National Trends in Hospitalizations for Stroke Associated with Infective Endocarditis and Opioid Use Between 1993-2015

1993-2015年与感染性心内膜炎和阿片类药物使用相关的中风住院病例的全国趋势

Stroke. 2020

Joinpoint regression was used to assess trends.

使用连接点回归来评估趋势。

Joinpoint regression detected two segments: no significant change in the hospitalization rate was apparent from 1993 to 2008 (annual percentage change, 1.9%; 95% CI, −2.2% to 6.1%), and then rates significantly increased from 2008 to 2015 (annual percentage change, 20.3%; 95% CI, 10.5% to 30.9%), most dramatically in non-Hispanic white patients in the Northeastern and Southern U.S.

连接点回归检测到两个部分：从1993年到2008年，住院率没有明显的变化（APC=1.9%），然后从2008年到2015年显著上升（APC=20.3%），尤其是美国东北部和南部的非西班牙裔白人患者。

Temporal trends in validated ischaemic stroke hospitalizations in the USA

美国经验证的缺血性脑卒中住院治疗的时间趋势

Am J Epidemiol. 2019

Validated rates declined during 1998-2011 from 4.7/1000 to 2.9/1000; however, the decline was limited to 1998-2007, with no further decline subsequently through 2011. 

1998-2011年，验证的住院率从4.7/1000下降到2.9/1000；然而，下降仅限于1998-2007年，随后在2011年没有进一步下降。

 Overall, ischaemic stroke hospitalization rates in the USA have declined during 1998-2007, but no further decline was observed from 2007 to 2011. 

总体而言，1998-2007年美国缺血性中风住院率有所下降，但2007 - 2011年没有进一步下降。

Temporal Trends in Hospitalization for Acute Decompensated Heart Failure in the United States, 1998-2011

1998-2011年美国急性失代偿性心力衰竭住院治疗的时间趋势

Am J Epidemiol. 2016

During 1998-2004, the rate of ADHF hospitalization increased by 2.0%/year (95% confidence interval (CI): 1.8, 2.5) versus a 1.4%/year (95% CI: 0.8, 2.1) increase in code 428 primary hospitalizations (P < 0.001).

1998-2004年期间，ADHF住院率每年增加2.0%，而第428代码初级住院率增加了1.4%/年(95%可信区间(CI): 0.8、2.1)(P < 0.001)。

In contrast, during 2005-2011, numbers of ADHF hospitalizations were stable (-0.5%/year; 95% CI: -1.4, 0.3), while the numbers of 428-primary hospitalizations decreased by -1.5%/year (95% CI: -2.2, -0.8) (P for contrast = 0.03).

相比之下，2005-2011年期间，ADHF住院人数稳定，428名初级住院患者的数量每年减少-1.5% 。

In conclusion, the estimated number of hospitalizations with ADHF is approximately 2 times higher than the number of hospitalizations with ICD-9-CM code 428 in the primary position.

总之，估计ADHF的住院人数大约是ICD-9-CM编码428在主要位置的住院人数的2倍。

The trend increased more steeply prior to 2005 and was relatively flat after 2005.

这一趋势在2005年之前急剧上升，2005年之后相对平稳。

Has the prevalence of overweight, obesity and central obesity levelled off in the United States? Trends, patterns, disparities, and future projections for the obesity epidemic

在美国，超重、肥胖和中心型肥胖的患病率是否已经趋于平稳?肥胖症流行的趋势、模式、差异和未来预测

International Journal of Epidemiology. 2020
The underlying assumption was that means and proportion would continue to increase or decrease at the annual rate without any non-linear components over time. Thus, in the main analysis, beta coefficients reflected average annual changes in binary outcome prevalence (OB, OB/OW, SOB, CO), and annual changes in BMI, WC and WhtR. 

