Taixiang Liu

Purpose To examine trends, Socio-demographic Index (SDI) associations, inequalities, and future burden of childhood inguinal, femoral, and abdominal hernia (IFAH) in low-income countries (LICs). Methods GBD 2023 estimates for children aged 0–14 years in 25 LICs were analyzed for 1990–2023. Counts, crude rates, estimated annual percentage changes (EAPCs), age- and sex-specific patterns, SDI associations, concentration indices, population–rate decomposition, lower-quantile benchmarking, and projections to 2050 were assessed. Results In 2023, IFAH accounted for 253,424 incident cases, 377 deaths, and 67,970 disability-adjusted life years (DALYs). From 1990 to 2023, incident cases increased by 64.38% and DALYs by 22.18%, whereas deaths decreased by 6.60%. Incidence, mortality, and DALY rates declined, with EAPCs of −0.62%, −2.54%, and −1.75%, respectively. Infants accounted for 64.12% of deaths and 46.72% of DALYs. Mortality and DALY rates were inversely associated with SDI and became increasingly concentrated in relatively lower-SDI countries. Population growth offset gains associated with declining rates. By 2050, incident cases, deaths, and DALYs were projected to reach 305,947, 422, and 77,279. Conclusion Childhood IFAH rates declined, but absolute burden remained substantial and may increase with population growth. Planning should prioritize infant care and LICs with high fatal and disabling burden.

Objectives: To analyze factors associated with prolonged mechanical ventilation (MV) after patent ductus arteriosus (PDA) ligation in preterm infants and identify high-risk patients. Methods: A retrospective analysis (2021–2025) was conducted on preterm infants (≤32 weeks) who underwent PDA ligation. Demographic, preoperative and postoperative data were analyzed; machine learning and SHAP analysis identified associated factors. Results: A total of 271 infants (152 males, 119 females; median gestational age 27 weeks [23–32 weeks], median birth weight 920 g [470–2220 g]) were included. Based on postoperative MV duration ≤6 days or >6 days, 150 cases were assigned to the short MV group and 121 to the prolonged MV group. Significant differences were found between groups in terms of gestational age, birth weight, weight at surgery, PDA diameter, postoperative slowest heart rate, Respiratory Severity Score (RSS), rate of bidirectional PDA shunting, preoperative high-frequency ventilation use, post-ligation cardiac syndrome incidence, and rate of preoperative pulmonary hemorrhage/atelectasis (p < 0.05). RSS was identified as the most central predictor of prolonged postoperative MV duration. RSS > 4.5 was associated with a markedly elevated risk of MV >6 days (AUC = 0.865, sensitivity = 80.2%, specificity = 82.5%). In contrast, birth weight > 1500 g or post-ligation heart rate >135 bpm was correlated with shorter MV duration. Conclusions: High RSS, low birth weight, and slow postoperative heart rate are associated with prolonged postoperative MV. This may aid in identifying infants requiring closer perioperative monitoring.

Background: Inguinal, femoral, and abdominal hernias (IFAH) are common and treatable pediatric surgical conditions, but delayed diagnosis and limited access to timely surgery may cause preventable death and disability in low-and middle-income countries (LMICs). This study aimed to assess the epidemiological trends and burden of IFAH among children aged 0–14 years in LMICs from 1990 to 2023. Methods: Based on the Global Burden of Disease 2023 data, we analyzed incidence, mortality, and disability-adjusted life years (DALYs) across 93 LMICs. Statistical analyses included trend assessment, decomposition, frontier analysis, and Bayesian age-period-cohort modeling to project future burden. Results: In 2023, LMICs accounted for 58.4% of global pediatric IFAH cases, with 83.8% of deaths and 74.0% of DALYs. While age-standardized rates declined in most regions since 1990, absolute incident cases rose in low Socio-demographic Index (SDI) regions. Infants under one year accounted for over 85% of deaths and males experienced a higher overall burden. Decomposition analysis indicated that epidemiological improvements were partially offset by population growth and aging. Health system performance varied, with countries like Myanmar and Haiti showing inefficiencies, while Somalia and Vanuatu performed better relative to resources. Projections suggest that by 2050, low SDI regions will face a continued rise in cases despite reductions elsewhere. Conclusions: Despite overall declines, significant inequalities persist in the burden of pediatric hernias across LMICs. Future efforts should prioritize early screening, surgical access for infants and children in low SDI regions, and strengthening basic surgical systems to address population growth challenges.

