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Early diagnosis of fibrotic interstitial lung disease: challenges and opportunities.

Lancet Respir Med 2021 Jul 28. Epub 2021 Jul 28.

Department of Respiratory Medicine, National Reference Coordinating Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France; Department of Respiratory Medicine, Université de Lyon, Université Claude Bernard Lyon 1, UMR754, IVPC, Lyon, France.

Many patients with interstitial lung disease (ILD) develop pulmonary fibrosis, which can lead to reduced quality of life and early mortality. Patients with fibrotic ILD often have considerable diagnostic delay, and are exposed to unnecessary and costly diagnostic procedures, and ineffective and potentially harmful treatments. Non-specific and insidious presenting symptoms, along with scarce knowledge of fibrotic ILD among primary care physicians and non-ILD experts, are some of the main causes of diagnostic delay. Read More

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Psychological impact of COVID-19 on speech and language therapists working with adult dysphagia: A national survey.

Int J Lang Commun Disord 2021 Jul 31. Epub 2021 Jul 31.

Speech and Language Pathology Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland.

Background: Speech and language therapists (SLTs) working with dysphagia have had to radically alter diagnostic and rehabilitation services during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, hereafter referred to as coronavirus disease (COVID-19). Given the aerosol-generating procedures inherent in swallow assessment and interventions, these SLTs have also been particularly susceptible to virus exposure.

Aims: To investigate the psychological impact of COVID-19 on SLTs working with adult dysphagia across the Republic of Ireland and to identify the personal and professional factors associated with depression, anxiety, stress and post-traumatic stress disorder (PTSD). Read More

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Analysis of the main soft tissue stress associated with flexible flatfoot deformity: a finite element study.

Biomech Model Mechanobiol 2021 Jul 30. Epub 2021 Jul 30.

Department of Orthopedics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, People's Republic of China.

A better understanding of soft tissue stress and its role in supporting the medial longitudinal arch in flexible flatfoot could help to guide the clinical treatment. In this study, a 3-Dimensional finite element (FE) foot model was reconstructed to measure the stress of the soft tissue, and its variation in different scenarios related to flexible flatfoot. All bones, cartilages, ligaments and related tendons around the ankle, and fat pad were included in the finite element model. Read More

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The impacts of road traffic on urban air quality in Jinan based GWR and remote sensing.

Sci Rep 2021 Jul 30;11(1):15512. Epub 2021 Jul 30.

School of Transportation and Logistics Engineering, Shandong Jiaotong University, Jinan, 250023, China.

Traffic congestion and smog are hot topics in recent years. This study analyzes the impacts of road traffic characteristic parameters on urban air quality quantitatively based on aerosol optical thickness (AOD) and geographical weighted regression (GWR) models, including the road network density, road area occupancy, intersection number, and bus network density as main factors. There are some major research findings. Read More

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The effects of graded calorie restriction XVII: Multitissue metabolomics reveals synthesis of carnitine and NAD, and tRNA charging as key pathways.

Proc Natl Acad Sci U S A 2021 Aug;118(31)

State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing 100101, China;

The evolutionary context of why caloric restriction (CR) activates physiological mechanisms that slow the process of aging remains unclear. The main goal of this analysis was to identify, using metabolomics, the common pathways that are modulated across multiple tissues (brown adipose tissue, liver, plasma, and brain) to evaluate two alternative evolutionary models: the "disposable soma" and "clean cupboards" ideas. Across the four tissues, we identified more than 10,000 different metabolic features. Read More

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The chemerin-CMKLR1 axis limits thermogenesis by controlling a beige adipocyte/IL-33/type 2 innate immunity circuit.

Sci Immunol 2021 Jul;6(61)

Department of Immunology and Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.

IL-33-associated type 2 innate immunity has been shown to support beige fat formation and thermogenesis in subcutaneous inguinal white adipose tissue (iWAT), but little is known about how it is regulated in iWAT. Chemerin, as a newly identified adipokine, is clinically associated with obesity and metabolic disorders. We here show that cold exposure specifically reduces chemerin and its receptor chemerin chemokine-like receptor 1 (CMKLR1) expression in iWAT. Read More

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Long-Term Outcome After Venoarterial Extracorporeal Membrane Oxygenation as Bridge to Left Ventricular Assist Device Preceding Heart Transplantation.

