC was assessed with the KörperkoordinationsTest für Kinder. Physical fitness was assessed with handgrip strength, standing long jump, and shuttle-run test. Height and weight were measured with standardized protocols. Analysis of variance, covariance, and logistic regression were used. RESULTS: A negative secular trend in GMC (based on raw scores) for boys and girls aged 6-8 years was observed. However, a positive trend was observed at 11 years of age but only in boys. Finally, there were no significant changes in the likelihood of children having below-normal GMC from 2009 to 2019. CONCLUSIONS: Secular trends in GMC were negative in Peruvian children, especially at 6-8 years of age. Further, body size and physical fitness trends did not affect the negative secular trend. A high prevalence of children had below-normal GMC in both 2009 and 2019.

Prostate cancer temporal and regional trends in Brazil.

Objectives: The Brazilian Unified Health System (Sistema Único de Saúde-SUS) is the universal public healthcare system of Brazil that maintains a nationwide database of its patients. Our primary objective was to analyze regional and temporal trends, while our secondary goal was to establish correlations between states' health economy status and their prostate cancer (PCa) epidemiology. Methods: We analyzed Brazil's nationwide data on prostate cancer (PCa) incidence, mortality, and care gathered between 2013 and 2021 by the Information Technology Department of SUS (DATA-SUS), updated monthly using the International Classification of Diseases (ICD-10) code. Results: In the period, 273,933 new cases of PCa and 135,336 PCa deaths were reported in men aged 50 years or over in Brazil. The median annual PCa-specific incidence rate (PCSIR) ranged from 14.7 in the Southeast to 6.9 in the North region and the median annual PCa-specific mortality rate (PCSMR) ranged from 7.7 in the Northeast to 6.0 in the South region (per 10,000 men >50). The median annual mortality to incidence ratio (MIR) was highest in the North (0.88) and lowest in the Southeast region (0.44). There were significant regional differences in PCa treatment rates (per new cases); the Midwest region had the highest median annual surgery rate (0.63) while the North region had the highest median annual systemic therapy rate (0.75) and the lowest radiation therapy rate (0.06). Temporal analysis of the data showed significant change in annual rate trends after the year 2018 for PCSIR (coefficient [ß] = +3.66, p < 0.001), any treatment (ß = -0.06, p = 0.016), surgery ([SR] ß = +0.05, p = 0.017) radiation therapy ([RTR] ß = -0.06, p = 0.005) and systemic therapy ([STR] ß = -0.10, p = 0.002). After the 2020 pandemic, annual PCSIR decreased (ß = -2.15, p = 0.002) but annual PCSMR, MIR, and treatment rates remained stable. Correlation studies showed that the PCSIR was strongly negatively correlated with STR (p < 0.001) and positively correlated with RTR (p = 0.004). MIR was positively correlated with STR (p < 0.001) and negatively correlated with the number of robotic surgical systems per million population (p = 0.003). Conclusion: Our data shows that PCa care is dependent on the region and is likely influenced by access to treatment options. Furthermore, changes after the year 2018 underscore the influence of international guidelines on Brazilian clinicians' decision-making especially concerning population screening which in turn affected incidence and treatment rates. Limitation of our study includes limited patient-related information and data on private practices as well as an unknown impact of traveling patients.

Temporal trends in cross-country inequalities of stroke and subtypes burden from 1990 to 2021: a secondary analysis of the global burden of disease study 2021.

