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The study was conducted on 60 L of suckling piglets out of 775 piglets, of which 227 piglets had diarrhea litres of piglets, and out of 775 piglets, 227 piglets had diarrhoea syndrome. There were 3 interventions in separate trials as follows: 1 and 2 involved antibiotic use (Enrofloxacin and Gentamicin); Trial 3 used the supplement Lectin C (LvCLT3 and LvCLT4) for a treatment period of 3–7 days. Intervention results on 227 piglets with diarrhea showed the highest cure rate when supplemented with Lectin C, with no mortality rate, longer treatment time, and no reinfection rate. While the two antibiotic trials still had lower cure rates, mortality and reinfection rates were higher. After 05 days of recovery, piglets were tested for MCV, MCH, and MCHC, showing an apparent decrease in the group supplemented with Lectin C, while the two groups using antibiotics still had high rates, with a confidence level of P < 0.05; 0.01 and 0.001. Antibiotics treat piglets in their early stages, so there is a risk of immunodeficiency and low infection response. It is necessary to supplement substances derived from dietary supplements. Supplementing Lectin C increases resistance, enhances immune response, improves the effectiveness of treating diarrhoea syndrome in piglets, and ensures safe meat quality in the future. Lectin C supplementation will improve piglet health and breed quality efficiency. This heralds a promising future for the pig industry with improved meat quality and reduced environmental impact. [ABSTRACT FROM AUTHOR]

In 1977, Michael Lipton introduced the Urban Bias Thesis as a framework for understanding how most economic policy initiatives have contributed to the overdevelopment of urban areas and the underdevelopment of rural areas. In Latin America, there has historically been a positive correlation between urbanization and mortality decline, as the region's health transition generally began in the main cities and tended to proceed more rapidly in countries with higher levels of urbanization. This paper seeks evidence of a residual urban bias in the region's mortality patterns. Using a sample of Latin American countries over the 2000–2010 period, I analyse the disparities in mortality patterns and avoidable causes of death by looking closely at urban and rural areas using continuum categories. The results indicate that the urban advantage does persist and that rural–urban mortality differentials have consistently favoured the largest cities. The metropolitan advantage in mortality is an outcome of lower mortality in causes of death that are avoidable through primary interventions. Even in scenarios of high mortality at younger adult ages (15–44), the metropolitan advantage remains, due primarily to unsuccessful efforts to reduce mortality in populations aged 45 years and over outside the main and large cities. [ABSTRACT FROM AUTHOR]

Background: Gallbladder cancer is a major health concern in China, and awareness of the associated incidence and mortality rates is particularly important given the aging population. Objective: To determine trends in gallbladder cancer incidence and mortality rates over 12 years and quantitatively analyze the influence of demographic factors on these rates in China. Methods: We performed a retrospective study of 98,860 Chinese citizens using the Chinese Cancer Registry, a national database. Gallbladder cancer incidence and mortality data pertaining to patients treated between 2005 and 2017 were collected. Joinpoint regression models were used to estimate the annual percentage change (APC) and average APC (AAPC). We used age-period-cohort analyses and decomposition methods to investigate differing trends in incidence and mortality. Results: The age-standardized gallbladder cancer incidence and mortality rates in China trended downward between 2005 and 2017, with AAPCs of -2.023% and -1.603%, respectively. Coefficients of age effect for incidence rate increased with age up to 70 years and peaked at 70–79 years, while coefficients of age effect for the mortality rate showed a consistent increase with age. Both coefficients of period for incidence and mortality rates increased in more recent periods; in terms of the cohort effect, coefficients of cohort for rates generally decreased in later birth years but showed a partial rise between 1982 and 1996. The crude incidence rates of gallbladder cancer according to demographic and non-demographic factors were 626.09% and -526.09% respectively (366.23% and -266.23% among men, and 6068.93% and -5968.93% among women, respectively). The rates were 543.01% and -443.01%, respectively, in urban areas and were 68.22% and 31.78%, respectively, in rural areas. The mortality rates according to demographic and non-demographic factors were -495.93% and 595.93%, respectively (-1763.10% and -1863.10% for men and -270.56% and -370.56% for women, respectively). These rates were -930.33% and 1030.33%, respectively, in urban areas and were 101.48% and -1.48%, respectively, in rural areas. Conclusions: The overall standardized gallbladder cancer incidence and mortality rates in China are trending downward, but not sufficiently so. Proper living and eating habits should be encouraged while exploring the establishment of long-term, standardized gallbladder cancer screening programs. [ABSTRACT FROM AUTHOR]

Glioblastoma (GB), the most common malignant brain tumour, has a poor prognosis despite advances in treatment. Standard management involves surgery followed by chemoradiotherapy. MRI-guided laser interstitial thermal therapy (LITT) is a minimally invasive technique that may offer an option for select patients with specific clinical profiles. While preclinical studies suggest that LITT could disrupt the blood-brain barrier (BBB) to enhance drug delivery, this has yet to be definitively demonstrated in clinical settings. Adhering to the PRISMA guidelines, various databases were searched until March 2024. Eligible studies focused on LITT for supratentorial GB in adults and evaluated its safety and efficacy. Data extraction covered various study characteristics, and statistical analysis was performed using the OpenMeta Analyst software. Quality assessment was performed using the Newcastle-Ottawa Scale. Fifteen studies were analyzed, mainly employing the Neuroblate–Monteris system in the US, as retrospective single-centre trials. Treatment involved LITT in 239 patients with tumours typically in deep-seated areas. Median OS ranged from 4.9 to 32.3 months, and PFS from two to 5.9 months. Most patients received adjuvant therapy, primarily radiation and temozolomide. While LITT showed efficacy in improving OS (10.21, 95% CI 9.05–11.37), PFS (3.94, 95% CI 3.20–4.69), and tumor volume reduction (18.23, 95% CI 14.591–21.860), complications odd-ration(OR) = 0.336 (95% CI, 0.188–0.484) and mortality rates OR = 0.033 (95% CI, 0.009–0.058 were notable. LITT shows promise for treating both newly diagnosed and recurrent GB cases in non-surgical candidates, linked to improved OS, PFS, reduced tumor volume, and shorter hospital stays. However, higher complication and mortality rates were noted, emphasising the need for additional well-designed prospective multicentre trials. [ABSTRACT FROM AUTHOR]