基本的假设是，平均值和比例将在没有任何非线性成分的情况下随时间继续以年增长率增加或减少。因此，在主分析中，beta系数反映了二元结局患病率(OB、OB/OW、SOB、CO)的年平均变化，以及BMI、WC和WhtR的年平均变化。

OB prevalence had consistently risen since 1999 and considerable differences existed across groups and regions.

自1999年以来，产科的患病率一直在上升，而且在不同群体和地区之间存在着相当大的差异。

Among adults, men's OB (33.7%) and OW (71.6%) levelled off in 2009-2012, resuming the increase to 38.0 and 74.7% in 2015-2016, respectively.

在成年人中，男性OB(33.7%)和OW(71.6%)在2009-2012年持平，2015-2016年分别恢复增长至38.0和74.7%。

Women showed an uninterrupted increase in OB/OW prevalence since 1999, reaching 41.5% (OB) and 68.9% (OW) in 2015-2016.

自1999年以来，女性的OB/OW患病率持续上升，2015-2016年分别达到41.5% (OB)和68.9% (OW)。

SOB levelled off in 2013-2016 (men: 5.5-5.6%; women: 9.7-9.5%), after annual increases of 0.2% between 1999 and 2012.

2013-2016年，SOB的比例趋于平稳(男性:5.5-5.6%;女性:9.7-9.5%)，而在1999年至2012年期间，这一比例每年增长0.2%。

OB prevalence in boys rose continuously to 20.6% and SOB to 7.5% in 2015-2016, but not in girls.

2015-2016年，男孩的OB患病率持续上升至20.6%，而女孩的SOB患病率上升至7.5%，但女孩的情况并非如此。

Since 1999, CO has risen steadily, and by 2030 is projected to reach 55.6% in men, 80.0% in women, 47.6% among girls and 38.9% among boys.

自1999年以来，CO水平稳步上升，预计到2030年，男性CO水平将达到55.6%，女性CO水平将达到80.0%，女孩CO水平将达到47.6%，男孩CO水平将达到38.9%。

Regional differences exist in adult OB prevalence (2011-2016) and across ethnicities; South (32.0%) and Midwest (31.4%) had the highest rates.

成人OB患病率存在地区差异(2011-2016年)和种族差异；南部（32.0%）和中西部（31.4%）比例最高。

Trends in Cancer Incidence Among American Indians and Alaska Natives and Non-Hispanic Whites in the United States, 1999-2015

1999-2015年美国印第安人、阿拉斯加原住民和非西班牙裔白人癌症发病率趋势

Epidemiology. 2020

Background: Female breast, prostate, lung, and colorectal cancers are the leading incident cancers among American Indian and Alaska Native (AI/AN) and non-Hispanic White (NHW) persons in the United States. To understand racial differences, we assessed incidence rates, analyzed trends, and examined geographic variation in incidence by Indian Health Service regions.

女性乳腺癌、前列腺癌、肺癌和结直肠癌是美国印第安人和阿拉斯加原住民(AI/AN)以及非西班牙裔白人(NHW)中发病率最高的癌症。为了了解种族差异，我们评估了发病率，分析了趋势，并检查了印度卫生服务地区发病率的地理差异。

Methods: To assess differences in incidence, we used age-adjusted incidence rates to calculate rate ratios (RRs) and 95% confidence intervals (CIs). Using joinpoint regression, we analyzed incidence trends over time for the four leading cancers from 1999 to 2015.

为了评估发病率的差异，我们使用年龄调整后的发病率来计算RRs及其95%置信区间(CIs)。利用联合点回归，我们分析了1999年至2015年四种主要癌症的发病率随时间的变化趋势。

Results: For all four cancers, overall and age-specific incidence rates were lower among AI/ANs than NHWs.

Incidence rates for lung cancer were higher among AI/ANs than NHWs in Alaska (RR: 1.46; 95% CI: 1.37, 1.56) and Northern and Southern Plains.

Similarly, colorectal cancer incidence rates were higher in AI/ANs than NHWs in Alaska and Northern and Southern Plains.

Also, AI/AN women in Alaska had a higher incidence rate for breast cancer than NHW women.