Background: Stroke remains a significant global health challenge, with persistent disparities in burden across different countries and regions. This study aimed to assess the temporal trends in cross-country inequalities of stroke and its subtypes burden from 1990 to 2021. Methods: We conducted a secondary analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The age-standardised disability-adjusted life years (DALYs) rate (ASDR) was used to assess the burden of stroke and its subtypes (ischemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage) across 21 GBD regions and 204 countries. The slope index of inequality (SII) and the concentration index were calculated to quantify the absolute and relative cross-country inequalities in the burden of stroke and its subtypes, with negative values indicating a higher burden in lower socio-demographic index (SDI) countries, and positive values indicating a higher burden in higher SDI countries. Estimated annual percentage change (EAPC) was used to illustrate temporal trends at global and regional levels from 1990 to 2021. The inequality changing patterns from 1990 to 2021 were classified as worsening, improving, and shifting to higher burdens among higher or lower SDI countries. Findings: From 1990 to 2021, the ASDR of total stroke decreased from 3078.95 (95% uncertainty interval [UI]: 2893.58, 3237.34) to 1886.20 (95% UI: 1738.99, 2017.90) per 100,000 population globally. While both absolute and relative inequalities increased, with a disproportionately higher burden shouldered by countries with lower SDI. The SII of total stroke exhibited a worsening inequality among lower SDI countries, increasing by 286.97 units from -2329.47 (95% confidence interval [CI]: -2857.50, -1801.43) in 1990 to -2616.44 (95% CI: -2987.33, -2245.56) in 2021. Similarly, the concentration index of total stroke increased by 0.03 from -0.0819 (95% CI: -0.1143, -0.0495) in 1990 to -0.1119 (95% CI: -0.1478, -0.0759) in 2021. The changing patterns from 1990 to 2021 were diverse across regions, yet most regions exhibited a worsening inequality among lower SDI countries in both SII and concentration index. Southern Sub-Saharan Africa showed the largest worsening inequality in SII (EAPC: -2.15, 95% CI: -2.71, -1.57) while Central Europe showed the largest worsening inequality in concentration index (EAPC: -0.51, 95% CI: -0.58, -0.44). In 2021, the highest negative SII was observed in Oceania and the highest negative concentration index was in the Caribbean. In terms of subtypes, ischemic stroke reported a worsening inequality among lower SDI countries in SII (EAPC: -2.13, 95% CI: -2.20, -2.05) while intracerebral haemorrhage showed an improving inequality in SII (EAPC: 0.44, 95% CI: 0.40, 0.47). SII in subarachnoid haemorrhage (EAPC: -0.18, 95% CI: -0.19, -0.17) and concentration index in ischemic stroke (EAPC: -0.25, 95% CI: -0.27, -0.23) presented a shift to higher burden among lower SDI countries from 1990 to 2021. Interpretation: Although the burden of stroke and its subtypes decreased from 1990 to 2021, inequalities have persisted and even widened in some regions. Timely and effective prevention and management strategies for stroke and its subtypes are needed in specific areas to reduce the stroke burden and achieve equity in health outcomes. Funding: None.

Global, regional, and national burden of bladder cancer, 1990-2019: an age-period-cohort analysis based on the Global Burden of Disease 2019 study.

OBJECTIVES: Bladder cancer is a common malignancy worldwide, with substantial morbidity and mortality. This study aimed to assess the global, regional, and national burden of bladder cancer from 1990 to 2019 using data from the Global Burden of Disease (GBD) 2019 study and to analyze the trends using an age-period-cohort (APC) model. STUDY DESIGN: In this cross-sectional study, secondary analyses were conducted to assess the burden of bladder cancer using data from GBD 2019. METHODS: Bladder cancer prevalence, incidence, mortality, disability-adjusted life years (DALYs), and their age-standardized rates (ASRs) were obtained from the GBD 2019 study. The estimated annual percentage changes (EAPCs) were calculated to quantify the trends in ASRs. An APC analysis was performed to distinguish the effects of age, period, and cohort on the observed temporal trends. RESULTS: The global prevalence of bladder cancer increased substantially from 1990 to 2019, reaching 2,869,046.4 cases (95% UI: 2,614,200.3-3,114,474.4) in 2019. The age-standardized prevalence rate rose from 20.9 per 100,000 population in 1990 to 37.1 per 100,000 population in 2019, with an EAPC of 1.97 (95% CI: 1.93-2.01). The global burden of bladder cancer, as measured by DALYs, increased from 48.0 per 100,000 population in 1990 to 56.8 per 100,000 population in 2019, with an EAPC of 0.47 (95% CI: 0.4-0.53), demonstrating the growing impact of this disease on population health. CONCLUSIONS: This study demonstrates a significant increase in prevalence, incidence, mortality, and DALYs, with substantial variations across sociodemographic index (SDI) quintiles and GBD regions. The findings emphasize the need for concerted efforts at the global, regional, and national levels to reduce the burden of bladder cancer through primary prevention, early detection, and improved access to treatment services.

Trends and multi-model prediction of hepatitis B incidence in Xiamen.

