A series of mass mortalities of the cultured blood clam, Tegillarca granosa, occurred in the Yueqing Bay of China from 2005 to 2009. An obligate intracellular prokaryote, designated as rickettsia-like organism （RLO）...A series of mass mortalities of the cultured blood clam, Tegillarca granosa, occurred in the Yueqing Bay of China from 2005 to 2009. An obligate intracellular prokaryote, designated as rickettsia-like organism （RLO）, was frequently found in the moribund or dead blood clam sample during ultra- structural examination. These organisms were usually round, ellipsoid or occasionally dumbbell- shaped, ranged from approximately 0.28 to 0.71 #m in size and had a trilaminar cell wall. Two reproductive modes of organisms, transverse binary fission and budding, were observed. The or- ganisms were able to form eosinophilic inclusions. Most inclusions were found within epithelial and connective tissues of the mantle, gills and digestive tube. The biological and morphological char- acteristics indicate that these organisms may belong to the family Rickettsiaceae. RLOs exhibited significant pathogenicity. Cytopathological examinations revealed extensive necrosis and destruc- tion in the infected cell. The degree of tissue destruction was positively related to the number of RLO inclusions in the tissues, and the cytopathological effects were positively related to the number of intracellular RLO. RLOs and their inclusions were discovered throughout different disease areas and in different time periods. The infection intensity of the RLOs was positively correlated with the mortality rate of clams. Therefore, RLO infection might be associated with mass mortalities of cultured blood clams in the Yueqing Bay.展开更多
The growth parameters and mortalities of five species of Synodontis in the lower river Benue at Makurdi,Benue State were studied from January,2016 to December,2018.The asymptotic length(L∞)calculated for the five spe...The growth parameters and mortalities of five species of Synodontis in the lower river Benue at Makurdi,Benue State were studied from January,2016 to December,2018.The asymptotic length(L∞)calculated for the five species ranged from 18.80cm in S.clarias females to 37.04cm in S.membranaceus females.The t0 values were all negative in the combined sexes of S.clarias,S.omias,S.gambiensis and S.membranaceus.In both combined sexes of S.membranaceus and S.schall,the t0 values were positive.The growth rate(K)was low in S.clarias and S.omias(0.301-0.497,0.171-0.310)respectively and higher in S.membranaceus(0.310-0.640),S.schall females(0.430-0.580);S.schall males(0.573),S.gambiensis(0.500-0.571).Growth performance index(Ø’)was 2.212 in S.gambiensis and 2.946 in S.schall combined.Natural Mortality(M)ranged from 0.5422 in S.omias females to 1.3340 in S.membranaceus males.Fishing Mortality(F)was 0.8214 in S.omias combined and 3.0934 in S.membranaceus females.Total mortality(Z)ranged from 1.52 in S.omias combined to 4.078 in S.membranaceus combined.Mean Exploitation(E)ratios was 0.61 in S.clarias,0.64 in S.omias,0.53 in S.gambiences,0.70 in S.membranaceus,and 0.66 in S.schall.The rate at which these species survived in the River was low(from 0.147,in S.omias combined,to 1.482 in S.membranaceus combined).展开更多
Introduction: The National Central Cancer Registry(NCCR) of China collected population-based cancer registration data from all cancer registries in China. This study aimed to compile national cancer incidences and mor...Introduction: The National Central Cancer Registry(NCCR) of China collected population-based cancer registration data from all cancer registries in China. This study aimed to compile national cancer incidences and mortalities in 2011 and estimate cancer incident new cases and cancer deaths.Methods: In 2014, there were 234 cancer registries that submitted records of new cancer cases and cancer deaths that occurred in 2011 to the NCCR. All datasets were evaluated based on the criteria of data quality of the NCCR. The data of 177 registries was of suicient quality and was compiled to evaluate cancer statistics in 2011. The pooled data were stratiied by area, sex, age group, and cancer type. Cancer incident cases and deaths were estimated using age-standardized rates(ASR) and the Chinese population. All incidences and mortalities were age-standardized to the 2000 Chinese standard population and Segi's population.Results: The estimates of new cancer incident cases and