From 1999 to 2015, incidence rates for all four cancers decreased in NHWs, but only rates for prostate (average annual percent change: -4.70) and colorectal (average annual percent change: -1.80) cancers decreased considerably in AI/ANs.

对于所有四种癌症，AI/ANs的总发病率和年龄别发病率低于NHWs。

在阿拉斯加、北部平原、南部平原，AI/ANs的肺癌发病率高于NHWs 。

同样，在阿拉斯加、北部平原、南部平原，AI/ANs的结直肠癌发病率高于NHWs。

此外，阿拉斯加的AI/AN妇女的乳腺癌发病率高于NHW妇女。

从1999年到2015年，NHW中，四种癌症的发病率都有所下降；但在AI/ANs中，只有前列腺和结肠直肠癌的发病率显著下降。

Conclusion: Findings from this study highlight the racial and regional differences in cancer incidence.

这项研究的结果突出了癌症发病率的种族和地区差异。

Incidence decreased over the entire time period (AAPC: -2.43; 95% CI: -2.69, -2.18) and specifically from 2001 to 2008 (APC: -2.84; 95% CI: -3.05, -2.63), from 2008 to 2011 (APC: -4.07; 95% CI: -5.36, -2.77), and from 2011 to 2015 (APC: -1.22; 95% CI: -1.65, -0.78). However, the trend was stable from 1999 to 2001 (APC: -0.95; 95% CI: -2.17, 0.29).

在整个时期发病率下降，特别是2001~2008年，2008~2011年，2011~2015年。但从1999年到2001年，这一趋势保持稳定。

Patterns of age-specific incidence rates for female breast cancer were consistent with previous studies.

女性乳腺癌的年龄特异性发病率模式与以前的研究一致。

Consistent with prior studies,   与之前的研究一致，

Some of this observed variation may be explained through healthcare access, sociodemographic characteristics, and health-related behaviors.

观察到的一些变化可以通过医疗保健获取、社会人口特征和与健康有关的行为来解释。

These differences in geographic variation among AI/ANs are not completely understood.

AI/ANs中这些地理的差异还没有被完全理解。

may be linked with   可能与…有关

may stem from   可能是由于

could stem from  可能源于

This variation may stem from the substantial regional differences in tobacco use, which is a major risk factor for lung cancer.

这种差异可能源于烟草使用方面的巨大区域差异，而烟草使用是肺癌的一个主要危险因素。

This decrease in incidence mirrors the reduction in the use of PSA testing,  发病率的下降反映了PSA检测使用的减少，

A possible reason for the decline is the implementation of tobacco-control strategies and policies;

however, declines in lung cancer due to tobacco control are observed decades after increased tobacco control efforts, due to the long latency period between smoking and cancer.

下降的一个可能原因是烟草控制战略和政策的实施；
然而，由于吸烟和癌症之间有很长的潜伏期，在加大烟草控制力度几十年后，才观察到肺癌的发病率下降。

 

Trends in Black and White Opioid Mortality in the United States, 1979-2015

1979-2015年美国阿片类药物黑人和白人死亡率趋势

Epidemiology. 2018

Background: Recent research on the US opioid epidemic has focused on the white or total population and has largely been limited to data after 1999. However, understanding racial differences in long-term trends by opioid type may contribute to improving interventions.

最近关于美国阿片类药物流行的研究集中在白人或总人口上，主要限于1999年以后的数据。然而，了解阿片类药物类型在长期趋势中的种族差异可能有助于改善干预措施。

Methods: Using multiple cause of death data, we calculated age-standardized opioid mortality rates, by race and opioid type, for the US resident population from 1979 to 2015. We analyzed trends in mortality rates using joinpoint regression.

