Category: Statistics

Diabetes Metab Res Rev. 2026 May;42(4):e70164. doi: 10.1002/dmrr.70164.

ABSTRACT

AIMS: To assess the global burden, trends, and inequalities of diabetes prevalence and treatment coverage among adults aged ≥ 45 years from 1990 to 2040.

MATERIALS AND METHODS: Diabetes prevalence and treatment coverage data were obtained from the NCD-RisC database. Average annual percentage changes (AAPC) were estimated using join point regression, and a Bayesian age-period-cohort model was used to project diabetes prevalence and treatment coverage from 2023 to 2040. Cross-national health inequalities were measured using the slope index of inequality (SII) and the relative concentration index (RCI).

RESULTS: Globally, diabetes prevalence rose from 12.85% in 1990 to 23.57% in 2022 (AAPC = 1.90%), and is projected to reach 37.44% by 2040 (AAPC = 2.59%). Treatment coverage grew from 33.22% to 45.88% (AAPC = 1.02%) and is projected to surge to 51.64% by 2040 (AAPC = 0.65%). Diabetes prevalence grew fastest in middle-income countries, whereas treatment coverage improved most in higher-income countries. The SII for prevalence burden decreased from -0.25% in 1990 to -14.86% in 2022, and is projected to further decline to -18.32% by 2040. For treatment coverage, the SII increased from 24.57% in 1990 to 43.91% in 2022, with a projected rise to 54.22% by 2040. The relative inequality measured by the RCI showed a similar pattern.

CONCLUSION: Between 1990 and 2040, diabetes prevalence is projected to increase significantly, while treatment coverage shows only limited improvement. Over the same period, the diabetes prevalence burden is increasingly concentrated in resource-limited regions, while treatment accessibility is becoming progressively more concentrated in economically developed areas.

PMID:41914208 | DOI:10.1002/dmrr.70164

Int Marit Health. 2026;77(1):50-54. doi: 10.5603/imh.111379.

ABSTRACT

BACKGROUND: Poland, a Central European country with the population of 37.5 million and a steadily improving economic situation, has experienced a continuous increase in the number of international travels, exceeding 15 million annually. The aim of this article was to profile Polish travellers seeking pre-departure advice between 2024 and 2025 at the largest diagnostic and treatment center for tropical and travel medicine in Poland.

MATERIAL AND METHODS: This retrospective study was based on the analysis of medical records of patients seeking pre-travel consultations at the University Centre of Maritime and Tropical Medicine in Gdynia, Poland. The dataset included 2,197 visits recorded in 2024 and 3,073 visits in 2025. The analysis focused on the following variables: age, sex, and travel-related characteristics, including purpose of travel, duration of stay, month of departure, and planned destinations by continent and country. The scope of preventive measures recommended or administered during consultations, including immunoprophylaxis and chemoprophylaxis, was also evaluated. Additionally, the health status of patients presenting to the travel medicine centre was assessed.

RESULTS: Patients seeking pre-travel advice were predominantly aged 18-35 years (49.5%) in 2024 vs. 46-65 years (50.5%) in 2025. Most of the examined patients travelled for tourism purposes, typically for up to 4 weeks, with departures most frequently planned for November, January, and February. The majority of travellers intended to visit Asia and Africa, most commonly Thailand (22.3% in 2024, 21.0% in 2025), Vietnam, Kenya, Indonesia, Tanzania, and India. The most frequently administered immunoprophylaxis included vaccinations against typhoid fever, hepatitis A, tetanus/diphtheria/pertussis/poliomyelitis and rabies. Other commonly recommended preventive measures included insect repellents, sunscreen, antidiarrheal medications, antimalarial drugs, and antithrombotic agents. Analysis of patient interviews showed that 41.4% of travellers admitted at the UCMTM in 2024 had underlying medical conditions. In contrast, among patients presenting for pre-travel consultations in 2025, as many as 62.0% reported various health problems. The most commonly reported medical conditions included allergies, thyroid disorders, cardiovascular diseases, psychiatric disorders, and gastrointestinal diseases.

CONCLUSIONS: A substantial proportion of Polish travellers visit destinations associated with an increased risk of infectious diseases. At the same time, due to the ageing of the Polish population, individuals aged 46-65 travel more frequently, including patients with chronic diseases or disorders. Providing professional medical advice during pre-travel consultations plays a crucial role in reducing the risk of travel-related health problems and improving overall travel safety.

PMID:41914195 | DOI:10.5603/imh.111379

Int Marit Health. 2026;77(1):39-49. doi: 10.5603/imh.105208.

ABSTRACT

BACKGROUND: Fishermen face challenges that increase their vulnerability to oral and perioral diseases due to demanding working conditions, excessive environmental exposure and limited access to health care.