A series of novel 3‐(6‐methyltriazinone)‐3,4‐dihydrobenzo[b][1,5]diazin‐2(1H)‐one derivatives was designed and synthesized as conformationally restricted analogues of insecticide pymetrozine. Conformational and physicochemical properties analyses indicated the rationality in reducing the energy barrier between the lowest‐energy and predicted bioactive conformations, as well as pesticide‐likeness. Insecticidal bioassays showed that the optimal compound VI‐6b exhibited a mortality rate of 67.7% against Aphis craccivora at 400 mg L−1. The molecular docking study of VI‐6b within the Nilaparvata lugens TRPV channel elucidated the predicted binding mode, wherein VI‐6b forms hydrogen bonds with Arg646 and Glu727, while engaging in π‐π interactions with Phe688. However, physicochemical properties revealed that low lipophilicity and poor aqueous solubility limited the insecticidal efficacy of these novel compounds. This study provides valuable insights for the future design of insecticides targeting the TRPV channel. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a progressively debilitating disorder that has seen a notable rise in prevalence in recent years. This study examines the burden of MS from 1990 to 2019, providing a detailed analysis by age, sex, and sociodemographic index (SDI) across 204 countries and territories. Methods: Data on the prevalence, death and disability-adjusted life years (DALYs) attributable to MS were obtained from the publically available Global Burden of Disease 2019 project. The estimates are reported as numbers, percentages, and age-standardized rates per 100,000, accompanied by 95% uncertainty intervals. Results: In 2019, MS accounted for 1.8 million prevalent cases, 22.4 thousand deaths and 1.2 million DALYs worldwide. There were significant declines in the global age-standardized prevalence, mortality and DALY rates of MS over the period 1990–2019. In 2019, females exhibited a higher global point prevalence and a greater total number of prevalent MS cases than males across all age groups. At the regional level, a non-linear relationship was observed between the age-standardized DALY rate of MS and SDI. Conclusion: Although the global age-standardized DALY rate of MS decreased between 1990 and 2019, MS continues to account for a considerable number of DALYs and prevalent cases. Integrating MS and its associated risk factors into healthcare planning is vital, especially in areas with high levels of socioeconomic development. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between hypernatremia and 28-day mortality in elderly sepsis patients. Methods: A total of 179 elderly patients (age ≥65 years) with elevated serum sodium admitted to the Department of Critical Care Medicine of Nanjing Hospital affiliated with Nanjing Medical University from September 2021 to September 2022 were included in this retrospective observational study. The clinical data of all patients were collected, and the patients were divided into septic group and nonseptic groups according to the Sepsis 3.0 definition. The clinical features, acute physiological and chronic health II score (APACHE II score), mechanical ventilation time, serum sodium value and duration of serum sodium elevation were compared between the two groups. ROC curves were drawn to evaluate the predictive value of each index on the prognosis of sepsis patients, and Kaplan‒Meier survival analysis was carried out on patients with different serum sodium peaks. Results: (1) The changes in serum sodium within 48 hours after admission in the sepsis group were small and statistically significant compared with those in the nonsepsis group (P = 0.039); however, the serum sodium elevation duration was longer (P = 0.018). (2) Compared with nonseptic patients, the 7-day mortality of septic patients was higher (15.8 vs. 7.7, P<0.001). The 28-day mortality of septic patients was higher than that of nonseptic patients, but there was no significant difference between the two groups (P = 0.086). (3) The serum sodium level in the sepsis group was higher than that in the nonsepsis group on the 1st, 3rd, 5th and 7th days (P<0.001). There was no significant difference in mechanical ventilation time or duration of stay in the ICU between the two groups. (4) The ROC curve analysis showed that the peak value of serum sodium had predictive value for the prognosis severity of elderly patients with sepsis. The area under the curve (AUC) was 0.753, the 95% confidence interval (95% CI) was 0.639~0.867, and the best cut-off value was 154.9 mmol/L. (5) According to the best cut-off value of the serum sodium peak, the septic patients were divided into two groups: the peak value of serum sodium was ≥154.9 mmol/L (group A), and the peak value of serum sodium was <154.9 mmol/L (group B). Among them, the case fatality rate was higher at 7 days and 28 days when the peak value of serum sodium was ≥154.9 mmol/L (group A) (22.0% vs. 8.6%); the χ2 value was 35.379, P<0.05; 75.6% vs. 37.1%, χ2 = 14.21, P = 0.003). There was no significant difference in mechanical ventilation time or duration of stay in the ICU between the two groups. (6) Kaplan‒Meier survival analysis showed that the median survival time of patients with a serum sodium peak ≥154.9 mmol/L (group A) was significantly shorter than that of patients with a serum sodium peak < 154.9 mmol/L (group B) (16.7±1.4 d vs. 24.8±1.2 d, P <0.05). Conclusions: The serum sodium increase in elderly sepsis patients lasts for a long time, and the serum sodium fluctuation is relatively small. The serum sodium peak value has predictive value for 28-day mortality. [ABSTRACT FROM AUTHOR]

Fluid overload predicts morbidity and mortality in dialysis patients. Diuretics can reduce fluid overload, but their effects on morbi-mortality following inception remain ill-defined. To determine whether diuretics reduce mortality and hospitalization rates in incident dialysis patients in the first 2 years after inception. Adult patients starting dialysis between 2009 and 2015 in the REIN registry were matched with the SNDS database and divided into four subgroups according to loop diuretics exposure: < 5%, 5–50%, 50–80% or > 80% over the observation period of each patient. The incidence of hospitalization was described based on the primary diagnoses of the discharge summaries and codes. In this study, which included 67,736 patients, 53,829 (79.5%) who had varying degrees of diuretic exposure exhibited a significantly lower mortality rate at 2 years compared to those without diuretic exposure (24.8% [95% CI 24.4–25.2], vs 37.5% [95% CI 36.7–38.3] respectively). However, the duration of diuretic exposure significantly impacted outcomes. The all-cause mortality rate at two years was highest in the group with ≥ 80% exposure (68.2% [95% CI 67.3–69.1]), followed by those with 50–80% exposure (15.7% [95% CI 15.0–16.4]), and those with 5–50% exposure (6.6% [95% CI 6.3–7.0]). An inverse probability weighting (IPW) propensity score analysis supported these findings. Stratified analyses showed consistent results regardless of a history of congestive heart failure and were similar for both hemodialysis and peritoneal dialysis patients. Additionally, the number of hospitalizations and length of stay were generally higher in the group with the longest exposure to loop diuretics. Diuretic exposure was generally associated with a lower mortality rate in dialysis patients. However, prolonged exposure (≥ 80%) was linked to an increased risk of mortality and hospitalization. This prolonged exposure may indicate residual diuresis at the cost of chronic fluid overload. [ABSTRACT FROM AUTHOR]

This report is of a systematic review and meta-analysis evaluating the efficacy and safety of transcatheter arterial embolization (TAE) for nonvariceal gastrointestinal bleeding (GIB) with n-butyl cyanoacrylate (NBCA) or coils as the primary embolic agent. The primary outcome was the clinical success rate. The secondary outcomes were technical success rates, 30-day rebleeding rates, major complication rates, and 30-day overall mortality rates. A systematic search was performed in PubMed, Embase, and Cochrane Library. Articles included had been published in English from January 2000 to August 2023 and assessed patients with nonvariceal upper and lower GIB (UGIB and LGIB) who received TAE with NBCA or coils. Single-arm meta-analyses were performed for these outcomes. Subgroup analyses comparing NBCA and coils were conducted if there were more than 10 articles selected for each outcome. Thirty-seven articles were selected for analysis. The pooled rates of TAE for UGIB and LGIB were clinical success 73.0% and 76.5%, technical success 94.9% and 91.4%, 30-day rebleeding 25.0% and 17.1%, major complications 3.5% and 10.0%, and 30-day overall mortality 20.7% and 11.4%, respectively. The subgroup analysis showed a significant difference only for the technical success rates of LGIB between NBCA and the coils (p < 0.001). The systematic review and meta-analysis indicate that TAE with NBCA or coils as the primary embolic agent is safe and effective for both UGIB and LGIB. [ABSTRACT FROM AUTHOR]

Background: Lung cancer has the highest fatality rate among all malignancies worldwide. Within this disease, bone metastasis (BM) emerges as a particularly deleterious site of metastatic dissemination, marked by a dismal prognosis. The objective of this investigation is to shed light on the current international research efforts and the development trajectory on lung cancer BM through a bibliometric analysis (performance and visualization analysis). Method: Data were obtained from the Web of Science Core Collection repository on lung cancer BM from 1 January 2012 to 1 January 2022. Subsequently, the collected data underwent scrutiny using the VOSviewer software to reveal patterns of co-authorship, co-citation, and keyword analysis, while the CiteSpace software facilitated the generation of keyword cluster maps and performed burst analyses. Results: The study included 327 papers of 2,154 authors, 587 organizations, and 41 countries, and explored the cooperation between them and the relationships between citations. Over the past decade, published papers showed a steady growth trend. China had the highest production with 189 papers, and USA had the highest collaboration with other countries, with 43 total link strength. Lung Cancer exhibited the highest frequency of co-cited journals, with a co-citation time of 412 and an IF/JCR partition of 6.081/Q1 in 2021. The most frequently co-cited article, authored by Tsuya A and published in Lung Cancer in 2007, amassed 70 co-citations. High-frequency keywords were categorized into four clusters: pathogenesis, treatment and clinical manifestations, prognosis, and diagnosis. In recent years, there has been a significant increase in the strong citation burst strength of keywords such as "predictor," "skeletal-related events," "efficacy," "migration," "docetaxel," and "impact." Lung adenocarcinoma is the most common type of tumor. Conclusion: This bibliometric study provides a comprehensive analysis of lung cancer BM in the recent 10 years. The field of early diagnosis, pathogenesis, and new treatments is entering a phase of rapid development and remains valuable for future research. [ABSTRACT FROM AUTHOR]

Background: Limited information is available regarding the relative risks of cancer-specific mortality and noncancer-specific mortality among long-term survivors with differentiated thyroid cancer (DTC). Methods: In this retrospective study, nationwide data from the Surveillance, Epidemiology, and End Results database (1992-2020) were utilized. The Accelerated Failure Time Model was applied to calculate Survival Time Ratios (TR), with the primary focus on mortality resulting from DTC. The competing risks model was employed to investigate the relative risks of various outcomes in DTC patients with a survival duration of 5 years or more. Results: In our cohort, 279 patients succumbed to DTC, while 748 died from other diseases. Notably, in DTC cohorts, noncancer-specific mortality rates were consistently higher than DTC-specific mortality rates across different age groups and genders. The risk of DTC and noncancer-specific mortality varied based on the TNM stage. With more advanced disease stages, the risk of DTC and other cancer-specific mortality gradually increased. The cumulative mortality from other cancer-specific causes was consistently the lowest. Conclusions: In long-term surviving DTC patients, noncancer-specific mortality outweighed DTC-specific mortality irrespective of age and gender. For stage I and II patients, increased attention should be directed toward noncancer-specific mortality in postoperative follow-ups. Conversely, for stage III and IV patients, greater consideration should be given to DTC-related causes of death. In addition, for stage III and IV DTC patients, the risk of death from other cancers was significantly higher than for stages I and II. [ABSTRACT FROM AUTHOR]

