Explore the vast range of titles available.

Background Stroke is a major global health concern, particularly for women of childbearing age (WCBA), who face unique biological and sociodemographic risks. This study analyzes temporal trends in stroke incidence, prevalence, disability‐adjusted life‐year (DALY), and deaths among WCBA at global, regional, and national levels over the past three decades, using age–period–cohort (APC) modeling. Methods Stroke burden data for WCBA from 1992 to 2021 across 204 countries were extracted from the Global Burden of Disease (GBD) 2021 study. An APC model assessed annual percentage changes in stroke burden (net drift), age group‐specific trends (local drift), and relative risks associated with age, period, and cohort factors. Future stroke burden was projected using Bayesian APC models through 2030. Results From 1992 to 2021, global stroke incidence cases among WCBA increased from 638,478 to 779,371, but ASIR and AS‐DALYs declined. High‐SDI regions consistently had the lowest stroke rates, while middle‐ and low‐SDI regions, particularly China and India, accounted for a significant portion of global cases. Despite declines in some regions, countries like the Philippines and Pakistan exhibited rising trends. Projections to 2030 indicate a continued increase in stroke incidence cases, with higher rates expected in middle‐income countries due to emerging risk factors like obesity and gestational diabetes. Conclusions While ASIR and AS‐DALYs declined globally, rising incidence case numbers and persistent disparities highlight the need for targeted prevention and policy strategies, particularly in low‐ and middle‐income regions, to reduce the stroke burden among WCBA.

Background Maternal disorders remain a significant global health challenge with inequalities across sociodemographic strata. This study examines the global burden of six maternal disorders—Maternal Hemorrhage, Maternal Sepsis and Other Maternal Infections, Maternal Hypertensive Disorders, Maternal Obstructed Labor and Uterine Rupture, Maternal Abortion and Miscarriage, and Ectopic Pregnancy—from 1990 to 2021, focusing on disease burden trends and disparities across sociodemographic indices. Methods We analyzed Global Burden of Disease Study 2021 data for women aged 15 to 49 years, examining disability-adjusted life years (DALYs) and incidence rates. The Sociodemographic Index (SDI) was used to contextualize inequalities across 204 countries and territories. Slope and concentration indices quantified absolute and relative disparities. Decomposition analyses explored demographic and epidemiological drivers of DALYs changes, while joinpoint regression identified temporal trend shifts. Age-period-cohort analysis examined incidence patterns, and Bayesian age-period-cohort modeling projected future trends to 2044, with internal and external validation. Results Global maternal disorder burden declined substantially from 1990 to 2021, with DALYs rates decreasing from 1,609.33 to 622.97 per 100,000 women. However, while absolute disparities narrowed between high and low-SDI regions, relative inequalities persisted or increased for most disorders. Low-SDI regions experienced slower burden reductions, primarily driven by population growth offsetting epidemiological improvements. Decomposition analyses revealed that population growth remains a central barrier to progress, while epidemiological advances substantially reduced DALYs across all disorders. Projections through 2044 suggest continued incidence declines globally, with validated models indicating persistent inequities requiring sustained intervention. Conclusion Despite overall global improvements in maternal health outcomes, persistent inequalities highlight the need for targeted interventions in low-SDI regions. Enhanced maternal healthcare access, improved nutrition programs, and strengthened health systems may help address these disparities and promote more equitable maternal health outcomes.

ObjectiveTo study the epidemiology and trends of HCV infection among women aged 15-49, this research aims to inform public health strategies and reduce its global impact by addressing maternal and child transmission risks.DesignThis research analyzed GBD data (1990-2021) on HCV in women aged 15-49, examining ASIR, ASPR, ASMR, and ASDR trends by region and age. APC and Bayesian models predicted future trajectories to guide public health policies.ResultsFrom 1990 to 2021, the global burden of hepatitis C virus (HCV) among women aged 15 - 49 witnessed a downward trend. The incidence rate (5.46 per 100,000) and mortality rate (0.068 per 100,000) of acute HCV were notably lower than those of chronic HCV, which stood at an incidence rate of 29.92 per 100,000 and a mortality rate of 1.42 per 100,000. In 2021, regions with a low Sociodemographic Index (SDI) endured the heaviest burden. Oceania, Central Asia, Eastern Europe, and several other regions experienced an upward trend in acute HCV cases; meanwhile, the number of chronic HCV cases increased in most regions, with the exception of Australasia. Pakistan had the highest HCV burden globally. Projections indicate that over the next decade, both the incidence and mortality rates of HCV will continue to decline, yet the total number of cases is expected to rise.ConclusionThis study reveals the complex epidemiological landscape of acute and chronic hepatitis C in women of reproductive age globally. Despite the anticipated decline in standardized incidence and mortality rates of acute and chronic hepatitis C among women of reproductive age worldwide in the coming decade, the actual number of cases continues to increase annually. This underscores the substantial challenges faced by the World Health Organization's goal of eliminating HCV infection by 2030.

