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ImportanceHealth-adjusted life expectancy, a measure of healthy longevity, lags longevity gains, resulting in a healthspan-lifespan gap.ObjectiveTo quantify the healthspan-lifespan gap across the globe, investigate for sex disparities, and analyze morbidity and mortality associations.Design, Setting, and ParticipantsThis retrospective cross-sectional study used the World Health Organization (WHO) Global Health Observatory as the global data source and acquired national-level data covering all continents. The 183 WHO member states were investigated. Statistical analysis was conducted from January to May 2024.ExposuresData represent 2 decades of longitudinal follow-up.Main Outcomes and MeasuresChanges in life expectancy and health-adjusted life expectancy, as well as the healthspan-lifespan gap were quantified for all participating member states. Gap assessment was stratified by sex. Correlations of the gap with morbidity and mortality were examined.ResultsThe healthspan-lifespan gap has widened globally over the last 2 decades among 183 WHO member states, extending to 9.6 years. A sex difference was observed with women presenting a mean (SD) healthspan-lifespan gap of 2.4 (0.5) years wider than men (P < .001). Healthspan-lifespan gaps were positively associated with the burden of noncommunicable diseases and total morbidity, and negatively with mortality. The US presented the largest healthspan-lifespan gap, amounting to 12.4 years, underpinned by a rise in noncommunicable diseases.Conclusions and RelevanceThis study identifies growing healthspan-lifespan gaps around the globe, threatening healthy longevity across worldwide populations. Women globally exhibited a larger healthspan-lifespan gap than men.
ImportanceHealth-adjusted life expectancy, a measure of healthy longevity, lags longevity gains, resulting in a healthspan-lifespan gap.ObjectiveTo quantify the healthspan-lifespan gap across the globe, investigate for sex disparities, and analyze morbidity and mortality associations.Design, Setting, and ParticipantsThis retrospective cross-sectional study used the World Health Organization (WHO) Global Health Observatory as the global data source and acquired national-level data covering all continents. The 183 WHO member states were investigated. Statistical analysis was conducted from January to May 2024.ExposuresData represent 2 decades of longitudinal follow-up.Main Outcomes and MeasuresChanges in life expectancy and health-adjusted life expectancy, as well as the healthspan-lifespan gap were quantified for all participating member states. Gap assessment was stratified by sex. Correlations of the gap with morbidity and mortality were examined.ResultsThe healthspan-lifespan gap has widened globally over the last 2 decades among 183 WHO member states, extending to 9.6 years. A sex difference was observed with women presenting a mean (SD) healthspan-lifespan gap of 2.4 (0.5) years wider than men (P < .001). Healthspan-lifespan gaps were positively associated with the burden of noncommunicable diseases and total morbidity, and negatively with mortality. The US presented the largest healthspan-lifespan gap, amounting to 12.4 years, underpinned by a rise in noncommunicable diseases.Conclusions and RelevanceThis study identifies growing healthspan-lifespan gaps around the globe, threatening healthy longevity across worldwide populations. Women globally exhibited a larger healthspan-lifespan gap than men.
BackgroundChronic back pain affected 619 million people globally in 2020 which accounts for a heavy disease burden causing tremendous productivity losses. Current therapies including ibuprofen, duloxetine, and opioids might cause side effects and even severe drug use disorders. Therefore, a non‐pharmacologic therapy with better or equivalent efficacy and fewer side effects is needed.MethodsWe did a multi‐center, single‐blinded, randomized, positive drug controlled, clinical trial. Patients with chronic back pain in moderate severity were randomized into receiving hot stone massage or flurbiprofen plaster group. Both interventions were 2 weeks with a follow‐up of 4 weeks. The primary outcome was the change in the score of the Global Pain Scale (GPS) from baseline to week 2. Secondary outcomes included Numerical Rating Scale (NRS), Chronic Pain Acceptance Questionnaire (CPAQ), Pain Self‐Efficacy Questionnaire (PSEQ), Hospital Anxiety and Depression Scale (HADS), and Short Form‐36 (SF36) from baseline to week 2 and week 6. Exploratory outcome assessment included the muscle thickness measured by ultrasound. Any adverse event was monitored throughout the study period.ResultsA total of 120 patients were enrolled in this trial. At 2 weeks GPS decreased significantly in the hot stone massage group compared to the flurbiprofen group (difference between groups = ‐8.1 points, 95% confidence interval [CI] ‐15.8 to ‐0.3, p = 0.047). Moreover, hot stone massage also showed more improvement at 2 weeks compared to flurbiprofen, including NRS (‐0.5 points, 95% CI ‐1.0 to ‐0.1, p = 0.029), PSEQ (5.4 points, 95% CI 0.5 to 10.2, p = 0.030), and mental component of Short Form‐36 (SF‐36) (1.7 points, 95% CI 0.4 to 2.9, p = 0.010), but not in CPAQ (p = 0.131), HADS (p = 0.303 for depression, p = 0.399 for anxiety), or SF‐36 (p = 0.129 for physical component, p = 0.246 for social component, p = 0.076 for fatigue component). A total of two participants in the hot stone massage group reported mild pain on skin surface when receiving the procedure at the first intervention session.
BackgroundThis study analyzes nasopharyngeal carcinoma (NPC) from 1990 to 2021 across 204 countries, focusing on prevalence, incidence, mortality, and disability‐adjusted life years (DALYs). It examines gender disparities, regional variations, age dynamics, and temporal trends to provide insights for health policy and resource allocation.MethodsWe used the Global Burden of Disease (GBD) approach to assess NPC's health burden, including incidence, prevalence, mortality, and DALYs. Trends from 1990 to 2021 were illustrated using estimated annual percent change (EAPC). Subgroup analysis revealed variations by gender, age, Socio‐Demographic Index (SDI), GBD classification, and country. Age‐period‐cohort (APC) and Bayesian age‐period‐cohort (BAPC) models predicted future trends.ResultsIn 2021, there were 118,878 new NPC cases globally (1.38 per 100,000), with a prevalence of 525,219 cases (6.14 per 100,000), 75,359 deaths (0.87 per 100,000), and 249,019 DALYs (28.91 per 100,000). Males had higher rates across all metrics. Incidence peaked at ages 50–54, mortality at 70–74, and DALYs at 50–54. High SDI regions, especially East and Southeast Asia, showed higher burdens. Despite decreasing age‐standardized incidence rates, absolute cases are rising, necessitating improved prevention and treatment strategies.ConclusionsNPC prevalence has increased due to better diagnosis and aging populations, despite decreasing age‐adjusted incidence rates. Lower mortality rates indicate improved treatment. Males, especially in East and Southeast Asia, bear a higher NPC burden. These findings highlight the need for targeted interventions and tailored public health policies in high‐risk regions.Level of EvidenceIII Laryngoscope, 2024
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