Background: This study aims to analyze the trend of Hepatitis B incidence in Xiamen City from 2004 to 2022, and to select the best-performing model for predicting the number of Hepatitis B cases from 2023 to 2027. Methods: Data were obtained from the China Information System for Disease Control and Prevention (CISDCP). The Joinpoint Regression Model analyzed temporal trends, while the Age-Period-Cohort (APC) model assessed the effects of age, period, and cohort on hepatitis B incidence rates. We also compared the predictive performance of the Neural Network Autoregressive (NNAR) Model, Bayesian Structural Time Series (BSTS) Model, Prophet, Exponential Smoothing (ETS) Model, Seasonal Autoregressive Integrated Moving Average (SARIMA) Model, and Hybrid Model, selecting the model with the highest performance to forecast the number of hepatitis B cases for the next five years. Results: Hepatitis B incidence rates in Xiamen from 2004 to 2022 showed an overall declining trend, with rates higher in men than in women. Higher incidence rates were observed in adults, particularly in the 30-39 age group. Moreover, the period and cohort effects on incidence showed a declining trend. Furthermore, in the best-performing NNAR(10, 1, 6)[12] model, the number of new cases is predicted to be 4271 in 2023, increasing to 5314 by 2027. Conclusions: Hepatitis B remains a significant issue in Xiamen, necessitating further optimization of hepatitis B prevention and control measures. Moreover, targeted interventions are essential for adults with higher incidence rates.

Epidemiology of Gestational Trophoblastic Disease.

Worldwide incidence rates of gestational trophoblastic disease (GTD) are difficult to estimate and compare due to large methodological differences within and between countries. Asia has generally reported higher incidence rates than Europe and North America, but modern reports have demonstrated a temporal decrease of GTD incidence rates in Asia and an increase in some European countries and North America. The main risk factors for hydatidiform mole are maternal age and previous molar events. Future studies on the epidemiology of GTD should include gestational trophoblastic neoplasia and international collaborative studies on this rare disease should be encouraged.

Temporal Trends in Patient Characteristics and Clinical Outcomes of TAVR: Over a Decade of Practice.

Background/Objective: Transcatheter aortic valve replacement (TAVR) is indicated for severe aortic stenosis patients with a prohibitive surgical risk. However, its use has been expanding in recent years to include intermediate- and low-risk patients. Thus, registry data describing changes in patient characteristics and outcomes are needed. The aim of this study was to analyse the temporal changes in patient profiles and clinical outcomes of all-comer TAVR. Methods: Baseline characteristics and VARC-3 outcomes of 1632 consecutive patients undergoing TAVR between 2008 and 2021 were analysed. Results: The annual rate of TAVR increased from 30 procedures in 2008-2009 to 398 in 2020-2021. Over the follow-up period, patient age decreased from 85 ± 4 to 80 ± 6.8 (p < 0.001) and the STS score decreased from 5.9% to 2.8% (p < 0.001). Procedural characteristics significantly changed, representing a shift into a minimally invasive approach: adoption of local anaesthesia (none to 48%, p < 0.001) and preference of transfemoral access (74% in 2011-2012 vs. 94.5% in 2020-2021, p < 0.001). The rates of almost all procedural complications decreased, including major vascular and bleeding complications, acute kidney injury (AKI) and in-hospital heart failure. There was a striking decline in rates of complete atrioventricular block (CAVB) and the need for a permanent pacemaker (PPM). PPM rates, however, remain high (17.8%). Thirty-day and one-year mortality significantly declined to 1.8% and 8.3%, respectively. Multivariable analysis shows that AKI, bleeding and stroke are strong predictors of one-year mortality (p < 0.001). Conclusions: The TAVR procedure has changed dramatically during the last 14 years in terms of patient characteristics, procedural aspects and device maturity. These shifts have led to improved procedural safety, contributing to improved short- and long-term patient outcomes.

Vascular disease and ischemic stroke in patients with atrial fibrillation: Temporal trends and age-related differences.

