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Advertisements often feature numeric claims comparing risks associated with one alternative (e.g., control) to another (treatment). Differences may be expressed in either absolute (Starting Rate − Modified Rate) or relative ([Starting Rate − Modified Rate] / Starting Rate) terms. For example, assume a new heart disease treatment reduces the five-year mortality rate from 7.5% (starting risk) to 4% (modified risk). The absolute difference in this case is 3.5%, whereas the relative difference is 46.6%. Because relative differences appear larger, they positively influence evaluations and are therefore more often used in advertising. Unfortunately, baseline information (starting and modified rates) is often omitted or featured inconspicuously in an advertisement. In three experiments, we find that consumers ignore baseline information and instead rely on the magnitude of the difference in forming judgments (Study 1) unless they are motivated to elaborate on the relative-difference claim (Study 2). When motivated, inferences of manipulative intent (IMIs) are activated, which reduce evaluations. In Study 3, when motivated consumers' ability to interpret a relative difference is enhanced, IMIs are affected by the magnitude of the absolute difference. Our findings suggest that motivated consumers or those with the ability to understand relative-difference claims find their use to be manipulative. [ABSTRACT FROM AUTHOR]

Recent experiments indicated that nanoparticles (NPs) might efficiently catalyze multiple chemical reactions, frequently exhibiting new phenomena. One of those surprising observations is intra-particle catalytic cooperativity, when the reactions at one active site can stimulate the reactions at spatially distant sites. Theoretical explanations of these phenomena have been presented, pointing out the important role of charged hole dynamics. However, the crucial feature of nanoparticles that can undergo dynamic structural surface rearrangements, potentially affecting the catalytic properties, has not yet been accounted for. We present a theoretical study of the effect of dynamic restructuring in NPs on intra-particle catalytic cooperativity. It is done by extending the original static discrete-state stochastic framework that quantitatively evaluates the catalytic communications. The dynamic restructuring is modeled as stochastic transitions between states with different dynamic properties of charged holes. Our analysis reveals that the communication times always decrease with increasing rates of dynamic restructuring, while the communication lengths exhibit a dynamic behavior that depends on how dynamic fluctuations affect migration and death rates of charged holes. Computer simulations fully support theoretical predictions. These findings provide important insights into the microscopic mechanisms of catalysis on single NPs, suggesting specific routes to rationally design more efficient catalytic systems. [ABSTRACT FROM AUTHOR]

Intracerebral hemorrhage (ICH) is associated with high rates of mortality and disability, underscoring an urgent need for effective therapeutic interventions. The clinical prognosis of ICH remains limited, primarily due to the absence of targeted, precise therapeutic options. Advances in novel drug delivery platforms, including nanotechnology, gel-based systems, and exosome-mediated therapies, have shown potential in enhancing ICH management. This review delves into the pathophysiological mechanisms of ICH and provides a thorough analysis of existing treatment strategies, with an emphasis on innovative drug delivery approaches designed to address critical pathological pathways. We assess the benefits and limitations of these therapies, offering insights into future directions in ICH research and highlighting the transformative potential of next-generation drug delivery systems in improving patient outcomes. This review describes the advances and classification of new drug delivery methods for Intracerebral hemorrhage (ICH) treatment and analyzes the advantages and disadvantages. The results may help to provide direction for future ICH treatment. [Display omitted] [ABSTRACT FROM AUTHOR]

Extensions of quantile regression modeling for time series analysis are extensively employed in medical and health studies. This study introduces a specific class of transformed quantile-dispersion regression models for non-stationary time series. These models possess the flexibility to incorporate the time-varying structure into the model specification, enabling precise predictions for future decisions. Our proposed modeling methodology applies to dynamic processes characterized by high variation and possible periodicity, relying on a non-linear framework. Additionally, unlike the transformed time series model, our approach directly interprets the regression parameters concerning the initial response. For computational purposes, we present an iteratively reweighted least squares algorithm. To assess the performance of our model, we conduct simulation experiments. To illustrate the modeling strategy, we analyze time-series measurements of influenza infection and daily COVID-19 deaths. [ABSTRACT FROM AUTHOR]

• Depression mildly increased overall mortality risk in people with diabetes (DM). • Such elevated mortality risk is more prominent in men and patients aged >50 years. • DM with depression related to raised rates of neuropathy & metabolic complications. • Effect of DM complication burden on mortality risk increased further by depression. People with depression have increased premature mortality and elevated prevalence of diabetes-mellitus compared to general population. However, risk of mortality and diabetes-related complications among patients with depression and co-occurring diabetes is under-studied. This population-based propensity score-matched (1:10) cohort study identified 12,175 patients with pre-existing depression and incident-diabetes (depression-diabetes group) and 117,958 patients with incident-diabetes only (diabetes-only group) between 2002 and 2021 in Hong-Kong, using territory-wide medical-record database of public-healthcare services, to investigate whether depression increased the risk of overall mortality, complications and post-complication mortality in people with diabetes. Associations of depression with all-cause mortality, complication and post-complication all-cause mortality rates were examined by Cox proportional-hazards model. Complications were assessed by Diabetes-Complications-Severity-Index (DCSI). Associations of complications, in terms of DCSI scores (complication burden), specific types and two-way combinations of complications (complication patterns) with all-cause mortality rate in depression were also examined. Our results showed that depression-diabetes group exhibited increased all-cause mortality risk (adjusted hazards-ratio: 1.06 [95 %CI: 1.02–1.10]) relative to diabetes-only group, particularly among men and older age group, with significantly higher rate of experiencing neuropathy (1.44 [1.27–1.62]) and metabolic complications (1.30 [1.09–1.56]) and lower likelihood of peripheral-vascular complications, retinopathy and nephropathy, albeit comparable macrovascular and microvascular complication rates. The mortality-rate-ratio for patients with depression and diabetes was significantly higher than patients with diabetes-only at a low level of complication burden. In conclusion, depression patients with co-occurring diabetes are at increased risk of excess mortality. Further research is warranted to improve diabetes-related outcomes and reduce mortality gap in this vulnerable population. [ABSTRACT FROM AUTHOR]

In the 2018 Organ Procurement and Transplantation Network donor heart allocation system, patients listed for re-transplantation due to cardiac allograft vasculopathy (CAV) are assigned to Status 4 unless hemodynamic criteria are met. We aim to examine waitlist outcomes of CAV patients among adult heart transplant candidates. We examined waitlist mortality stratified by CAV and waitlist status among adult heart transplant candidates using Scientific Registry of Transplant Recipients data from 10/1/2018–11/1/2023. We analyzed waitlist mortality using Kaplan-Meier curves and doubly-robust Cox regressions adjusted for age, gender, sex, race, and dialysis. We compared CAV to non-CAV patients by initial waitlist status, first status of interest, and time-dependent status. Of 21,586 listed patients, 368 were listed for CAV. CAV patients were most often listed at Status 4 with lower proportions at Status 3/2/1 compared with non-CAV patients. Status 4 and Status 3 CAV candidates demonstrated higher than expected waitlist mortality compared to non-CAV counterparts (Status 4: HR 0.51, 95% CI 0.31–0.84; p < 0.01; Status 3: HR 0.61, 95% CI 0.23–1.64; p = 0.33) with similar mortality to non-CAV patients in Status 3 and 2, respectively (Status 4: HR 0.80, 95% CI 0.48–1.35; p = 0.4; Status 3: HR 1.07, 95% CI 0.40–2.86; p = 0.89). When stratifying by status tier, CAV waitlist patients ever listed at Status 4 and 3 had a higher probability of death compared to their non-CAV counterparts (Status 4: HR 1.99, 95% CI 1.20–3.31, p < 0.01; Status 3: HR 3.06, 95% CI 1.06–8.87, p = 0.04). After 2018, CAV patients had a higher risk of waitlist mortality at Status 4 and 3 compared to non-CAV patients. These results suggest that CAV patients are underprioritized in the current allocation system. [ABSTRACT FROM AUTHOR]

