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From the beginning of the Iraq war, in March of 2003, to the present day, controversy has swirled around the death toll of the war. This paper narrows down the range of uncertainty for the numbers and trends in violent deaths in the war. I assemble and appraise all primary sources that cover the period from March of 2003 onwards—six sample surveys plus a casualty recording project (Iraq Body Count [IBC]). Data permitting, I present cumulative monthly figures with, for the surveys, 95% bootstrapped uncertainty intervals. The analysis uncovers a core of high-quality mainstream sources that are highly consistent with each another. In addition, there are three outlier surveys that are compromised by serious flaws and produce estimates far outside the mainstream. Discarding the outlying and flawed surveys reveals a clear picture of the violent death toll from the Iraq war. IBC figures, extended to include combatants, occupy a central position within the mainstream range of estimates. The strong consistency across the high-quality sources provides a rare validation of three war-death-measurement methodologies—household-based surveys, sibling-based surveys, and casualty recording. Methodological success notwithstanding, we must transcend the numbers to truly comprehend the human costs of the war. [ABSTRACT FROM AUTHOR]

During the 2022 summer, Europe experienced heatwaves with record temperatures, and a study has argued that they caused about 62,000 deaths between 30 May and 4 September. The total number of excess deaths during the same period was about 137,000, indicating that the heatwaves were a substantial contributor. Not ruling out that explanation entirely, this paper argues that it was unlikely a strong cause. First, if the heatwaves were a strong cause of numerous deaths, one would assume that the older and deprived were relatively likely to die. However, during the 2022 summer heatwaves in England, which were claimed to have caused about 2900 deaths, the oldest age cohort did not have a higher excess death rate than the middle age cohort, and the excess death rate actually decreased with deprivation status. Moreover, Iceland had among Europe's highest excess death rates during the summer, which cannot be attributed to heatwaves. During June, July, and August 2022, comparable southern hemisphere countries furthermore had high excess death rates, which cannot be attributed to heatwaves either, as it was during their winter. Also, Europe's excess death rate was higher during the 2022–2023 winter than during the 2022 summer, and intuitively not attributed to heatwaves, but neither to cold weather, as that winter was abnormally mild. Finally, the paper discusses the puzzling issue that about 56% more women than men, relative to the population, presumably died from the heatwaves. [ABSTRACT FROM AUTHOR]

Severe traumatic brain injury (sTBI) is a silent epidemic, causing approximately 300,000 intensive care unit (ICU) admissions annually, with a 30% mortality rate. Despite worldwide efforts to optimize the management of patients and improve outcomes, the level of evidence for the treatment of these patients remains low. The concomitant occurrence of thromboembolic events, particularly pulmonary embolism (PE), remains a challenge for intensivists due to the risks of anticoagulation to the injured brain. We performed a literature review on sTBI and concomitant PE to identify and report the most recent advances on this topic. We searched PubMed and Scopus for papers published in the last five years that included the terms "pulmonary embolism" and "traumatic brain injury" in their title or abstract. Exclusion criteria were papers referring to children, non-sTBI populations, and post-acute care. Our search revealed 75 papers, of which 38 are included in this review. The main topics covered include the prevalence of and risk factors for pulmonary embolism, the challenges of timely diagnosis in the ICU, the timing of pharmacological prophylaxis, and the treatment of diagnosed PE. [ABSTRACT FROM AUTHOR]

Background: A nanny state imposes restrictions on people's liberty and freedom of action in order to advance their interest and welfare. The extent to which this is desirable, or even ethically acceptable, is debated in the literature. This paper formulates and tests the following hypothesis: the more of a nanny a state has been in the past, the more likely it is that the incumbent government will respond to a new, unknown threat with interventions of a paternalist nature, irrespective of other factors that might contribute to shaping government's response. This hypothesis is then taken to the data using the first wave of COVID-19 as an empirical test. Methods: Data are collected from secondary sources for a sample of 99 countries. Nanny statism is measured by the number of paternalist laws and regulations adopted by a country in the past. The response to COVID is proxied by the time of adoption of control and containment measures and their stringency. The public health outcome is measured by the COVID-19 death toll at the end of June 2020. These variables, plus several controls, are then used to estimate a set of linear and probit regressions and a proportional hazard model of the timing of adoption of control and containment measures. Results: An increase in nanny statism by 0.1 (on a scale from 0 to 10) on average increases the probability of adoption of control and containment measures by 0.077 (i.e. 7.7 percentage points). The central tenement of the hypothesis is therefore consistent with the empirical evidence. The linear and probit regressions also show that there is no evidence of a significant effect of nanny statism on the stringency of the measures adopted. Irrespective of stringency, however, early adoption of control and containment measures is found to reduce the death toll of COVID-19 in the first half of 2020: an increase in nanny statism by 0.1 reduces the COVID death toll by approximately 7%. Conclusions: A tradition of nanny statism potentially leads to a more timely and effective public policy response to a new, unknown crisis. Further tests of the hypothesis should look at the relationship between nanny statism and public health outcomes from natural disasters. [ABSTRACT FROM AUTHOR]

A database of lightning-related fatalities and injuries in Turkey was constructed by collecting data from the Turkish State Meteorological Service, newspaper archives, European Severe Weather Database, and the internet. The database covers January 1930 to June 2014. In total, 742 lightning incidents causing human fatalities and injuries were found. Within these 742 incidents, there were 895 fatalities, 149 serious injuries, and 535 other injuries. Most of the incidents (89%) occurred during April through September, with a peak in May and June (26 and 28%) followed by July (14%). Lightningrelated fatalities and injuries were most frequent in the afternoon. Most of the incidents (86%) occurred in the rural areas, with only 14% in the urban areas. Approximately, two thirds of the victims with known gender were male. Because of the unrepresentativeness of the historical data, determining an average mortality rate over a long period is not possible. Nevertheless, there were 31 fatalities (0.42 per million) in 2012, 26 fatalities (0.35 per million) in 2013, and 25 fatalities (0.34 per million) in 2014 (as of June). There were 36 injuries (0.49 per million) in each of 2012 and 2013, and 62 injuries (0.84 per million) in 2014 (as of June). [ABSTRACT FROM AUTHOR]