J Cardiothorac Vasc Anesth 2021 Jul 3. Epub 2021 Jul 3.

Department of Cardiac Surgery, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.

Objectives: To determine if venoarterial extracorporeal membrane oxygenation (VA ECMO) as a bridge to left ventricular assist device (LVAD) in heart transplant (HT) candidates (ie, double bridge to HT) was associated with increased morbidity and mortality when compared to LVAD bridging to HT (ie, single bridge to HT).

Design: A retrospective analysis of patients undergoing LVAD support from 2011 to 2020. A Kaplan-Meier survival curve and Cox-Mantel hazard ratios (HR) were calculated during LVAD support and after HT. Read More

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Pharmacy student reflections and perceptions of competency and predictors of success in remediation.

Curr Pharm Teach Learn 2021 Sep 24;13(9):1160-1167. Epub 2021 Jun 24.

Palm Beach Atlantic University, 901 S. Flagler Drive, West Palm Beach, FL 33401, United States. Electronic address:

Introduction: Pharmacy programs employ a variety of remediation methods intended to bring underperforming students to a level of competency. Our objective was to evaluate pharmacy students' perceptions of eligibility criteria and academic outcomes of remediation and potential predictors for lack of success in the original and remediated course.

Methods: Palm Beach Atlantic University School of Pharmacy revised its remediation policy in fall 2017, shifting from a course-centric to student-centric policy. Read More

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September 2021

Cybersecurity of Cardiovascular Implantable Electronic Devices and Remote Programming.

Card Electrophysiol Clin 2021 Sep 8;13(3):499-508. Epub 2021 Jul 8.

Product Security Systems Architect, Global Product Cybersecurity, Boston Scientific, 4100 Hamline Avenue North, St Paul, MN 55112, USA.

The ability to remotely reprogram a cardiac implantable electronic device (CIED) and the ability to remotely install software or firmware updates would reduce the need for in-office visits and could provide a mechanism to rapidly deploy important software or firmware updates. The challenges of implementing remote reprogramming of cardiac implantable electronic devices are no longer technical. Using asymmetric cryptography, sophisticated end-to-end secure communication protocols and hardware accelerators, the resources required to identify and take advantage of a cybersecurity vulnerability of a single CIED would be very significant and likely well beyond the gain that an intruder would deem worthwhile. Read More

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September 2021

Protecting patients and staff in residential treatment centers during exposure to COVID-19: commentary.

Addict Sci Clin Pract 2021 Jul 30;16(1):49. Epub 2021 Jul 30.

Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Background: The COVID-19 pandemic has created a crisis in access to addiction treatment. Programs with residential components have been particularly impacted as they try to keep infection from spreading in facilities and contributing to further community spread of the virus. This crisis highlights the ongoing daily trade-offs that organizations must weigh as they balance the risks and benefits of individual patients with those of the group of patients, staff and the community they serve. Read More

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Noninvasive respiratory support outside the intensive care unit for acute respiratory failure related to coronavirus-19 disease: a systematic review and meta-analysis.

Crit Care 2021 Jul 30;25(1):268. Epub 2021 Jul 30.

Department of Medicine and Surgery, University of Perugia, Piazza Università 1, 06123, Perugia, Italy.

Background: Noninvasive respiratory support (NIRS) has been diffusely employed outside the intensive care unit (ICU) to face the high request of ventilatory support due to the massive influx of patients with acute respiratory failure (ARF) caused by coronavirus-19 disease (COVID-19). We sought to summarize the evidence on clinically relevant outcomes in COVID-19 patients supported by NIV outside the ICU.

Methods: We searched PUBMED®, EMBASE®, and the Cochrane Controlled Clinical trials register, along with medRxiv and bioRxiv repositories for pre-prints, for observational studies and randomized controlled trials, from inception to the end of February 2021. Read More

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The correlation between social support and post-traumatic stress disorder in children and adolescents: A meta-analysis.

J Affect Disord 2021 Jul 16;294:543-557. Epub 2021 Jul 16.

Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, UK.

Background: Risk factors exploring the link between trauma and Post-traumatic stress disorder (PTSD) have been extensively explored in adults, however, less is known about child and adolescent populations.

Methods: The current meta-analysis aimed to systematically evaluate and summarise the child focused literature to estimate the strength of the relationship between social support and PTSD symptoms following traumatic events.