Background This study aimed to compare the clinical outcomes of decompressive craniectomy (DC) and craniotomy in treating acute subdural hematoma (ASDH) to provide a more precise assessment of the procedures' outcomes. Methods We searched for relevant articles in PubMed, Web of Science, Embase, Scopus, and Cochrane till August 2023, including cohort studies and randomized controlled trials comparing craniotomy and DC for ASDH. The analysis was conducted using "Review Manager" software, using the risk ratio along with a 95% confidence interval (CI) for categorical data, whereas continuous data were analyzed using the mean difference (MD) and 95% CI. Results Our analysis included 13 studies with a total of 4,689 patients, of whom 1,910 (40.7%) underwent DC and 2,779 (59.3%) underwent craniotomy. The results revealed a statistically significant difference in favor of craniotomy concerning good recovery in delayed GOS (risk ratio [RR] = 1.42; 95% CI [1.12, 1.81]), postoperative mortality (RR = 0.81; 95% CI [0.71, 0.94]), mortality at last follow-up (RR = 0.75; 95% CI [0.62, 0.91]), and hospital stay (MD = –3.71; 95%CI [–5.82, –1.60]). A nonsignificant difference (RR = 1.06; 95% CI [0.52, 2.17]; p = 0.87) was found between the two interventions concerning seizures. Conclusion Despite craniotomy's favorable clinical outcomes and mortality rates, the significant baseline differences between DC and craniotomy make these data inconclusive. To establish solid evidence regarding the use of DC versus craniotomy in ASDH, it is necessary to conduct well-controlled randomized studies with large sample sizes. [ABSTRACT FROM AUTHOR]

Background There is still no consensus on whether primary pontine hemorrhage (PPH) should be managed conservatively or treated promptly via surgical evacuation of the hematoma. The purpose of this study was to assess the therapeutic effect of robotic frameless stereotactic aspiration with thrombolysis in the treatment of PPH. Methods A total of 39 patients with PPH treated between January 2012 and November 2016 were included in the study. Sixteen patients underwent frameless stereotactic surgical treatment (ST group) and 23 patients underwent conservative treatment (CT group). Clinical and radiologic parameters were assessed, and the patient outcomes were analyzed over a 6-month follow-up period. Results Surgical treatment did not result in any intracranial infections, or complications. Baseline characteristics did not significantly differ between the two groups. At discharge, the average Glasgow Coma Scale (GCS) score and the overall Glasgow Outcome Scale (GOS) score were significantly higher in the ST group compared to the CT group (p < 0.05). The mortality rate (GOS score 1) was significantly lower in the ST group (18.75%, 3/16) than in the CT group (52.17%, 12/23). For patients with hematoma volumes of 5 to 10 mL or GCS scores of 6 to 8, following treatment, the ST group exhibited markedly higher GOS scores in comparison to the CT group. Conclusion Our study suggests that robotic frameless stereotactic aspiration with thrombolysis is a safe and efficient method for the treatment of PPH. Patients with hematomas of 5 to 10 mL or GCS scores of 6 to 8 could benefit from surgery. [ABSTRACT FROM AUTHOR]

• We performed a systemtic review to evluate fetal death after implementation of ACOG's 39-week rule. • Implementation of the 39-week rule resulted in 8% increased risk of fetal death. The "39-week rule," implemented in August 2009, strongly discouraged early term deliveries before 39 weeks without accepted ACOG delivery indications. In this study, we evaluated fetal death rates before and after the 39-week rule in the United States (US) by review of published series. Systematic literature searches were performed in PubMed, Cochrane Central Register of Controlled Trials, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and Scopus databases (January 2009-June 2023). Searches were focused on the 39-week rule and fetal death. Articles were excluded if they were non-English, included non-US population, or included multiple gestations. The articles were then exported to EndNote for reference management and uploaded to Rayyan for title and abstract screening by two independent reviewers. The study was prospectively registered in PROSPERO. Of 833 articles identified after initial search, 6 peer-reviewed studies met the inclusion criteria. After combining the data from these studies, there were 8713 fetal deaths/7,294,911 total births (0.12 %) post-implementation of the 39-week rule, and 8523 fetal deaths/7,705,422 total births (0.11 %) pre-implementation. Compared to pre-implementation, the odds of fetal death after implementation of the 39-week rule were 1.08 (95 % CI 1.05–1.11). Implementation of ACOG's 39-week rule resulted in an 8 % increased risk of fetal death compared to pre-implementation of the 39-week rule. This is alarming, but must be evaluated in the setting of decreased neonatal morbidity and mortality following the introduction of the 39-week rule. [ABSTRACT FROM AUTHOR]

Mantle cell lymphoma (MCL) is a rare, incurable B-cell non-Hodgkin lymphoma and over half of patients affected are older adults (≥65 years of age). New targeted treatments for MCL have emerged over the past two decades. Nonetheless, MCL-specific death rates for older adults remain elevated compared with younger adults, demonstrating the challenge of treating this population. The older adult population is at risk for overtreatment or undertreatment. Clinicians must be mindful of how to optimize the holistic care of older adults receiving treatment for MCL. Evaluating fitness through a geriatric assessment (GA) is an important step when choosing therapy. The treatment armamentarium includes both chemotherapy and non-chemotherapy options and toxicities must be considered in the context of the patient's GA and proactively managed. Herein, the treatment of MCL in older adults is reviewed and strategies for choosing treatment are offered to assist in treatment decision-making for this challenging population. [ABSTRACT FROM AUTHOR]

The study aimed to prepare pure immunoglobulin Y (IgY) and investigate its potential of use in avian influenza (AI) H5N1 control in naturally infected ducks. The IgY was prepared using the polymer precipitation method and was found to have high hemagglutination inhibition (HI) mean titres against H5, H9, and ND by the 5th and 8th week post-vaccination (wpv). The separated IgY had mean HI titres against H5 7.20±0.46 and 7.60±0.74 for 5 and 8 wpv, respectively. SDS-PAGE analysis showed the presence of two prominent bands with molecular weight 65.08 and 27.96 kDa at 5 wpv, which resolved into 65.98 and 27.96 kDa at 8 wpv. The protein concentration of IgY was 3.92 and 5.71 mg/mL at 5 and 8 wpv, respectively. The therapeutic potential of IgY was evaluated in 33-dayold Muscovy male ducks showing signs of AI H5N1 infection with 35% mortality within 36 hours. The ducks were injected intramuscularly (i.m.) with 1 mL IgY diluted 1/5 or 1/10 for three successive days. The results showed that the ducks injected with IgY had reduced mortality rates compared to the non-injected ducks. After the third injection, the ducks appeared to be normal, and the total mortality rate was 23.7% and 45.18% in 1/5 and 1/10 injected birds, respectively, compared to 98.08% in non-injected birds. In conclusion, the study suggests that IgY prepared from immunised hens can be used to control AI H5N1 in ducks. However, further investigations are needed to determine the accurate dose, time, and concentration of protein required for effective treatment. [ABSTRACT FROM AUTHOR]