BACKGROUND AND AIMS: We examined temporal trends and age-related differences in the prevalence of vascular diseases and in their association with ischemic stroke (IS) risk in patients with atrial fibrillation (AF). METHODS: The registry-based FinACAF study covered all patients with AF in Finland during 2007-2018. Incidence rate ratios (IRRs) of IS were computed with Poisson regression, and the interaction of vascular diseases with age and calendar year period was assessed. RESULTS: We identified 229,565 patients (50.0 % female; mean age 72.7 years) with incident AF. The overall prevalence of any vascular disease was 28.6 %, and the prevalence increased from 2007 to 2018, primarily among patients over 75 years. Overall, 5909 (2.6 %) patients experienced IS within the first year after AF diagnosis. Crude IS rate decreased continuously during the study period in both patients with and without vascular diseases, with the rates remaining consistently higher in patients with vascular diseases. Vascular diseases were independently associated with higher IS incidence among patients under 65 years (adjusted IRR with 95 % confidence interval 1.35 (1.10-1.66)), while among older patients, only peripheral artery disease was associated with IS, and other vascular conditions had no association with IS. No interactions between the calendar year period and vascular diseases with IS rate were observed. CONCLUSIONS: The association between vascular diseases and IS has remained stable over time and vascular diseases were independently associated with higher incidence of IS particularly in patients with AF under the age of 65.

Demographic disparities in the incidence and case fatality of subarachnoid haemorrhage: an 18-year nationwide study from New Zealand.

Background: Although the incidence and case-fatality of subarachnoid haemorrhage (SAH) vary within countries, few countries have reported nationwide rates, especially for multi-ethnic populations. We assessed the nationwide incidence and case-fatality of SAH in New Zealand (NZ) and explored variations by sex, district, ethnicity and time. Methods: We used administrative health data from the national hospital discharge and cause-of-death collections to identify hospitalised and fatal non-hospitalised aneurysmal SAHs in NZ between 2001 and 2018. For validation, we compared these administrative data to those of two prospective Auckland Regional Community Stroke Studies. We subsequently estimated the incidence and case-fatality of SAH and calculated adjusted rate ratios (RR) with 95% confidence intervals to assess differences between sub-populations. Findings: Over 78,187,500 cumulative person-years, we identified 5371 SAHs (95% sensitivity and 85% positive predictive values) resulting in an annual age-standardised nationwide incidence of 8.2/100,000. In total, 2452 (46%) patients died within 30 days after SAH. Compared to European/others, Maori had greater incidence (RR = 2.23 (2.08-2.39)) and case-fatality (RR = 1.14 (1.06-1.22)), whereas SAH incidence was also greater in Pacific peoples (RR = 1.40 (1.24-1.59)) but lesser in Asians (RR = 0.79 (0.71-0.89)). By domicile, age-standardised SAH incidence varied between 6.3-11.5/100,000 person-years and case fatality between 40 and 57%. Between 2001 and 2018, the SAH incidence of NZ decreased by 34% and the case fatality by 12%. Interpretation: Since the incidence and case-fatality of SAH varies considerably between regions and ethnic groups, caution is advised when generalising findings from focused geographical locations for public health planning, especially in multi-ethnic populations. Funding: NZ Health Research Council.

Temporal trends in lower extremity amputation in Middle East and North Africa (MENA) region: analysis of the GBD dataset 1990-2019.

BACKGROUND: Lower extremity amputations (LEAs) significantly contribute to mortality and morbidity, often resulting from peripheral artery disease and diabetes mellitus (DM). Traumatic injuries also account for many LEAs. Despite the global burden, the epidemiology of LEAs, particularly in the Middle East and North Africa (MENA) region, remains underexplored. This study utilizes the Global Burden of Disease (GBD) dataset to analyze temporal trends in LEAs in the MENA region from 1990 to 2019. METHODS: The study utilized the 2019 GBD dataset, which includes estimates for incidence, prevalence, and disability-adjusted life-years (DALYs) across 369 diseases. Age-standardized incidence rates (ASIRs) for LEAs were extracted for 21 MENA countries. Trends were analyzed using percentage change calculations and Joinpoint regression to identify significant shifts in LEA rates over time. RESULTS: From 1990 to 2019, male LEA rates generally decreased, while female rates increased. Significant increases in LEA rates were observed in Syria, Yemen, and Afghanistan, correlating with periods of conflict and instability. Conversely, countries like Iraq, Palestine, Sudan, Lebanon, Iran, and Kuwait saw marked decreases. The study highlighted a complex interplay of socio-political factors, natural disasters, and chronic diseases like DM in shaping LEA trends across the region. CONCLUSION: The study reveals variable LEA trends in the MENA region, influenced by conflicts, natural disasters, and chronic diseases. These findings underscore the need for targeted public health interventions, improved healthcare access, and robust data collection systems to reduce the burden of LEAs and improve patient outcomes in the MENA region.