利用多原因死亡数据，我们计算了1979年至2015年美国居民按种族和阿片类药物类型划分的年龄标准化阿片类药物死亡率。我们用连接点回归分析死亡率的趋势。

Results: From 1979 to 2015, the long-term trends in opioid-related mortality for Earlier data did not include ethnicity so this is incorrect. It is all black and all white residents in the US. blacks and whites went through three successive waves. In the first wave, from 1979 to the mid-1990s, the epidemic affected both populations and was driven by heroin. In the second wave, from the mid-1990s to 2010, the increase in opioid mortality was driven by natural/semi-synthetic opioids (e.g., codeine, morphine, hydrocodone, or oxycodone) among whites, while there was no increase in mortality for blacks. In the current wave, increases in opioid mortality for both populations have been driven by heroin and synthetic opioids (e.g., fentanyl and its analogues). Heroin rates are currently increasing at 31% (95% confidence interval [CI] = 27, 35) per year for whites and 34% (95% CI = 30, 40) for blacks. Concurrently, respective synthetic opioids are increasing at 79% and 107% annually.

从1979-2015年，早期数据中的阿片类药物相关死亡率的长期趋势不包括族裔，因此这是不正确的。美国的居民都是黑人和白人。黑人和白人先后经历了三次浪潮。在1979-1990年代中期的第一次浪潮中，这一流行病影响了两种人群，并由海洛因推动。在第二波，从20世纪90年代中期到2010年，阿片类药物死亡率的增加是由白人中的天然/半合成阿片类药物（如可待因、吗啡、氢可酮或羟可酮）推动的，而黑人的死亡率没有增加。在当前这一波中，海洛因和合成阿片类药物（如芬太尼及其类似物）导致了两类人群阿片类药物死亡率的增加。目前，白人的海洛因吸食率正在以每年31%和34%的速度增长。同时，各自的合成阿片类药物每年增加79% 和107%。

Conclusion: Since 1979, the nature of the opioid epidemic has shifted from heroin to prescription opioids for the white population to increasing of heroin/synthetic deaths for both black and white populations. 

自1979年以来，类阿片流行病的性质已从海洛因转向面向白人的处方类阿片，转而增加了海洛因/合成制剂在黑人和白人人口中的死亡人数。

Secular trends in Swedish hip fractures 1987-2002: birth cohort and period effects

1987-2002年瑞典髋部骨折的长期趋势：出生队列和时期的影响

Epidemiology. 2012

Background: Recently, a leveling off in hip-fracture incidence has been reported in several settings, but the annual number is nonetheless predicted to increase due to the growing elderly population.

最近，有报道称髋部骨折的发生率趋于平稳，但由于老年人口的增长，预计每年髋部骨折的数量仍将增加。

Methods: Using Swedish national data for 1987-2002 for all inpatients 50 years or older, we examined the annual number and incidence of hip fractures and explored age, period, and cohort effects.

Age adjustment was done by direct standardization, time-trend analysis by linear regression, changes in linear trends by joinpoint regression, and age-period-cohort effects by log-likelihood estimates in Poisson regression models.

利用1987-2002年瑞典全国50岁以上住院患者的数据，我们调查了髋关节骨折的年发病率和发病数，并探讨了年龄、时期和队列效应。

采用直接标准化调整年龄，

采用线性回归分析时间趋势，

采用联合点回归分析线性趋势变化，

采用泊松回归模型的对数似然估计计算年龄-时期-队列效应。

Results: 

Before 1996, the age-standardized hip fracture incidence was stable (0.1% per year [95% confidence interval = -0.2% to 0.5%]), and the annual number of hip fractures increased (2.1% per year [1.8% to 2.4%]).

1996年以前，年龄标准化髋部骨折发生率稳定，每年髋部骨折次数增加。

After 1996, both the age-standardized hip fracture incidence (-2.2% per year [-2.8% to -1.6%]) and the number of hip fractures (-0.9% per year [-1.5% to -0.4%]) decreased.