Results: Fifty primary studies reporting an effect size for the relationship between total social support scale or a source of social support with PTSD were included. Read More

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Diagnostic accuracy of monitoring tests of fellow eyes in patients with unilateral neovascular age related macular degeneration (EDNA study).

Ophthalmology 2021 Jul 27. Epub 2021 Jul 27.

Centre for Public Health, Queen's University Belfast, Belfast BT12 6BA. Electronic address:

Objective: To evaluate the diagnostic accuracy of routinely used tests of visual function and retinal morphology compared to fundus fluorescein angiography (FFA) to detect onset of active macular neovascularisation in unaffected fellow eyes of patients with unilateral neovascular age-related macular degeneration (nAMD).

Design: Prospective diagnostic accuracy cohort study conducted in 24 eye clinics in the UK over 3 years.

Participants: Older adults (>50y) with recently diagnosed unilateral nAMD with a fellow (study) eye free of nAMD. Read More

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Helping People with Disabilities in the Workplace: Mezzo-Level Interventions Targeting Corporate Culture.

Chi Kin Kwan

Soc Work 2021 Jul 30. Epub 2021 Jul 30.

This article explores the relevance of mezzo-level interventions to help people with disabilities improve their employability. It begins with an overview of the micro-mezzo-macro spectrum in the context of vocational rehabilitation services and shows that corporate culture plays a critical role in determining the employment outcomes of people with disabilities. This case study, a collaborative project of two business enterprises in Hong Kong, illustrates the benefits brought by a mezzo-level intervention for people with disabilities. Read More

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From late fatherhood to prenatal screening of monogenic disorders: evidence and ethical concerns.

Hum Reprod Update 2021 Jul 30. Epub 2021 Jul 30.

Competence Centre on Health Technologies, Tartu, Estonia.

Background: With the help of ART, an advanced parental age is not considered to be a serious obstacle for reproduction anymore. However, significant health risks for future offspring hide behind the success of reproductive medicine for the treatment of reduced fertility associated with late parenthood. Although an advanced maternal age is a well-known risk factor for poor reproductive outcomes, understanding the impact of an advanced paternal age on offspring is yet to be elucidated. Read More

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Knowledge of Triad and RED-S in Female Cross-Country Athletes and Support Staff.

J Athl Train 2021 Jul 30. Epub 2021 Jul 30.

*Syracuse University, NY.

Context: Female endurance athletes exhibit an increased risk of Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (RED-S). Triad and RED-S are conditions that explore the health and performance consequences of low energy availability (LEA). Few studies to date have assessed the knowledge that athletes, coaches, and athletic trainers (ATs) have regarding Triad/RED-S. Read More

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Dimension effect of anammox granule: Potential vs performance.

Sci Total Environ 2021 Jun 24;795:148681. Epub 2021 Jun 24.

Department of Environmental Engineering, College of Environmental & Resource Sciences, Zhejiang University, Hangzhou, China. Electronic address:

Anammox granule is the key support of anammox sludge bed reactor. In this study, the anammox granules from a steady-state reactor were divided into 6 groups to investigate their dimension effects. The results of batch cultivation showed that the anammox granules with VMD (volume surface mean diameter) of 2. Read More

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Metagenomic analysis of primary colorectal carcinomas and their metastases identifies potential microbial risk factors.

Mol Oncol 2021 Jul 30. Epub 2021 Jul 30.

Ruprecht-Karls University of Heidelberg, Medical Faculty Mannheim, Department of Experimental Surgery - Cancer Metastasis, Ludolf-Krehl-Str. 13-17, 68167, Mannheim, Germany.

The paucity of microbiome studies at intestinal tissues has contributed to a yet limited understanding of potential viral and bacterial co-factors of colorectal cancer (CRC) carcinogenesis or progression. We analyzed whole-genome sequences of CRC primary tumours, their corresponding metastases and matched normal tissue for sequences of viral, phage and bacterial species. Bacteriome analysis showed Fusobacterium nucleatum, Streptococcus sanguinis, F. Read More

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The Association between Baseline Eye Tracking Performance and Concussion Assessments in High School Football Players.