Exploring Prostate Cancer Incidence Trends and Age Change in Cancer Registration Areas of Jiangsu Province, China, 2009 to 2019.

(1) Background: Over the past few decades, Jiangsu Province, China, has witnessed a remarkable surge in the incidence of prostate cancer (PCa), accompanied by notable demographic shifts; (2) Methods: PCa data for Jiangsu Province from 2009 to 2019 were obtained from the Jiangsu Cancer Registry. We calculated crude and age-specific incidence rates (ASIRs), average age at onset, and age-specific composition ratios. Standardization was performed based on the Segi's world population. Birth cohorts (1929-2019) were analyzed to assess PCa incidence by birth year. Trend analysis was conducted using the Joinpoint Regression Model, and average annual percent changes (AAPCs) with corresponding 95% confidence interval (CI) were computed. A linear regression model was used to analyze the relationship between the average age at diagnosis and calendar years; (3) Results: The ASIRs of PCa in Jiangsu Province increased significantly, with an AAPC of 11.25% (95%CI: 10.09%, 12.42%) from 2009 to 2019. This increase was observed across all age groups, particularly among those aged 0-59 years. Birth cohort analysis revealed a rising trend with earlier birth years showing higher incidence, notably in the 1959 cohort. In rural areas, the age-standardized average age at onset of PCa decreased from 75.45 years in 2009 to 73.39 years in 2019, and the peak age group shifted from 75-79 years in 2009 to 70-74 years in 2019; (4) Conclusions: The rising incidence of PCa in Jiangsu Province, along with an increased proportion of cases in younger age groups, highlights the need for targeted interventions.

Global increase of lianas in tropical forests.

Lianas profoundly affect tropical forests dynamics, reducing productivity and carbon storage, which underscores the importance of monitoring change in their abundance in projecting the future of the global terrestrial carbon store. While increasing liana populations are documented within the Neotropics, the global consistency of these patterns is questioned, and remains to be determined. To evaluate pantropical trends in liana abundance comprehensively and quantitatively, we conducted a systematic literature review and meta-analysis. This approach allowed us to synthesize data from published longitudinal studies examining liana trends across the tropics. We calculated standardized effect sizes and standard errors, and applied a Bayesian hierarchical meta-analytic model to adjust for publication bias. Our analysis reveals an overall pan-tropical increase in lianas abundance, occurring at an average rate of 1.7 ± 0.7 SE% per year (~10% to 24% per decade). This upward trend, confirmed to be robust against publication bias, extends beyond Neotropical regions, indicating a widespread phenomenon. Although a global trend of increasing liana abundance is evident, significant local variation exist, attributable to differences in life cycle stages, abundance metrics, forest successional stages, and biogeographical realms. Notably, increases in stem density of saplings and biomass of canopy lianas, especially in old-growth forests, point to global climatic drivers and heightened turnover rates in tropical forests as factors promoting sustained liana growth in the canopy and clonal colonization in the understory. These trends suggest that the rise in liana abundance may not only persist but could also intensify under climate change. Considering both previous and current research on lianas, our findings confirm growing concerns about lianas' expanding impact on pan-tropical carbon storage, highlighting their significant potential effect on global carbon dynamics.

Temporal trends in adherence to lifestyle recommendations of patients with hypertension in Korea, 2007-2021.