Background Financial risk protection (FRP) is central to Universal Health Coverage (UHC), aiming to shield individuals from financial hardship when accessing essential healthcare services. This study estimates trends and projections for FRP indicators in Vietnam from 2010 to 2030 at both national and sub-national levels, assesses the probability of achieving UHC targets, and analyses demographic-, geographic-, and socioeconomic-related inequalities. Methods Data from 168,812 households collected in six nationally representative surveys (2010–2020) were analysed. FRP coverage was evaluated using indicators including catastrophic health expenditure (CHE), impoverishing health expenditure (IHE), further impoverishing health expenditure (FIE), financial hardship expenditure (FHE), and the revised SDG 3.8.2 indicator, across multiple thresholds (10%, 15%, 25%, 40%). Bayesian models projected trends and estimated the probability of achieving the 2030 UHC targets. Inequality analyses using relative, slope, and concentration indices were conducted across ethnicity, dependency ratio, urban-rural residence, region, wealth quintile, and educational level. Findings National FRP coverage was relatively high in 2020 (78.1%–94.9%), with modest improvements projected for 2030 (81.4%–95.4%). However, probabilities of achieving UHC targets remain low, with only protection from IHE showing moderate prospects (83.6%). Ethnic minorities, rural households, and those with high dependency ratios were consistently disadvantaged, especially regarding IHE and FHE. Regional disparities were pronounced, with lower coverage in Central highland and Central Coast regions, compared to the Southeast and Red River Delta regions. Significant socioeconomic inequalities persisted, disproportionately affecting the poorest and least educated groups. Inequality gaps widened over time, particularly among regions and educational levels. Interpretation Our findings suggest that Vietnam is unlikely to achieve full financial risk protection by 2030, given modest projected improvements and low probabilities of meeting UHC targets. Persistent and widening inequalities, particularly by region and educational level, underscore the need for targeted health financing reforms that prioritize disadvantaged groups such as ethnic minorities, rural households, and those with high dependency ratios. Strengthening social health insurance, expanding fiscal space for health, and integrating financial protection policies with broader poverty reduction and social development programs will be critical for advancing equity and moving closer to UHC in Vietnam.

Colorectal cancer is among the leading causes of cancer worldwide. Processed meat was known to be positively associated with a higher risk of gastrointestinal cancer. This study focused on the long-time trends of colorectal cancer mortality attributable to high processed meat intake in China from 1990 to 2019 and the projection for the next decade based on data obtained from the Global Burden of Disease 2019 study. We used an age-period-cohort model to fit the long-time trend. The joinpoint model was conducted to estimate the average and annual change of the attributable mortality. The Bayesian age-period-cohort model was used to project the crude attributable mortality from 2020 to 2030. An upward trend in colorectal cancer mortality attributable to high processed meat intake was observed for both sexes in China from 1990 to 2019, with an overall net drift of 4.009% for males and 2.491% for females per year. Projection analysis suggested that the burden of colorectal cancer incidence and mortality would still be high. Our findings suggested that colorectal cancer death attributable to high processed meat intake is still high in China, and elderly males were at higher risk. Gradually decreasing the intake of processed meat could be an effective way to reduce colorectal cancer mortality.

Background Respiratory infections (RTIs) have a serious impact on global health, especially those under the age of 19. Method Using the 2021 Global Burden of Disease (GBD) dataset, this study assessed the RTIs burden in adolescents and analysed life years for life loss and disability-adjusted life years. Studies examined the burden of disease at the global, regional and national levels over the past 30 years using a Bayesian age-period-cohort approach. In addition, the study explores sociodemographic factors influencing the burden of disease and assesses health inequalities through inequality slope and concentration indexes. Finally, the study predicts the trend of adolescent RTIs through 2040. Result Globally, while incidence and prevalence increased, Disability-Adjusted Life Years (DALYs) decreased, with a decline in age-adjusted rate (ASR) for all. Zambia had the lowest estimated annual percentage change (EAPC) for incidence and prevalence, and China for DALYs. From 1990 to 2020, RTI case numbers, crude rates, and ASR rose, with females having slightly higher rates than males. Joinpoint regression indicated significant declines from 1990–2021. Inequality analysis showed a burden in high-Socio-demographic Index (SDI) countries, reflecting increased relative inequality. Predictions suggest rising incidence and prevalence after 2030, while DALYs will continue to decline. Conclusion Despite significant advancements in prevention and treatment over the past three decades, projections indicate an increasing trend in respiratory infections among children and adolescents. However, effective public health strategies and ongoing research remain crucial for global disease management.

Trends of persistent low fertility and increasing life expectancy have set Germany to undergo rapid population ageing and decline. In the context of the Syrian refugee crisis, immigration has been considered as a key mechanism to combat these demographic outlooks. This study assesses the demographic impact of Syrian migration into Germany. Deterministic and Bayesian probabilistic projection methods are used to determine the contribution of Syrian migrants to aggregate total fertility rate and the likelihood of subsequent population growth. Findings reveal that Syrian migration is projected to increase German period total fertility but not by the required levels to prevent depopulation. Whilst Syrian migration into Germany has been substantial over the past few years, fertile female cohorts are largely underrepresented in the migrant population and so only a moderate net-effect of Syrian migrants on German fertility is forecasted. A solution to Germany’ population decline may thus not be offered through Syrian migration, with depopulation projected to be a likely scenario.