Background: Human immunodeficiency virus (HIV) and tuberculosis (TB) are still the two major deadly pandemics globally, causes 167,000 deaths in 2022. The two lethal combinations pose a substantial challenge to public health, especially in areas with high burden of both diseases such as Sub-Saharan Africa including Ethiopia. However, there is no study that showed national figure on mortality of TB/HIV co-infected patients. Hence, this review intended to provide pooled mortality rate and its predictors among patients co- infected with twin pandemics. Methods: Using reputable electronic data bases, primary studies were searched from January 25 to February 5, 2024. The review included papers published in English language conducted between 2004 and 2024. Heterogeneity between included studies was evaluated using Cochrane Q-test and the I2 statistics. Sub-group analysis was done to mitigate significant heterogeneity. Sensitivity analysis was also done to evaluate the effect of single studies on pooled estimated result. Results: In this systematic review and meta-analysis a total of 5,210 study participants were included from 15 primary studies. The review disclosed that the pooled proportion and incidence of mortality were 18.73% (95% CI: 15.92-20.83) and 4.94 (95% CI: 2.98-6.89) respectively. Being bedridden and ambulatory functional status, poor ART adherence, CD4 count below the threshold (<200 cells/mm3), advanced WHO clinical staging, not provision of cotrimoxazole and isoniazid preventing therapy, anemia and extra pulmonary TB were significant predictors of mortality. Conclusion and recommendations: The analyzed data of this systematic review and meta-analysis depicted that the national pooled proportion and incidence of mortality among TB-HIV co-infected patients were considered to be still high. The authors strongly recommended scale up and continuous provision of cotrimoxazole and isoniazid preventive therapy. In addition, early identification and treatment of anemia will greatly halt the high burden of mortality. Generally, to reduce mortality and improve survival, a collaborative effort is mandatory to emphasize close follow up of patients with identified predictors. [ABSTRACT FROM AUTHOR]

Background: While TB-related mortality in the US declined four-fold from 1990 to 2019, country-level estimates of TB burden obscure within-state racial heterogeneity and changes in TB burden over time. In sixteen US Southern States and Washington DC, the effects of health inequities engendered by Jim-Crow laws enacted from the late 1800s to the 1960s have not been evaluated for TB-related mortality. We, therefore, sought to compare TB mortality rates and annualized rate of change (AROC) between 1990 and 2019 in former Jim-Crow vs. non-Jim-Crow states to help guide response efforts and inform resource prioritization to improve racial equity. Methods: We evaluated whether TB-related mortality varied over time, from 1990 to 2019, between states that have a history of enacting Jim-Crow laws vs. states with no such history using estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019). TB mortality per 100,000 population and bootstrap 95% uncertainty intervals (UIs) were modeled using the Cause of Death Ensemble model (CODEm) framework with varying combinations of predictive covariates. For changes over time, we present age-standardized AROC as the percent difference in the natural logarithm of the rate in 1990 and 2019 divided by 30 (i.e., 100*[ln(2019 Rate/1990 Rate)/(30)) and the corresponding 95% UIs. Results: TB-related mortality in all US states declined between 1990 and 2019. From 1990 to 2019, most former Jim-Crow states had higher mortality rates than states that did not enact Jim-Crow laws. The most significant decline in TB mortality was in Washington DC, with a six-fold decline from 2.69 (2.46–2.96) per 100,000 population in 1990 to 0.45(0.37–0.55) in 2019, corresponding to an AROC of -0.83% (-0.86;-0.79). The lowest decline was in Iowa, from 0.30 (0.27–0.33) to 0.09 (0.07–0.11) (AROC: -0.70% (-0.76; -0.63)). Eleven of the 16 states and Washington DC in the third tertile of TB mortality rate in 1990 (range 0.81–2.69) had a history of Jim-Crow laws, whereas none of the 17 states in the first tertile (range 0.30–0.51) had such history. Conversely, mortality decreased relatively slowly in former Jim-Crow states than in non-Jim-Crow states. Conclusions: Even though the 1964 Civil Rights Act dismantled Jim-Crow statutes, racial inequities in TB burden experienced by past generations may still be felt in subsequent generations. Understanding the role of structural racism at the intersection of science and medicine shows the complex ways historical laws, such as Jim-Crow laws, continue to negatively impact health outcomes and warn of future dangers, such as COVID-19, to avoid. [ABSTRACT FROM AUTHOR]

Corticosteroid is essential in the treatment regimen for connective tissue disease (CTD); however, its long-term use poses significant risks, including pulmonary infections. The relationship between cumulative corticosteroid doses and adverse pneumonia outcomes requires further investigation. This study aimed to explore the association between cumulative methylprednisolone dosages (CMD) and pneumonia mortality risks among CTD patients. We conducted a retrospective analysis of data from CTD patients treated with intravenous or oral corticosteroids across six academic hospitals over approximately five years in China. We evaluated follow-up outcomes at 30 and 90 days after the onset of pneumonia. Piecewise linear regression, Cox regression analysis, and survival analysis were employed to investigate the relationship between CMD and 30-day and 90-day mortality risks. Among 335 CTD patients with pneumonia, the mean CMD was 12 g. The 30-day and 90-day mortality rates were 25.07% and 29.55%, respectively. After adjusting for potential confounders, smooth curve fitting analysis revealed a specific nonlinear relationship between CMD and 30-day and 90-day mortality risks. Cox regression analysis indicated that the lowest pneumonia mortality risk occurred when CMD ranged from 11 to 24 g (30-day adjusted hazard ratio (aHR) 0.33, 95% CI 0.14–0.77; 90-day aHR 0.37, 95% CI 0.17–0.81). Patients in the 11–24 g CMD group demonstrated significantly lower cumulative hazard and death rates compared to both the low CMD (< 11 g) and high CMD (> 24 g) groups (P < 0.05). Furthermore, interaction testing suggested that CMD's negative impact on pneumonia mortality risks was more pronounced in community-acquired pneumonia (CAP) compared to hospital-acquired pneumonia (P for interaction < 0.05). CMD shows a distinct nonlinear relationship with 30-day and 90-day pneumonia mortality risks, with potentially lower risks observed within the 11–24 g CMD range. Moreover, the varying impact of CMD on CAP mortality risk warrants further consideration in clinical management strategies. [ABSTRACT FROM AUTHOR]

Background and Aims Severe tricuspid regurgitation is associated with increased mortality rates, but benefit of its correction and ideal timing are not clearly determined. This study aimed to identify patient subsets who might benefit from the surgery. Methods In TRIGISTRY, an international cohort study of consecutive patients with severe isolated functional tricuspid regurgitation (33 centres, 10 countries), survival rates up to 10 years were compared between patients who underwent isolated tricuspid valve surgery (repair or replacement) and those conservatively managed, overall and according to TRI-SCORE category (low: ≤3, intermediate: 4–5, and high: ≥6). Results One thousand and two hundred seventeen were managed conservatively, and 551 underwent isolated tricuspid valve surgery (200 repairs and 351 replacements). TRI-SCORE distribution was 33% low, 32% intermediate, and 35% high. At 10 years, survival rates were similar between surgical and conservative management [41% vs. 36%; hazard ratio (HR).97; 95% confidence interval (CI).88–1.08, P =.57]. Surgery improved survival compared with conservative management in the low TRI-SCORE category (72% vs. 44%; HR.27; 95% CI.20–.37, P <.0001), but not in the intermediate (36% vs. 37%; HR 1.17; 95%CI.98–1.40, P =.09) or high categories (20% vs. 24%; HR 1.06; 95% CI.91–1.25, P =.45). Both repair and replacement improved survival in the low TRI-SCORE category (84% and 61% vs. 44%; HR.11; 95% CI.06–.19, P <.0001, and HR.65; 95% CI.47–.90, P =.009). Repair showed benefit in the intermediate category (59% vs. 37%; HR.49; 95% CI.35–.68, P <.0001) while replacement was possibly harmful (25% vs. 37%; HR 1.43; 95% CI 1.18–1.72, P =.0002). Conclusions Higher survival rates were observed with repair than replacement and benefit of intervention declined as TRI-SCORE increased with no benefit of any type of surgery in the high TRI-SCORE category. These results emphasize the importance of timely intervention and patient selection to achieve the best outcomes and the need for randomized controlled trials. [ABSTRACT FROM AUTHOR]

