Incidence Geometry

Dementia is an increasing focus for policymakers, civil organizations and multidisciplinary researchers. The most recent descriptive epidemiological research into dementia is enabling investigation into how the prevalence and incidence are changing over time. To establish clear trends, such comparisons need to be founded on population-based studies that use similar diagnostic and research methods consistently over time. This narrative Review synthesizes the findings from 14 studies that investigated trends in dementia prevalence (nine studies) and incidence (five studies) from Sweden, Spain, the UK, the Netherlands, France, the USA, Japan and Nigeria. Besides the Japanese study, these studies indicate stable or declining prevalence and incidence of dementia, and some provide evidence of sex-specific changes. No single risk or protective factor has been identified that fully explains the observed trends, but major societal changes and improvements in living conditions, education and ...

Primary biliary cholangitis (PBC) has been regarded as female-predominant without evidence of gender difference in survival. We aimed to compare the overall survival, incidence and prevalence of PBC in two well defined population-based studies over a recent decade, considering also sex ratios and mortality. We have taken advantage of population-wide records, during 2000-2009, in Lombardia, Northern Italy, and Denmark. We focused on the incident cases of PBC, including gender and outcome, among 9.7 million inhabitants of Lombardia and 5.5 million of Denmark. In Lombardia there were 2,970 PBC cases with a female:male ratio of 2.3:1. The age/sex-adjusted annual incidence of PBC was 16.7 per million. Point prevalence was 160 per million on January 1 st 2009. In Denmark there were 722 cases of incident PBC, female:male ratio was 4.2:1, and the annual incidence was 11.4 per million, a point prevalence of 115 per million in 2009. Cox regression multivariate analysis identified male sex as an independent predictor of all-cause mortality in both Italian (HR 2.36) and Danish population (HR 3.04). Our data indicate for PBC a sex ratio significantly lower than previously cited, a reversal of the usual latitudinal difference in prevalence and a surprisingly higher overall mortality for male patients. Autoimmune diseases include more than 70 different conditions affecting approximately 5% of the population of developed countries 1 ; they are a major health problem and can greatly impair the quality of life of affected subjects. Primary biliary cholangitis (PBC), until recently known as Primary Biliary Cirrhosis 2-9 , is considered a model autoimmune disease because of the homogeneity among patients and the high disease specificity of the accompanying anti-mitochondrial and antinuclear antibodies (AMA, ANA); there has been an enormous effort in studying PBC in both humans and murine models . The pathogenesis of PBC remains enigmatic despite the well-established influence of environmental and genetic factors and including extensive immunological data . Reliable epidemiological data could suggest clues to etiology by identifying environmental factors, which initiate the disease in predisposed individuals. According to earlier data PBC is considered a disease predominantly affecting women with female:male (F:M) ratios of up to 10:1 and is therefore a prime example of the characteristic sexual dimorphism in autoimmunity. There is a wide variation among studies of incidence and prevalence rates, with rates increasing over time . Thus the annual incidence and prevalence rates of PBC per 100,000 inhabitants have ranged from 0.33-5.8 per 100,000 and 1.91-40.2, respectively 34 ; attributed to ethnic differences in study populations, methods, and case ascertainment. Most epidemiological studies are performed in developed countries. True population-based studies are scarce, and studies based on case finding are subject to obvious shortcomings which pertain also for other autoimmune diseases 35 . Indeed, there have been multiple attempts to understand the female predominance in a variety of autoimmune and inflammatory diseases .

Background In South Africa, large increases in early adult mortality during the 1990s and early 2000s have reversed since public HIV treatment rollout in 2004. In a rural population in KwaZulu-Natal, we investigate trends in parental mortality and orphanhood from 2000–2014. Methods Using longitudinal demographic surveillance data for a population of approximately 90,000, we calculated annual incidence and prevalence of maternal, paternal and double orphanhood in children and adolescents (<20 years) and, overall and cause-specific mortality of parents by age. Results The proportion of children and adolescents (<20 years) for whom one or both parents had died rose from 26% in 2000 to peak at 36% in 2010, followed by a decline to 32% in 2014. The burden of orphanhood remains high especially in the oldest age group: in 2014, 53% of adolescents 15–19 years had experienced the death of one or both parents. In all age groups and years, paternal orphan prevalence was three-five times ...