OBJECTIVE: This systematic review aims to map and synthesize the available evidence on the prevalence of oral and perioral diseases among fishermen.

MATERIAL AND METHODS: An extensive literature search was conducted in September 2024, including electronic databases, grey literature, and manual searches, without date or language restrictions, to identify observational studies evaluating the prevalence of oral and perioral diseases among fishermen. The risk of bias was assessed using the JBI critical appraisal checklist for studies reporting prevalence data. Meta- analyses were conducted to combine prevalence data from the included studies. The GRADE approach assessed the certainty of the evidence.

RESULTS: Thirteen analytical cross-sectional studies, involving 4,546 fishermen, of moderate methodological quality were found. The meta-analysis showed that the overall prevalence of oral and perioral diseases was around 49% (95% CI: 27-72%; 4,546 participants; low-quality evidence). Considering the most common diseases reported, the pooled prevalence of dental caries was 84%, leukoplakia 26%, and actinic cheilitis 35%. The most frequent risk factors identified as associated were smoking habits, alcohol consumption, and poor oral hygiene.

CONCLUSIONS: These findings should be recognized as a public health concern and addressed through preventive and informational policies in fishing communities and related organizations. Further studies using more reliable methods, larger sample sizes, and adequate management of confounding factors are necessary to confirm these findings.

PMID:41914194 | DOI:10.5603/imh.105208

Int Marit Health. 2026;77(1):31-38. doi: 10.5603/imh.105891.

ABSTRACT

BACKGROUND: Fishing is a physically demanding occupation that exposes workers to harsh environmentalconditions, awkward working postures and vibrations. These factors contribute to the development of musculoskeletal disorders (MSDs). This study aimed to determine the prevalence of MSDs as well as their associated factors among fishermen.

MATERIAL AND METHODS: This cross-sectional descriptive study was conducted among 576 male fishermen aged 20 to 58 years. Data were collected through clinical examinations and face-to-face interviews using the standardized Nordic Musculoskeletal Questionnaire.

RESULTS: The 7-day prevalence of MSDs among fishermen was 85.2%. The most affected anatomical sites were the lower back (79.5%), wrists/hands (71.0%), and shoulders (56.6%). Associated factors identified included age 40 and above, work experience of 10 years or more, being overweight/obese, alcohol abuse, and engine crew or fisherman vs. fishing boat captain.

CONCLUSIONS: Musculoskeletal disorders are a highly prevalent occupational health issue among fishermen. Preventive measures should focus on improving working conditions, promoting health education, conducting regular screenings, and strengthening occupational health services to reduce the risks and impacts of MSDs in this workforce.

PMID:41914193 | DOI:10.5603/imh.105891

Int Marit Health. 2026;77(1):23-30. doi: 10.5603/imh.106749.

ABSTRACT

BACKGROUND: Commercial fishing remains one of the most hazardous occupations globally, with smallscale fleets exhibiting persistent safety challenges. In Türkiye, fishing operations are characterized by low regulatory compliance, insufficient training, and fatigue-related risks.

OBJECTIVES: This study assessed occupational health and safety (OHS) compliance levels among Turkish fishing vessel crews and identified key predictors of safety outcomes across vessel size categories.

MATERIAL AND METHODS: A cross-sectional study was conducted (June-August 2018) across Türkiye’s Aegean, Marmara, and Black Sea regions, involving 356 crew members from 180 vessels. Data collection included structured questionnaires, observational checklists, and interviews. Analyses employed descriptive statistics, χ² tests, independent t-tests, and multiple linear regression (SPSS v26).

RESULTS: Of all participants, 38.8% reported at least one occupational accident in the past year. The most frequent injuries were cuts (12.9%), falls (9.3%), and equipment-related trauma (5.9%). The main contributing factors were the hasty work pace in the workplace (52.2%), inadequate training (28.9%), and fatigue due to long working hours (19.0%). PPE compliance was low at 18%, and only 27% of participants had received formal safety training. A significant association was found between vessel size and accident occurrence (χ² = 12.45, p = 0.002), with smaller vessels having a significantly higher accident risk than larger vessels. Workers involved in accidents reported longer working hours (M = 14.3, SD = 1.8) than their counterparts (M = 13.1, SD = 2.2; p < 0.001). Regression analysis identified formal training (β = 0.35, p < 0.001), education level (β = 0.21, p < 0.001), and vessel size (β = 0.14, p = 0.01) as significant predictors of OHS compliance (R² = 0.29).

CONCLUSIONS: Occupational health and safety compliance in Türkiye’s fishing sector remains inadequate, particularly for small-scale vessels. Prioritizing training expansion, work-hour regulations, and targeted support for high-risk fleets is essential.