As a no-disturbance integrated-retrofitting technique, an external rocking frame was widely used on reinforced concrete (RC) structures. Yet, with the increasing demand for seismic strengthening of existing buildings, it has become a concern to evaluate the seismic strengthening schemes based on seismic resilience. Firstly, the dynamic equation of the structural system was derived, and the deformation control mechanism was revealed; thus, the corresponding design method was put forward for the rocking frame reinforcement. Secondly, after soft-first-floor structures were reinforced by rocking frames, the evaluation method of the reinforcement scheme was investigated based on seismic resilience. Finally, the feasibility of the assessment method was verified by a soft-first-floor frame structure, and a comparison was made between the method proposed in this paper and the conventional method. The results find that the soft-first-floor structure reinforced by the rocking frame increased by 10% in the inter-layer displacement and improved by 55.6% and 63.0% in the injury and mortality rates, compared to the buckling-restrained brace scheme. This indicates that the reinforcement scheme of soft layer structures with rocking frames is feasible and effective, and the reinforcement evaluation method proposed in this paper can quantitatively reflect the improvement in seismic performance. [ABSTRACT FROM AUTHOR]

Earthquake death tolls are a basic statistical measure of the capability of a country to manage seismic risk. The extremely high Turkish death toll of 50,000 from the Kahramanmaras earthquake doublet of 6 February 2023 is the product of a cascade of detrimental factors. These need to be explained if lessons from this disaster are to be learned. This is the purpose and objective of this paper, which is a contribution to the interdisciplinary Frontiers research topic on integrated perspectives on the 2023 Turkey and Syria earthquakes: advancing understanding and preparedness across earth sciences, engineering and public health. This paper covers these three disciplines by focusing on casualties, and identifying crucial aspects of earth sciences and engineering which contributed to the high death toll. First, there was a surprising combination of multiple fault segment ruptures, and a high level of ground motion relative to the risk-based Turkish code, indicative of the under-representation of the M7.5+ earthquake doublet event in the national probabilistic seismic hazard model. This combination of fault segment ruptures was missing from all seismic source models. Furthermore, the capability of buildings to cope with strong ground motion was much reduced by informal construction methods, which eroded the margin of safety needed to avoid building collapse. The extent of building code non-compliance was widely underestimated in seismic risk models. Noncompliance is often hard to identify, but construction amnesties make noncompliance more transparent and trackable. The disastrous outcome of the Kahramanmaras earthquake doublet of 6 February 2023 has drawn global attention to systemic building code non-compliance, and the open official acceptance of informal housing. To demonstrate that this key systemic risk is far from being just a Turkish problem, notably in Istanbul, the challenge of Italian informal housing is highlighted within the context of international building code non-compliance. [ABSTRACT FROM AUTHOR]

In this paper, we consider the influence of a nonlinear contact rate caused by multiple contacts in classical SIR model. In this paper, we unversal unfolding a nilpotent cusp singularity in such systems through normal form theory, we reveal that the system undergoes a Bogdanov-Takens bifurcation with codimension 2. During the bifurcation process, numerous lower codimension bifurcations may emerge simultaneously, such as saddle-node and Hopf bifurcations with codimension 1. Finally, employing the Matcont and Phase Plane software, we construct bifurcation diagrams and topological phase portraits. Additionally, we emphasize the role of symmetry in our analysis. By considering the inherent symmetries in the system, we provide a more comprehensive understanding of the dynamical behavior. Our findings suggest that if this occurrence rate is applied to the SIR model, it would yield different dynamical phenomena compared to those obtained by reducing a 3-dimensional dynamical model to a planar system by neglecting the disease mortality rate, which results in a stable nilpotent cusp singularity with codimension 2. We found that in SIR models with the same occurrence rate, both stable and unstable Bogdanov-Takens bifurcations occur, meaning both stable and unstable limit cycles appear in this system. [ABSTRACT FROM AUTHOR]

The papers in this special section focus on modeling and simulation in disaster and emergency management. The COVID-19 pandemic of 2020 has wrought damage globally to a degree that is totally unprecedented in human history.Within three months that the first known death from the illness caused by the so-called novel Coronavirus was reported by state media in China on the 11th of January 2020, close to 1.8 million people worldwide had tested positive, with more than 100,000 deaths reported. By the time the pandemic will have been declared to be under control, millions more are expected to have been infected and tens (possibly hundreds) of thousands more will have perished as a result of the disease. Not only are the numbers of COVID-19 infected people and deaths staggering. Economies throughout the world have suffered tremendously, with many companies forced to shut down, or at the very least significantly scale down, their production of goods and services as a result of the need for social distancing and self-isolation required to prevent the unmitigated transmission of the disease. All this has led to hundreds of millions worldwide losing their employment or other sources of livelihood. Governments of all nations, large and small, developed and underdeveloped, have needed to pump into their economy and onto their struggling citizens whatever financial resources they could manage to generate. [ABSTRACT FROM AUTHOR]

Vaccination has been the most effective way to control the outbreak of the COVID-19 pandemic. The numbers and types of vaccines have reached considerable proportions, even if the question of vaccine procedures and frequency still needs to be resolved. We have come to learn the necessity of defining vaccination distribution strategies with regard to COVID-19 that could be used for any future pandemics of similar gravity. In fact, vaccine monitoring implies the existence of a strategy that should be measurable in terms of input and output, based on a mathematical model, including death rates, the spread of infections, symptoms, hospitalization, and so on. This paper addresses the issue of vaccine diffusion and strategies for monitoring the pandemic. It provides a description of the importance and take up of vaccines and the links between procedures and the containment of COVID-19 variants, as well as the long-term effects. Finally, the paper focuses on the global scenario in a world undergoing profound social and political change, with particular attention on current and future health provision. This contribution would represent an example of vaccination experiences, which can be useful in other pandemic or epidemiological contexts. [ABSTRACT FROM AUTHOR]

In this paper, with the method of epidemic dynamics, we assess the spread and prevalence of COVID-19 after the policy adjustment of prevention and control measure in December 2022 in Taiyuan City in China, and estimate the excess population deaths caused by COVID-19. Based on the transmission mechanism of COVID-19 among individuals, a dynamic model with heterogeneous contacts is established to describe the change of control measures and the population's social behavior in Taiyuan city. The model is verified and simulated by basing on reported case data from November 8th to December 5th, 2022 in Taiyuan city and the statistical data of the questionnaire survey from December 1st to 23rd, 2022 in Neijiang city. Combining with reported numbers of permanent residents and deaths from 2017 to 2021 in Taiyuan city, we apply the dynamic model to estimate theoretical population of 2022 under the assumption that there is no effect of COVID-19. In addition, we carry out sensitivity analysis to determine the propagation character of the Omicron strain and the effect of the control measures. As a result of the study, it is concluded that after adjusting the epidemic policy on December 6th, 2022, three peaks of infection in Taiyuan are estimated to be from December 22nd to 31st, 2022, from May 10th to June 1st, 2023, and from September 5th to October 13th, 2023, and the corresponding daily peaks of new cases can reach 400 000, 44 000 and 22 000, respectively. By the end of 2022, excess deaths can range from 887 to 4887, and excess mortality rate can range from 3.06% to 14.82%. The threshold of the infectivity of the COVID-19 variant is estimated 0.0353, that is if the strain infectivity is above it, the epidemic cannot be control with the previous normalization measures. [ABSTRACT FROM AUTHOR]