Objective This article compares the occurrence of cancer and germinal damage in the city of Guarapari-Espírito Santo (ES), an area with high natural ionizing radiation, with other coastal cities. Material and Methods The evaluated cities were: Guarapari (ES), Campos (Rio de Janeiro), Rio Grande (Rio Grande do Sul), and Ilhéus (Bahia); the following factors were considered: mortality rate % from tumors (2007–2017), mortality rate % from tumors up to 15 years of age (2007–2017), hospital morbidity rate % from tumors up to 15 years of age (2008–2018), and hospital morbidity rate % from congenital malformation and chromosomal anomalies (2008–2018). Radiometric surveys were conducted by the Applied Physics Group at Universidade Federal do Espírito Santo. Results The natural radiation levels recorded in Guarapari resulted in accumulated dose between 3.65 and 10.95 mSv/year, and 1 mSv in the other cities. The highest average cancer mortality rates were: Rio Grande = 22.4%; Guarapari = 17.6%; Campos = 16.7%; and Ilhéus = 11.8%. The proportional hospital mortality and morbidity rates for cancer up to 15 years of age are as follows: Ilhéus = 3.36 and 5.87%; Rio Grande = 0.79 and 7.38%; Guarapari = 0.64 and 7.25%; and Campos = 0.39 and 9.13%. The hospital morbidity rate due to congenital malformations and chromosomal anomalies was 0.72% for Campos, 0.63% for Rio Grande, 0.62% for Guarapari, and 0.43% for Ilhéus. Conclusion There was no increase in cases of cancer or germ damage in Guarapari. These results indicated a dose threshold in the induction of these damages, contradicting the current linear no-threshold theory. [ABSTRACT FROM AUTHOR]

In the United States (US) and worldwide alcohol is a major contributor to premature mortality and morbidity. We explored US trends in alcohol related mortality from 1999 to 2020 overall and by age, gender, race, and region Publicly available US Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) and the underlying cause of death file from CDC WONDER using ICD-10 codes. In 1999, there were 19,356 alcohol-related deaths, a mortality rate of 10.7 per 100,000. By 2020, deaths increased to 48,870 or 21.6 per 100,000. Overall, the mortality rate ratio (MRR) was significantly increased by about 2.0-fold. There were significant increases in all 10-year age groups with the largest 3.8-fold in those 25 to 34. Women experienced a 2.5-fold increase; Asians and Pacific Islanders had the largest increase of 2.4-fold; and the Midwest showed the largest regional increase of 2.5-fold. During the last 20 years there have been significant increases of about 2-fold in US alcohol-related mortality. Clinical challenges are increased by interrelationships of risk factors, especially overweight and obesity, and diabetes, alcohol, overweight and obesity all cause liver damage which may be additive and lead to earlier onset of alcohol related mortality. In addition, health providers should also consider demographic shifts and regional differences. Targeted interventions by health care providers may reduce this increasing US epidemic of alcohol related mortality. These data also generate many hypotheses testable in analytic studies designed a priori to do so. [ABSTRACT FROM AUTHOR]

Species reintroductions require large resource investments for rearing and placement and are further complicated by the paucity of robust monitoring regimes. Nonetheless, continued population declines in many species necessitate such actions. The white abalone (Haliotis sorenseni) in California has experienced steep population declines and a reintroduction programme through outplanting juvenile, captive-bred abalone is considered necessary for its recovery. A novel module known as the Short-term Abalone Fixed Enclosure (SAFE) was developed to allow red abalone (H. rufescens), a surrogate species that is not endangered and co-occurs with white abalone, a period of adjustment before dispersing. Outplant events were conducted at multiple sites in California, USA and monitored regularly for shells and live animals in a process known as metareplication, considered essential for robust outplant reporting. Time-lapse cameras were also placed on SAFEs to document predator visitation. Live animals and shells both increased on-site throughout the first six months and declined thereafter, with most animals unaccounted for. Empty shells on site were considered a proxy for the mortality rate and the lack of encounters after a short period suggests successful emigration from modules into the reef habitat. Predator visitation was generally low, and no significant differences were found across outplant periods. Results from this study indicate outplant mortality may peak early and predator activity is generally low and unrelated to abalone introduction. This vital step illustrates this outplant method may be an effective tool in restoring abalone to subtidal rocky reefs. [ABSTRACT FROM AUTHOR]

Increasing trends for prostate cancer incidence and mortality rates in many countries in Africa, Asia, and Latin America and the Caribbean probably reflect an increase in detection (incidence) and limited access to and availability of treatment (mortality). Our aim was to examine worldwide patterns and trends for prostate cancer (PC) incidence and mortality using high-quality, up-to-date, population-based data. We analyzed age-standardized PC incidence and mortality rates by country and region from the 2022 GLOBOCAN estimates and temporal trends in incidence (50 countries/territories) and mortality (59 countries/territories) rates using data from the Cancer Incidence in Five Continents series and the World Health Organization mortality database. Estimated PC rates across regions in 2022 varied 13-fold for incidence and 9.5-fold for mortality. The highest incidence rates were in Australia/New Zealand, North America, Northern Europe, and Latin America/Caribbean. The highest mortality rates were in sub-Saharan Africa and Latin America/Caribbean. During the most recent 5-yr period, incidence rates increased in 11 of the 50 countries included in the study and mortality rates increased in nine of 59 countries, mostly located in Africa, Asia, Latin America/Caribbean, and Central and Eastern Europe. Mortality rates decreased in 38 countries, largely located in Europe, Oceania, and Latin America/Caribbean. Limitations include the lack of data for low- and middle-income countries. The increase in PC incidence and mortality rates in many countries in Africa, Asia, and Latin America/Caribbean may be because of increases in detection (incidence) and limited access to and availability of treatments (mortality only). The findings reinforce the importance of improving the health care infrastructure in these countries to mitigate the rising burden of PC. [ABSTRACT FROM AUTHOR]

This paper examines a recently developed statistical approach for evaluating the effectiveness of vaccination campaigns in terms of deaths averted. The statistical approach makes predictions by comparing death rates in the vaccinated and unvaccinated populations. The statistical approach is preferred for its simplicity and straightforwardness, especially when compared to the difficulties involved when fitting the many parameters of a dynamic SIRD-type model, which may even be an impossible task. We compared the estimated number of deaths averted by the statistical approach to the "ground truth" number of deaths averted in a relatively simple scheme (e.g., constant vaccination, constant R0, pure SIR dynamics, no age stratification) through mathematical analysis, and quantified the difference and degree of underestimation. The results indicate that the statistical approach consistently produces conservative estimates and will always underestimate the number of deaths averted by the direct effect of vaccination, and thus obviously the combined total effect (direct and indirect effect). For high R0 values (e.g. R0 x 8), the underestimation is relatively small as long as the vaccination level (v) remains below the herd immunity vaccination threshold. However, for low R0 values (e.g. R0 = 1.5), the statistical approach significantly underestimates the number of deaths averted by vaccination, with the underestimation greater than 20%. Applying an approximate correction to the statistical approach, however, can improve the accuracy of estimates for low R0 and low v. In conclusion, the statistical approach can provide reasonable estimates in scenarios involving high R0 values and low v, such as during the Omicron variant epidemic in Australia. For low R0 values and low v, applying an approximate correction to the statistical approach can lead to more accurate estimates, although there are caveats even for this. These results suggest that the statistical method needs to be used with caution. [ABSTRACT FROM AUTHOR]