Quantifying interactive effects of environmental drivers on population dynamics can be critical for a robust analysis of population viability. Fire regimes, among the most widespread disturbances driving population dynamics, are increasingly modified by and interact with human activities. However, viability of fire-adapted species is typically assessed overlooking disturbance interactions, potentially resulting in suboptimal management actions. We investigated whether increasing human disturbances in fire-prone ecosystems may pose a threat or an opportunity to improve population viability, using demographic data of the carnivorous, post-fire recruiting plant Drosophyllum lusitanicum, endemic to heathlands in the southwestern Mediterranean Basin. We built integral projection models and simulated population dynamics under different combinations of two key disturbance types affecting populations: fire and livestock browsing and trampling. We used perturbation analyses to determine potential long-term consequences of maintaining fundamentally different disturbance types. Despite most populations inhabiting browsed habitats, simulations showed a greater extinction risk in populations under high livestock pressure compared with ones under low or moderate pressures. Extinction risk decreased when fire return intervals shortened in populations under low or moderate livestock pressure; however, the opposite pattern emerged in heavily browsed populations, where short intervals between fires increased extinction. Elasticity analyses showed that decreases in viability under frequent disturbance interactions (heavy browsing and frequent fire) may be explained by selection against seed dormancy in populations with frequent browsing and trampling. This may potentially cause populations to collapse when fires kill above-ground plants without populations being able to recover from a seed bank. Synthesis and applications. Incorporating disturbance interactions can result in a different assessment of viability of a fire-adapted species than considering fire regimes alone. In Mediterranean ecosystems, fire management may be more effective when integrating moderate human activities. However, replacing fires by human disturbances, a currently widespread strategy in many fire-prone ecosystems, is not recommended since it may fundamentally alter population dynamics and selection pressures and decrease viability of fire-adapted species.

Background Numerical solutions of the chemical master equation (CME) are important for understanding the stochasticity of biochemical systems. However, solving CMEs is a formidable task. This task is complicated due to the nonlinear nature of the reactions and the size of the networks which result in different realizations. Most importantly, the exponential growth of the size of the state-space, with respect to the number of different species in the system makes this a challenging assignment. When the biochemical system has a large number of variables, the CME solution becomes intractable. We introduce the intelligent state projection ( ISP ) method to use in the stochastic analysis of these systems. For any biochemical reaction network, it is important to capture more than one moment: this allows one to describe the system’s dynamic behaviour. ISP is based on a state-space search and the data structure standards of artificial intelligence ( AI ). It can be used to explore and update the states of a biochemical system. To support the expansion in ISP , we also develop a Bayesian likelihood node projection ( BLNP ) function to predict the likelihood of the states. Results To demonstrate the acceptability and effectiveness of our method, we apply the ISP method to several biological models discussed in prior literature. The results of our computational experiments reveal that the ISP method is effective both in terms of the speed and accuracy of the expansion, and the accuracy of the solution. This method also provides a better understanding of the state-space of the system in terms of blueprint patterns. Conclusions The ISP is the de-novo method which addresses both accuracy and performance problems for CME solutions. It systematically expands the projection space based on predefined inputs. This ensures accuracy in the approximation and an exact analytical solution for the time of interest. The ISP was more effective both in predicting the behavior of the state-space of the system and in performance management, which is a vital step towards modeling large biochemical systems.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age, defined by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. It is associated with infertility, metabolic abnormalities, and an increased cardiovascular risk. This study provides an updated and comprehensive analysis of PCOS burden from 1990 to 2021 using the latest Global Burden of Disease (GBD) dataset, focusing on trends, regional disparities, and future projections. Data on the prevalence, incidence, and disability-adjusted life years (DALYs) associated with PCOS were obtained from the GBD 2021. Temporal trends were evaluated using estimated annual percentage change (EAPC). Regional disparities were examined by stratifying data according to the socio-demographic index (SDI). Age-Period-Cohort (APC) modeling was employed to investigate disease dynamics across age groups and birth cohorts, while Bayesian Age-Period-Cohort (BAPC) models were utilized to project global burden trends through 2036. In 2021, there were 65.8 million prevalent cases, 1.18 million incident cases, and 0.58 million DALYs due to PCOS globally. Middle SDI regions showed the highest growth rates in prevalence (EAPC 1.73%), incidence (EAPC 1.39%), and DALYs (EAPC 1.72%). Adolescents aged 15-19 demonstrated the highest incidence rates, while the peak prevalence shifted to women aged 30-34. High SDI regions had the highest age-standardized rates (ASRs), whereas Southeast Asia exhibited the most rapid growth. BAPC models forecast continued increases in PCOS burden, with prevalence projected to reach 77.87 million by 2036, though the age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) are expected to decline. PCOS represents an urgent global health challenge, with rising burdens, especially in middle-income regions. Targeted and equitable interventions are essential to improve early diagnosis, raise public awareness, and mitigate long-term health and socioeconomic consequences.