Optom Vis Sci 2021 Jul;98(7):826-832

Significance: Concussions are complex injuries that require a multifaceted testing battery. Vision impairments are common after concussion, but it is unknown exactly how eye tracking may be affected after injury and how it is associated with other clinical concussion assessments.

Purpose: This study aimed to (1) examine the relationship between eye tracking performance (BOX score) and other common concussion evaluations, (2) identify if eye tracking adds novel information that augments baseline concussion evaluations, and (3) examine the effect of age, concussion history, and attention-deficit/hyperactivity disorder on eye tracking and other ophthalmological measures. Read More

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Cold acclimation induces life stage-specific responses in the cardiac proteome of western painted turtles (Chrysemys picta bellii): implications for anoxia tolerance.

J Exp Biol 2021 Jul 30;224(14). Epub 2021 Jul 30.

Department of Biology, Saint Louis University, St Louis, MO 63103, USA.

Western painted turtles (Chrysemys picta bellii) are the most anoxia-tolerant tetrapod. Survival time improves at low temperature and during ontogeny, such that adults acclimated to 3°C survive far longer without oxygen than either warm-acclimated adults or cold-acclimated hatchlings. As protein synthesis is rapidly suppressed to save energy at the onset of anoxia exposure, this study tested the hypothesis that cold acclimation would evoke preparatory changes in protein expression to support enhanced anoxia survival in adult but not hatchling turtles. Read More

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Migratory pattern of the coronavirus disease 2019 and high fatality rates among kidney transplant recipients: report from the Brazilian Multicenter Cohort Study.

J Bras Nefrol 2021 Jul 28. Epub 2021 Jul 28.

Universidade Federal de São Paulo, Hospital do Rim, São Paulo, SP, Brasil.

Introduction: The unprecedented coronavirus disease 2019 (COVID-19) pandemic has affected kidney transplant (KT) recipients, with worldwide fatality rates around 25%. Considering the well-known Brazilian socio-demographic disparities, this report describes for the first time the main outcomes of COVID-19 in KT recipients according to Brazilian geographic regions.

Methods: This multicenter national retrospective analysis included data from KT recipients with confirmed COVID-19 between March and November 2020. Read More

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Perceptions of heat-health impacts and the effects of knowledge and preventive actions by outdoor workers in Hanoi, Vietnam.

Sci Total Environ 2021 Jun 10;794:148260. Epub 2021 Jun 10.

Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Global Asia Institute, National University of Singapore, Singapore; The N.1 Institute for Health, National University of Singapore, Singapore; The Institute for Digital Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore.

Extreme heat is an increasing climate threat, most pronounced in urban areas where poor populations are at particular risk. We analyzed heat impacts and vulnerabilities of 1027 outdoor workers who participated in a KAP survey in Hanoi, Vietnam in 2018, and the influence of their mitigation actions, their knowledge of heat-risks, and access to early warnings. We grouped respondents by their main income (vendors, builders, shippers, others, multiple jobs, and non-working) and analyzed their reported heat-health impacts, taking into consideration socioeconomics, knowledge of heat impacts and preventive measures, actions taken, access to air-conditioning, drinking amounts and use of weather forecasts. Read More

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Healthcare Providers' Perceptions of Challenges with Frequent Users of Emergency Department Care in Switzerland: A Qualitative Study.

Inquiry 2021 Jan-Dec;58:469580211028173

Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Switzerland.

Frequent users of emergency departments (FUED; ≥ 5 ED visits/year) commonly cumulate medical, social, and substance use problems requiring complex and sustained care coordination often unavailable in ED. This study aimed to explore ED healthcare providers' challenges related to FUED care to gain insight into the support and resources required to address FUED complex needs. An online survey was sent to all general adult emergency services within Switzerland (N = 106). Read More

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Healthcare stakeholders' perspective on barriers to integrated care in Switzerland: Results from the open-ended question of a nationwide survey.

J Eval Clin Pract 2021 Jul 29. Epub 2021 Jul 29.

Center for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems, University of Lausanne, Lausanne, Switzerland.

Objective: We aimed to identify the main barriers to integrated care (IC) as reported by healthcare stakeholders from various linguistic regions and health system specificities, according to their reality of practice.

Methods: Information was gathered through an open-ended question from a national survey conducted in Switzerland in 2019. Responses were analysed qualitatively with the IRaMuTeQ software. Read More

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Slingshot Challenge and Star Mines: Two digital games as a prisoner's dilemma to assess cooperation in children.