Background: Heart failure (HF) is a complex disorder that has an association with increased morbidity and mortality rates globally. The association of statin use with mortality rate in individuals with HF remains unclear. Objectives: To examine the association of statin use with the short-term and long-term all-cause mortality rate in critically ill individuals with HF. Methods: We performed a retrospective cohort analysis based on the Medical Information Mart for Intensive Care (MIMIC)-IV database. The critically ill people with HF were assigned to a statin group and a non-statin group according to whether they had been treated with statin or not during hospitalization. The Kaplan−Meier (KM) method and Cox proportional hazard models were adopted to explore the link between statin administration and the 30-day, 90-day, as well as 1-year mortality rates. To ensure the robustness of the findings, a 1:1 nearest propensity-score matching (PSM) was also performed. Results: The current research included 11,381 patients for the final analysis, with 7,561 in the statin group and 3,820 in the non-statin group. After multiple confounders were adjusted, we found that the Cox regression models revealed great beneficial effects of statin therapy on the 30-day, 90-day, as well as 1-year mortality rates among critically ill individuals with HF in the fully adjusted model. PSM also achieved consistent results. After PSM, the risk of mortality reduced by 23% for the 30-day mortality (HR = 0.77, 95%CI: 0.68–0.88, p < 0.001), 16% for the 90-day mortality rate (HR = 0.84, 95%CI: 0.75–0.93, p < 0.001), and 12% for the 1-year mortality rate (HR = 0.88, 95%CI: 0.81–0.97, p = 0.007). Patients treated with rosuvastatin had the greatest reduction in mortality rate. The 30-day, 90-day, and 1-year all-cause mortality rates were remarkably lower in patients who were treated with low-dose statins. Conclusion: Our study unveiled that statin use was related to decreased short-term and long-term all-cause mortality rates in critically ill individuals with HF. Rosuvastatin was associated with the greatest reduction of all-cause mortality rates. Low-dose statins can significantly reduce short-term and long-term mortality, while high-dose statins are not significantly correlated with mortality. However, the results are not conclusive and should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Objective: Potassium ion disorders are prevalent among patients in Intensive Care Units (ICUs), yet there is a notable deficiency in established protocols and supplemental plans for potassium management. This retrospective study conducted at a single center aims to explore the relationship between potassium levels, their variability, and the 28-day mortality rate in ICU patients. Methods: This study analyzed data from patients admitted to the ICU of the First Affiliated Hospital of Guangxi Medical University between October 2022 and October 2023. We assessed serum potassium variability using the coefficient of variation and categorized it into four quartile groups (Q1, Q2, Q3, Q4). Additionally, patients were classified into six groups based on serum potassium concentrations. The associations between these categories and the 28-day mortality rate were evaluated using binary logistic regression, adjusting for potential confounders. Results: A total of 506 patients and 12,099 potassium measurements were analyzed. The group with the lowest potassium variability (Q1) exhibited the lowest mortality rate at 21% (P<0.01). It is noteworthy that within 28 days in the intensive care unit (ICU), the coefficient of variation (CV) of potassium levels significantly increased among deceased patients compared to surviving patients (P < 0.01). Conclusion: Significant variability in potassium levels is associated with an increased risk of 28-day mortality among ICU patients, underscoring the need for stringent monitoring and management of potassium levels in this population. [ABSTRACT FROM AUTHOR]

Introduction: Diseases have a negative impact on production and profitability of small ruminants. A good herd health program can decrease the number of sick animals and improve herd performance. Methods: In a longitudinal study, small ruminant herd health interventions such as community-based strategic gastrointestinal (GI) parasite control, prevention and control of major respiratory diseases and capacity development activities were implemented. In four districts of Ethiopia, where the Community Based Breeding Program (CBBP) is implemented, morbidity and mortality data were collected from January 2018 to July 2021 in 1047 smallholder farms with the objective of evaluating the impact of herd health interventions. A total of 2,643 sick animals and 516 deaths of small ruminants were recorded during the study period. The disease cases were categorized into eight groups: gastrointestinal, neurological, reproductive, respiratory, skin, systemic, other diseases (eye disease, foot disease etc) and unknown diseases. Chi-square and proportions were used to analyze morbidity and mortality by district, agro-ecological zone and age of the animal. Results: The data showed that the general trend in the occurrence of cases and morbidity rate were decreasing from 2018 to 2021 in intervention villages. Overall, the morbidity rate in young animals (7.36%) was highier than in adults (3.49%) and the mortality rate difference between young and adult animals was also statistically significant (p < 0.001). The morbidity and mortality rates varied significantly (p < 0.001) among districts and among agro-ecologies. According to the data, treating and following up of infected animals reduced the mortality rate significantly. The relative risk of death in treated animals after the case reported was 0.135. Generally, the intervention impact analysis revealed that morbidity rate was significantly decreased (p = 0.009) in intervention years (6.31% in 2018 to 3.02% in 2021) and that herd health interventions provide an added value. Conclusion: Generally, herd health intervention had significant impact in reducing the morbidity rates in years and treatment and follow up of sick animals due to early reporting reduced mortality rate significantly. It is recommended that the herd health management should be the core activity under small ruminant production programs. [ABSTRACT FROM AUTHOR]

Pancreatic diseases such as pancreatitis and pancreatic cancer represent significant health challenges characterized by high mortality rates and limited survival durations. Autophagy, a crucial cellular catabolic process, has emerged as a focal point in understanding various pathological conditions, spanning inflammation-related disorders to malignant neoplasms. This comprehensive review aims to elucidate the biological intricacies of autophagy and its pivotal roles within two extensively researched pancreatic diseases, namely pancreatitis and pancreatic cancer, drawing upon recent scholarly contributions. The discussion will delve into the nuanced mechanisms underlying autophagy's involvement in these diseases, shedding light on its potential as a therapeutic target. Furthermore, the review will explore cutting-edge therapeutic interventions leveraging autophagy regulation for managing pancreatitis and pancreatic cancer. Through this analysis, we endeavor to offer novel insights into the pathophysiology of pancreatic disorders and contribute to the development of innovative therapeutic modalities in this challenging clinical domain. [ABSTRACT FROM AUTHOR]

Anthocyanins, as a type of polyphenolic compound, have been discovered to offer multiple health benefits to humans, including anti-aging and anti-inflammatory properties. This prospective cohort study aims to examine the relationship of dietary intake of anthocyanin with all-cause mortality and cardiovascular diseases mortality in the US. The aim of this research was to explore the possible correlation between anthocyanin consumption and the mortality rate from all causes as well as from cardiovascular disease. Based on the Public Access NHANES-linked National Death Index files up to December 31, 2019, we identified mortality status and heart disease-specific causes of death. A multivariate Cox regression analysis was employed to evaluate the effects of anthocyanin intake on mortality outcomes, generating hazard ratios and 95% confidence intervals, adjusting for various demographic characteristics, lifestyle factors, and comorbid conditions. Additionally, we utilized Kaplan-Meier survival curves, subgroup analyses. In different scenarios, dietary anthocyanin intake was assessed using restricted cubic spline models. A total of 11,959 participants completed the final cohort, averaging 47.12 years of age (SD ± 0.35). Following adjustments for multiple variables, an inverse relationship was identified between anthocyanin intake in the highest quartile and all causes mortality, yielding a hazard ratio (HR) of 0.68 (95% CI: 0.52–0.89). Similarly, elevated anthocyanin consumption was linked to a reduction in heart disease mortality, with HR of 0.61 (95% CI: 0.38–0.97). Additionally, dose–response curve revealed a consistent decrease in both all-cause and cardiovascular mortality with increasing anthocyanin intake. Further subgroup analyses revealed that elevated intake of anthocyanins was linked to decreased all-cause mortality in White individuals and males. Moreover, high anthocyanin intake was significantly correlated with reduced all-cause mortality irrespective of hypertension or hyperlipidemia status. Our research indicates that an appropriate dietary intake of anthocyanins is associated with a reduction in overall mortality rates. Furthermore, the findings reveal a substantial association between anthocyanin intake and decreased mortality from cardiovascular diseases, suggesting that anthocyanins may effectively lower the risk of cardiovascular-related deaths. [ABSTRACT FROM AUTHOR]

