Global and regional quality of care index for prostate cancer: an analysis from the Global Burden of Disease study 1990-2019

Global burden and risk factors of male cancers from 1990 to 2021, with forecasts to 2040

Male cancers, which refers to cancers that occur exclusively in males, is a prevalent type of cancer worldwide, primarily including prostate cancer (PCa) and testicular cancer (TCa). These cancers are significant contributors to the global disease burden. We aim to study specific patterns and trends in male cancers from 1990 to 2021 to inform health policy, allocation of medical resources, and optimization of patient management plans. We analyzed Global Burden of Disease (GBD) 2021 on male cancers data for 21 regions and 204 countries to understand better the health burden using prevalence, incidence, mortality, and disability-adjusted life years (DALYs). We tested correlations with Socio-demographic Index (SDI) using Spearman's analysis. Decomposition analysis was utilized to dissect the reasons behind changes in epidemiological indicators of the disease, and autoregressive integrated moving average (ARIMA) modeling forecasted future disease trends. In 2021, the age-standardized rates (ASR) per 100,000 people for PCa in terms of prevalence, incidence, deaths, and DALYs were 260.05, 34.05, 12.63, and 217.83, respectively, while for TCa were 16.59, 2.24, 0.29, and 13.83, respectively. Compared to 1990, the ratios for PCa changed by 0.19, 0.04, -0.23, and - 0.21, respectively, and for TCa they changed by 0.66, 0.5, -0.14, and - 0.08, respectively. Age analysis revealed a heavier burden of PCa after the age of 70 and a heavier burden of TCa in the 25-34 age group. In regions with High SDI, the ASR for prevalence and incidence were higher, while in regions with Low SDI, the ASR for deaths and DALYs were higher. Aging was the main reason for the increase in PCa, epidemiological change was the main reason for TCa, and population growth was the main reason for death change from 1990 to 2021. Smoking and high calcium diets are risk factors for PCa. For the forecast in 2040, the ASR indicators for PCa in terms of prevalence, incidence, deaths, and DALYs per 100,000 people are projected to be 266.23, 35.21, 9.11, and 176.16, respectively; for TCa cancer they are projected to be 20.63, 2.7, 0.26, and 12.73, respectively. From 1990 to 2021 and with projections to 2040, the prevalence and incidence of global male cancers generally show an upward trend, while deaths and DALYs exhibit a downward trend. Additionally, the higher burden of PCa in individuals over the age of 70 and TCa in the middle-aged group of 25 to 34 years highlights the urgent need for healthcare professionals and policymakers to propose innovative prevention and healthcare strategies based on the existing burden and its new changes, to alleviate the global burden of male cancers.

Global, regional, and national survey on burden and Quality of Care Index (QCI) of orofacial clefts: Global burden of disease systematic analysis 1990-2019

BACKGROUND

Orofacial clefts are the most common craniofacial anomalies that include a variety of conditions affecting the lips and oral cavity. They remain a significant global public health challenge. Despite this, the quality of care for orofacial clefts has not been investigated at global and country levels.

OBJECTIVE

We aimed to measure the quality-of-care index (QCI) for orofacial clefts worldwide.

METHODS

We used the 2019 Global Burden of Disease data to create a multifactorial index (QCI) to assess orofacial clefts globally and nationally. By utilizing data on incidence, prevalence, years of life lost, and years lived with disability, we defined four ratios to indirectly reflect the quality of healthcare. Subsequently, we conducted a principal component analysis to identify the most critical variables that could account for the observed variability. The outcome of this analysis was defined as the QCI for orofacial clefts. Following this, we tracked the QCI trends among males and females worldwide across various regions and countries, considering factors such as the socio-demographic index and World Bank classifications.