Lactation may protect women with previous gestational diabetes mellitus (GDM) from developing type 2 diabetes mellitus, but the results of existing studies are inconsistent, ranging from null to beneficial. We aimed to conduct a systematic review to gather available evidence. Databases MEDLINE, CINAHL, PubMed, and EMBASE were searched on December 15, 2015, without restriction of language or publication year. A manual search was also conducted. We included observational studies (cross-sectional, case-control, and cohort study) with information on lactation and type 2 diabetes mellitus incidence among women with previous GDM. We excluded case studies without control data. Data synthesis was conducted by random-effect meta-analysis. Fourteen reports of 9 studies were included. Overall risk of bias using RoBANS ranged from low to unclear. Longer lactation for more than 4 to 12 weeks postpartum had risk reduction of type 2 diabetes mellitus compared with shorter lactation (OR 0.77, 95% C...

Objective. To compile an injury profile of 46 fast bowlers aged 11 - 18 years, and to identify the associated risk factors for injury during one academy cricket season. Methods. The fast bowlers selected were tested and observed for one academy cricket season (March - November). Subjects were grouped into injury classifications (uninjured=S1; injured but able to play=S2; injured and unable to play=S3). Anthropometrical and postural data for the subjects were collected preseason (T1). Physical fitness screenings were conducted and the relationship between fitness and occurrence of injuries was assessed. Additional factors such as bowling techniques and bowling workload were assessed. A regression analysis was conducted to analyse the relationship between bowling workload and weeks incapacitated. Results. Fifteen per cent of the subjects remained injury free for the duration of the season. The incidence of serious injury (S3) showed a statistical and moderate, practical significant in...

Laryngeal complications (LCs) following cardiac operations contribute to increased morbidity and resource utilization. Using a nationally representative cohort of cardiac surgical patients, we characterized the incidence of LC as well as its associated clinical and financial outcomes. All adults undergoing coronary artery bypass grafting and/or valvular operations were identified using the 2010–2017 Nationwide Readmissions Database. International Classification of Diseases 9th and 10th Revision diagnosis codes were used to identify LC. Trends were analyzed using a rank-based, non-parametric test (nptrend). Multivariable linear and logistic regressions were used to evaluate risk factors for LC, and its impact on mortality, complications, resource use and 30-day non-elective readmissions. Of an estimated 2,319,628 patients, 1.7% were diagnosed with perioperative LC, with rising incidence from 1.5% in 2010 to 1.8% in 2017 (nptrend 

Background: The incidence of kidney cancer from different areas of Iran was reported. Nevertheless, there is no available systematic reviews in this regard. Therefore, the present systematic review carried out to estimate the incidence rate of kidney cancer among Iranian people. Method: This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) in September 2017. A search was concluded using Medline/ PubMed, Scopus, ScienceDirect, and Google scholar for international papers and four national databases (Scientific Information Database, MagIran, IranMedex, and IranDoc) for Persian papers. The incidence rate of kidney cancer was calculated using random effect model. Result: An aggregate of 159 papers were retrieved in the primary search of the databases. Further screening and advanced refinement of the retrieved studies produced 15 studies totally. The age-standardized rate (ASR) of kidney cancer was 1.94, 95% CI (1.62-2.55) and 1.36, 95 % CI (1.09-1.62) in males and females, respectively. Conclusion: In comparison to other parts of the world, the incidence of kidney cancer was lower in Iran. Afterwards, further studies are necessary to outline the exact incidence rate and the trend of kidney cancer in Iran.

Introduction. The incidence and risk factors for ventilator-related pneumonia (VAP) in patients with delirium are deficient, and there is a lack of in-depth knowledge of the impact of VAP on outcomes in this population. We investigated the incidence, risk factors, and outcomes of VAP in patients with delirium. Materials and Methods. This prospective observational study was performed in a surgical ICU at Be’sat Hospital in Hamadan, Iran, between 2018 and 2019. A total of 108 patients with delirium were identified using the Confusion Assessment Method (CAM) for the ICU and Intensive Care Delirium Screening Checklist (ICDSC) and enrolled in this study. The association between VAP and delirium, risk factors, and outcomes (ICU length of stay and ICU mortality) for VAP were investigated using the Cox proportional hazards model and logistic and simple linear regression analyses with a 95% confidence interval. Results. Of 108 delirium patients, 86 patients (79.6%) underwent mechanical venti...

To estimate incidence of cleft lip and cleft palate among Jordanian infants and to identify associated anomalies, we carried out a prospective, hospital-based study over a 5-year period, January 2000-January 2005. The total number of liveborn infants was 25 440, 60 of whom (2.4/1000) had facial clefts: 20 (33%) with cleft lip, 15 (25%) with cleft palate and 25 (42%) with both. Congenital heart disease was the commonest associated anomaly (47%) identified, followed by skeletal abnormalities (13%). Renal anomalies were found in 10% of cases. The high prevalence of congenital heart disease may justify routine echocardiography screening. The high consanguineous marriage rate may be a contributing factor to the high incidence of cleft anomalies.