Adherence to lifestyle recommendations is crucial in managing hypertension, independent of medical treatment. This study aimed to evaluate the implementation of adherence to lifestyle recommendations and analyze the trends in adherence to lifestyle recommendations among patients with hypertension in Korea from 2007 to 2021 using the Korea National Health and Nutrition Examination Survey (KNHANES). The study included adults aged ≥20 years. Factors such as regular physical activity, smoking and alcohol abstinence, weight and stress management, and adherence to a healthy diet were analyzed. In 2021, A doublefold increase was observed in the proportion of patients with hypertension who adhered to sodium restriction compared to 2007. However, 70% of patients with hypertension consume more sodium than recommended. Moreover, potassium intake has steadily decreased since 2014, with only 23.8% of patients with hypertension meeting the recommended intake. The body mass index (BMI) and waist circumference of patients with hypertension have gradually increased, with fewer patients maintaining an appropriate weight. The neglect of diet and weight control among young patients with hypertension who experience high stress levels poses challenges in modifying their lifestyles. Patients with hypertension in Korea still consume high amounts of sodium, whereas potassium intake is gradually decreasing. Additionally, obesity rates have been increasing, especially among young patients with hypertension. A multidisciplinary approach is necessary for improving the lifestyle habits of hypertensive patients.

Temporal trends of per- and polyfluoroalkyl substances concentrations: Insights from Australian human biomonitoring 2002-2021 and the U.S. NHANES programs 2003-2018.

Perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA) are persistent contaminants detected in human blood worldwide, raising significant health concerns. In response, countries such as the United States and Australia have implemented regulatory measures to limit their use. This study analysed temporal trends in serum concentrations of these four PFAS and how these trends align with regulatory measures, using data from NHANES (2003-2004 to 2017-2018) and the Australian Human Biomonitoring Program (2002-2003 to 2020-2021). Multiple regression analyses adjusted for age and gender were performed to estimate mean concentration changes over time, and differences within each dataset were assessed. Results indicated significant reductions (p < 0.001) in PFOS, PFOA, and PFHxS concentrations post-2002-2003, while PFNA concentrations increased until 2009-2010 before declining in both Australia and the U.S. Age-related trends in the U.S. during the last monitoring period showed higher PFAS concentrations in the oldest age groups, while in Australia, this trend was evident for PFOS and PFHxS. In Australia, the age group of 0-5 years had PFOA and PFNA concentrations similar to those of adults over 46 years, indicating ongoing exposure. Gender differences were consistent in both programs, with females aged 6-15, 31-45, and 46-60 years exhibiting lower serum concentrations, particularly in the 31-45 years age group. These findings support Australian and U.S. efforts to reduce PFAS exposure through regulatory actions, highlight the need to address ongoing exposure in young children, and consider gender-specific factors affecting PFAS concentrations.

The utility of temporal trends of blood biomarkers as predictors for bloodstream infections in left ventricular assist device recipients.

BACKGROUND: Temporal trends of routinely obtained parameters may provide valuable information for predicting BSIs, but this association has not yet been established in LVAD patients. METHODS: This retrospective analysis included data from 347 consecutive recipients of three rotary LVAD types. Study endpoints included the incidence of BSI, the association of temporal trends of routinely obtained blood biomarkers with the development of BSIs, the incidence of BSIs, and survival on LVAD support. RESULTS: During follow-up, 47.8% (n = 166) of the patients developed BSI. In multivariate analyses, the development of BSI was a significant predictor of mortality (HR 5.78, 95% CI 4.08-8.19, p < 0.0001). In univariate analyses, after adjusting for potential confounders, albumin (SHR 0.94, 95% CI 0.91-0.97, p < 0.00010), creatinine (SHR 1.49, 95% CI 1.03-2.15, p = 0.033), and C-reactive protein (SHR 1.19, 95% CI 1.08-1.32, p = 0.0007) significantly predicted the development of BSIs during LVAD support. Notably, the strength of the association of parameter changes with the prediction of BSIs demonstrated a time-dependent correlation in the cases of albumin (p = 0.045) and creatinine (p = 0.003). CONCLUSION: Bloodstream infections are highly prevalent among LVAD recipients and are independent predictors of mortality. Temporal biomarker trends significantly predict the development of BSIs. These findings suggest opportunities for interventions aiming to reduce the incidence of BSIs.

Evidence for differences in patterns of temporal trends in meta-analyses of diagnostic accuracy studies in the Cochrane database of systematic reviews.