Background: The prognostic nutritional index (PNI), reflecting the body's immune-nutritional status, has been established as a correlate of prognosis across various diseases. However, its significance in community-acquired pneumonia (CAP) remains unclear. This study investigated the relationship between PNI and clinical outcomes in CAP patients. Methods: In this retrospective cohort study, we aimed to evaluate the prognostic value of the PNI in adults with CAP admitted to the ICU. Participants were selected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and categorized into quartiles (Q1–Q4) according to their PNI values. We employed Kaplan-Meier survival analysis, multivariate Cox regression, and restricted cubic spline (RCS) models to explore the association between PNI and the clinical outcomes of these CAP patients. Results: In this study, we included 1,608 patients with CAP. The observed 30-day and 90-day mortality rates stood at 30.85% and 39.99%, respectively. Patients with higher PNI levels exhibited a reduced risk of both 30-day and 90-day mortality. Following adjustment for confounders, PNI showed a significant negative association with 30-day mortality [HR, 0.93 (0.91–0.94), P < 0.001] and 90-day mortality [HR, 0.94 (0.92–0.95), P < 0.001]. RCS analysis revealed a consistent trend of declining all-cause mortality risk corresponding to increasing PNI values. PNI demonstrated predictive value for 30-day and 90-day mortality in CAP patients, with AUCs of 0.71 and 0.68, respectively. Combining PNI with CURB-65 enhanced the predictive value of CURB-65. Conclusion: Our investigation identified a significant negative association between the PNI and the risk of mortality in patients with CAP. Additionally, the PNI demonstrated superior predictive value for mortality risk in CAP patients when compared to the CURB-65 scoring system. [ABSTRACT FROM AUTHOR]

Radical esophagectomy remains the only potentially curative option in the treatment of esophageal cancer. However, this procedure is burdened with high morbidity and mortality rates, even in high-volume centers. A tracheo- or bronchoesophageal fistula (TBF) is rare but is one of the most difficult life-threatening complications following an esophagectomy for cancer treatment. Several classifications have been proposed regarding the localization of a TBF, its etiology, and the timing of its occurrence; hence, no classification is universally accepted. However, one of the most common etiological explanations for the formation of a TBF is a prior esophagogastric anastomotic leak. Treatment options include a conservative approach, which usually combines several endoscopic methods. Surgical treatment is directed towards fistula closure with direct suturing or, more often, the usage of pediculated flaps. Here, we present a patient with late TBF following a minimally invasive esophagectomy, which was surgically solved in an atypical way. We believe that this type of repair may be useful in patients in whom pedunculated flaps are not an option. [ABSTRACT FROM AUTHOR]

We aim to investigate cardiovascular mortality risk among diffuse large B-cell lymphoma (DLBCL) patients and explore cardiovascular mortality trends in the past decades in United States. We extracted data from the Surveillance, Epidemiology, and End Results database for adult patients diagnosed with DLBCL between 1975 and 2019. Standardized mortality ratio, joinpoint regression analysis, and competing risk model were analyzed. Overall, 49,918 patients were enrolled, of whom 4167 (8.3%) cardiovascular deaths were observed, which was 1.22 times the number expected (95%CI, 1.19–1.26). During 1985–2019, the incidence-based cardiovascular mortality rate increased by 0.98% per year (95%CI, 0.58–1.39%), with statistically significant increases in age groups younger than 75 years. The cumulative mortality from cardiovascular disease increased by age but never exceeded that from DLBCL. Older age, male sex, earlier year of diagnosis, lower tumor stage at diagnosis, chemotherapy, radiotherapy, and surgery were all poor prognostic factors for cardiovascular mortality. [ABSTRACT FROM AUTHOR]

Sudden cardiac death (SCD) represents a critical acute cardiovascular event characterized by rapid onset of cardiac and respiratory arrest, posing a significant threat to patients due to its high fatality rate. Monitoring indices related to SCD using wearable devices holds profound implications for preemptive measures aimed at reducing the incidence of such life-threatening events. Hence, this study proposed a predictive algorithm for SCD leveraging single-lead electrocardiogram (ECG) signals featuring low signal-to-noise ratios. Initially, simulated electrode motion artifact noise was introduced to ideal ECG signals to emulate the signal conditions with low signal-to-noise ratios encountered in everyday scenarios. To meet the criteria of simplicity and cost-effectiveness required for wearable devices, the analysis focused exclusively on single-lead signals. The proposed algorithm in this study employed a lightweight machine learning approach to extract 12-dimensional features encompassing ventricular late potentials, T-wave electrical alternation, and corrected QT intervals from the signal. The algorithm achieved an average prediction accuracy of 93.22% within 30 min prior to SCD onset, and 95.43% when utilizing a normal sinus rhythm database as a control, demonstrating robust performance. Additionally, a comprehensive Sudden Cardiac Death Index (SCDI) was devised to quantify the risk of SCD, formulated by integrating pivotal two-dimensional features contributing significantly to the algorithm. This index effectively distinguishes high-risk signals indicative of SCD from normal signals, thereby offering valuable supplementary insights in clinical settings. [ABSTRACT FROM AUTHOR]

Purpose: Acute hypoxaemic respiratory failure (AHRF) is a common reason for intensive care unit (ICU) admission. However, patient characteristics, outcomes, and trends over time are unclear. We describe the epidemiology and outcomes of patients with AHRF over time. Methods: In this binational, registry-based study from 2005 to 2022, we included all adults admitted to an Australian or New Zealand ICU with an arterial blood gas within the first 24 h of ICU stay. AHRF was defined as a partial pressure of oxygen/inspired oxygen ratio (PaO2/FiO2) ≤ 300. The primary outcome was adjusted in-hospital mortality, categorised based on PaO2/FiO2 (mild: 200–300, moderate: 100–200, and severe < 100, and non-linearly). We investigated how adjusted mortality evolved based on temporal trends (by year of admission), sex, age, admission diagnosis and the receipt of mechanical ventilation. Results: Of 1,560,221 patients, 826,106 (52.9%) were admitted with or developed AHRF within the first 24 h of ICU stay. Of these 826,106 patients, 51.4% had mild, 39.3% had moderate, and 9.3% had severe AHRF. Compared to patients without AHRF (5.3%), patients with mild (8%), moderate (14.2%) and severe (29.9%) AHRF had higher in-hospital mortality rates. As PaO2/FiO2 ratio decreased, adjusted in-hospital mortality progressively increased, particularly below an inflection point at a PaO2/FiO2 ratio of 200. The adjusted in-hospital mortality for all patients decreased over time (13.3% in 2005 to 8.2% in 2022), and this trend was similar in patients with and without AHRF. Conclusion: The healthcare burden due to AHRF may be larger than expected, and mortality rates remain high in severe AHRF. Although mortality has decreased over time, this may reflect improvements in ICU care in general, rather than specifically in AHRF. More research is required to earlier identify AHRF and stratify these patients at risk of deterioration early, and to validate our findings. [ABSTRACT FROM AUTHOR]

Purpose: Loop-mediated isothermal amplification (LAMP) is a simple and rapid nucleic acid method for DNA amplification at a constant temperature. The "gold standard" culture method for yeast detection, has low sensitivity with severe consequences, increasing morbidity and mortality rates. Here, we report the development of a LAMP method for the specific detection of C. glabrata. Methodology: The specific LAMP primers for C. glabrata detection were designed and evaluated. Results: The LAMP assay accurately detected C. glabrata with no cross-reactivity with other Candida species. Conclusion: The developed molecular method would be a promising tool in the management of invasive candidiasis. [ABSTRACT FROM AUTHOR]

Aim: Elevated body mass index (BMI) presents a significant public health challenge in the United States, contributing to considerable morbidity, mortality and economic burden. This study investigates the health burden of overweight and obesity in the United States from 1990 to 2021, leveraging the Global Burden of Disease data set to analyse trends, disparities and potential determinants of high BMI‐related health outcomes. Materials and Methods: Our study focused on the United States, analysing trends in disability‐adjusted life years (DALY) and deaths attributable to high BMI, defined as a BMI of 25 kg/m2 or higher for adults. Statistical analyses included estimated annual percentage change (EAPC) in age‐standardized DALY rates and age‐standardized death rates. Pearson correlation was performed between EAPCs and the socio‐demographic index (SDI), with significance set at p < 0.05. Results: From 1990 to 2021, age‐standardized DALY rates attributable to high BMI increased by 24.9%, whereas the age‐standardized death rates increased by 5.2%. Age disparities showed DALYs peaking at 60–64 years for males and 65–69 years for females, with deaths peaking at 65–69 years for males and 90–94 years for females. A strong negative correlation was found between the EAPC in age‐standardized DALY and death rates and the SDI. Conclusions: Overweight and obesity significantly impact public health in the United States, especially among older adults and lower socio‐demographic regions. Comprehensive public health strategies integrating behavioural, technological and environmental interventions are crucial. Future research should focus on longitudinal studies, personalized interventions and policy‐driven approaches to address the multifaceted influences on high BMI. [ABSTRACT FROM AUTHOR]