cancer deaths were 3,372,175 and 2,113,048 in 2011, respectively. The crude incidence was 250.28/1,00,000(277.77/1,00,000 for males and 221.37/1,00,000 for females). The ASRs of incidence by the Chinese standard population(ASRIC) and by the world standard population(ASRIW) were 186.34/1,00,000 and 182.76/1,00,000, respectively, with a cumulative incidence(0–74 years old) of 21.20%. Cancers of the lung, female breast, stomach, liver, colorectum, esophagus, cervix, uterus, prostate, and ovary were the most common cancers, accounting for approximately 75% of all new cancer cases. Lung, liver, gastric, esophageal, colorectal, female breast, pancreatic, brain, and cervical cancers and leukemia were the leading causes of cancer death, accounting for approximately 80% of all cancer deaths. Cancer incidence, mortality, and spectrum were all diferent between urban and rural areas and between males and females.Conclusions: The population covered by the cancer registries greatly increased from 2010 to 2011. The data quality and representativeness of cancer registries have gradually improved. Cancer registries have an irreplaceable role in research on cancer prevention and control. The disease burden of cancer is increasing, and the health department must implement efective measures to contain the increased cancer burden in China.展开更多
Background: There are many reports from different parts of the world addressing different aspects of surgical mortality. However, none has been done in this centre as it relates to orthopaedics and trauma admissions. ...Background: There are many reports from different parts of the world addressing different aspects of surgical mortality. However, none has been done in this centre as it relates to orthopaedics and trauma admissions. Such data are invaluable to health planning and epidemiological monitoring. Objective: To retrospectively review all mortalities arising from orthopaedics and trauma admission as they present to Irrua specialist Teaching Hospital (ISTH) Irrua from Jan 2005-Dec 2014. Method: Medical records of case mortalities among orthopaedic and trauma admissions over ten years (Jan 2005-Dec 2014) were retrospectively reviewed. Results: Over this period, 2129 admissions and 45 deaths were recorded, with an overall crude mortality rate of 2.11%. No death was recorded among the paediatric age group. Thirty-four patients (75.56%) died from trauma (fracture) related diagnosis, majority of which were from head injury followed by infection 5 (11.11%), tumours 4, (8.89%) and disc herniation 2 (4.44%). Males were more affected 77.78% and median age at death was 44 years. Medical co-morbidities were found in 37.77% of the deceased patients. Conclusion: Patients with trauma related cases particularly head injuries, topped the list of mortalities. Young and middle aged adult males were most affected. Need for manpower development, investment in diagnostic and therapeutic facilities and preventive measures is emphasised.展开更多
Background: Studies have suggested epidemiological transition in the mortality pattern in Nigeria from communicable to non-communicable diseases of which Diseases of the cardiovascular system (DCVS) is prime. DCVS is?...Background: Studies have suggested epidemiological transition in the mortality pattern in Nigeria from communicable to non-communicable diseases of which Diseases of the cardiovascular system (DCVS) is prime. DCVS is?thus a growing public health concern but its mortality profile is under-studied?in Port Harcourt. This study was therefore designed to review the mortality profile of DCVS in Port Harcourt. Methodology: A retrospective case controlled study of deaths ascribed to DCVS at the University of Port Harcourt Teaching Hospital (UPTH) between January 2012 and December 2017. The composite diseases were grouped using the ICD10 scheme and analyzed using SPSS version 23. Minitab version 16 was used for trend analysis. Results: Of the overall 1902 deaths recorded within the period, 566 (29.8%) were cardiovascular system related. Of these, 301 (53.3%) were males and 265 (46.7%) were females. The elderly of 50 - 99 years were most commonly affected (65.5% of the mortalities). Cerebrovascular accidents (CVA) accounted for 322 deaths (56.9%);various types of shock caused 116 deaths (20.5%) while?congestive cardiac failure (CCF) accounted for 114 deaths (20.1%). Pulmonary?embolism, myocardial infarction, carotid aneurysm, and hypertensive encephalopathy caused 1.8%, 0.4%, 0.2%, and 0.2% deaths respectively. Peak annual mortality of 143 (25.3%) was recorded in 2013. Although the trend of mortality was undulating, there was an overall increase in annual incidence over the years.?Conclusion: DCVS constitute the commonest systemic cause?of death in Port Harcourt. Governmental and donor agencies involved in public health policy planning and implementation should scale-up strategies for the prevention and control of DCVS in order to stem the rising tide of associated mortalities.展开更多
