Maternal hemorrhage remains the leading cause of maternal mortality worldwide, hindering progress toward Sustainable Development Goal (SDG) 3.1, which aims to reduce the global maternal mortality ratio (MMR) to less than 70 deaths per 100,000 livebirths by 2030. Comprehensive estimates of its global burden and inequalities are limited. Based on data from the Global Burden of Disease Study 2021, we assessed maternal hemorrhage burden across 204 countries from 1990 to 2021. Indicators included incidence, maternal mortality ratio (MMR), and disability-adjusted life years (DALYs). Temporal trends were analyzed using estimated/average annual percentage changes (EAPC/AAPC), and health inequality was quantified using the Slope Index of Inequality (SII) and Concentration Index (CI). The relationship between burden and Socio-demographic Index (SDI) was examined via LOESS and frontier analysis. Projections to 2030 were conducted using a Bayesian age-period-cohort model. From 1990 to 2021, the global age-standardized incidence rate decreased by 27.7% (from 495.93 to 358.57 per 100,000 population), and MMR declined by 58.2% (from 86.63 to 36.23 per 100,000 livebirths). South Asia and East Asia were the fastest decrease in ASIR (EAPC = -2.71 [-2.86 to -2.55]) and MMR (EAPC = -7.76 [-8.47 to -7.05]), respectively. In 2021, low-SDI regions bore the highest burden, with maternal mortality up to 93 times higher than in high-SDI regions. Inequality analysis showed narrowing absolute disparities (SII: -980.27 to -288.12) but widening relative inequalities (CI: -0.57 to -0.66). Adolescents (10–14 years) and women aged ≥ 35 years had elevated MMRs. Frontier analysis revealed inefficient outcomes in some high-SDI countries. By 2030, maternal hemorrhage is projected to cause approximately 13 million incident cases and 33,186 deaths. Despite global improvements, maternal hemorrhage persists as a major public health challenge with significant regional inequalities. Tailored strategies are urgently needed to reduce the burden in low-resource settings and accelerate progress toward SDG 3.1.

The maternal mortality ratio (MMR) is a core indicator of health-system performance and equity. In China, interpretation of recent maternal mortality trends is increasingly influenced by differences between modeled global estimates and national surveillance data. We aimed to characterize the maternal mortality transition and subnational inequities in China from 1990 to 2023 by comparing Global Burden of Disease (GBD) 2023 estimates with data from the National Maternal Mortality Surveillance System (NMMSS). We integrated model-based estimates from the GBD 2023 with real-world data from China’s NMMSS. Assessment focused on key burden metrics, including disability-adjusted life years, MMR, mortality and incidence. Joinpoint regression was used to identify temporal trend changes. Scenario-based projections and Bayesian age-period-cohort (BAPC) models were applied to forecast progress toward the “Healthy China 2030 target”. Subnational inequalities in maternal healthcare service coverage were also examined. GBD estimates showed China’s MMR declined from 121.9 (1990) to 10.7 (2023) per 100,000 live births, while NMMSS reported 15.1 per 100,000 live births in 2023. According to GBD, the leading cause shifted from maternal hemorrhage to indirect disorders, whereas NMMSS consistently identified obstetric hemorrhage as the primary cause. The urban–rural disparity narrowed substantially, but subnational inequities persisted, particularly in western provinces. The MMR rapid decline during 2004–2015 was followed by a plateau. Scenario-based projections indicate that sustaining recent progress would enable China to achieve the Healthy China 2030 target (MMR <12 per 100,000 live births). China has made remarkable progress in maternal health and significantly reduced urban–rural disparities. However, critical differences between GBD estimates and NMMSS data underscore the need for improved local data collection. Targeted strategies, such as integrating cardiovascular risk screening in eastern provinces and strengthening obstetric emergency capacity in western regions, are essential to further reduce maternal mortality and achieve the Healthy China 2030 goal.

Purpose: Pruritus is a common and distressing symptom among older adults, yet long-term patterns and regional differences across Europe remain insufficiently characterized. As European populations age rapidly, understanding how the burden of pruritus has evolved and may change is essential for clinical and public health planning. Methods: Using Global Burden of Disease (GBD) 2023 estimates, we quantified incidence, prevalence, and disability-adjusted life years (DALYs) of pruritus among adults aged over 60 years in Central, Eastern, and Western Europe from 1990 to 2023. Age-standardized rates and case numbers were extracted for 5-year age groups by sex and country. Temporal trends were evaluated using estimated annual percentage change (EAPC) and Joinpoint regression. Future burden to 2050 was projected with Bayesian age–period–cohort models using Integrated Nested Laplace Approximation. All estimates included 95% uncertainty intervals. Results: From 1990 to 2023, age-standardized incidence, prevalence, and DALY rates increased significantly across all three European regions. In 2023, Central Europe exhibited the highest rates, whereas Western Europe had the largest absolute numbers of affected individuals. Females consistently showed higher rates and earlier peak ages than males. Age-specific curves demonstrated an inverted-U shape, and country rankings were generally aligned with long-term EAPC patterns. Projections suggest continued growth in incident and prevalent cases and DALYs through 2050, especially in Western Europe, with persistent sex- and age-related disparities. Conclusion: The burden of pruritus among older adults in Europe has risen steadily over the past three decades and is projected to increase further. Integrating routine itch assessment, optimized skin care, medication review, and strengthened referral pathways into primary, geriatric, and long-term care services is urgent to mitigate preventable disability in aging populations.