1996年后，年龄标准化髋部骨折发生率和髋部骨折次数均有所下降。

The period + cohort effects were more marked among women than men, with a major reduction in hip fracture incidence in subsequent birth cohorts (estimated incidence rate ratio = 2.2 comparing women born 1889-1896 with 1945-1952) or periods (estimated incidence rate ratio = 1.1 comparing women living 1987-1990 with 1999-2002).

时间段+队列效应在女性中比男性更显著，后续出生队列或时间段的髋部骨折发生率显著降低。

Conclusion: 

The age-standardized hip fracture incidence has decreased since 1996, more than counteracting the effects of the aging population and resulting in a decline in the annual number of hip fractures through 2002.

The magnitude of the combined period and cohort effects in women seems to be of biologic importance. If this persists into older age, the annual number of hip fractures will be lower than has been projected.

自1996年以来，年龄标准化髋部骨折的发生率已经下降，这抵消了人口老龄化的影响，并导致到2002年髋部骨折的年发病率下降。

对妇女的时期和队列联合效应的大小似乎具有生物学重要性。如果这种情况持续到老年，每年髋部骨折的数量将低于预期。

Mobile phone use and incidence of glioma in the Nordic countries 1979-2008: consistency check

Epidemiology. 2012

Background: 

Some case-control studies have reported increased risks of glioma associated with mobile phone use.

If true, this would ultimately affect the time trends for incidence rates (IRs). Correspondingly, lack of change in IRs would exclude certain magnitudes of risk.

We investigated glioma IR trends in the Nordic countries, and compared the observed with expected incidence rates under various risk scenarios.

一些病例对照研究报道了与使用手机相关的神经胶质瘤风险增加。

如果是这样，这将最终影响发病率的时间趋势。相应地，IRs缺乏变化将排除某些程度的风险。

我们研究了北欧国家胶质瘤的IR趋势，并将不同风险情景下观察到的发病率与预期发病率进行了比较。

Methods: 

We analyzed annual age-standardized incidence rates in men and women aged 20 to 79 years during 1979-2008 using joinpoint regression (35,250 glioma cases). 

我们分析了1979-2008年间20 - 79岁男性和女性的年年龄标准化发病率（35250例胶质瘤病例）。

Results: 

For the period 1979 through 2008, the annual percent change in incidence rates was 0.4% (95% confidence interval = 0.1% to 0.6%) among men and 0.3% (0.1% to 0.5%) among women.

1979年至2008年期间，男性发病率的年变化百分比为0.4%(95%可信区间= 0.1%至0.6%)，女性发病率的年变化百分比为0.3%(0.1%至0.5%)。

Incidence rates have decreased in young men (20-39 years) since 1987, remained stable in middle-aged men (40-59 years) throughout the 30-year study period, and increased slightly in older men (60-79 years).

自1987年以来，年轻男性(20-39岁)的发病率有所下降，在30年的研究期间，中年男性(40-59岁)的发病率保持稳定，而老年男性(60-79岁)的发病率略有上升。

In simulations, assumed relative risks for all users of 2.0 for an induction time of up to 15 years, 1.5 for up to 10 years, and 1.2 for up to 5 years were incompatible with observed incidence time trends. For heavy users of mobile phones, risks of 2.0 for up to 5 years' induction were also incompatible.

在模拟中，假设所有用户的诱导时间(15年)为2.0，诱导时间(10年)为1.5，诱导时间(5年)为1.2，这与观察到的发病时间趋势不一致。对于大量使用手机的人来说，在5年的诱导期达到2.0的风险也是不兼容的。

Conclusion: 

No clear trend change in glioma incidence rates was observed.

胶质瘤发病率无明显变化趋势。

Several of the risk increases seen in case-control studies appear to be incompatible with the observed lack of incidence rate increase in middle-aged men.

病例对照研究中发现的一些风险增加似乎与中年男性中未观察到的发病率增加不一致。

This suggests longer induction periods than currently investigated, lower risks than reported from some case-control studies, or the absence of any association.

这表明比目前调查的诱导期更长，比一些病例对照研究报告的风险更低，或不存在任何关联。