The worsening life expectancy of middle-aged White Americans due to suicides and substance overdoses has been hypothesized to be caused by various societal conditions. Work is a social determinant of health, but its role in this demographic shift has not been examined. This article describes the characteristics and trends of suicides and overdose fatalities occurring in U.S. workplaces among all workers between 2011 and 2022. Data originated from the Census of Fatal Occupational Injury database. Fatality rates were calculated using the Current Population Survey. Fatality rates were calculated and compared among demographic and occupational groups. Annual rates were modeled with a first-order auto-regressive linear regression to account for serial correlation. Analyses were conducted in 2023–2024. Between 2011 and 2022, the rate of workplace overdose fatality rates increased from 0.05 per 100,000 workers to 0.33—an increase of 560%. Workplace suicide rates were relatively stable (0.19 per 100,000 to 0.17). Most industries and occupations experienced significant increases in workplace overdose rates and nonsignificant decreases in workplace suicide rates. The largest workplace overdose rates occurred in the transportation and warehousing industry (0.47, 95% CI=0.27, 0.67) and farming, fishing, and forestry occupations (0.68, 95% CI=0.27, 1.08). Fatal workplace suicides and substance overdoses have different trends and impact industries, occupations, and demographic groups differently. The rise in workplace overdoses deserve immediate attention. [ABSTRACT FROM AUTHOR]

Suicides and deaths of undetermined intent frequently involve cannabis or opioids, yet the relationships between cannabis and opioids, and cannabis policies and cannabis or opioid involvement in these deaths, are not well-characterized. Additionally, although there have been substantial changes to cannabis policies, there have been conflicting findings on relationships between changing cannabis policies and cannabis-involved or opioid-involved deaths. This was a repeated, cross-sectional study of decedents using restricted access data from the National Violent Death Reporting System from 2003 to 2018 and the Cannabis Policy Scale. The following associations were assessed among decedents from suicide and deaths of undetermined intent using mixed effects logistic regression: (1) relationships between cannabis involvement and opioid involvement; (2) relationships between cannabis policies and cannabis involvement; and (3) relationships between cannabis policies and opioid involvement. Analyses were conducted from 2021 to 2022. States contributing to National Violent Death Reporting System increased in number from 7 to 41 throughout the study period, and the final sample included 68,924 decedents of suicide and undetermined intent. Cannabis involvement was associated with increased odds of opioid involvement (AOR=1.29, 95% CI=1.22, 1.37). A 10% increase in Cannabis Policy Scale, representing a more restrictive cannabis policy environment, was associated with reduced odds of cannabis involvement (AOR=0.87, 95% CI=0.84, 0.90) and opioid involvement (AOR=0.88, 95% CI=0.85, 0.91). These findings do not support the idea that cannabis policy liberalization and/or cannabis use are likely to be useful strategies to reduce cannabis or opioid involvement in deaths of suicide and undetermined intent. [ABSTRACT FROM AUTHOR]

Scholars have started unpacking how individuals, organizations, and communities interact to build a shared capacity for resilience. This research, however, has not yet examined how the institutional environment influences local responses to crises. This is an important omission since crises do not occur in a vacuum—decisions of actors, at one level, constrain or catalyze the resilience responses of communities and the individuals and organizations within them. Furthermore, research on resilience often assumes a relatively static nature of crises, without accounting for the need to revise responses over time. Using an original set of high frequency data on COVID-19 rates in the United States, we investigate the relationship between healthcare decision agency at the county level and the incidence of the pandemic as reflected in the number of COVID cases and death by county. Our results provide robust evidence that higher degrees of decision-making autonomy are associated with lower rates of COVID-19 cases and deaths. That is, a positive relationship exists between decision-making autonomy and higher capacities for resilience. We further show that this relationship is strengthened, the larger and more heterogeneous is the mix of healthcare organizations in a county, and the higher is the need for revising responses given the changing nature of the crisis. Our results emphasize the need for a system approach to the study of resilience, and suggest that, by enabling the customization of responses to local needs and resources, decision-making autonomy enhances the shared capacities for resilience. [ABSTRACT FROM AUTHOR]

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Background: Metabolic syndrome (MetS) encompasses a collection of metabolic abnormalities. This study aims to determine which combination of MetS components has the highest mortality risk, and to investigate the causal relationships between MetS components and longevity. Methods: Prospective analyses were conducted on 340,196 participants from the MJ cohort at baseline, and 121,936 participants had follow-up MetS information. We defined MetS according to the NCEP ATP III criteria. The study's outcomes included mortality from cardiovascular disease (CVD), cancer, and all causes combined. We employed Cox proportional hazard models to calculate hazard ratios (HRs) and 95% confidence intervals. Multivariable Mendelian randomization (MVMR) was employed to infer causality using the genetic data of MetS components and longevity. Results: Elevated blood pressure (BP) was the initial split for all-cause mortality, cancer mortality, and CVD mortality. Participants with MetS, especially those with elevated BP and elevated fasting plasma glucose (FPG), had higher mortality risks than those with other types of MetS. In the MJ cohort, participants with elevated BP and FPG (BG-type MetS) had a 44% (HR = 1.44, 95% CI = 1.37–1.51), 73% (HR = 1.73, 95% CI = 1.62–1.84), and 34% (HR = 1.34, 95% CI = 1.27–1.42) increased risk of all-cause mortality, cancer mortality, and CVD mortality, respectively, compared with non-BG-type MetS (12%, 24%, 5%). The highest mortality rate and mortality risk were observed in participants with BG-type MetS at baseline and follow-up (mortality rate/1000 person years = 9.73, 95% CI = 8.81–10.74; HR = 1.52, 95% CI = 1.35–1.72). SBP and FPG increases that were genetically proxied to a 1-standard deviation higher level decreased the probabilities of living to the 90th percentile age by 41% (OR = 0.59, 95% CI = 0.40–0.86) and 32% (OR = 0.68, 95% CI = 0.48–0.98) in MVMR, respectively. Conclusions: Individuals with BG-type MetS are at a higher risk of death than those with other types of MetS. Therefore, these individuals should be targeted to improve MetS outcomes. [ABSTRACT FROM AUTHOR]

In 1919 and 1921 Raymond Pearl published four empirical studies on the Spanish Flu epidemic in which he explored the factors that might explain the explosiveness and destructiveness of the epidemic in America's largest cities. Using partial correlation coefficients he tried to isolate the net effects of the possible explanatory factors, such as general demographic characteristics of the cities and death rates for various diseases, on the variables measuring the severity of the epidemic. Instead of Pearl's correlation analysis, we apply a bootstrap simulation to forward variable selection with a null factor for generalized linear regression with AICc validation. The null factor or pseudo-variable is a random variable that is independent of the response. The number of times it is included in the model selection simulation provides an important metric for deciding which terms should remain in the model. Our results are largely consistent with Pearl's conclusions in that the pre-pandemic death rates from organic heart disease and from all causes are most predictive of pandemic explosiveness or severity. However, our results also contain substantive nuances. Our paper contributes to the literature showing that state-of-the-art methodology for variable selection proves useful for historical epidemiology. [ABSTRACT FROM AUTHOR]