Background: Women of childbearing age (WCBA) in East Asia and Pacific (EAP) have experienced rapid epidemiological change, yet research focus and policy priorities often remain concentrated on maternal survival. We aimed to characterize three-decade comprehensive transitions in causes and risk factors, and quantify cross-country gaps. Methods: We analyzed modelled GBD 2023 estimates for women aged 15– 49 in the EAP region from 1990 to 2023, quantifying the disease burden by disability-adjusted life years (DALYs). Long-term trends were summarized using estimated annual percentage changes (EAPC), and investigated changes before and after the COVID-19 pandemic. Frontier analysis quantifies the disparities in preventable disease burden across countries. Results: From 1990 to 2023, the age-standardized DALY rate among WCBA in EAP declined from 35,218 to 27,534 per 100,000, yet non-communicable diseases expanded their share from 62.3% to 75.7%. By 2023, gynecological disorders, depression, and headache disorders constituted the leading causes of burden. Among risk factors, high body-mass index risk increased significantly since 1990, and became the top risk factor (ASDR = 583.5 per 100,000) in 2023. During the acute pandemic phase, DALYs rose in 33 of 35 EAP regions. Frontier analysis revealed a 2.8-fold disparity in avoidable burden across countries at comparable development levels, with distance-to-frontier in ASDR ranging from 0.35 (Nauru) to 0.98 (China) in 2023. Conclusion: The WCBA disease burden in EAP has transitioned from maternal and infectious conditions toward chronic, metabolic, and disability-related disorders, with significant persistent intra-regional disparities. Health systems should pivot from isolated reproductive care toward integrated life-course surveillance, embedding NCD and mental health services within routine women’s health platforms to address this evolving burden.

Background: N6-methyladenosine (m6A) modification plays a crucial role in tumor biology; however, the function of the methyltransferase adaptor WTAP in melanoma remains poorly understood. Methods: We analyzed WTAP expression and its clinical relevance using TCGA-SKCM and GTEx datasets, followed by immunohistochemical validation in melanoma tissues. The biological effects of WTAP were assessed through gain- and loss-of-function experiments in melanoma cell lines. Weighted gene co-expression network analysis (WGCNA) and LASSO regression were used to identify key WTAP-related genes. Results: WTAP expression was significantly decreased in melanoma compared with normal skin and was negatively correlated with tumor progression and poor survival. Functionally, WTAP overexpression suppressed melanoma cell proliferation and migration, whereas its knockdown produced the opposite effects. Bioinformatic analyses and rescue experiments identified KLF9 as a potential downstream effector of WTAP. WTAP depletion reduced KLF9 mRNA and protein levels, while overexpression restored them. Moreover, MeRIP-qPCR confirmed that WTAP promotes m6A enrichment on KLF9 mRNA, suggesting a post-transcriptional regulatory mechanism. Conclusions: Our findings reveal a novel WTAP–KLF9 axis that mediates melanoma suppression through m6A-dependent regulation. This study provides new insight into the context-specific role of WTAP in melanoma and suggests it may serve as a potential biomarker or therapeutic target.

Background: Condyloma acuminata (CA) is a common sexually transmitted disease caused by human papillomavirus (HPV). Abnormal keratinocyte proliferation is a hallmark of CA, but the underlying mechanisms remain unclear. BST2, an interferon-stimulated gene, is implicated in viral inhibition and tumor cell proliferation. This study aimed to investigate whether BST2 is involved in HPV-induced keratinocyte proliferation. Methods: We conducted bioinformatics analysis using publicly available datasets from the Gene Expression Omnibus (GEO) to assess BST2 expression in CA. HPV-6/11 live virus and HPV11-E7 lentiviruses were used to infect HaCaT cells to mimic early HPV infection and viral genome integration. We examined BST2 expression in both CA patient tissue samples and in vitro models using RT-qPCR, Western blot, and immunohistochemistry. To investigate the signaling mechanisms, we used siRNA to knock down key components of the cGAS/STING pathway and examined BST2 expression levels. Additionally, we assessed keratinocyte proliferation through CCK-8 assays and cell counting. Activation of downstream signaling pathways was evaluated using Western blot analysis for key molecules in the MEK/ERK/c-Myc pathway. Results: BST2 was significantly upregulated in CA lesions and HPV-infected keratinocytes through the cGAS/STING pathway. BST2 activation promoted keratinocyte proliferation via the MEK/ERK/c-Myc pathway, and this effect was significantly inhibited by BST2 knockdown. Conclusions: HPV could promote the proliferation of keratinocytes from condyloma acuminata lesions through inducing BST2, indicating that BST2 would be a potential therapeutic target for condyloma acuminata.