OBJECTIVES: Temporal trends in comparative meta-analyses of interventions are well-recognized in the medical literature. For studies of diagnostic test accuracy (DTA), evidence of temporal trends is growing and the importance of assessing and reporting them has been highlighted in recent guidelines on postmarket surveillance in several jurisdictions. In this study, we evaluate the prevalence and patterns of time trends using a larger and more up-to-date set of DTA systematic reviews than has previously been examined, from the Cochrane Database of Systematic Reviews. STUDY DESIGN AND SETTING: Cumulative meta-analysis was conducted on bivariate random effects meta-analysis estimates of sensitivity and specificity, after ranking studies by publication date. Trends for all studies were assessed graphically using plots of summary estimates by study rank, and using receiver operating characteristic plots of sensitivity vs specificity. Linear trends were also described using weighted linear regression with autocorrelated errors of summary estimates against study rank. Various patterns of nonlinear trends were characterized descriptively. RESULTS: The analysis included 46 reviews (92 meta-analyses) conducted between 2017 and 2022. The total number of studies within all reviews was 1486, with a median (IQR) 7134 (2782-16,406) participants per review. Reviews had a median (IQR) time span of 19 (15-25) publication years. Time trends in at least 1 DTA measure were observed in 40 (87%) reviews, and statistically significant linear trends in 32 (71%) reviews. Nonlinear time trends were observed in 16 (35%) reviews. There was no evidence for a trend in either DTA measure in 6 (13%) reviews. CONCLUSION: The study contributes evidence on the variety in patterns of linear and nonlinear temporal DTA trends which has not previously been described. We recommended researchers check statistical assumptions of trend analysis methods, eg, using graphical methods. Further research into potential reasons for time trends could contribute to the robustness of future meta-analyses.

Impact of COVID-19 on temporal trends and health risks of urinary metal concentrations among residents of Guangzhou, China.

Long-term biomonitoring of urinary metal ions is an essential tool for the epidemiological assessment of chronic exposure levels, enabling us to track changes in metal exposure over time and better understand its health implications. In this study, we evaluated the temporal trends of urinary metal ions among 1962 residents of Guangzhou, China, from 2018 to 2022. The total metal ion concentrations in the urine of the population did not change significantly between 2018 and 2019. With the onset of the COVID-19 pandemic in 2020, urinary total metal ion concentrations began to decline dramatically, reaching their lowest level in 2021. A rebound in concentrations was observed in 2022, which returned to the initial levels observed in 2018. Urine chromium and cadmium concentrations peaked in 2020, while urinary lead levels were the highest in 2021, and urinary nickel concentrations were the highest in 2022. Males consistently displayed higher urinary concentrations of lead and arsenic throughout each year of the study. Furthermore, minors consistently had higher urinary nickel levels than adults, whereas adults consistently had higher urinary cadmium concentrations than minors. Cluster analyses were conducted annually on urinary metal ions to examine the differences in their distribution and to evaluate changes in metal exposure patterns over time. The Monte Carlo simulations indicate that the whole population exhibits a high non-carcinogenic risk from arsenic exposure and significant carcinogenic risks associated with exposure to nickel, arsenic, chromium, and cadmium. The next two years were predicted by a gray prediction model, and the results are tested using mean absolute percentage error which demonstrating high accuracy.

Temporal trends of exposure to the herbicide glyphosate in the United States (2013-2018): Data from the National Health and Nutrition Examination Survey.

Glyphosate, the most widely used herbicide in the United States, is applied to control broadleaf weeds and grasses. Public concern is mounting over how pesticides affect human and environmental health. Glyphosate toxicity in animals is known, but human carcinogenicity is controversial, and limited epidemiologic evidence suggests associations between exposure and respiratory diseases (e.g., asthma) and adverse child neurodevelopment. Understanding the extent of the general U.S. population exposure to glyphosate is important. To examine temporal trends in exposure to glyphosate, we determined urinary concentrations of glyphosate among U.S. children and adults from three cycles of the National Health and Nutrition Examination Survey (NHANES) conducted 2013-2018. Most of the population (70.0%-81.7%, depending on cycle) was exposed, including children as young as 3 years of age. Concentrations decreased from 2013 to 2018 by 38%; the decline was smaller in younger age groups. The downward trend likely reflects changes in glyphosate use resulting, at least in part, from changes in agricultural practices, regulatory actions, and shifts in public awareness regarding glyphosate toxicity. Continuing glyphosate biomonitoring will help understand how changes in use and actions to restrict applications of this common pesticide affect human exposures.