Background : Cancer is a rapidly increasing global problem, and one of the leading causes of burden and mortality. This study aims to compare the burden of cancer in Iran between the year 1990 and 2019. Methods : We used Global Burden of Disease data on cancer from 1990 to 2019 by province, year, age group, and sex. We then estimated the trend of age standardized mortality and Disability-Adjusted Life Years (DALYs) of the cancers by sex. Age pattern and geographical variation in the ranking of cancers were assessed at national and sub-national levels from 1990 to 2019. Results : The mortality rate decreased from 102 (95% UI: 91, 111) to 96 (95% UI: 88, 103) per 100000 population. Additionally, the DALYs rates decreased from 2619 (95% UI: 2357, 2852) to 2321 (95% UI: 2116, 2497) per 100000 between 1990 and 2019. Both of the mortality and DALYs rate from cancers increased with age. These indicators were significantly higher in men than in women across all age groups. Consequently, the mortality rate and DALYs per 100,000 of cancers were higher in the northwest and northeast of Iran. Notably, stomach cancer was identified as the leading cause of cancer mortality in 23 provinces of Iran in 2019. The highest percentage change of DALYs per 100,000 rate between 1990 and 2019 was observed for malignant skin melanoma, stomach cancer, and cervical cancers with rate of −41.1, −40.1, and −38.4, respectively. Conclusion : Overall, the mortality and DALYs per 100,000 rates of all cancers for both sexes in Iran have decreased between 1990 and 2019. However, there is an increasing trend in types of cancers, such as pancreatic, ovarian, and breast cancers. [ABSTRACT FROM AUTHOR]

Infants’ and children’s health is particularly susceptible to exposure to various environmental contaminant insults as their immune systems are immature and daily activities may present differing patterns of exposure. Although some studies noted an association between long-term exposure to ambient fine particulate matter (PM2.5) and increased infant mortality frequency, few investigations examined the relationship between reduced exposure to PM2.5 and changes in infant mortality rates. Therefore, this study was conducted to determine whether diminished levels of PM2.5 in Taiwan improved post-neonatal infant health. Avoidable premature post-neonatal infant mortality was employed as an indicator of health impact. A mean value was calculated for annual PM2.5 levels across Taiwan for the years 2006, 2015, and 2023. Using these averages and following WHO methodology, differences in the number of post-neonatal infant deaths attributed to ambient PM2.5 exposure were determined. PM2.5 concentrations fell markedly throughout Taiwan over the 20-year study period. In conjunction with this decline, a lowered health burden was noted, which was represented as a fall in post-neonatal infant deaths (14.8% in 2006 to 10.3% in 2023). Reduction in annual levels of PM2.5 to 10 µg/m3 was associated with a decrease in the total burden of post-neonatal infant mortality occurrence, with a 5.58–9.31% decline in PM2.5-related deaths during that period. Evidence indicates that exposure to PM2.5 air pollution poses a significant burden to Taiwan children’s health. Our findings indicate that the potential benefits to children’s health need to be given importance when considering improving air quality policies. [ABSTRACT FROM AUTHOR]

Objective: This study aims to examine and compare premature cancer mortality in young people aged 15–44 years old between rural and urban areas to inform early-onset cancer prevention. Methods: The data were obtained from the China Death Surveillance Datasets from 2004 to 2021. The study sample consisted of cancer deaths of young people aged 15–44 years old. Age-standardized mortality rates (ASMRs) were calculated, and joinpoint regressions were used to examine trends in ASMRs. Results: There were overall decreasing trends in ASMRs for all cancers in both rural and urban young people in China from 2004 to 2021. However, the decrease was relatively slower in rural areas, where ASMRs for pancreatic and ovarian cancers showed increasing trends. The five leading types of cancer deaths consistently remained liver, lung, leukemia, stomach, and other cancers in both rural and urban areas after 2013. Conclusion: Our findings indicate that there were rural-urban disparities in cancer mortality in young people, which showed a different pattern compared to other age groups. More efforts are needed to develop effective early-onset cancer prevention strategies, with particular emphasis on liver cancer and rural areas. [ABSTRACT FROM AUTHOR]

Background: The impact of lactate-to-albumin ratio (LAR) on mortality of critically ill cirrhotic patients with sepsis is scant. Methods: Critically ill cirrhotic patients with sepsis were obtained from the MIMIC-IV database (v3.0). Cox regression models alone and in combination with restricted cubic splines, generalized additive models and smoothed curve fitting were used to investigate the relationship between LAR and all-cause mortality. Results: A total of 1864 patients were included. The 30-day, 90-day, and 180-day all-cause mortality rates were 38.0%, 46.3%, and 49.5%, respectively. Higher LAR were significantly and nonlinearly associated with higher risks of 30-day, 90-day, and 180-day all-cause mortality (all adjusted HR = 1.17, P < 0.001). L-shaped associations between LAR and 30-day, 90-day, and 180-day all-cause mortality were observed, with an inflection point of 1.05 (P for log-likelihood ratio < 0.01). Compared with patients with LAR < 1.05, patients with LAR ≥ 1.05 had higher risks of 30-day, 90-day, and 180-day all-cause mortality (adjusted HR (95% CI): 1.48 (1.27–1.72), 1.44 (1.25–1.66), and 1.38 (1.21–1.57), respectively). No potential modifiers were found in the relationship between LAR and mortality. Conclusions: LAR was positively and nonlinearly associated with all-cause mortality in critically ill cirrhotic patients with sepsis. Thus, it could be used as a prognostic biomarker. [ABSTRACT FROM AUTHOR]

Background: Regional ventilation/perfusion (V/Q) mismatch in intrapulmonary shunt in dependent regions has always been considered a hallmark of ARDS. However, little is known about the spatial distribution of shunt, and a clear definition has been lacking. The aim of the study was to propose two phenotypes for the spatial distribution of intrapulmonary shunt using electrical impedance tomography (EIT) and to investigate the clinical characteristics and outcomes in the two preset phenotypes. Methods: A total of 76 ARDS patients who received EIT saline contrast examination were included in this retrospective study. Deadspace(%), Shunt(%), and V/Qmismatch(%) were calculated based on the lung V/Q matching map. EIT maps were divided into two horizontal anterior-to-posterior regions of interest, ranging from gravity-independent regions to gravity-dependent regions. The dosal shunt proportion (Shuntdosal/Shuntglobal%) was defined as the percentage of shunt in gravity-dependent regions. Based on Shuntdosal/Shuntglobal%, the patients were divided into a dependent-shunt group (D-shunt, Shuntdosal/Shuntglobal% > 50%) and a nondependent-shunt group (ND-shunt, Shuntdosal/Shuntglobal% ≤ 50%). Results: The D-shunt group (n = 46) had lower dorsal ventilation, lower dorsal deadspace, and a higher Shuntdosal/Shuntglobal% than the ND-shunt group (n = 30). Multivariable Cox regression analysis showed that Shuntdosal/Shuntglobal% was an independent predictive factor for 28-day mortality (HR = 0.06; 95% CI, 0.01–0.36; P = 0.002). There was no significant difference in regional perfusion distribution, global shunt, global deadspace and global V/Q mismatch between the two groups. Moreover, a higher BMI (25.4 [22.9, 29.2] vs. 22.9 [20.8, 26.4], P = 0.04) and more extrapulmonary ARDS patients [65% (30/46) vs. 33% (10/30), P = 0.01] were found in the D-shunt group. A similar PaO2/FiO2 ratio was found between the two groups on Day 0, but the D-shunt group had a higher PaO2/FiO2 ratio on Day 4. A higher 28-day mortality (40% vs. 17%, P = 0.03) and fewer ventilation-free days (VFDs) on day 28 (11.0 [0, 21.8] vs. 20.5 [4.8, 24.0], P = 0.04) were found in the ND-shunt group. Conclusion: Two phenotypes of regional shunt gravitational distribution can be revealed by EIT. Patients exhibiting a predominance of dependent shunt were characterized by a higher BMI and extrapulmonary ARDS and may experience faster improvement in oxygenation as well as better clinical outcomes. Further research is necessary to evaluate shunt distribution patterns to guide the individualized treatment of ARDS patients. [ABSTRACT FROM AUTHOR]