Skin cancer is the predominant form of cancer worldwide, including 75% of all cancer cases. This study aims to evaluate the effectiveness of the spectrum-aided visual enhancer (SAVE) in detecting skin cancer. This paper presents the development of a novel algorithm for snapshot hyperspectral conversion, capable of converting RGB images into hyperspectral images (HSI). The integration of band selection with HSI has facilitated the identification of a set of narrow band images (NBI) from the RGB images. This study utilizes various iterations of the You Only Look Once (YOLO) machine learning (ML) framework to assess the precision, recall, and mean average precision in the detection of skin cancer. YOLO is commonly preferred in medical diagnostics due to its real-time processing speed and accuracy, which are essential for delivering effective and efficient patient care. The precision, recall, and mean average precision (mAP) of the SAVE images show a notable enhancement in comparison to the RGB images. This work has the potential to greatly enhance the efficiency of skin cancer detection, as well as improve early detection rates and diagnostic accuracy. Consequently, it may lead to a reduction in both morbidity and mortality rates. [ABSTRACT FROM AUTHOR]

This paper combines data on GDP and unemployment and from Google's COVID-19 Community Mobility Reports with data on deaths from COVID-19 to study the macroeconomic outcomes of the pandemic. We present results from an international perspective using data at the country level as well as results for individual US states and key cities throughout the world. The data from these different levels of geographic aggregation offer a remarkably similar view of the pandemic despite the substantial heterogeneity in outcomes. Countries like South Korea, Japan, Germany, and Norway and cities such as Tokyo and Seoul have comparatively few deaths and low macroeconomic losses. At the other extreme, New York City, Lombardy, the United Kingdom, and Madrid have many deaths and large macroeconomic losses. There are fewer locations that seem to succeed on one dimension but suffer on the other, but these include California and Sweden. The variety of cases potentially offers useful policy lessons regarding how to use non-pharmaceutical interventions to support good economic and health outcomes. [ABSTRACT FROM AUTHOR]

A balanced ecosystem with coexisting constituent species is often perturbed by different natural events that persist only for a finite duration of time. What becomes important is whether, in the aftermath, the ecosystem recovers its balance or not. Here we study the fate of an ecosystem by monitoring the dynamics of a particular species that encounters a sudden increase in death rate. For exploration of the fate of the species, we use Monte-Carlo simulation on a three-species cyclic rock-paper-scissor model. The density of the affected (by perturbation) species is found to drop exponentially immediately after the pulse is applied. In spite of showing this exponential decay as a short-time behavior, there exists a region in parameter space where this species surprisingly remains as a single survivor, wiping out the other two which had not been directly affected by the perturbation. Numerical simulations using stochastic differential equations of the species give consistency to our results. [ABSTRACT FROM AUTHOR]

During a pandemic outbreak, it is important for health officials to know the proportions of deaths among infected individuals and to understand how these proportions change overtime, to accurately predict the impact of the pandemic and to implement effectively new intervention policies and health protocols and to adjust them accordingly. However, most studies where efforts have been made to estimate accurately the case fatality rates did not address the issue of measuring the dynamics of the pandemic deadliness during its course. Daily data on COVID-19 cases and deaths were collected from selected MENA countries. In this paper, two new measures of the pandemic fatality are developed based on the estimated time it takes hospitalized infected patients to eventually die from the disease. The first measure assigns COVID-19 deaths to its most significant lagged number of cases based on a fixed-effects panel data model. The second fatality measure relates pandemic deaths and cases based on their respective change points. The results find notable variations of the pandemic lethality between the Middle East countries, likely due to the difference in the quality of health care. Although crude case-fatality rate does not identify the pandemic lethality variations during the ongoing of the disease, this paper develops two novel measures for COVID-19 case fatality which can identify the dynamics and the variations of the pandemic deadliness. [ABSTRACT FROM AUTHOR]

BACKGROUND Kinship groups can have considerable importance (e.g., generational support, inheritance, and information for key life events). During demographic transitions, kinship networks are reshaped by changes in mortality and fertility rates. OBJECTIVE This paper analyzes consanguineous and female kin and explores the effect on the size and structure of living kin before and after a demographic transition. We compute the kinship network of a female individual with average demographic traits (here called the Focal) at all ages but focus on only demographically dense ages (age 15 to 39). METHODS The analysis uses a time-invariant model (Caswell 2019) to calculate the expected number of living kin using fertility and mortality rates. We use three examples (China, India, and Japan) with fertility and mortality from World Population Prospect 2019, based on empirical data. CONCLUSIONS We highlight two key results. First, at a demographically dense age of the Focal, the maximum expected number of living aunts, sisters, or daughters is approximately the net reproductive rate R0 (linear), while the number of living cousins is approximately R0² (quadratic). Second, such effects on kinship size depend on the magnitude of fertility change and on the age-pattern of changes in mortality. And the effects of fertility and mortality on the number of kin are not additive. CONTRIBUTION This paper shows a simple relationship between demographic transition and kinship size, which makes it possible to estimate kinship size based on the net reproductive rate. The quadratic relationship between the number of certain kin (e.g., cousins, nieces) and the net reproductive rate is informative but not a priori obvious. [ABSTRACT FROM AUTHOR]

OBJECTIVES This paper investigates ethnic and regional disparities in fatality rates in the Russian military in 2022-2023 during the war in Ukraine. METHODS The analysis uses a new crowdsourced dataset comprising the names of over 20,000 Russian soldiers killed in Ukraine between February 2022 and April 2023. This dataset was compiled by a team of volunteers who gathered information from social media and other accessible sources. The dataset is incomplete and therefore the findings reported in this paper are tentative. Mortality rates and relative risks are estimated by ethnic group and region, and a linear model is fitted to assess the correlation between the ethnic composition of the population, socioeconomic factors, and regional fatality rates. RESULTS The study reveals significant disparities in military fatality rates across Russian regions, with the highest mortality observed among soldiers originating from economically disadvantaged areas in Siberia and the Russian Far East and the lowest among soldiers from Moscow and St. Petersburg. Buryats and Tuvans are overrepresented among the fatalities relative to their population share. However, when regional socioeconomic disparities are accounted for, ethnic differences in mortality rates are considerably reduced. CONCLUSIONS The observed regional and ethnic fatality disparities appear to be driven by socioeconomic inequalities between regions. CONTRIBUTION This paper evaluates social inequalities in fatalities in the Russian military in Ukraine and compares these findings with research on US military casualties. [ABSTRACT FROM AUTHOR]