RESULTS

Globally, the QCI for orofacial clefts exhibited a consistent upward trend from 1990 to 2019 (66.4 to 90.2) overall and for females (82.9 to 94.3) and males (72.8 to 93.6). In the year 2019, the top five countries with the highest QCI scores were as follows: Norway (QCI = 99.9), Ireland (99.4), France (99.4), Germany (99.3), the Netherlands (99.3), and Malta (99.3). Conversely, the five countries with the lowest QCI scores on a global scale in 2019 were Somalia (59.1), Niger (67.6), Burkina Faso (72.6), Ethiopia (73.0), and Mali (74.4). Gender difference showed a converging trend from 1990 to 2019 (optimal gender disparity ratio (GDR): 123 vs. 163 countries), and the GDR showed a move toward optimization (between 0.95 and 1.05) in the better and worse parts of the world.

CONCLUSION

Despite the positive results regarding the QCI for orofacial clefts worldwide, some countries showed a slight negative trend.

Network pharmacology, molecular docking, and in vitro study on Aspilia pluriseta against prostate cancer

BACKGROUND

Current prostate cancer treatments are associated with life-threatening side effects, prompting the search for effective and safer alternatives. Aspilia pluriseta Schweinf. ex Engl. has previously shown anticancer activity in lung and liver cancer cell lines. This study investigated its potential for prostate cancer.

METHODS

A crude extract of A. pluriseta root was prepared using dichloromethane/methanol (1:1 v/v) and partitioned into hexane, ethyl acetate, and water fractions. The MTT assay was used to assess the antiproliferative activity of the fractions. The active fractions were tested at 6.25-200 µg/ml on human prostate cancer DU-145 cells and non-cancerous Vero E6 cells. Qualitative phytochemical and gas chromatography-mass spectrometry (GC-MS) analyses were conducted to identify chemical compounds. Network pharmacology was employed to predict molecular targets and modes of action of the identified chemical compounds, with subsequent validation through molecular docking and real-time PCR.

RESULTS

Active extracts included crude dichloromethane/methanol, hexane, and ethyl acetate fractions, inhibiting DU-145 cell proliferation with IC50 values of 16.94, 20.06, and 24.14 µg/ml, respectively. Selectivity indices were determined to be 6.04 (crude), 3.62 (hexane), and 6.68 (ethyl acetate). Identified phytochemicals comprised phenols, terpenoids, flavonoids, tannins, sterols, and saponins. GC-MS analysis revealed seventy-nine (79) compounds, with seven (7) meeting ideal drug candidate parameters; their hub gene targets included MAPK3, MAPK1, IL6, TP53, ESR1, PTGS2, MMP9, MDM2, AR, and MAP2K1, implicating regulation of PI3K/Akt, MAPK, and p53 signaling pathways as potential modes of action. Core compounds such as 1-heneicosanol, lanosterol, andrographolide, and retinoic acid exhibited strong binding activities, particularly lanosterol with MAPK21 (-9.7 kcal/mol), ESR1 (-8.9 kcal/mol), and MAPK3 (-8.8 kcal/mol). Treatment with A. pluriseta downregulated AR expression and upregulated p53, while also downregulating CDK1 and BCL-2 and upregulating caspase-3.

CONCLUSIONS

A. pluriseta extracts inhibited DU-145 cell growth without causing cellular toxicity, suggesting great potential for development as an anti-prostate cancer agent. However, further in vitro and in vivo experiments are recommended.

Updated review on analysis of long non-coding RNAs as emerging diagnostic and therapeutic targets in prostate cancers

Despite advancements, prostate cancers (PCa) pose a significant global health challenge due to delayed diagnosis and therapeutic resistance. This review delves into the complex landscape of prostate cancer, with a focus on long-noncoding RNAs (lncRNAs). Also explores the influence of aberrant lncRNAs expression in progressive PCa stages, impacting traits like proliferation, invasion, metastasis and therapeutic resistance. The study elucidates how lncRNAs modulate crucial molecular effectors, including transcription factors and microRNAs, affecting signaling pathways such as androgen receptor signaling. Besides, this manuscript sheds light on novel concepts and mechanisms driving PCa progression through lncRNAs, providing a critical analysis of their impact on the disease's diverse characteristics. Besides, it discusses the potential of lncRNAs as diagnostics and therapeutic targets in PCa. Collectively, this work highlights state of art mechanistic comprehension and rigorous scientific approaches to advance our understanding of PCa and depict innovations in this evolving field of research.