Introduction: Post-anaesthesia care unit (PACU) delirium is a potentially preventable condition that results in a significant long-term effect. In a multicentre prospective cohort study, we investigate the incidence and risk factors of postoperative delirium in elderly patients undergoing major non-cardiac surgery. Methods: Patients were consented and recruited from 4 major hospitals in Singapore. Research ethics approval was obtained. Patients older than 65 years undergoing non-cardiac surgery >2 hours were recruited. Baseline perioperative data were collected. Preoperative baseline cognition was obtained. Patients were assessed in the post-anaesthesia care unit for delirium 30–60 minutes after arrival using the Nursing Delirium Screening Scale (Nu-DESC). Results: Ninety-eight patients completed the study. Eleven patients (11.2%) had postoperative delirium. Patients who had PACU delirium were older (74.6±3.2 versus 70.6±4.4 years, P=0.005). Univariate analysis showed those who h...

Results: Age-standardized incidence rate (ASR) (per 100,000 population) of breast cancer among women increased dramatically from 11.8 in 2001 to 22.7 in 2014, indicating a 92.4% increase over the decade. Colorectal cancer incidence was the highest among men, and its ASR per 100,000 population increased from 5.0 to 10.6 in men and from 5.0 to 8.2 in women. Among communicable diseases, incidences of hepatitis B, measles, chickenpox, and brucellosis decreased while dengue fever increased. An alarming increase was observed in the incidence rate of non-communicable diseases namely, obesity, diabetes, and hypertension. Conclusion: The incidence rate of non-communicable diseases increased over the decade and was associated with increased mortality and disability, reduced quality of life, and increased health-care costs, indicating an urgent need to establish prevention and control programs. The rising trend in the incidence of cancers may also become a health care issue in Saudi Arabia in the coming years.

The importance of circadian factors in managing patients is poorly understood. We present two retrospective cohort studies showing that lungs reperfused between 4 and 8 AM have a higher incidence (OR 1.12; 95% CI 1.03 to 1.21; p=0.01) of primary graft dysfunction (PGD) in the first 72 hours after transplantation. Cooling of the donor lung, occurring during organ preservation, shifts the donor circadian clock causing desynchrony with the recipient. The clock protein REV-ERBα directly regulates PGD biomarkers explaining this circadian regulation while also allowing them to be manipulated with synthetic REV-ERB ligands.

Background: Esophageal Cancer (EC) is the eighth most common cancer in terms of incidence. Despite various studies, there is no general estimate of EC incidence in Iran. Therefore, the present study is conducted to evaluate the incidence rates of EC in Iran. Method: A systematic search was conducted on all published studies of EC incidence using Medline/PubMed, Scopus, Web of sciences, Google scholar, and four Iranian databases (Scientific Information Database, MagIran, IranMedex, and IranDoc) until November 2017. This systematic review was done according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Result: The database, grey literature searches, and hand searching yielded 346 potentially relevant studies. A total of 22 studies were included. The results of the random effect model were demonstrated the age-standardized rate (ASR) of EC was 25.05, 95% CI (20.84 to 29.26) among males and 22.93 95 % CI (18.97-26.88) among females. Conclusion: In c...

In the literature, there are but a few incidence geometries on which the McLaughlin sporadic group McL acts as a flag-transitive automorphism group. Their highest rank is four. In the present paper, we construct a geometry of rank six on which McL acts flag-transitively and which has the following diagram.

Eleven-year retrospective study was carried out on small ruminants submitted for necropsy in the Department of Veterinary Pathology, University of Ibadan between 1999 and 2010 to determine the disease pattern, incidence and type of pneumonia in small ruminants from urban and peri-urban area of Ibadan, Nigeria. Approximately 92.4% of the carcasses had their diagnosis made through post-mortem examination, while (7.6%) were inconclusive. The post-mortem diagnosis was obtained from records while the type of pneumonia was by histopathology using standard techniques. Student't' test was used for the test of significance for evaluating the effect of age, sex and the type of pneumonia. Pneumonia was the most common 81 out of the 105 cases (69.8%). Of the 81 pneumonic cases diagnosed, peste des petits ruminants (PPR) 69 (85.2%), Mannheimiosis (MH) in 6 (7.4%), PPR and MH in 6 (7.4%). More pneumonic cases were recorded in goats (80%) than sheep (76.7%) and in rainy season (67.2%) than dry season (27.6%). The gastrointestinal tract (GIT) was the second (16.9%) which includes enterotoxemia (9%), helminthoses (4.3%) and ruminal impaction (2.6%). Severe malnutrition (2.6%), and trypanosomosis (1.72%), was the third most reported. Others includes congestive heart failure (0.9%), cyanide poisoning (0.9%), and heartwater (0.9%). Histopathologically, bronchopneumonia predominated with fibrinous (30%) and suppurative (10%) type, others were interstitial pneumonia (15%), broncho-interstitial pneumonia with giant cells (40%) and collapsed lung (5%). This showed that pneumonia still remains an important condition in Nigerian small ruminants and broncho-interstitial pneumonia with giant cells, suggestive of complicated PPR is commonly encountered.