Prostate cancer remains a prevalent health concern, emphasizing the critical need for early diagnosis and precise treatment strategies to mitigate mortality rates. The accurate prediction of cancer grade is paramount for timely interventions. This paper introduces an approach to prostate cancer grading, framing it as a classification problem. Leveraging ResNet models on multi-scale patch-level digital pathology and the Diagset dataset, the proposed method demonstrates notable success, achieving an accuracy of 0.999 in identifying clinically significant prostate cancer. The study contributes to the evolving landscape of cancer diagnostics, offering a promising avenue for improved grading accuracy and, consequently, more effective treatment planning. By integrating innovative deep learning techniques with comprehensive datasets, our approach represents a step forward in the pursuit of personalized and targeted cancer care. [ABSTRACT FROM AUTHOR]

Reliable estimates of age-specific vital rates are crucial in demographic studies, while ages are, in most cases, commonly grouped in bins of five years. Indeed, public health and national systems require single age-specific data to achieve accurate social planning. This paper introduces a deep learning approach for splitting the abridged death rates, providing a more comprehensive perspective on the indirect age-specific vital rates estimation from grouped data. Additionally, we contribute to the existing literature by introducing a multi-population (countries and genders) approach, providing reliable estimates considering the heterogeneity of longevity dynamics over age, years, and across populations. We also contribute to the state of the art in indirect estimation by introducing, for the first time, a multi-population indirect estimation leveraging subnational data. Our model accurately captures mortality dynamics by age over time and among different populations. We prove the model's ability to estimate reliable predictions of age-specific mortality rates by also studying how the hyperparameters' choice affects the model reliability and analyzing the age-specific relative differences between the real and the estimated mortality rates. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic led to 231,841 deaths and 940,243 hospitalisations in England, by the end of March 2023. This paper calculates the real-time infection hospitalisation risk (IHR) and infection fatality risk (IFR) using the Office for National Statistics Coronavirus Infection Survey (ONS CIS) and the Real-time Assessment of Community Transmission Survey between November 2020 to March 2023. The IHR and the IFR in England peaked in January 2021 at 3.39% (95% Credible Intervals (CrI): 2.79, 3.97) and 0.97% (95% CrI: 0.62, 1.36), respectively. After this time, there was a rapid decline in the severity from infection, with the lowest estimated IHR of 0.32% (95% CrI: 0.27, 0.39) in December 2022 and IFR of 0.06% (95% CrI: 0.04, 0.08) in April 2022. We found infection severity to vary more markedly between regions early in the pandemic however, the absolute heterogeneity has since reduced. The risk from infection of SARS-CoV-2 has changed substantially throughout the COVID-19 pandemic with a decline of 86.03% (80.86, 89.35) and 89.67% (80.18, 93.93) in the IHR and IFR, respectively, since early 2021. From April 2022 until March 2023, the end of the ONS CIS study, we found fluctuating patterns in the severity of infection with the resumption of more normative mixing, resurgent epidemic waves, patterns of waning immunity, and emerging variants that have shown signs of convergent evolution. The severity of SARS-CoV-2 infection varied over the course of the pandemic due to factors such as changes in variant characteristics and population immunity from previous infection or vaccination. Here, the authors estimate infection hospitalisation and infection fatality rates in England over time from the start of the pandemic until March 2023. [ABSTRACT FROM AUTHOR]

Cerebral infarction is a common neurological disease with high rates of morbidity, mortality, and recurrence, posing a great threat to human life and health. Cerebral infarction is the second leading cause of death in the world and the leading cause of long-term disability in humans. The results of the third national retrospective sampling survey on causes of death in 2008 showed that cerebral infarction has become the leading cause of death in China and its mortality rate is 4–5 times that of European and American countries. Therefore, this article proposed a study on the predictive value of Cmmi-MHR combined with thromboelastography parameters that was performed for acute cerebral infarction. This paper mainly proposed a high frame rate imaging technology and analyzed its algorithm. In this article, in the experimental part, an in-depth analysis of the predictive value of the Monocyte-to-high-density lipoprotein cholesterol ratio (MHR) combined with thromboelastography parameters was performed for acute cerebral infarction. The final experimental results showed that HDL (OR = 1.695%, P-trend = 0.049) had a probability of death within 90 days of hospitalization (OR = 0.81, 95% CI = 1.06–3.11, P-trend = 0.523). There were no significant differences in mortality rate after 90 days. Regardless of adjusting for confounders such as age, gender, and NIHSS score, there was no significant difference in the risk of MHR or monocyte count within 90 days of hospitalization. The conclusion indicates that the combination of Cmmi-MHR and thromboelastography parameters provides a new perspective and method for the diagnosis and treatment of cerebral infarction, and provides important support for personalized treatment and management of cerebral infarction. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Transverse colonic volvulus (TCV) is a serious condition with a mortality rate of up to 33%. It is very rare, especially in children. Despite its rarity, surgeons should have a high index of suspicion and include it in the list of differential diagnoses, especially in patients with developmental delays and associated uncommon syndromes. Resection and anastomosis, whether as a one‐stage or two‐stage procedure, proved to be the best treatment options for children. Since prompt identification and management are vital, this paper presents useful information on the presentation, treatment, and outcome of this case report. [ABSTRACT FROM AUTHOR]

Botulism is a priority disease worldwide because it has a very severe course of evolution that can lead to death. This paper aims to describe the main epidemiological characteristics of botulism cases confirmed in Romania over 14 years (2007–2020). We performed a retrospective study using the publicly available national surveillance data and reported to the National Institute of Public Health. A total of 325 cases of foodborne botulism were reported in Romania, with no infant or wound botulism. Most of the cases (125, 38.5%) were reported among young adults (25–44 years old), over half (205, 63%) of them living in rural areas. The incriminated food item was identified in 161 cases; in most cases (145, 90%) the food item was prepared in the household. The main food category was represented by meat and meat-based products (94, 68.6%). In almost all cases the identified type was BoNT/B (230/231, 99.5%). Fifteen deaths were recorded, and the case fatality rate was 4.6%. Botulism cases were reported annually in Romania. Surveillance data are essential for implementing control measures and adapting educational campaigns according to existing needs. [ABSTRACT FROM AUTHOR]