Background: Estimating the indirect mortality due to COVID-19 is of the utmost importance to develop adequate public health policy during future outbreaks. Methods: From province-wide administrative datasets, we identified British Columbians who tested negative for COVID-19 during the first wave and never tested positive throughout 2020. We obtained a pre-pandemic (2018) cohort matched on age, sex, history of non-communicable disorders (NCDs), multimorbidity, and severity/acuity, and implemented a doubly robust estimation of the effect of the first pandemic wave on mortality. Results: The adjusted odds ratio (AOR) of death was 3.2 times higher for a 2020 cohort who tested negative for COVID-19 (n = 123,133), compared to matched pre-pandemic controls. In both cohorts, a majority (72.5%) experienced at least one pre-existing NCD. Stratification by NCD shows an AOR of death ranges between 2–for people with substance use disorders– and 7–for people previously undiagnosed with NCDs (e.g., incident cases that went untreated). The largest subgroup was composed of people with mental disorders (47,413 people), with an AOR of death of 2.5. Though the COVID-19 direct mortality in the general population remained low (1.9 per 10,000), the excess mortality in this COVID-negative cohort was extremely high − 4,085 of the 123,133– which entails a minimum indirect excess mortality death rate of 6.5 per 10,000 in the general population. Conclusions: During the first pandemic year, mortality in COVID-negative adults was several times greater than before COVID-19, in people with matched NCD distribution and severity. Our findings suggest that low direct COVID-19 mortality was accompanied by less visible–but much higher– indirect mortality due to undiagnosed and/or untreated NCDs, highlighting the need to focus not only on mitigating the harms of new agents, but also of continuing service delivery for treatable conditions. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome (MetS) and sarcopenia (SP) are increasingly significant public health issues in aging societies, sharing common pathophysiological mechanisms and being associated with severe health consequences. This study investigates the impact of MetS and SP on all-cause and cause-specific mortality using a longitudinal, nationally representative population-based cohort. Methods: The study analyzed data from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2018. Mortality data were obtained from the National Death Index up to December 2019. Results: Among the 21,962 participants, 13,517 (61.5%) had neither MetS nor SP(MetS-/SP-), 5,407 (24.6%) had MetS only(MetS+/SP-), 2,698 (12.2%) had SP only(MetS-/SP+), and 340 (1.5%) had both MetS and SP(MetS+/SP+). Compared to the group without MetS and SP, the groups with MetS only, SP only, and both MetS and SP showed increased all-cause mortality, with adjusted hazard ratios (HR) of 1.23 (95% CI: 1.11-1.37), 1.63 (95% CI: 1.41-1.89), and 1.61 (95% CI: 1.33-1.95), respectively. The MetS+/SP+ group had the highest overall mortality risk (trend test p<0.0001). For cause-specific mortality, the MetS+/SP+ group exhibited increased cardiovascular mortality (HR: 1.89, 95% CI: 1.27-2.81), cardiac mortality (HR: 1.89, 95% CI: 1.25-2.86), respiratory mortality (HR: 2.63, 95% CI: 1.29-5.35), and diabetes mortality (HR: 8.79, 95% CI: 2.62-29.45) compared to the group without MetS and SP. Conclusion: The coexistence of MetS and SP significantly increases the risk of all-cause and cause-specific mortality. Individuals with either condition may require more vigilant management to prevent the onset of the other condition, thereby reducing mortality rates. These findings highlight the importance of integrated healthcare strategies targeting both MetS and SP to improve patient outcomes and longevity. [ABSTRACT FROM AUTHOR]

Vessel strikes are a substantial source of mortality for large whales worldwide and may pose conservation threats for small populations. Model-based estimates of mortality rates, which inform management strategies to reduce vessel strike mortality, typically assume a reduced likelihood that a whale-vessel collision will be lethal to the whale at slower vessel speeds. In this study, we reviewed and updated available data on observed whale-vessel interactions in U.S. waters and developed a new model characterizing the probability that an interaction will be lethal to the whale as a function of vessel speed, length (as a proxy for mass), and whale taxon. We found a significant effect of vessel size class on the probability of lethality. In addition, decreasing vessel speeds reduced the likelihood of a lethal outcome for all vessel size classes, but this effect was strongest for vessels less than 108m in length. The probability that a strike by a very large ocean-going vessel will be lethal exceeded 0.80 at all speeds above 5 knots. Whale taxon also affected both the likelihood of a lethal strike and the effect of vessel speed. Humpback whales (Megaptera novaeangliae) had significantly lower rates of lethal strikes compared to other large whales. This difference may be associated with data limitations, differing behavioral responses between species, varying vessel types between regions or differences in body composition and blubber thickness. The model is consistent with biophysical models that demonstrate a high rate of strike lethality for large vessels with high masses. Vessel speed restrictions are one of the primary approaches to reduce the risk of vessel strikes to whales in the face of continued industrialization of the oceans, and the model presented here will help better inform management efforts. [ABSTRACT FROM AUTHOR]

Background: A serious worldwide health concern is cutaneous squamous cell carcinoma (cSCC). For the purpose of creating focused strategies, it is essential to comprehend geographical variations in cSCC prevalence and trends. Methods: This study utilized data from the 2021 Global Burden of Diseases (GBD) survey to analyze cSCC across 204 countries and territories. We assessed the age-standardized prevalence rate (ASPR), mortality rate (ASMR), disability-adjusted life years (ASDR), and estimated annual percentage changes (EAPCs), with trends stratified by region, country, age, sex, and Sociodemographic Index (SDI). To evaluate disparities in cSCC burden, we combined the SDI with the inequality slope and concentration indices for an international health inequality analysis. Decomposition analysis assessed the effects of population growth, aging, and epidemiological trends on disease burden, while frontier analysis linked cSCC outcomes with socio-demographic development. A Bayesian Age-Period-Cohort (BAPC) model projected future prevalence, mortality, and DALYs, identifying key drivers of cSCC burden. Results: In 2021, there were 2,275,834 cases of cSCC globally, reflecting a 345% increase since 1990. During this period, the ASPR rose from 14.69 to 26.85 per 100,000, while the ASMR increased slightly from 0.67 to 0.69 per 100,000. Disability-adjusted life years (DALYs) rose from 544,973 to 1,210,874. Among socio-demographic regions, the high SDI region had the highest ASPR, while the middle SDI region exhibited the highest ASMR and ASDR. Decomposition analysis identified population growth and demographic aging as key drivers of the rising ASMR. Countries like Georgia showed significant disparities in frontier analysis, indicating potential for better cSCC management. Health inequality analysis confirmed that the burden was concentrated in nations with higher SDI. By 2045, the global ASPR is projected to reach 64.66, with the ASMR and ASDR expected to decrease to 1.02 and 20.63 per 100,000, respectively. Conclusion: Over the last three decades, the global burden of cSCC has increased significantly. While mortality rates and DALYs are expected to decline over the next twenty years, the prevalence of cSCC is projected to remain high. This highlights the urgent need to reevaluate preventive efforts aimed at reducing morbidity, particularly in areas with substantial populations over the age of 95. [ABSTRACT FROM AUTHOR]