Original Article Global burden of developmental intellectual disability in children and adolescents with congenital heart disease, 1990–2021: a population-based study Xinjia Gu, Taixiang Liu, Ruiying Qian, Yujia Wang, Dandan Wang

Background: Despite widespread vaccination, pertussis persists as a critical global public health threat, particularly for individuals under 20 years old. This study aimed to comprehensively assess the global burden of pertussis in this population, with a specific focus on disparities related to age, sex, location, and socioeconomic development. Methods: We utilized data from the Global Burden of Disease (GBD) study 2021 to quantify the burden of pertussis including incidence, mortality, disability-adjusted life years (DALYs) among individuals under 20 years old across 204 countries and territories from 1990 to 2021. Burden estimates were stratified by age, sex, location, and socio-demographic index (SDI). Temporal trends were assessed using estimated annual percentage change (EAPC), and the association between burden metrics and SDI was evaluated via smoothing spline models and Spearman’s correlation analysis. Results: From 1990 to 2021, the global incidence of pertussis in individuals under 20 years old decreased by 77.7%. Similarly, deaths and DALYs due to pertussis declined by 80.3%. In 2021, low-SDI regions reported the highest number of pertussis cases, deaths, and DALYs, whereas high-SDI regions had the lowest. Geographically, South Asia had the highest case count, and Western Sub-Saharan Africa led in deaths and DALYs. Infants had the highest incidence, mortality, and DALY rates. Gender disparities were observed, with females generally having higher rates than males, except in Eastern Sub-Saharan Africa. A negative correlation was noted between SDI and pertussis burden. Conclusions: Our study provides valuable insights into the global pertussis burden among individuals under 20 years old. Despite overall improvements, significant variations exist. Our findings emphasize the need for sustained and improved vaccination strategies such as maternal immunization, improved coverage and timeliness, and better healthcare access, to further address these inequalities.

Preterm birth and low birth weight (PBLBW) persist as critical public health concerns worldwide, significantly contributing to the global disease burden [1]. Preterm birth (PTB) is characterised by the delivery of an infant before reaching 37 weeks of gestation. Low birth weight (LBW) is defined as a birth weight of less than 2500 g, irrespective […]

To construct a model with the indices obtained by echocardiography to predict whether patent ductus arteriosus (PDA) was required to be treated with pharmacologic treatment or surgical ligation, we performed a prospective observational study, including all neonates with gestational age ≤ 30 weeks and assessed the hemodynamics of PDA by serial daily echocardiography examination at postnatal age of 0–12 h, 24 h, 48 h, and 72 h, respectively. The infants were classified in two groups based on whether they were treated with non-steroidal anti-inflammatory drugs (NSAIDs) and/or surgical ligation to close the PDA from the second week after birth. We compared the echocardiographic indices between the two groups and utilized the indices to construct a model to predict which premature infants’ PDA requires intervention. The results showed that a total of forty-two preterm infants were enrolled in the study. 15 (35.7%) preterms were in the intervention group and 27 (64.3%) preterms were in the non-intervention group. Compared with the non-intervention group, the intervention group had a higher proportion of left ventricular volume overload and systemic shunt effect. In addition, the combined indicators of PDA size/weight > 3.2 mm/kg and LA/Ao > 1.4 at postnatal age of 72 h had a highest value to predict whether PDA requires intervention. These findings denoted that serial daily echocardiographic assessment can be useful in predicting whether a PDA will be closed with NSAIDs and/or surgical ligation in preterm infants with gestational age ≤ 30 weeks. Trial registration Number: IRB No. 2018-IRB-073. Date: 2018/09/21, retrospectively registered.