Aim: Poor cardiorespiratory fitness has been suggested to increase the risk of chronic diseases in obesity. We investigated the ability of key variables from cardiopulmonary exercise testing (CPET) to predict all‐cause mortality in an obese cohort. Methods: The sample included 469 participants of both sexes (mean age 40 ± 13 years) who underwent a CPET for clinical reasons between 1 March 2009 and 1 December 2023. All‐cause mortality was the prognostic endpoint. A receiver operating characteristic analysis was performed to establish optimal cut‐points for CPET variables. Kaplan–Meier and Cox regression analyses were used to determine the association between CPET variables and all‐cause mortality. Results: There were 46 deaths during a mean follow‐up period of 69 ± 48 months, resulting in an annual mortality rate of 2%. Despite the sample being made up of mostly women (70%), there were more deaths in men (18 vs. 6%, p < 0.001).The optimal thresholds for discrimination of survival were as follows: (a) peak oxygen uptake (pVO2) ≤16 mL/kg/min; (b) minute ventilation/carbon dioxide production (VE/VCO2) slope ≥31; (c) ventilatory power ≤5.8 mmHg; and (d) circulatory power ≤2980 mmHg/mL O2/min. Kaplan–Meier survival plots revealed a significant positive association between lower pVO2, circulatory power and ventilatory power values and survival (log‐rank, p < 0.001) and higher mortality for men than women. Adjusted Cox regression models showed that a pVO2 ≤16 mL/kg/min had a 20‐fold higher risk of mortality when compared with >16 mL/kg/min. Conclusion: Given the strong association of VO2, ventilatory efficiency, circulatory and ventilatory power with all‐cause mortality, our findings support the notion that poorer cardiorespiratory fitness is associated with a poor prognosis in patients with obesity. [ABSTRACT FROM AUTHOR]

Background and Aims: The impact of hepatitis C virus (HCV) eradication via direct‐acting antiviral (DAA) therapy on overall mortality, particularly non‐liver‐related mortality, is understudied. Methods: We recruited 4180 patients with chronic HCV infection who achieved sustained virological response (SVR) (HCV eradication) through DAA therapy (n = 2501, SVR group) or who did not receive antiviral therapy (n = 1679, non‐SVR group); 1236 from each group were chosen using propensity score matching. Causes of death and all‐cause mortality, including non‐liver‐related diseases, were investigated. Results: Of the 4180 patients, 592 died during the follow‐up period. In the SVR group, the mortality rates from liver‐related and non‐liver‐related diseases were 16.5% and 83.5%, respectively. Compared to the non‐SVR group, mortality rates from liver‐related and non‐liver‐related diseases were 50.1% and 49.9%, respectively (p <.001). In non‐cirrhotic patients, multivariable analysis revealed that SVR was an independent factor associated with both liver‐related (hazard ratio [HR],.251; 95% confidence interval [CI],.092–.686) and non‐liver‐related (HR,.641; 95% CI,.415–.990) mortalities. In cirrhotic patients, multivariable analysis revealed that SVR remained an independent factor significantly associated with liver‐related mortality (HR,.151; 95% CI,.081–.279). In propensity score‐matched patients, the eradication of HCV (SVR group) decreased both liver‐related (p <.001) and non‐liver‐related mortality (p =.008) rates compared to persistent HCV infection (non‐SVR group). Conclusions: The elimination of HCV via DAA therapy reduced not only liver‐related mortality but also non‐liver‐related mortality in patients with chronic HCV. [ABSTRACT FROM AUTHOR]

The construction industry has long been plagued by low productivity and high injury and fatality rates. Robots have been envisioned to automate the construction process, thereby substantially improving construction productivity and safety. Despite the enormous potential, teaching robots to perform complex construction tasks is challenging. We present a generalizable framework to harness human teleoperation data to train construction robots to perform repetitive construction tasks. First, we develop a teleoperation method and interface to control robots on construction sites, serving as an intermediate solution toward full automation. Teleoperation data from human operators, along with context information from the job site, can be collected for robot learning. Second, we propose a new method for extracting keyframes from human operation data to reduce noise and redundancy in the training data, thereby improving robot learning efficacy. We propose a hierarchical imitation learning method that incorporates the keyframes to train the robot to generate appropriate trajectories for construction tasks. Third, we model the robot's visual observations of the working space in a compact latent space to improve learning performance and reduce computational load. To validate the proposed framework, we conduct experiments teaching a robot to generate appropriate trajectories for excavation tasks from human operators' teleoperations. The results suggest that the proposed method outperforms state-of-the-art approaches, demonstrating its significant potential for application. [ABSTRACT FROM AUTHOR]

In 2021, White Trevally or Striped Jack cultured in the western part of Japan exhibited mild, but chronic mortalities from late September through early October. The cumulative mortality rate was approximately 0.02% per a net pen containing approximately 50,000 fish. Although the cumulative mortality rate was not high, most of the fish in net pens showed characteristic gross signs and an abnormal swimming behaviour. The body of diseased fish became pale and the yellow lines on the lateral sides of fish body became darken. In addition, silver lines along the dorsal fin became apparent. Loss of schooling behaviour was noted during the mortality event. In addition, affected fish became lethargic and failed to swim against current, or frequently stopped swimming and sank to the bottom of net pens after feeding. The goal of this study was to identify the cause of the mortality event. To achieve the goal, we used histopathology and metatranscriptome analysis. Histopathological examination revealed that xenoma of microsporidian were frequently observed in the nerve axon in the brain and spinal cord. Spores observed in the sections were stained with a fluorescent dye, Uvitex 2B, indicating those spores are microsporidian. The data from metatranscriptome analysis indicated that the microsporidian is Spraguea sp. The microsporidian was frequently detected from diseased fish with similar symptoms collected in the same region, suggesting that the microsporidian was highly associated with abnormal swimming behaviour of fish. [ABSTRACT FROM AUTHOR]

Early life history traits of small pelagic fish are usually affected by environmental conditions. Patagonian sprat, Sprattus fuegensis, is a small pelagic fish that inhabits the continental shelf, fjords and channels of Patagonia. Their larvae are usually exposed to large variations in physical and biological conditions. We evaluated the effects of environmental conditions on early life history traits of this key species encompassing over 20 years of information. The characterization of oceanographic features, larval abundance and distribution was carried out in western Patagonia between 1996 and 2019, while the growth and mortality rates were estimated for the austral spring 2019 between 49°54′S and 53°55′S. Larval abundance decreased three to ten times from 1996 to 1997 to the rest of the study period (2008–2010 and 2014–2019), with larger abundances being found over the shelf. In spring 2019, the growth rate was 0.20 ± 0.05 mm d−1 for larvae between 9 and 19 days after hatching. The growth rate was similar in partially stratified (7–50 J m−3) and stratified waters (50–100 J m−3), but slower in mixed waters (< 7 J m−3). GAM modelling showed that the faster larval growth occurred in partially stratified waters with temperatures above 7.5°C. Natural mortality rates were higher in partially stratified waters (24% of daily loss), lower in stratified areas (14%) and the lowest in the mixed water column (12%). Accordingly, larvae living in channels had faster growth rates but higher daily mortality, while those that hatched or were advected to water parcels on the continental shelf had slower growth but lower daily mortality. Finally, these latter traits may be an example of an inverse growth‐selective survival strategy. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to assess: (i) trends in alcohol‐specific — that is, fully attributable — morbidity and mortality in the German adult population aged 15–69 between 2000 and 2021; and (ii) changes in alcohol‐attributable disease burden — that is, fully and partially alcohol‐attributable categories — for 2006, 2012, 2018 and 2021. Methods: Morbidity data was pulled from hospitalisation and rehabilitation statistics and mortality data was pulled from the causes of death registry. Alcohol use, adjusted for unrecorded consumption, was estimated using the Epidemiological Survey of Substance Abuse and triangulated with per capita consumption from annual sales data. For major disease categories, alcohol‐attributable fractions were estimated for males and females by age groups (15–29, 30–49, 50–69 years) using the comparative risk assessment methodology. Results: For males and females, the age‐standardised rate of alcohol‐specific morbidity peaked in 2012 and decreased thereafter showing a steep decline from 2019 to 2021. The rates of alcohol‐specific mortality decreased constantly from 2000 to 2019 but increased from 2019 to 2021. Compared to 2006 the age‐standardised alcohol‐attributable morbidity and mortality rates in males and females were lower in 2021. For both sexes, the age‐standardised alcohol‐attributable morbidity and mortality rates and the proportions of morbidity/mortality rates relative to all‐cause morbidity/mortality decreased between 2006 and 2021. Discussion: The declines in alcohol‐attributable morbidity and mortality are in line with decreases in consumption and signal that the importance of alcohol in health service utilisation and mortality has weakened. Sex ratios in morbidity and mortality do not indicate a strong converging trend. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to compare outcomes post‐admission to a Swedish paediatric intensive care unit (PICU) in children with complex chronic conditions (CCC) and without CCC. Methods: In this observational registry‐based study, consecutive admissions to the Astrid Lindgren Children's Hospital PICU from 1 January 2008 to 31 December 2016 were analysed. Data on demographics, predicted death rates (PDR), admission diagnoses and causes of death were collected. Mortality was recorded up to 15 years after admission and compared between groups. Results: Patients with CCC constituted 64.6% (n = 3026) of PICU admissions and 83.5% (n = 111) of PICU deaths. The crude mortality rate in PICU was 2.84% overall. CCC‐patients were 2.83 times more likely to die in PICU compared to non‐CCC (OR 2.83; 95% CI: 1.78–4.49). Mortality increased in the CCC‐cohort up to 5 years after PICU discharge, while non‐CCC patients generally survived if they survived in PICU. Of the patients who died in PICU, the median PDR was 22.9% for CCC‐patients and 66.5% in the non‐CCC cohort. Conclusion: Children with CCC accounted for most admissions and deaths in PICU. Despite lower severity of illness scores upon admission, CCC patients were nearly three times more likely to die in PICU compared to non‐CCC patients. [ABSTRACT FROM AUTHOR]