This paper aims to introduce a novel family of probability distributions by the well-known method of the T–X family of distributions. The proposed family is called a "Novel Generalized Exponent Power X Family" of distributions. A three-parameters special sub-model of the proposed method is derived and named a "Novel Generalized Exponent Power Weibull" distribution (NGEP-Wei for short). For the proposed family, some statistical properties are derived including the hazard rate function, moments, moment generating function, order statistics, residual life, and reverse residual life. The well-known method of estimation, the maximum likelihood estimation method is used for estimating the model parameters. Besides, a comprehensive Monte Carlo simulation study is conducted to assess the efficacy of this estimation method. Finally, the model selection criterion such as Akaike information criterion (AINC), the correct information criterion (CINC), the Bayesian information criterion (BINC), the Hannan–Quinn information criterion (HQINC), the Cramer–von-Misses (CRMI), and the ANDA (Anderson–Darling) are used for comparison purpose. The comparison of the NGEP-Wei with other rival distributions is made by Two COVID-19 data sets. In terms of performance, we show that the proposed method outperforms the other competing methods included in this study. [ABSTRACT FROM AUTHOR]

Background: Mortality estimates at the subnational level are of urgent need in India for the formulation of policies and programmes at the district level. This is the first-ever study which used survey data for the estimation of life expectancy at birth () for the 640 districts from NFHS-4 (2015-16) and 707 districts from NFHS-5 (2019-21) for the total, male and female population in India. Methods: This study calculated annual age-specific mortality rates from NFHS-4 and NFHS-5 for India and all 36 states for the total, male and female population. This paper constructed the abridged life tables and estimated life expectancy at birth and further estimated the model parameters for all 36 states. This study linked state-specific parameters to the respective districts for the estimation of life expectancy at birth for 640 districts from NFHS-4 and 707 districts from NFHS-5 for the total, male and female population in India. Results: Findings at the state level showed that there were similarities between the estimated and calculated in most of the states. The results of this article observed that the highest varies in the ranges of 70 to 90 years among the districts of the southern region. falls below 70 years among most of the central and eastern region districts. In the northern region districts lies in the range of 70 years to 75 years. The estimates of life expectancy at birth shows the noticeable variations at the state and district levels for the person, male, and female populations from the NFHS (2015-16) and NFHS (2019-21). In the absence of age-specific mortality data at the district level in India, this study used the indirect estimation method of relating state-specific model parameters with the IMR of their respective districts and estimated across the 640 districts from NFHS-4 (2015-16) and 707 districts from NFHS-5 (2019-21). The findings of this study have similarities with the state-level estimations of from both data sources of SRS and NFHS and found the highest in the southern region and the lowest in the eastern and central region districts. Conclusions: In the lack of estimates at the district level in India, this study could be beneficial in providing timely life expectancy estimates from the survey data. The findings clearly shows variations in the district level . The districts from the southern region show the highest and districts from the central and eastern region has lower . Females have higher as compared to the male population in most of the districts in India. [ABSTRACT FROM AUTHOR]

This paper presents a comprehensive analysis of flood frequency and a spatio-temporal characterization of historical torrential floods in the Šumadija region using water discharge datasets and documented events. A chronology of 344 recorded torrential flood events, spanning from 1929 to 2020, illustrates the region's vulnerability, with a death toll exceeding 43. The study defines the intra-annual primary and secondary peaks of torrential flood occurrences and explains their spatial distribution. Furthermore, the identification of suitable probability distribution functions underscores the necessity of tailored approaches for effective flood risk management in this diverse geographical environment. The study employed Flood Frequency Analysis (FFA) and goodness-of-fit tests, including the Kolmogorov–Smirnov (K-S) and Cramér–von Mises (CvM) tests, to assess the frequency and magnitude of flood events and evaluate diverse distribution functions. The main results include the identification of suitable probability distribution functions for each river within the region, emphasizing the need for tailored approaches in flood risk management. Additionally, discharge values for various return periods offer crucial insights for informed decision-making in flood risk management and infrastructure planning. [ABSTRACT FROM AUTHOR]

This paper uses panel data for Canada from 1976 to 2018, across 10 provinces, to reassess the relationship between mortality rates and economic fluctuations. The key contribution of our paper lies in examining the extent to which this relationship is driven by the employment rate (extensive margin) versus average hours worked (intensive margin). We find evidence of procyclical mortality for females at the aggregate level; aggregate male mortality remains largely unaffected by economic fluctuations. Our findings also reveal temporal heterogeneity, as the extensive margin becomes the driving force for female mortality rates during the more recent period (1990 onwards). These findings remain robust when accounting for personal income and pollution. Finally, we find some support for a procyclical relationship for individuals in the working age groups, while mortality exhibits a countercyclical pattern for children (age 0 to 14) and the elderly (age 65 and above). [ABSTRACT FROM AUTHOR]

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The COVID-19 virus caused a global pandemic leading to a swift policy response. While this response was designed to prevent the spread of the virus and support those with COVID-19, there is growing evidence regarding measurable impacts on non-COVID-19 patients. The paper uses a large dataset from administrative records of the Brazilian public health system (SUS) to estimate pandemic spillover effects in critically ill health care delivery, i.e. the additional mortality risk that COVID-19 ICU hospitalizations generate on non-COVID-19 patients receiving intensive care. The data contain the universe of ICU hospitalizations in SUS from February 26, 2020 to December 31, 2021. Spillover estimates are obtained from high-dimensional fixed effects regression models that control for a number of unobservable confounders. Our findings indicate that, on average, the pandemic increased the mortality risk of non-COVID-19 ICU patients by 1.296 percentage points, 95% CI 1.145–1.448. The spillover mortality risk is larger for non-COVID patients receiving intensive care due to diseases of the respiratory system, diseases of the skin and subcutaneous tissue, and infectious and parasitic diseases. As of July 2023, the WHO reports more than 6.9 million global deaths due to COVID-19 infection. However, our estimates of spillover effects suggest that the pandemic's total death toll is much higher. [ABSTRACT FROM AUTHOR]