Behav Res Methods 2021 Jul 29. Epub 2021 Jul 29.

Laboratório de Desenvolvimento-Aprendizagem e Processos Psicossociais (LDAPP), Universidade Federal do Vale do São Francisco (Univasf), Petrolina, Brazil.

The prisoner's dilemma (PD) has been widely adopted by researchers to investigate cooperation among adults and children. However, studies using the PD with children are not as extensive as experiments with adults. The main aim of this work was to introduce and show the feasibility and validity of two digital games with the structural features of a PD (Slingshot Challenge [SC] and Star Mines [SM]) to investigate children's cooperative behavior. Read More

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Identifying and Prioritizing Workplace Climate Predictors of Burnout Among VHA Primary Care Physicians.

J Gen Intern Med 2021 Jul 29. Epub 2021 Jul 29.

Center for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA.

Objective: Burnout, or job-related stress, affects more than half of all US physicians, with primary care physicians (PCPs) experiencing some of the highest rates in medicine. Our study analyzes national survey data to identify and prioritize workplace climate predictors of burnout among PCPs within a large integrated health system.

Design: Observational study of annual survey data from the Veterans Health Administration (VHA) All Employee Survey (AES) for 2013-2017. Read More

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Access route selection for percutaneous coronary intervention among Vietnamese patients: Implications for in-hospital costs and outcomes.

Lancet Reg Health West Pac 2021 Apr 2;9:100116. Epub 2021 Mar 2.

School of Public Health, Curtin University, Perth, Australia.

Background: Little is known about rates of access site (transradial (TRI) or transfemoral (TFI)) preference for percutaneous coronary intervention (PCI) and in-hospital costs of patients undergoing these procedures in lower-and middle-countries. Here, we report on access site use, in-hospital costs and outcomes of patients undergoing PCI in Vietnam.

Methods: Information from 868 patients were included in the cohort of 1022 patients recruited into the first PCI registry in Vietnam. Read More

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Community-based management of epilepsy in Southeast Asia: Two intervention strategies in Lao PDR and Cambodia.

Lancet Reg Health West Pac 2020 Nov 9;4:100042. Epub 2020 Oct 9.

INSERM U1094, Univ. Limoges, CHU Limoges, IRD, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 2 rue du Docteur Marcland, 87025 Limoges, France.

Background: Epilepsy affects more than 50 million people worldwide, 80% of whom live in low- and middle-income countries (LMICs). In Southeast Asia, the prevalence is moderate (6‰), and the main public health challenge is reducing the treatment gap, which reaches more than 90% in rural areas.

Methods: This 12-month comparative study (intervention vs. Read More

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November 2020

The competence of village clinicians in the diagnosis and management of childhood epilepsy in Southwestern China and its determinants: A cross-sectional study.

Lancet Reg Health West Pac 2020 Oct 23;3:100031. Epub 2020 Sep 23.

Peking University People's Hospital, Beijing, China.

Background: Due to lack of neurologists in low- and middle-income countries, communities of patients living with epilepsy are calling for task-shifting of diagnosis and management from physicians to paramedical providers in the primary health care systems to narrow the huge treatment gap. Evidence to guide this work has been limited. This study assesses the competence of village clinicians (VC)- mostly paramedical providers- in the diagnosis and management of a presumptive case of childhood epilepsy and its determinants. Read More

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October 2020

Burden of maternal disorders in China from 1990 to 2019: Analysis of the Global Burden of Disease Study 2019.

Lancet Reg Health West Pac 2021 Jun 27;11:100141. Epub 2021 Apr 27.

National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, 100050 Beijing, PR China.

Background: Efforts to quantify the burden of maternal disorders at the national and provincial levels are valuable for resource allocation and for development and adoption of public health policies.

Methods: Following the methods of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, the prevalence of maternal disorders and the resulting disability-adjusted life years (DALYs), years lived with disability(YLD), deaths, and years of life lost (YLL) at the national and provincial levels in China were examined for the 1990-2019 period. Estimated annual percentage changes (EAPCs) were calculated to estimate the trends of age-standardized rate (ASR) of prevalence, DALYs, death, and YLD due to maternal disorders and its main subcategories from 1990 to 2019. Read More

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