Background: Phosphatidylinositol 3‐kinase (PI3K) inhibitors transformed management of various malignancies. This study preclinically characterized TQ‐B3525 (dual PI3Kα/δ inhibitor) and assessed the recommended phase 2 dose (RP2D), safety, efficacy, and pharmacokinetics in relapsed or refractory (R/R) lymphoma or advanced solid tumors (STs). Methods: Oral TQ‐B3525 was given at eight dose levels on a 28‐day cycle. Primary end points were dose‐limiting toxicity (DLT), maximum tolerated dose (MTD), and safety. Results: TQ‐B3525 showed high selectivity and suppressed tumor growth. Between June 12, 2018, and November 18, 2020, 80 patients were enrolled (63 in dose‐escalation cohort; 17 in dose‐expansion cohort). Two DLTs occurred in two (two of 63, 3.2%) DLT‐evaluable patients; MTD was not identified. TQ‐B3525 at 20 mg once daily was selected as RP2D. Grade 3 or worse treatment‐related adverse events mainly included hyperglycemia (16.3%), neutrophil count decreased (15.0%), and diarrhea (10.0%). Two (2.5%) treatment‐related deaths were reported. Sixty patients with R/R lymphoma and 11 advanced STs demonstrated objective response rates of 68.3% and 9.1%, disease control rates of 91.7% and 54.6%, median progression‐free survivals of 12.1 and 1.1 months; median overall survivals were not reached. Conclusion: TQ‐B3525 exhibited rapid absorption and a nearly proportional increase in exposure. Acceptable safety and promising efficacy support further investigation of TQ‐B3525 (20 mg once daily) for R/R lymphoma. Considering the black‐box warnings associated with several phosphatidylinositol 3‐kinase (PI3K) inhibitors, it remains crucial to develop novel PI3K inhibitors with reduce toxicities. This study presents the results of the preclinical and phase 1 study of TQ‐B3525, suggesting that TQ‐B3525 may be a feasible therapeutic approach in patients with relapsed or refractory lymphomas, with a comparable safety and efficacy profile. [ABSTRACT FROM AUTHOR]

Background: Acetaminophen, ibuprofen, and indomethacin are widely used as first-line drugs for patent ductus arteriosus (PDA) closure in preterm neonates. However, their relative safety profiles remain unclear. Methods: Adverse event reports related to the first-line drugs used in PDA and neonates in general were retrieved from the US Food and Drug Authority (FDA) Adverse Event Reporting System. Deduplicated reports were analyzed using proportional reporting ratios and reporting odds ratios to identify disproportionality safety signals between drugs. Results: A total of 969 unique reports related to the first-line drugs used in PDA and 499 reports in the neonatal period were included. Acetaminophen signals primarily involved the liver, while ibuprofen and indomethacin signals pertained to gastrointestinal, renal, vascular, and mortality outcomes. Higher occurrences of death were reported with indomethacin and ibuprofen compared with acetaminophen. Conclusion: This first comparison of PDA drug safety profiles from spontaneous reports highlights some differences, with acetaminophen potentially conferring a safer adverse effect profile overall. While limitations include missing data and reporting biases, the signals warrant further validation. Given its comparable efficacy to ibuprofen, as demonstrated in other studies, acetaminophen has the potential to be preferred as an initial medical therapy for PDA. [ABSTRACT FROM AUTHOR]

In Morocco and many other Mediterranean countries, cultivation of Opuntia spp. has been severely impacted by infestations of Dactylopius opuntiae (Cockerell) (Hemiptera: Dactylopiidae). Several control approaches have been adopted worldwide to address the spread of this pest, including biological control. Many entomopathogenic fungal isolates (EPFs) have been described as promising agents for this purpose worldwide. The efficacy of three EPFs: Alternaria murispora (PP264308), Alternaria destruens (PP264311), and Macrophomina tecta (PP264310) against D. opuntiae young females and nymphs was assessed in laboratory and field settings. Under laboratory conditions, A. murispora and A. destruens at 108 conidia mL−1, and D-limonene (the positive control) applied at 2.5 cc. L−1, were the most effective, which resulted in significant mortality rates in adult females and nymphs (97%, 86%, and 93% respectively (adult females) and 100%, 98%, and 99% respectively (nymphs)) after 6 days of exposure, leading to LT50 values of 3.0, 6.0 and 3.0 days, respectively (young female) and 3.0 (nymph). Under field conditions, A. murispora at 108 (88.9% mortality (nymphs) and 71.6% mortality (females)) and 107 conidia mL−1 (84.2% mortality (nymphs) and 64.2% mortality (females)), and D-limonene at 2.5 cc/L (88.8% mortality (nymphs) and 65.9% mortality (females)) showed the highest effectiveness in controlling D. opuntiae. We also observed that infected scale pests showed signs of mycosis, spore formation and discharge, which will contribute to the spread of the EPFs tested as biological control agents. Hence, alongside D-limonene, A. murispora, and A. destruens could be incorporated into an IPM strategy to control D. opuntiae. [ABSTRACT FROM AUTHOR]

Background and Objective: Our understanding of homicide-suicide (H-S), a rare yet tragic event, is sparse. While the phenomenon has been studied in the West for many years, only limited literature is available from Asia and none to our knowledge from Pakistan. There is evidence of complexity of the interaction between cultural, societal, and psychological mechanisms underlying this phenomenon; therefore, research findings from the Western countries cannot be directly applied in non-Western societies. Our objective was to study homicide-suicides in Pakistan, describe the characteristics of offenders and victims, determine the types of H-S, and examine possible motives and any events prior to the offense. Methods: In the absence of any official data on homicide-suicides, we used newspaper surveillance approach of four most widely circulated Pakistani newspapers (one Urdu and three English Daily) for two years (1st January 2019 to 31st December 2020). Each case was categorized using the modified Marzuk et al., Tardiff, and Hirsch's classification of homicide-suicides. Descriptive statistics were used to analyze the data that was then compared with published literature. Results: There were 114 H-S incidents with 198 victims of homicide during the study period, reported in the newspapers. Familial H-S particularly filicide-suicide were predominant, followed by spousal/ consortial H-S. Forty-one (36%) H-S involved multiple victims. The perpetrators across all categories of H-S were predominantly male (67%); the victims were predominantly women and children. Firearms were used in most incidents. The primary motive for the majority of H-S cases was familial, financial, and social stressors. Conclusions: The study highlights several unique patterns (predominance of familicide, multiple victims including high proportion of children) and a series of vulnerabilities (incidents related mostly to familial/ financial and social stressors) that overlap each other and ultimately lead to this tragic end. There is need to increase our understanding and develop effective evidence-based prevention strategies for H-S in Pakistan. It is also very important to have a national surveillance network and national violent death reporting system in the country for studying H-S cases, and for evaluating the impact of prevention programs. [ABSTRACT FROM AUTHOR]

The trade-off between current and future reproduction remains a central issue for understanding the diversity of fish life-histories along a slow-fast continuum. Fish living in rivers of tropical oceanic islands generally have a fast type life-history, but variations in key reproductive traits can occur in response to spatial changes in selection pressures. Here, we investigated the reproductive strategies of two sympatric amphidromous gobies widely distributed in Caribbean streams, Sicydium plumieri (n = 308) and Sicydium punctatum (n = 383), along a river gradient of Guadeloupe Island. Beyond the new insights provided on the reproductive traits (ovarian organization, gonadal development, length at maturity, and spawning season), the histological observations of testes and ovaries revealed variation in reproductive strategies. Sicydium punctatum showed a time-minimizing strategy, featuring early reproduction, a high spawning frequency, an extended reproductive period, and a broad spawning area along the river course. Sicydium plumieri displayed a size-maximizing strategy, featuring a delayed maturity, lower spawning frequency, and a shorter reproductive period restricted to the upper reaches of rivers. We discuss the advantages provided by these two strategies in response to the spatial changes in predation and disturbance levels along the upstream–downstream continuum, which probably affects the survival rate and mortality risk before the first reproduction. [ABSTRACT FROM AUTHOR]