This paper seeks to show the relevance of Simone Weil's writings on work for contemporary political and social theory. More specifically, by drawing on Weil's factory writings, I argue that Weil's analysis of speed, humiliation and affliction is highly pertinent for reflecting upon the consequences of the increasingly ubiquitous recourse to digital tracking and monitoring tools by today's employers. The paper also proposes to read Weil's account of suffering and affliction in light of recent scholarship on "slow violence". Inspired by Rob Nixon's work, this scholarship is interested in forms of harm that are slow-paced, attritional, 'out of sight' and intimately tied to our (distracted) attention regimes. As I argue, Weil very lucidly described the paradox at the heart of many types of modern work: namely, that its fast pace causes the slow death of workers' souls and bodies. The paper draws out the importance of Weil's account of affliction for understanding the harms caused by new forms of digital domination in the twenty-first century workplace. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the death penalty in the People's Republic of China in the Xi Jinping era (2012-). Unlike previous administrations, Xi does not appear to have articulated a signature death penalty policy. Where policy in China is unclear, assessing both the quality and frequency of discourse on the topic can provide evidence regarding an administration's priorities. Therefore, we analyse death penalty discourse during Xi's tenure and compare it with discourse under his predecessors. We base our analysis on three large datasets assembled for this project--the collected works of China's leaders, a complete corpus of The People's Daily and a database of academic publications in China. We find no references to the death penalty in Xi Jinping's speeches. We also find a decline in The People's Daily coverage of the death penalty beginning in 2015 and a sharp decrease in academic publications on capital punishment beginning in 2011. Our findings indicate that discourse on the death penalty has declined in the Xi era. We argue that the death penalty has been demobilised under Xi as a discursive site of political signalling. Finally, we conclude with some observations about discursive silence. [ABSTRACT FROM AUTHOR]

Introduction: Avoidable mortality is widely used by public health researchers to measure population health, and many related methodologies have been proposed for doing so. This scoping review presents a comprehensive view of global peer-reviewed and grey literature exploring the association between socioeconomic status (SES) and avoidable mortality. Methods: We searched Ovid Medline, Scopus, and Web of Science to find articles that investigated SES inequalities in avoidable mortality. We limited our review to articles in English published between 2000 and 2020. For grey literature, we searched leading global and Canadian health information websites. We extracted data on different study characteristics, avoidable mortality definition, SES indicator, method of analysis of the association between avoidable mortality and SES, and main findings of the studies. Results: We identified 34 articles to review, including 29 scientific papers and 5 grey literature documents. The findings of the selected articles consistently indicate a negative association between SES and avoidable mortality rates. Studies have not all used the same definitions of avoidable mortality or SES nor operationalized them in the same way. Conclusion: Our review highlights the absence of a globally standard definition in avoidable mortality health equity research. Additional work to establish a standardized definition is crucial for supporting global comparability. [ABSTRACT FROM AUTHOR]

Road fatalities were labelled a pandemic as early as 1973 (BMJ 1973). The number of road fatalities reached 1.35 million in 2016. Currently over 3 500 people perish every day on the world's roads. South Africa has one of the highest road fatality rates in the world, with a fatality rate of 25.9 deaths per 100 000 population (WHO 2018). In order to understand and improve the road safety situation of a region, effective road safety assessments must be carried out. This paper presents a comparison of four different road safety assessment approaches, both traditional and novel, and serves as a proof of concept for the 'road safety desert' methodology, a new technique adapted from the 'transit desert' concept. This new approach to road safety assessment explores the possibility of geo-coded supply and demand comparisons to identify 'road safety deserts' - areas that have a comparatively higher road safety risk. This paper shows that there are several unique and effective ways to assess road safety, and that each approach incorporates different characteristics within their methodologies. It is recommended that road safety analysis is conducted using a multitude of methods, so as to improve understanding and intervention selection. [ABSTRACT FROM AUTHOR]

Background. Intra-arterial chemotherapy (IAC) is considered a unique technique for retinoblastoma (Rb) management and has widespread applicability as a first-line or second-line treatment due to the high globe survival rates. Objectives. This meta-analysis aimed to assess the efficacy of IAC approach among patients with Rb. Materials and methods. This study outlined the most recent research on IAC effectiveness in Rb treatment. We carried out a systematic search for published papers examining IAC treatment among patients with Rb using electronic search engines, including Embase, Web of Science (WoS), PubMed, OVID, and Google Scholar, until October 2021. Results. This meta-analysis included 39 observational studies with 2604 treated eyes and 3112 individuals who were eligible for inclusion. Enucleation rates varied from 0% to 43.7% in the chosen trials, with an odds ratio (OR) of 0.52 (95% confidence interval (95% CI): 0.41-0.66, p < 0.0001). A range of 30-100% was reported for globe salvage across 27 investigations involving 2310 eyes. The estimated OR of globe salvage was 2.41, with 95% CI of 1.6-3.63 and a p-value <0.0001. The combined total effect sizes and the death rate for the proportion of cases with metastatic Rb were as follows: OR = 0.03 (95% CI: 0.03-0.03) and OR = 0.05 (95% CI: 0.04-0.05, p < 0.0001), respectively. Conclusions. Retrospective trials have shown that intra-arterial-based therapy for Rb is an effective choice. Intra-arterial chemotherapy also reduced enucleation and metastasis incidence rates. The paucity of evidence in the literature necessitates further high-level studies. [ABSTRACT FROM AUTHOR]

(1) Background: Among Korean research papers there have been studies on the correlation between tuberculosis-hypertension and diabetes and the correlation between dementia-hypertension and diabetes, but there were no analysis data specifically on tuberculosis and dementia. (2) Methods: A total of 2992 tuberculosis patients in the Gyeongbuk region were analyzed through a final analysis of integrated disease and health management system data collected from 2021 to 2022. In this selection, patients with tuberculosis under 50 years of age and 368 people diagnosed with tuberculosis were excluded. (3) Results: From 2021 to 2022, among the 2992 tuberculosis patients in Gyeongsangbuk-do aged 50 or older, 2722 (91.0%) belonged to the general tuberculosis patient group, while 270 (9.0%) belonged to the dementia–tuberculosis patient group. The average age in the dementia–tuberculosis group was 81.4 years, significantly higher than the general group's average of 75.7 years. Within the dementia–tuberculosis patient group, 235 patients (87.0%) had underlying medical conditions in addition to dementia and tuberculosis. The tuberculosis treatment cure rate was 56.3% (1477 patients) in the general group and 38.9% (105 patients) in the dementia–tuberculosis patient group. (4) Conclusions: The cure rate was notably higher in the general group. Similarly, the mortality rate (deaths due to tuberculosis) was significantly higher in the dementia–tuberculosis patient group (7.0%, 19 patients) compared to the normal group (3.0%, 81 patients). The mortality rate in the dementia group was more than twice that of the general group. [ABSTRACT FROM AUTHOR]