PMID:41914192 | DOI:10.5603/imh.106749

Int Marit Health. 2026;77(1):1-12. doi: 10.5603/imh.108038.

ABSTRACT

BACKGROUND: Recreational diving creates risk for decompression sickness (DCS), which can occur in SCUBA diving even if current decompression algorithms are respected. The aim of this study was to identify the primary risk factors for decompression sickness in real-world regular recreational diving.

MATERIAL AND METHODS: This study analyzed 127,957 dives from 5,907 divers in the DAN DSL database (version 07/2024) to identify independent risk factors for DCS in recreational diving.

RESULTS: Decompression sickness was reported in 628 dives, yielding an incidence rate of 0.49%. The most critical predictor was the DAN Surface Supersaturation Gradient (DSSG), with significantly higher median values in DCS dives (0.866) compared to non-DCS dives (0.743, p < 0.001). Multivariate logistic regression identified 12 independent predictors of DCS, including DSSG (logarithmic effect on odds ratio [OR]), leading compartment, female gender (OR = 4.63), lower BMI classification (OR = 0.85), reduced number of repetitive dives (OR = 0.94 per dive), shorter surface intervals (OR = 0.96 per hour), greater gas count (OR = 2.87), exercise before diving (OR = 2.06), perceived thermal comfort (OR = 2.83), workload during dive (OR = 1.61), technical dive purpose (OR = 1.36), and pre-dive fatigue perception (protective, OR = 0.30). The model showed excellent discrimination with an area under the ROC curve of 0.910 and Somer’s D = 0.8287. Notably, dives using more than one gas mixture and those performed by females carried substantially increased DCS risk.

CONCLUSIONS: The study confirms that both physiological and operational factors influence DCS risk and provides a basis for personalized risk prediction tools in recreational diving.

PMID:41914190 | DOI:10.5603/imh.108038

J Pregnancy. 2026;2026(1):e8982438. doi: 10.1155/jp/8982438.

ABSTRACT

OBJECTIVES: The objectives of this study are to identify risk factors associated with failed labor induction in obese pregnancies at term and evaluate related maternal and neonatal outcomes.

METHODS: This cross-sectional study included obese pregnant women (BMI ≥ 30 kg/m²) who underwent labor induction at 37-41 weeks’ gestation in two academic hospitals in Surabaya, Indonesia, during 2023. Participants were classified into successful and failed induction groups. Maternal characteristics, induction-related factors, and pregnancy outcomes were compared. Multivariable logistic regression was used to identify independent risk factors for induction failure.

RESULTS: A total of 159 women were included, comprising 53 failed and 106 successful inductions. Failed induction was significantly associated with primiparity (adjusted odds ratio [aOR], 3.10; 95% CI, 1.46-6.58), Bishop score < 3 (aOR, 2.02; 95% CI, 1.14-3.55), and higher maternal weight gain during pregnancy (aOR per kg increase, 0.89; 95% CI, 0.84-0.95). Maternal weight gain demonstrated a moderate effect size (standardized mean difference, 0.62). Compared with successful induction, failed induction was associated with higher rates of severe preeclampsia (18.9% vs. 1.9%), cesarean delivery (100% vs. 5.7%), longer hospitalization, and lower 1-min Apgar scores. No significant differences were observed in 5-min Apgar scores, fetal growth restriction, congenital anomalies, or NICU admission.

CONCLUSIONS: In obese pregnancies at term, primiparity, unfavorable cervical status, and excessive gestational weight gain are independently associated with failed labor induction. These findings highlight the importance of optimized patient selection, cervical assessment, and anticipatory counseling to improve maternal and neonatal outcomes.

PMID:41914186 | DOI:10.1155/jp/8982438

Front Biosci (Schol Ed). 2026 Mar 23;18(1):46442. doi: 10.31083/FBS46442.

ABSTRACT

BACKGROUND: Epstein-Barr virus (EBV) is a well-known cause of infectious mononucleosisand it has also been linked to the development of various malignant tumors. EBV can be classified into two genotypes based on EBNA-2 and EBNA-3 polymorphisms, with further subclassification predominantly based on BNLF-1 and EBNA-1 variations. Currently, EBV subtyping has not been performed using EBER genes. Thus, this study aimed to determine EBV subtypes in various malignant tumors and to assess the potential of EBER polymorphisms for EBV classification.

METHODS: DNA was isolated from tissue samples of patients diagnosed with classical Hodgkin lymphoma (cHL), angioimmunoblastic T cell lymphoma (AITL), and nasopharyngeal carcinoma (NPC). Specific fragments of the BNLF-1, EBNA-1, EBNA-3C, and EBER genes were amplified, and population sequencing was conducted.