Data on COVID-19 cases, deaths, hospitalizations, and vaccinations in Oklahoma, USA, have not been systematically described. The relationship between vaccination and COVID-19-related outcomes over time has not been investigated. We graphically described data c ollected during February 2020-December 2021 and conducted spatiotemporal modeling of monthly increases in COVID-19 cumulative death and hospitalization rates, adjusting for cumulative case rate, to explore the relationship. A 1 percentage point increase (absolute change) in the cumulative vaccination rate was associated with a 6.3% (95% CI 1.4%-10.9%) relative decrease in death outcome during April-June 2021, and a 1.9% (95% CI 1.1%-2.6%) relative decrease in death outcome and 1.1% (95% CI 0.5%-1.7%) relative decrease in hospitalization outcome during July-December 2021; the effect on hospitalizations was driven largely by data from urban counties. Our findings from Oklahoma suggest that increasing cumulative vaccination rates might reduce the increase in cumulative death and hospitalization rates from COVID-19. [ABSTRACT FROM AUTHOR]

Limited data exist on mortality rates after tuberculosis (TB) treatment in the United States. We analyzed mortality rates for all adults in Georgia, USA, who had a TB diagnosis and finished treatment during January 1, 2008-December 31, 2019. We obtained posttreatment mortality rate data from the National Death Index and calculated standardized mortality ratios (SMRs) for TB treatment survivors and the general Georgia population. Among 3,182 TB treatment survivors, 233 (7.3%) had died as of December 31, 2019. The overall TB cohort age- and sex-adjusted SMR was 0.89 (95% CI 0.73-1.05). The SMR among US-born TB treatment survivors was 1.56 (95% CI 1.36-1.77). In the TB cohort, US-born status, HIV co-infection, excess alcohol use, diabetes mellitus, and end-stage renal disease were associated with increased risk for death after TB treatment. TB treatment survivors could benefit from improved linkage to primary and HIV comprehensive care to prevent posttreatment death. [ABSTRACT FROM AUTHOR]

Oropouche virus has recently caused outbreaks in South America and the Caribbean, expanding into areas to which the virus was previously not endemic. This geographic range expansion, in conjunction with the identification of vertical transmission and reports of deaths, has raised concerns about the broader threat this virus represents to the Americas. We review information on Oropouche virus, factors influencing its spread, transmission risk in the United States, and current status of public health response tools. On the basis of available data, the risk for sustained local transmission in the continental United States is considered low because of differences in vector ecology and in human-vector interactions when compared with Oropouche virus-endemic areas. However, more information is needed about the drivers for the current outbreak to clarify the risk for further expansion of this virus. Timely detection and control of this emerging pathogen should be prioritized to mitigate disease burden and stop its spread. [ABSTRACT FROM AUTHOR]

Background Haemophagocytic lymphohistiocytosis (HLH) is a rare complication of dengue fever with potentially life-threatening consequences and high mortality. Therefore, this study aims to investigate the prevalence, management and outcome of HLH in dengue fever. Methods The major electronic databases, including PubMed, ScienceDirect and Ovid SP, were searched from inception until 31 January 2024 to identify relevant studies. Pooled prevalence and mortality were calculated using the random-effects generic inverse variance model with a 95% CI. All the statistical analysis was conducted using R programming. Results A total of nine studies with 157 patients with HLH, 576 patients with severe dengue and 5081 patients with dengue fever were included in this meta-analysis. The prevalence of HLH in severe dengue (22.1%, 95% CI 8.07 to 48.0%) was significantly higher than the prevalence in dengue fever (3.12%, 95% CI 0.37 to 21.9%). The prevalence of HLH in severe dengue was higher in the paediatric population (22.8%, 95% CI 3.9 to 68.4%) compared with the adult population (19.0%, 95% CI 3.0 to 63.9%). The overall mortality rate was 20.2% (95% CI 9.7 to 37.2%). Conclusion The prevalence of dengue-associated HLH was low in patients with dengue fever but is significantly higher in patients with severe dengue and a high mortality rate. [ABSTRACT FROM AUTHOR]

Precise estimates of the impact of famine on infant and child mortality are rare due to lack of representative data. Using vital statistics reports on the Netherlands for 1935–47, we examine the impact of the Dutch famine (November 1944 to May 1945) on age-specific mortality risk and cause of death in four age groups (stillbirths, <1 year, 1–4, 5–14) in the three largest famine-affected cities and the remainder of the country. Mortality during the famine is compared with the pre-war period January 1935 to April 1940, the war period May 1940 to October 1944, and the post-war period June 1945 to December 1947. The famine's impact was most visible in infants because of the combined effects of a high absolute death rate and a threefold increase in proportional mortality, mostly from gastrointestinal conditions. These factors make infant mortality the most sensitive indicator of famine severity in this setting and a candidate marker for comparative use in future studies. [ABSTRACT FROM AUTHOR]

Demographers have developed a number of methods for expanding abridged mortality data into a complete schedule; however, these can be usefully applied only under certain conditions, and the presence or absence of one or more additional sources of incompleteness can degrade their relative accuracy, lead to implausible profiles, or even cause the methods to fail. We develop a new method for expanding an abridged schedule based on calibrated splines; this method is accurate and robust in the presence of errors in mortality rates, missing values, and truncation. We compare its performance with the performance of existing methods for expanding abridged data and find that it is superior to current methods at producing accurate and plausible complete schedules over a broad range of data-quality conditions. The method when applied is a valuable addition to existing tools for estimating mortality, especially for small nations, countries with incomplete vital statistics, and subnational populations. [ABSTRACT FROM AUTHOR]

Most recent studies on the coronavirus disease 2019 (COVID‐19) pandemic and cutaneous melanoma (CM) focused more on delayed diagnosis or advanced presentation. We aimed to ascertain mortality trends of CM between 2012 and 2022, focusing on the effects of the COVID‐19 pandemic. In this serial population‐based study, the National Vital Statistics System dataset was queried for mortality data. Excess CM‐related mortality rates were estimated by calculating the difference between observed and projected mortality rates during the pandemic. Totally there were 108,853 CM‐associated deaths in 2012–2022. CM‐associated mortality saw a declining trend from 2012 to 2019 overall. However, it increased sharply in 2020 (ASMR 3.73 per 100,000 persons, 5.95% excess mortality), and remained high in 2021 and 2022, with the ASMRs of 3.82 and 3.81, corresponding to 11.17% and 13.20% excess mortality, respectively. The nonmetro areas had the most pronounced rise in mortality with 12.20% excess death in 2020, 15.33% in 2021 and 20.52% in 2022, corresponding to a 4–6 times excess mortality risk compared to large metro areas during the pandemic. The elderly had the most pronounced rise in mortality, but the mortality in the younger population was reduced. [ABSTRACT FROM AUTHOR]

This study provides a comprehensive analysis of global, continental, and national trends in the prevalence and mortality of prostate cancer (PC), breast cancer (BC), and thyroid cancer (TC). Utilizing 2021 Global Burden of Diseases (GBD2021) data, prevalence and death rates for 2021 were examined, with temporal trends from 1990 to 2021 analyzed via Joinpoint regression. Annual percentage change (APC) and average APC (AAPC) were calculated with 95% CI. Distributive inequalities were quantified using the slope index of inequality and concentration index. In 2021, PC, BC, and TC showed higher global age-standardized prevalence rates (ASPR) in Europe and America compared to Africa and Asia, while higher age-standardized death rates (ASDR) for PC and BC were noted in Africa. Over the study period, significant global increases in ASPR were observed for PC (AAPC = 0.78, 95% CI: 0.67 to 0.89), BC (AAPC = 0.31, 95% CI: 0.24 to 0.37), and TC (AAPC = 1.42, 95% CI: 1.31 to 1.52). Conversely, ASDR significantly decreased for PC (AAPC = -0.83, 95% CI: -0.92 to -0.74), BC (AAPC = -0.48, 95% CI: -0.56 to -0.39), and TC (AAPC = -0.23, 95% CI: -0.29 to -0.17). Variations were observed across continents and time periods, affecting 204 countries and territories. Higher Social Development Index (SDI) levels were associated with a more pronounced burden of these cancers. The findings highlight significant global heterogeneity in prevalence, death rates, and temporal trends of endocrine cancers, with important implications for epidemiology and public health policies. [ABSTRACT FROM AUTHOR]