Objective: Assessing changes in breast cancer (BC) incidence and stage distribution in the District of Modena, Italy, during the period 1992-1998, and their relationship to a mammographic screening program launched in 1995. Methods: Demographic, clinical, and pathological data of all BC cases reported to the population-based Modena Cancer Registry between 1992 and 1998 were collected and linked to the screening database. Results: A total of 3429 women were diagnosed with BC in the District of Modena between 1992 and 1998. In this period the incidence rate increased by 15.7% (from 134.3 in 1992 to 155.4 per 100,000 in 1998). The increase began in 1995 and exclusively included women aged 50-69; the incidence rose by 30.4%. Moreover, the rise was confined to early tumors, with more than half (54%) of all cases reported in 1998 diagnosed as stage 0 or I disease, compared with 42% in 1992. Screen-detected tumors were significantly smaller (13.2 mm) than other tumors diagnosed in women aged 50-69 (18.5 mm), with 46% of screen-detected tumors smaller than 10 mm. Overall, a decline in the average tumor diameter was shown (from 20.2 mm in 1992-1994 to 18 mm in 1996-1998). Conclusions: Our data confirm that mammographic screening leads to an increase in the incidence of early-stage BC cancers.

We study the properties (2T) 1 , (IP) 2 , PRI, RPRI, QPRI and RWPRI for inductively minimal pairs (Γ, G) consisting of a finite geometry and a group acting flag-transitively on it. For each of these properties, we characterize which inductively minimal pairs satisfy it.

Results: There were a total of 5909 childhood cancer cases; 2959 aged 0-14 years (1659 males, 1300 females) and 2950 aged 15-24 years (1590 males, 1358 females). For 0-14-year-old boys, there was statistically significant sinusoidal variation in month of birth for acute non-lymphocytic leukaemia (p = 0.04; peak in September) and astrocytoma (p = 0.03; peak in October). Based on month of diagnosis, there was statistically significant sinusoidal variation in girls for all lymphomas (p = 0.05; peak in March) and Hodgkin lymphoma (p = 0.005; peak in January), and in boys for osteosarcoma (p = 0.05; peak in October). For 15-24-year-olds, there was significant heterogeneity for germ cell tumours (p = 0.04), cervical (p = 0.03) and female breast carcinoma (p = 0.05), based on month of birth, and PNETs (p = 0.05) and skin carcinoma (p = 0.05), based on month of diagnosis. Significant sinusoidal variation in month of birth for malignant melanoma in females (p = 0.03; peak in March) and cervical carcinoma (p = 0.03; peak in October) was observed. Conclusions: These findings suggest that seasonal environmental factors around the time of birth or time of diagnosis may be involved in the aetiology of specific diagnostic groups. Further research is needed to study possible aetiological mechanisms and factors. Putative agents include sunlight, pesticides, diet and infections.

Low Birth Weight (LBW) is an indicator of public health. The morbidity and mortality risk of LBW is 4 times greater than non-LBW. Low birth weight (LBW) both in pre term and term gestational age infants often occurs jaundice. This study aims to determine the distribution of LBW with neonatal jaundice based on gestational age in Perinatology Ward at Dustira Hospital. This quantitative descriptive study uses data sources from medical records in the Perinatology Ward from January to December 2019. The results of this study showed there were 51 (87.9%) pre-term LBW and 7 (12,1%) term LBW and none post-term LBW infant. There are 42 (72,8%) cases of LBW with neonatal jaundice with 35 (83,3%) pre-term LBW and 7 (16,7%) term LBW. Neonatal jaundice occurrs more often in pre-term LBW than term LBW as done by other studies. The incidence of LBW with neonatal jaundice is not only affected by gestational age, but also by ABO blood group incompatibility, maternal age during pregnancy, the gender of the infants, and asphyxia.