Background and Aims To improve upon the estimation of 10-year cardiovascular disease (CVD) event risk for individuals without prior CVD or diabetes mellitus in the Asia-Pacific region by systematic recalibration of the SCORE2 risk algorithm. Methods The sex-specific and competing risk-adjusted SCORE2 algorithms were systematically recalibrated to reflect CVD incidence observed in four Asia-Pacific risk regions, defined according to country-level World Health Organization age- and sex-standardized CVD mortality rates. Using the same approach as applied for the original SCORE2 models, recalibration to each risk region was completed using expected CVD incidence and risk factor distributions from each region. Results Risk region-specific CVD incidence was estimated using CVD mortality and incidence data on 8 405 574 individuals (556 421 CVD events). For external validation, data from 9 560 266 individuals without previous CVD or diabetes were analysed in 13 prospective studies from 12 countries (350 550 incident CVD events). The pooled C-index of the SCORE2 Asia-Pacific algorithms in the external validation datasets was.710 [95% confidence interval (CI).677–.744]. Cohort-specific C-indices ranged from.605 (95% CI.597–.613) to.840 (95% CI.771–.909). Estimated CVD risk varied several-fold across Asia-Pacific risk regions. For example, the estimated 10-year CVD risk for a 50-year-old non-smoker, with a systolic blood pressure of 140 mmHg, total cholesterol of 5.5 mmol/L, and high-density lipoprotein cholesterol of 1.3 mmol/L, ranged from 7% for men in low-risk countries to 14% for men in very-high-risk countries, and from 3% for women in low-risk countries to 13% for women in very-high-risk countries. Conclusions The SCORE2 Asia-Pacific algorithms have been calibrated to estimate 10-year risk of CVD for apparently healthy people in Asia and Oceania, thereby enhancing the identification of individuals at higher risk of developing CVD across the Asia-Pacific region. [ABSTRACT FROM AUTHOR]

Background: Armed conflict severely impacts children's health, leading to malnutrition and increased child mortality. The republic of South Sudan gained independence from Sudan in 2011 and suffered from seven-years civil war between December 2013–2021. The war led to mass population displacement both internally and externally and worsened the health status of the population, especially the children. Aim: To investigate the effect of conflict intensity on global acute malnutrition and under-five crude mortality rate in South Sudan during the civil war between 2014–2021. Methods: The study used an ecological panel data analysis of armed conflict data from Uppsala Conflict Data Program (UCDP) and child health data from Standardized Monitoring and Assessment of Relief and Transitions surveys conducted in 2014–2021. Child health is evaluated as global acute malnutrition (GAM) and under-five crude mortality rate (U5CMR). The study analyzed the correlation between the intensity of conflict and the prevalence of malnutrition and under-five crude mortality on a state level. Internal displacement and food prices were used as indirect effects of conflict. One year lag effect regressions were used to estimate potential correlation between child health and armed conflict. Results: Total number of conflict related deaths between 2014–2021 was on best estimate (9,577), and on high estimate (13,178). The average GAM rate for the same period was (15.29%), and U5CMR was (0.77). Data analysis showed a significant correlation between the high estimate of conflict intensity with GAM (.047), and with U5CMR (.043). Internal displacement and food prices had a significant correlation with GAM (P =.048, P =.016), but no significant correlation was noticed with U5CMR. Best estimate of conflict intensity did not show a significant effect on children health variables. Conclusion: The effect of conflict on children's health outcome is complex and multifactorial. The high estimate of conflict intensity from UCDP showed significant correlation with the health outcome, while best estimate did not have significant correlation, this could be due to limited child health data, underreporting of conflict-related deaths, and a small sample size. The study suggests that other factors such as food prices and displacement might play an additional factor that increases the effect of conflict intensity on child health outcomes. The study underscores the challenge of data scarcity in researching health determinants in South Sudan. [ABSTRACT FROM AUTHOR]

Background: Noonan Syndrome (NS) is a rare multisystemic disorder with heterogeneous phenotypic manifestations. The aim of this study was to analyse rates of survival, hospitalisation, surgeries and prescriptions in children born with NS in the first 10 years of life. Methods: This is a multi-centre population-based cohort study. Data on 175 liveborn children diagnosed with NS from 11 EUROCAT congenital anomaly registries were linked to healthcare databases. Each registry applied a common data model to standardise data and run common syntax scripts to produce aggregated results which were pooled using random effects meta-analyses. Results: Mortality rates were high in the first year of life with 5.4% (95%CI 1.5%-10.1%) of children dying before the age of 1 year with a further 2% dying up to age 5. In the first year, 87.9% (95%CI 75.3%-94.3%) of children were hospitalized and the median Length Of hospital Stay (LOS) was 15.3 days (95%CI 9.3–21.2). After the first year, the proportion of children hospitalized remained higher than 70%, but the LOS decreased to 1.3 days per year. In the first 5 years, 65.2% of children underwent a median of two surgical procedures. The median age at first surgery was 29 weeks. The proportion of children with an antibiotic prescription increased from 53.6% at age 1 to 62.4% yearly until 4 years of age. Conclusions: Children with NS have high mortality and morbidity not only in the first year of life but also up to five years of age. This study evaluated the health burden of NS and provided information for clinicians, health-care providers and families. [ABSTRACT FROM AUTHOR]

The measurement of the concentration of PM2.5 and PM10 pollutants was carried out by means of a device for measuring suspended particles (LowVolume) for 24 hours and during 6 months in the number of 180 samples in industrial and non-industrial areas. The average concentration of PM2.5 and PM10 measured in the air of the industrial area was 29.70 and 56.13 µg/m3, respectively, and in the air of the non-industrial area was 29.40 and 46.15 µg/m3, respectively. The attributed component related to total mortality caused by PM2.5 and PM10 in the industrial area was equal to 17.31% and 14.90% and in the non-industrial area was equal to 17.12% and 11.50%, respectively. The rate of respiratory mortality attributed to PM2.5 and PM10 was 20.98% and 37.26% in the industrial area and 20.75% and 29.74% in the non-industrial area, respectively.    [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the all-cause mortality rate and renal outcomes in patients with diabetes and chronic kidney disease (CKD) following hospital discharge for COVID-19. Methods: This single-center prospective observational study included 187 discharged COVID-19 patients with diabetes and CKD, admitted between December 2022 and January 2023 at West China Hospital, Sichuan University. Cox regression analysis was used to assess mortality risk, and logistic regression was applied to identify risk factors for rapid CKD progression after discharge. Results: During the one-year follow-up, the all-cause mortality rate was 26.7%, with a COVID-19-related acute kidney injury (AKI) incidence of 35.3%, and 35.8% of patients experienced rapid CKD progression after discharge. Cox proportional hazards regression indicated that sepsis and mechanical ventilation were major risk factors for post-discharge all-cause mortality. Logistic regression identified baseline eGFR < 60 mL/min/1.73 m² as an independent risk factor for rapid CKD progression. Conclusions: During the one-year follow-up period, we observed that patients with diabetes and CKD exhibited higher all-cause mortality and experienced rapid deterioration of kidney function after acute infection with COVID-19. This underscores the importance of ongoing longitudinal follow-up to more accurately track the long-term health effects of COVID-19 on patients with diabetes and CKD. [ABSTRACT FROM AUTHOR]