RESULTS: Based on EBNA-3C sequences, all tumor samples were genotype EBV-1, whereas the BNLF-1, EBNA-1, and EBER sequences indicated that the tumor tissues were infected with different EBV subtypes. The B95-8 subtype predominated in cHL, whereas North Carolina and P-ala were the most frequent subtypes in NPC. In addition, we propose a newly designed algorithm for EBER-based subclassification, which showed that the subtype Cro2 is more frequently present in cHL and AITL than in NPC.

CONCLUSION: The results of this study show characteristic pattern of EBV diversity based on the EBNA-3C, EBNA-1, and BNLF-1 gene sequences, as well as the EBER promoter sequence in AITL, NPC, and cHL cohorts specific for the Caucasian population of southeastern Europe; however, these results may not relate to the distribution of EBV variants in other geographic areas.

PMID:41914172 | DOI:10.31083/FBS46442

Front Biosci (Elite Ed). 2026 Feb 9;18(1):44274. doi: 10.31083/FBE44274.

ABSTRACT

BACKGROUND: Adeno-associated viruses (AAVs) are established vectors for efficient gene delivery to the central nervous system (CNS). Increasingly, strategies aim to restrict transduction to specific neuronal subtypes defined by the associated functional properties, thereby enhancing precision and therapeutic potential.

METHODS: Recombinant AAV9 vectors carrying fluorescent reporters under the control of cytomegalovirus (CMV), human synapsin (hSyn), or homeobox 9 (Hb9) promoters were delivered intrathecally in Wistar rats. Transgene expression was evaluated 7 days post-injection by confocal microscopy. Neurons in laminae VII-X were quantified across cervical, thoracic, lumbar, and sacral spinal cord levels. Statistical analysis was performed using the Kruskal-Wallis test followed by Mann-Whitney U tests with Bonferroni correction.

RESULTS: In lamina VII, consistent neuronal expression was mediated by hSyn across all spinal levels, with significantly higher transduction at cervical compared to thoracic and lumbar regions (p < 0.01). CMV and Hb9 showed no detectable tropism for this lamina. In lamina VIII, CMV drove markedly higher expression than hSyn and Hb9, with a 2.8-fold difference at the lumbar level (p < 0.001). In lamina X, CMV expression exceeded hSyn at the lumbar and sacral levels (p < 0.05), while Hb9 showed no activity. In lamina IX, all promoters mediated motoneuron transduction, but only Hb9 restricted expression specifically to motoneuron somata. Notably, CMV induced off-target expression in glial cells.

CONCLUSIONS: AAV9-mediated expression patterns in the spinal cord are strongly shaped by promoter choice and segmental level. Hb9 provides high motoneuron specificity, hSyn supports broad neuronal activation across laminae VII-X, whereas CMV drives robust but non-specific expression with significant off-target activity. These findings highlight the importance of rational promoter selection for spinal cord gene therapy and strategies aimed at functional recovery in motor system disorders.

PMID:41914168 | DOI:10.31083/FBE44274

J Pediatr Orthop. 2026 Mar 31. doi: 10.1097/BPO.0000000000003241. Online ahead of print.

ABSTRACT

BACKGROUND: Torsional abnormalities of the femur, such as femoral retrotorsion, can significantly impact gait and joint biomechanics in children and adolescents. However, the resulting gait patterns as well as the relationship between static imaging measurements and dynamic gait deviations remain unclear. This study aimed to investigate biomechanical differences in gait between young individuals with true femoral retrotorsion and typically developing peers, examining correlations between gait deviations, clinical measurements, and imaging data.

METHODS: A multicenter retrospective study was conducted, including 31 patients with unilateral or bilateral femoral retrotorsion and a control group of typically developing children. Femoral torsion was assessed using MRI or CT, while 3D motion capture was used for gait analysis. Clinical hip rotation was measured, and statistical analyses, including correlation assessments, were performed to evaluate relationships between imaging, clinical, and gait parameters.

RESULTS: Patients exhibited significantly increased hip external rotation and out-toeing gait compared with controls. However, no correlation was found between femoral torsion measured by imaging and hip rotation during gait or foot progression angle. In contrast, the midpoint of clinical hip rotation correlated moderately with both hip rotation and foot progression angle during gait. In addition, patients had higher BMI and demonstrated compensatory knee valgus, despite no radiologic evidence of knee malalignment.

CONCLUSION: Children and adolescents with femoral retrotorsion exhibit distinct gait deviations, but static imaging alone does not reliably predict dynamic gait patterns. This emphasizes the need for dynamic assessment in clinical decision-making.

PMID:41914160 | DOI:10.1097/BPO.0000000000003241