A study on the evaluation of the effectiveness of three traditional methods of protecting guinea fowl from mortality was carried out at CRA-SS （Centre de Recherche Agronomique de la Savane S6che） in northem Togo. Gu...A study on the evaluation of the effectiveness of three traditional methods of protecting guinea fowl from mortality was carried out at CRA-SS （Centre de Recherche Agronomique de la Savane S6che） in northem Togo. Guinea fowl were divided into 5 batches, of which 3 batches received prophylactic medical treatment including plant decoctions, the 4th batch was followed by a medical prophylaxis program as a control group and the 5th batch considered as a negative control, has not received any prophylactic treatment. The results showed that a mortality rate of 25% for the reference lot and two other batches which received plant decoctions （Euphorbia poissonii or Khaya senegalensis） were recorded against a rate of 87.5% in the batch of guinea fowl which received the decoction of Pteleopsis suberosa. Meanwhile, regardless of weight growth, daily average gain （GMQ） or food consumption, no significant difference was observed （p 〉 0.05） between the guinea fowl that received a baseline health monitoring and those having taken the decoction orE. poissonii. On the other hand, the values recorded in these two batches of guinea fowl differed statistically from those in the guinea fowl that received the decoction of K. senegalensis. Although the decoction of K. senegalensis has a protective effect in guinea fowl, the growth of guinea fowl has been slowed down. On the basis of these results, it appears that two endogenous practices tested （K. senegalensis or E. poissonii） have positive effects. However, it would be desirable to carry out a toxicity test in order to determine the recommended doses.展开更多
BACKGROUND:Sepsis is a highly heterogeneous organ dysfunction syndrome.There is limited evidence regarding phenotypes and clinical outcomes in sepsis patients with initial normal lactate levels.We sought to identify t...BACKGROUND:Sepsis is a highly heterogeneous organ dysfunction syndrome.There is limited evidence regarding phenotypes and clinical outcomes in sepsis patients with initial normal lactate levels.We sought to identify the lactate-based clinical phenotypes and outcomes of sepsis patients.METHODS:The Medical Information Mart for Intensive Care IV(MIMIC-IV)and eICU databases were used to conduct a retrospective cohort study.Adult sepsis patients were included.Lactate was measured via blood gas,and the same assay type was used across both databases.Serial lactate measurements were analyzed via a two-point classification system based on the highest values recorded during two consecutive 24-hour periods following ICU admission.The fi rst measurement window(T1)comprised the initial 24 h post-admission,whereas the second window(T2)covered 24-48 h post-admission.The lactate diff erence was defi ned as the numerical change between the highest lactate level at T2 and the highest level at T1.The time interval between these two measurements was fi xed,with T2 commencing immediately after T1,together encompassing the fi rst 48 h post-ICU admission.A normal lactate level was defi ned as≤2 mmol/L,and an elevated level was defi ned as>2 mmol/L.Sepsis patients were stratifi ed into four trajectory phenotypes:(1)normal-normal(N-N);(2)normal-elevated(N-E);(3)elevated-normal(E-N);and(4)elevated-elevated(E-E).The primary outcome was in-hospital mortality.RESULTS:This study enrolled 6,926 sepsis patients.The clinical phenotypes of the sepsis patients were as follows:N-N(24.4%),N-E(3.8%),E-N(36.4%),and E-E(35.3%).The in-hospital mortality rates of sepsis patients with the four phenotypes from the MIMIC-IV and eICU databases were as follows(N-N:18.9%vs.17.6%,P=0.66;N-E:35.3%vs.29.2%,P=0.45;E-N:16.6%vs.14.2%,P=0.14;E-E:43.6%vs.37.8%,P=0.01).After adjusting for