In this paper, we propose a simple dynamic mortality model to fit and forecast mortality rates for measuring longevity and mortality risks. This proposal is based on a methodology for modelling interest rates, which assumes that changes in spot interest rates depend linearly on a small number of factors. These factors are identified as interest rates with a given maturity. Similarly, we assume that changes in mortality rates depend linearly on changes in a specific mortality rate, which we call the key mortality rate. One of the main advantages of this model is that it allows the development of an easy to implement methodology to measure longevity and mortality risks using simulation techniques. Particularly, we employ the model to calculate the Value-at-Risk and Conditional-Value-at-Risk of an insurance product testing the accuracy and robustness of our proposal using out-of-sample data from six different populations. [ABSTRACT FROM AUTHOR]

Background A paucity of evidence exists regarding the optimal management for abdominal aortic graft infection. The aim of this paper was to assess short- and long-term outcomes following different surgical options in aortic graft infection patients. Methods Medline, Embase and the Cochrane Library were searched from inception to February 2023. Network meta-analysis was performed using a frequentist method. Patients were divided into four treatment groups: complete graft removal with in situ repair, complete graft removal with extra-anatomic repair, partial graft removal with in situ repair and partial graft removal with extra-anatomic repair. The mortality rate at 30-days and 1-year was the primary outcome. Secondary outcomes were longer-term mortality rate, primary patency and reinfections. For included RCTs, the Cochrane risk-of-bias tool was utilized to assess the risk of bias. The methodological quality of cohort studies was evaluated using the Newcastle–Ottawa scale. Results Among 4559 retrieved studies, 22 studies with 1118 patients (11 multi-arm and 11 single-arm studies) were included. Patients received complete graft removal with in situ repair (N = 852), partial graft removal with in situ repair (N = 36), complete graft removal with extra-anatomic repair (N = 228) and partial graft removal with extra-anatomic repair (N = 2). Both network meta-analysis results and pooled results of multi- and single-arm cohorts indicated that partial graft removal with in situ repair has the lowest 30-day and 1-year mortality rates (0% and 6.1% respectively), followed by complete graft removal with in situ repair (11.9% and 23.8% respectively) and complete graft removal with extra-anatomic repair (16.6% and 41.4% respectively). In addition, complete graft removal with in situ repair had a lower 3-year (complete graft removal with in situ repair versus complete graft removal with extra-anatomic repair: 32.1% versus 90%) and 5-year (complete graft removal with in situ repair versus complete graft removal with extra-anatomic repair: 45.6% versus 67.9%) mortality rate when compared with complete graft removal with extra-anatomic repair. Patients in the complete graft removal with in situ repair group had the lowest reinfections (8%), followed by partial graft removal with in situ repair (9.3%) and complete graft removal with extra-anatomic repair (22.4%). Conclusion Partial graft removal with in situ repair was associated with lower 30-day and 1-year mortality rates when compared with complete graft removal with in situ repair and complete graft removal with extra-anatomic repair. Partial graft removal with in situ repair might be a feasible treatment for specific aortic graft infection patients. [ABSTRACT FROM AUTHOR]

Patients with COVID-19 have been reported to experience neurological complications, although the main cause of death in these patients was determined to be lung damage. Notably, SARS-CoV-2-induced pathological injuries in brains with a viral presence were also found in all fatal animal cases. Thus, an appropriate animal model that mimics severe infections in the lungs and brain needs to be developed. In this paper, we compared SARS-CoV-2 infection dynamics and pathological injuries between C57BL/6Smoc-Ace2em3(hACE2-flag-Wpre-pA)Smoc transgenic hACE2-C57 mice and Syrian hamsters. Importantly, the greatest viral distribution in mice occurred in the cerebral cortex neuron area, where pathological injuries and cell death were observed. In contrast, in hamsters, viral replication and distribution occurred mainly in the lungs but not in the cerebrum, although obvious ACE2 expression was validated in the cerebrum. Consistent with the spread of the virus, significant increases in IL-1β and IFN-γ were observed in the lungs of both animals. However, in hACE2-C57 mice, the cerebrum showed noticeable increases in IL-1β but only mild increases in IFN-γ. Notably, our findings revealed that both the cerebrum and the lungs were prominent infection sites in hACE2 mice infected with SARS-CoV-2 with obvious pathological damage. Furthermore, hamsters exhibited severe interstitial pneumonia from 3 dpi to 5 dpi, followed by gradual recovery. Conversely, all the hACE2-C57 mice experienced severe pathological injuries in the cerebrum and lungs, leading to mortality before 5 dpi. According to these results, transgenic hACE2-C57 mice may be valuable for studying SARS-CoV-2 pathogenesis and clearance in the cerebrum. Additionally, a hamster model could serve as a crucial resource for exploring the mechanisms of recovery from infection at different dosage levels. [ABSTRACT FROM AUTHOR]

Colorectal cancer is a frequent neoplasm in western countries, mainly due to dietary and behavioral factors. Its incidence is growing in developing countries for the westernization of foods and lifestyles. An increased incidence rate is observed in patients under 45 years of age. In recent years, the mortality for CRC is decreased, but this trend is slowing. The mortality rate is reducing in those countries where prevention and treatments have been implemented. The survival is increased to over 65%. This trend reflects earlier detection of CRC through routine clinical examinations and screening, more accurate staging through advances in imaging, improvements in surgical techniques, and advances in chemotherapy and radiation. The most important predictor of survival is the stage at diagnosis. The screening programs are able to reduce incidence and mortality rates of CRC. The aim of this paper is to provide a comprehensive overview of incidence, mortality, and survival rate for CRC. [ABSTRACT FROM AUTHOR]