Background Human immunodeficiency virus (HIV)/AIDS among elderly persons presents a new public health challenge in China. We aimed to explore historical trends (2004–2018) and project the future (2019–2030) burden of HIV/AIDS incidence and mortality among the elderly in China. Methods We utilized data from the Data Center of China Public Health Science database on HIV/AIDS incidence and mortality, employing the Bayesian age-period-cohort model to reveal the age-period-cohort effect in the HIV/AIDS burden, and projecting the incidence and mortality rates up to 2030. Results From 2004 to 2018, HIV/AIDS incidence rates increased from 0.56 to 20.78 per 100 000 for men and 0.28 to 7.84 per 100 000 for women. The mortality rates also increased in both sexes. We observed the highest age effect in incidence among men aged 70–74 years and women aged 55–59 years, with the effect estimates being 0.02 (95% confidence interval [CI], −.10 to.13) and 0.46 (95% CI,.35–.57), respectively. Similar sex disparities were observed for mortality, with the highest age effect observed in men aged 75–79 years and women aged 50–54 years. However, no significant disparities were found between men and women in the period and cohort effects. By 2030, the incidence rates were projected to be 96.25 per 100 000 in men and 44.90 per 100 000 in women, while the mortality rates were projected to be 48.27 and 13.67 per 100 000, respectively. Conclusions HIV/AIDS incidence and mortality rates rose notably among the elderly in China and are expected to keep increasing in the coming decades. Rates were consistently higher in men than in women. Tailored interventions for older men are crucial. [ABSTRACT FROM AUTHOR]

Recently, COVID-19 (coronavirus) has been a huge influence on the socio and economic field. COVID-19 cases are seriously increasing day-day and also don't identified proper vaccine for COVID-19. Hence, COVID-19 is fast spreading virus and it causes more deaths. In order to address this, the work has proposed a machine learning (ML) scheme for the prediction of COVID-19 positive, negative, and deceased instances. Initially, the data is pre-processed by eliminating redundant and missing values. Then, the features are selected using hybrid grey assisted whale optimization algorithm (H-GAWOA). Finally, the classifier ANFIS (adaptive network-based fuzzy inference systems) is used for investigating the confirmed, survival and death rate of COVID-19. The performance is analysed on John Hopkins University dataset and the performances like MSE, RMSE, MAPE, and R2 are measured. In all the comparisons, the MSE value is very less for the proposed model. Particularly, in the deceased cases prediction, the MSE value is 0.00 for the proposed H-GAWOA-ANFIS. Finally, it is proved that the suggested model is able to generate the better results when contrast to the other approaches. [ABSTRACT FROM AUTHOR]

This study analyzed trends in the incidence and mortality of laryngeal cancer (LC) in China from 2004 to 2018, provided projections up to 2033, and identified contributing factors influencing these trends. LC data were obtained from the Chinese Cancer Registry Annual Reports for 2004 to 2018. Estimated Annual Percent Change (EAPC) and 95% confidence intervals (CI) were calculated using Joinpoint Regression Software to evaluate trends. LC incidence and mortality rates in registry areas, combined with national population data, were used to estimate new cases and deaths. Projections were made to 2033, and a decomposition analysis identified factors influencing trends. From 2004 to 2018, the age-standardized incidence rate (ASIR) of LC decreased from 1.29 to 1.14 per 100,000, with an EAPC of −1.75% (95% CI: −2.36% to −1.12%). The age-standardized mortality rate (ASMR) also declined from 0.67 to 0.61 per 100,000, with an EAPC of −0.76% (95% CI: −1.28% to −0.25%). Mortality among males aged 60–69, however, showed a significant increase. Population growth and aging contributed to the rise in LC cases and deaths, while epidemiological factors partially offset these increases. By 2033, ASIR and ASMR for males and ASIR for females are projected to decrease, while ASMR for females is expected to rise. ASIR and ASMR in China showed a declining trend from 2004 to 2018, with further decreases projected through 2033. Yet, rising mortality in older males underscores the need for targeted prevention and early detection. Population aging and growth are key drivers of the LC burden, although epidemiological improvements have helped mitigate case increases. Comprehensive public health strategies remain essential to reduce LC impact in China. [ABSTRACT FROM AUTHOR]

Background: Cirrhosis is a dynamic disease process leading to liver-related death, which has increased by over 65% over the last decade. Unpredictable hepatic decompensation complications are a major source of morbidity and mortality. Thus, accurately characterizing disease progression through discrete stages of cirrhosis is critical towards implementing timely intervention and liver transplant (LT) waitlisting. Methods: A retrospective, longitudinal, population-cohort study of adult patients with cirrhosis from a US metropolitan area (2006–2012) was conducted. Clinical diagnoses were defined by ICD-9 and CPT codes. Cirrhosis stages were defined as: compensated without portal hypertension (Stage 1), compensated with portal hypertension (Stage 2), variceal bleeding (Stage 3), hepatic encephalopathy (Stage 4a), ascites (Stage 4b), and ≥2 different decompensating complications (Stage 5). Multivariate Fine-Gray competing risk survival analysis adjusted for clinicodemographic covariates. Results: Among 12,196 patients with cirrhosis, the mean (±SD) age was 56.8 (±11.7) years with a follow-up time of 2.35 (±1.81) years. A novel 5-stage disease progression framework was used. The 1-year mortality rates for each stage were 7.3% for Stage 1, 5.4% for Stage 2, 11.4% for Stage 3, 10.0% for Stage 4a, 20.2% for Stage 4b, and 43.8% for Stage 5. Compared to those in Stage 1, Stage 3 (sHR:1.83, 95% CI:1.36–2.48, P<0.001), Stage 4b (sHR:1.45, 95% CI:1.23–1.70, P<0.001), and Stage 5 (sHR:1.95, 95% CI:1.71–2.23, P<0.001) patients had higher risks of mortality. Additional disease progression rates were identified. Conclusion: Even among patients with compensated cirrhosis, the 1-year mortality rate was as high as 7.3% and subsequently increases with each decompensation complication. This one-year mortality rate is higher than 5-years mortality rate reported in previously known non-US studies. The highest associated risk of death was observed among patients with ≥2 different decompensating complications (95.2%), variceal bleeding (83.2%) and ascites (44.9%). Overall, patients in advanced stages of cirrhosis were more likely to die than they were to receive a LT, suggesting that patients should be referred and waitlisted for LT earlier in the disease process. [ABSTRACT FROM AUTHOR]

Background For decades after the identification of mpox in humans in the Democratic Republic of Congo (DRC) in 1970, the disease was largely confined to the rural areas of Central and West Africa and thus did not garner broad attention. On August 13, 2024, mpox was declared a Public Health Emergency of Continental Security (PHECS) by the Africa Centers for Disease Control and Prevention (Africa CDC), a notice that was followed the next day by a declaration of a Public Health Emergency of International Concern (PHEIC) by the World Health Organization. Methods In this study we analyzed all mpox cases and deaths, based on clinical or laboratory diagnosis, that were reported to the Africa CDC from January 1, 2022, to October 30, 2024, to identify temporal variations, geographic distributions, and epidemiologic trends. Results From January 1, 2022, to August 18, 2024, a total of 45,652 mpox cases were clinically diagnosed and laboratory-confirmed in 12 African countries. These cases resulted in 1492 deaths (case fatality rate, 3.3%). From 2022 to 2024, weekly laboratory-confirmed mpox cases increased by a factor of 2.8 (from 176 to 489 cases), whereas all weekly reported cases (including those with a clinical diagnosis) increased by a factor of 4.3 (from 669 to 2900 cases). The DRC, which had reported approximately 88% of mpox cases in Africa in 2024, had 19,513 cases before the emergency declaration, with a case fatality rate of 3.1% — a weekly average of 591 cases as compared with 281 in 2023. In 2024, six African countries reported their first imported mpox infections, with Burundi also reporting local transmission. Conclusions The high mpox disease burden in Africa, especially in the DRC — with a rising number of cases, high case fatality rate, and high degree of spread to other previously mpox-free African countries — is cause for increased international concern. Case detection, contact tracing, public health measures, and affordable vaccines are needed to implement interventions in the DRC to reduce the risk of global spread of the virus. [ABSTRACT FROM AUTHOR]