Many fungal species cause infection in the nose and paranasal sinuses. Almost half of them are capable of causing systemic and CNS infections. Clinical presentation, imaging features, and treatment differ based on type of fungal sinusitis. We retrospectively reviewed 40 patients admitted and treated surgically for sinusitis in otorhinolaryngology department of the Vinayaka Missions Medical College & Hospitals, Karaikal for the last three months, April, May & June 2015. The clinical presentation, laboratory examination, radiological finding, cultre report and treatment method were analyzed. We had encountered 11 cases of fungal sinusitis, which is very much a high value of incidence than reported elsewhere (27. 5%). A combined prospective and retrospective study is currently going on in our department to determine the etiology for such increased incidence. We are hereby discussing the classification of fungal sinusitis and present 4 cases of each type.

Wasting is an acute malnutrition which could indirectly increase infant mortality and morbidity. Currently, wasting was serious public health problem in Indonesia with 11,1% of prevalence. This study aimed to determine the incidence of wasting in childrens aged 6-59 months in the working area of Puskesmas Kelurahan Penjaringan I, North Jakarta from March to April, 2019. The researcher measured antropometry of children to see nutritional status based on indicator of BB/TB. A case control method, as well as purposive and accidental sampling technique, was carried out in this study. As many as 60 respondents were divided into 2 groups (30 cases group and 30 control group). The data were analyzed by using chi square test and multiple logistic regression. Infectious disease history (p=0.031) and protein intake (p=0.024) were associated with wasting incidence in children. Infectious diseases history was dominant factor determining of wasting in children aged 6-59 months in Puskesmas Kelur...

Background : The burden of surgical site infections (SSI) in Brazilian hospitals is high. Both international and local guidelines from governmental agencies advise preventive interventions against SSI. Objective: To measure the combined impact of successive interventions applied in a teaching hospital on the time trends of SSI rates. Methods : Prospective surveillance (both in-hospital and post-discharge) of SSI was performed. A time series of monthly overall SSI rates was obtained for the period from January 2011 through December 2016. During that period, successive interventions, including rules for preoperative care (e.g. hair removal) and intra-operative procedures (e.g., antimicrobial prophylaxis) where implemented. Joinpoint regression analysis was performed on that time series, in order to identify both significant linear trends and trend changes (joinpoints). Results : Overall SSI rate for the study period was 8,5%. Monthly states were stable from January 2011 through April ...

prevalence of coeliac disease (CD). Recent meta-analysis estimates prevalence at 5.8%. The DS Medical Interest Group (DSMIG), does not recommend routine screening, despite guidance from the European Society of Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). HLA-DQ haplotyping for CD has been offered for the last 3 years. Method Children with DS identified from Support Needs System (SNS). In 2016, families were invited for HLA DQ haplotyping for DQ2.2 2.5& 8 (and coeliac serology). Subsequently, families invited though discussions in clinic. Children with positive typing are offered coeliac serology every 3 years (or sooner if symptomatic). Results 35 (17 female/18 male) DS children were identified. (1 child excluded as already diagnosed). 28 (76%) children have been tested. 12 (39%) had negative haplotypes, excluding them from life-long screening. 16 (57%), tested positive (table 1). Mean age at testing was 7 years.

492 Recent Change in the Incidence of Cervical Cerclage Maria Bisulli, MD; Neil S. Seligman, MD; Komal Soin, MS; Anju Suhag, MD; Vincenzo Berghella, MD Div. of Maternal-Fetal Medicine, Dept. of Ob/Gyn, Jefferson Medical College of Thomas Jefferson University, Philadelphia , PA Email: vincenzo.berghella@jefferson.edu

Background Coccidioidomycosis is an emerging infection in the southwestern United States. We examined the effects of precipitation and temperature on the incidence of coccidioidomycosis in California during 2000-2020, and estimated incident cases attributable to the California droughts of 2007-09 and 2012-15. Methods We analyzed monthly California coccidioidomycosis surveillance data from 2000-2020 at the census tract-level using generalized additive models. Models included distributed lags of precipitation and temperature within each endemic county, pooled using fixed-effects meta-analysis. An ensemble prediction algorithm of incident cases per census tract was developed to estimate the impact of drought on expected cases. Results Across 14 counties examined, coccidioidomycosis was strongly suppressed during, and amplified following, the 2007-2009 and 2012-2015 droughts. An estimated excess of 1,358 and 2,461 drought-attributable cases were observed in California in the two years f...