The paper analyses the age structure of mortality from suicide, injuries with undetermined intent in general, as well as hanging or jumping/falling from heights with undetermined intent as a potential indicator of latent suicides. It is shown that the age profile of suicide mortality has fundamentally changed over the last 30 years: during the 1990s crisis, a sigmoidal mortality curve with a peak in middle age developed among men, while at the height of the crisis, in the mid-1990s, the maximum age-specific mortality rates were observed among the 50-54-year-olds. Fundamental gender differences in the age profile were only noted during the systemic crisis of the 1990s: as Russian men developed a sigmoidal suicide mortality curve, the age profile of mortality of Russian women was characterised by a stable increase in age-specific indicators starting from age 25-29, while in the mid-1990s women, too, experienced a mortality peak among the 50-54-year-olds. In the 2000s, a gradual flattening-out of the mortality peak in middle age and reaching a maximum at old age took place. Post-2010, a further normalisation of the suicide mortality profile with formation of a plateau at working ages was observed. A comparative analysis of the age profile of suicide mortality and mortality from hanging and jumping/falling from heights with undetermined intent corroborated the hypothesis of these causes being a potential reservoir of latent suicide, which raises the suicide losses of men, from 80% among the 15-24-year-olds to 50% in older individuals, while among women the suicide mortality rate doubles at all ages above 15 years. [ABSTRACT FROM AUTHOR]

As the ultimate spaces of invisibility and marginalization beyond the pale of respectable humanity, prisons engender the “mortification” of inmates, whether understood as a ‘civil death’, the stripping away of citizenship rights and of the legal protections deriving from them, or as a ‘social death’ triggered by the absence of any meaningful intercourse with society and crippling isolation at the margins of humanity. This is even more acutely the case for those subjected to protracted solitary confinement, which has been deemed by the United Nations a specific form of torture yet still marks the deep end of the American criminal justice system. Against this background, my paper explores the manner in which two recent collections of stories, Six by Ten: Stories from Solitary (2018) and Hell is a Very Small Place: Voices from Solitary Confinement (2016), offer glimpses into one of the most secretive and inaccessible spaces in contemporary society, the US prison. It is my contention that, aiming to render visible the covert practices and abuses fostered by the American criminal justice system, the (hi/her)stories in the two volumes under scrutiny offer humanizing perspectives of this deeply contentious and divisive contemporary issue of segregated incarceration. [ABSTRACT FROM AUTHOR]

Irregular heartbeat results in heart diseases. Cardiac deaths are most seen across the globe. Detecting the heart problems in early stage can reduce the death rate. Electrocardiogram (ECG) is one of the most popular method for diagnosing different arrhythmias. Arrhythmia means irregular activity of heart or abnormal heart rhythm. In this paper, cardiac signal peaks P-wave, QRS complex and T-wave are detected for classifying the type of arrhythmia. These are the main components of ECG signal. P-wave is of very small duration, it is ex-plains about the atrial depolarization. The QRS complex may include combination of Q-wave, R-wave, and S-wave. But every QRS complex may not contain Q-R-S waves. It explains about ventricular depolarization. Whereas T wave is about ventricular re-polarization. S-Golay filter is used for denoising. This is used for smoothing the data which thereby, increases the precision of data without distortion of signal tendency. The patient data is collected from MIT-BIH Arrhythmia database for analysis. The simulation is done in Matlab software. [ABSTRACT FROM AUTHOR]

Reducing excess population mortality caused by crises due to armed conflict and natural disasters is an existential aim of humanitarian assistance, but the extent to which these deaths are averted in different humanitarian responses is mostly unknown. This information gap arguably weakens governance and accountability. This paper considers methodological challenges involved in making inferences about humanitarian assistance's effect on excess mortality, and outlines proposed approaches. Three possible measurement questions, each of which contributes some inferential evidence, are presented: (1) whether mortality has remained within an acceptable range during the crisis (for which different direct estimation options are presented); (2) whether the humanitarian response is sufficiently appropriate and performant to avert excess mortality (a type of contribution analysis requiring in-depth audits of the design of humanitarian services and of their actual availability, coverage and quality); and (3) the actual extent to which humanitarian assistance has reduced excess deaths (potentially the most complex question to answer, requiring application of causal thinking and careful specification of the exposure, and for which either quasi-experimental statistical modelling approaches or a combination of verbal and social autopsy methods are proposed). The paper concludes by considering possible 'packages' of the above methods that could be implemented at different stages of a humanitarian response, and calls for investment in improved methods and actual measurement. [ABSTRACT FROM AUTHOR]

Mortality statistics is underlay for public health measures and action and consequently it is one of the major indicator in measures of Covid-19 impact on population. This study aim to explore excess mortality during the Covid-19 pandemic in Serbia. Excess mortality compares expected and observed number of deaths during the given period. Analysis in this paper was based on excess deaths and excess mortality rate. Data was downloaded from the national COVID-19 database and obtained from a relevant source from the Statistical Office of the Republic of Serbia. In order to provide better understanding of excess death, the excess mortality rate was calculated for the period January 2015-June 2022. For the period January 2015-February 2020, 38 months were observed without excess deaths, while in months with excess deaths, almost in all months excess mortality rate was below 12%. Since March 2020, the excess mortality rate has increased significantly, with highest values in December 2020 (91.4%), October (84.3) and November (67.8) 2021. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is the second most common cause of death and disability-adjusted life years (DALYs) globally. However, the incidence and impact of stroke by ethnicity and gender is frequently distinct. This is particularly the case in Ecuador where geographic and economic marginalization are often correlated with ethnic marginalization and the extent to which females lack the same opportunities as their male counterparts. The aim of this paper is to investigate the differential impacts in terms of stroke diagnosis and burden of disease by ethnicity and gender, using hospital discharge records over the years 2015-2020. Methods: This paper calculates stroke incidence, and fatality rates using hospital discharge and death records over the years 2015-2020. The DALY package in R was employed to calculate the Disability Adjusted Life Years lost due to stroke in Ecuador. Results: The results show that while the incidence rate of stroke in males (64.96 per 100,000 persons-year) is higher than that for females on average (57.84 per 100,000 persons-year), males accounted for 52.41% of all stroke cases and 53% of all surviving cases. Thus, hospital data suggests that females had a higher death rate when compared to males. Case fatality rates also differed significantly by ethnicity. The highest fatality rate corresponded to the Montubio ethnic group (87.65%), followed by Afrodescendants (67.21%). The estimated burden of disease of stroke calculated using Ecuadorian hospital records (2015-2020) varied from 1,468 to 2,991 DALY per 1,000 population on average. Discussion: Differences in the burden of disease by ethnic group are likely to reflect differential access to care by region and socio-economic group, both of which are frequently correlated with ethnic composition in Ecuador. Equitable access to health services remains an important challenge in the country. The gender discrepancy in fatality rates suggests that there is a need for targeted educational campaigns to identify stroke signs early, especially in the female population. [ABSTRACT FROM AUTHOR]