age,sex,Sequential Organ Failure Assessment(SOFA)score,vasopressor therapy,and infection sites,the N-E phenotype was associated with a higher risk of in-hospital mortality(odds ratio[OR]1.44;95%confidence intervals[95%CI]1.11-1.86;P=0.006;adjusted OR 1.61;95%CI 1.23-2.11;P<0.001).The E-N phenotype was associated with the most favorable outcomes for in-hospital mortality in the multivariable analysis(adjusted OR 0.41;95%CI 0.36-0.46;P<0.001).The E-E phenotype was associated with the highest risk of in-hospital mortality in the overall cohort(adjusted OR 3.00;95%CI 2.67-3.37;P<0.001).CONCLUSION:In sepsis patients with normal initial lactate levels,serial lactate measurements could be valuable for prognostic assessment.展开更多
Objective This study aims to investigate the joint associations of sarcopenia and social isolation with mortality risk.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)and the UK Biobank...Objective This study aims to investigate the joint associations of sarcopenia and social isolation with mortality risk.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)and the UK Biobank,sarcopenia was diagnosed according to European and Asian Working Groups for Sarcopenia criteria.Social isolation was assessed using standardized questionnaires,including questions on solitude,frequency of social activities,contact with others,and marital status(for the CLHLS only).Results During the follow-up period,8,249 deaths occurred in the CLHLS and 26,670 deaths in the UK Biobank groups.While no significant interaction was observed between sarcopenia and social isolation in predicting all-cause mortality in the CLHLS cohort,the association between social isolation and mortality was stronger among individuals with sarcopenia in the UK Biobank(P-interaction=0.03,relative risk due to interaction:0.23,95%confidence interval[CI]:0.06–0.41).Further joint analyses showed that participants with sarcopenia and high levels of social isolation had the highest mortality risk(hazard ration[HR]:1.99;95%CI:[1.74–2.28]in the CLHLS and 1.69[1.55–1.85]in the UK Biobank)compared to those without either condition.Conclusion The combination of social isolation and sarcopenia synergistically increases the risk of mortality in middle-aged and older adults across diverse populations.展开更多
Rowlands et al.1present an analysis of accelerometer data from the UK Biobank cohort,examining variations in the duration,intensity,and accumulation of moderate-intensity physical activity(MPA)and vigorous-intensity p...Rowlands et al.1present an analysis of accelerometer data from the UK Biobank cohort,examining variations in the duration,intensity,and accumulation of moderate-intensity physical activity(MPA)and vigorous-intensity physical activity(VPA)sufficient to reduce the risk of all-cause mortality.In this study,the authors questioned if shorter durations(i.e.,1,2,3,4,5,10,15,and 20 min/day)of MPA and VPA performed continuously or accumulated throughout the day would equally reduce the risks of all-cause mortality as longer duration MPA and VPA recommended in the physical activity(PA)guidelines.展开更多
BACKGROUND:Serum osmolality is a prognostic indicator in critically ill patients.This study aimed to evaluate the association between high osmolality and 28-day mortality in patients with cardiac arrest(CA)admitted to...BACKGROUND:Serum osmolality is a prognostic indicator in critically ill patients.This study aimed to evaluate the association between high osmolality and 28-day mortality in patients with cardiac arrest(CA)admitted to the intensive care unit(ICU).METHODS:Baseline data of adult patients with CA who were admitted to the ICU from 2008 to 2019 were collected from the Medical Information Mart for Intensive Care(MIMIC)-IV.Patients were divided into survivor and non-survivor groups according to the 28-day prognosis.Serum concentrations of sodium,potassium,glucose,and urea nitrogen on the fi rst day of ICU admission were used to determine serum osmolarity.The primary endpoint of this study was 28-day all-cause mortality.Propensity score matching(PSM)analysis was performed to reduce bias between the survivor and nonsurvivor groups.RESULTS:Among the 798 included CA patients,the high osmolarity on the first day of ICU admission remained significantly associated with increased 28-day mortality(62.0%vs.35.5%,P<0.001)and reduced cumulative survival(log-rank P<0.05)after PSM.Cox regression identifi ed the high osmolarity on the fi rst day of ICU admission as an independent predictor.High serum osmolarity on the fi rst day of ICU admission eff ectively predicted 1-,3-,7-,and 28-day all-cause mortality,with the strongest predictive performance for 1-day mortality both before and after PSM(all P<0.05).CONCLUSION:In this study,elevated serum osmolarity on the first day of ICU admission was independently associated with increased 28-day mortality in CA patients and could serve as a prognostic marker.展开更多
BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suita...BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.展开更多
According to the 2024 global cancer data from GLOBOCAN,liver cancer ranks the 6th most common malignancy and the 3rd leading cause of cancer-related mortality worldwide[1].Among these cases,hepatocellular carcinoma(HC...According to the 2024 global cancer data from GLOBOCAN,liver cancer ranks the 6th most common malignancy and the 3rd leading cause of cancer-related mortality worldwide[1].Among these cases,hepatocellular carcinoma(HCC)accounts for approximately 85%−90%[2,3].Its incidence and mortality rates remain persistently high worldwide.However,China has the highest incidence and mortality rates of the disease in the world[4].And the majority of patients are diagnosed at intermediate or advanced stages.Thus,identifying novel tumor biomarkers for early detection and implementing precision therapy has long been a key focus of research.展开更多
Objective To determine whether frailty is a risk factor for hospitalization and mortality in older adults enrolled in the "Chronic Heart Failure Program" at a hospital in Lima, Peru, between 2018–2021.Metho...Objective To determine whether frailty is a risk factor for hospitalization and mortality in older adults enrolled in the "Chronic Heart Failure Program" at a hospital in Lima, Peru, between 2018–2021.Methods This was an ambispective cohort study. A total of 85 older adults participating in the Chronic Heart Failure Program at Guillermo Almenara National Hospital were included. Each had an initial frailty assessment, forming two cohorts: frail and non-frail older adults. Medical records were reviewed, and patients were followed for one year to track events of interest(hospitalization and mortality). Overall survival and risk factors for hospitalization and death were determined.Results During follow-up, 15.3% of the older adults died, and frailty was identified in 58.8% of the patients. Overall survival using the Kaplan-Meier method was 96.5% at 3 months after entering the Chronic Heart Failure Program;92.9% at 6 months;and85.9% at one year. Multivariate analysis using Poisson regression found that frailty was not a risk factor for hospitalization(a RR =0.92;95% CI: 0.42–2.03). Survival analysis using the Cox proportional hazards model showed that frailty was also not a risk factor for mortality after one year of follow-up(a HR = 1.32;95% CI: 0.27–6.53).Conclusions Our research does not confirm frailty as a risk factor for hospitalization or mortality in older adults enrolled in the“Chronic Heart Failure Program” after one year of follow-up.展开更多
Effective treatment methods for stroke,a common cerebrovascular disease with a high mortality rate,are still being sought.Exosome therapy,a form of acellular therapy,has demonstrated promising efficacy in various dise...Effective treatment methods for stroke,a common cerebrovascular disease with a high mortality rate,are still being sought.Exosome therapy,a form of acellular therapy,has demonstrated promising efficacy in various diseases in animal models;however,there is currently insufficient evidence to guide the clinical application of exosome in patients with stroke.This article reviews the progress of exosome applications in stroke treatment.It aims to elucidate the significant potential value of exosomes in stroke therapy and provide a reference for their clinical translation.At present,many studies on exosome-based therapies for stroke are actively underway.Regarding preclinical research,exosomes,as bioactive substances with diverse sources,currently favor stem cells as their origin.Due to their high plasticity,exosomes can be effectively modified through various physical,chemical,and genetic engineering methods to enhance their efficacy.In animal models of stroke,exosome therapy can reduce neuroinflammatory responses,alleviate oxidative stress damage,and inhibit programmed cell death.Additionally,exosomes can promote angiogenesis,repair and regenerate damaged white matter fiber bundles,and facilitate the migration and differentiation of neural stem cells,aiding the repair process.We also summarize new directions for the application of exosomes,specifically the exosome intervention through the ventricular-meningeal lymphatic system.The review findings suggest that the treatment paradigm for stroke is poised for transformation.展开更多
Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.T...Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.The study aim was to determine clinical characteristics,risk of adverse cardiovascular events,and mortality in patients aged≥85 years compared to those aged<85 undergoing PCI.Methods In this retrospective study,data were obtained from the nationwide Netherlands Heart Registration on patients undergoing PCI between January 1st,2017 and January 1st,2021.The primary endpoint was all-cause mortality at long-term followup.Results A total of 155,683 patients underwent PCI,of which 100,209(64.4%)acute coronary syndrome cases.Compared to patients aged<85 years,patients aged≥85 were more often female and showed a higher number of cardiovascular comorbidities,including impaired left ventricle ejection fraction and reduced kidney function.Mortality at short-term and long-term follow-up were significantly higher in those aged≥85(P<0.001).Patients aged≥85 were more likely to have a myocardial infarction within 30 days following the index intervention(0.9%vs.0.7%;P=0.024),though they less often underwent revascularization at longterm follow-up compared to patients aged<85(P<0.001).Conclusions The elderly(≥85 years)patient requiring PCI carries an extensive cardiovascular risk profile,translating in significant risk of recurrent cardiovascular events and increased mortality rate.Clinicians should carefully weigh perceived risks and potential benefits in the individual patient,considering the patients’age,cardiovascular risk profile,and associated risk of morbidity and mortality.展开更多
The impact of spinal cord injury(SCI)on the immune system is increasingly recognized in a field traditionally focused on motor impairments.SCI can seriously affect the immune system by progressively disrupting the reg...The impact of spinal cord injury(SCI)on the immune system is increasingly recognized in a field traditionally focused on motor impairments.SCI can seriously affect the immune system by progressively disrupting the regulatory mechanisms that control immune responses.This dysregulation varies widely among patients and can evolve over time,ranging from systemic inflammatory responses to immunosuppression,greatly contributing to the morbidity and mortality of individuals with SCI(Bao et al.,2011;Brennan et al.,2024).展开更多
Adolescent smoking constitutes a critical public health challenge as early initiation increases the risk of premature mortality and smoking-related chronic diseases due to longer exposure and higher cumulative tobacco...Adolescent smoking constitutes a critical public health challenge as early initiation increases the risk of premature mortality and smoking-related chronic diseases due to longer exposure and higher cumulative tobacco use^([1]).Adolescents are especially prone to developing persistent smoking habits,with many adult smokers having started before the age of 18.In China,16.7%of secondary school students have tried smoking and 4.7%are current smokers,highlighting the critical need for targeted tobacco control interventions among the youth.展开更多
Background:That Central and Eastern Europe and Central Asia(CEECA)experienced a major mortality crisis in the 1990s is a well-established finding,with most analyses focusing on singular causes like alcohol-related dea...Background:That Central and Eastern Europe and Central Asia(CEECA)experienced a major mortality crisis in the 1990s is a well-established finding,with most analyses focusing on singular causes like alcohol-related deaths.However,the utility of the integrated“deaths of despair”framework,which views alcohol,drug,and suicide deaths as a unified socio-economic phenomenon,remains under-explored in this context.Crucially,the long-term evolution of the composition of despair within the region remains a largely unexplored area of inquiry.Therefore,this study aims to analyze the long-term trends,changing composition,and regional heterogeneity of deaths from despair in the CEECA region from 1980 to 2021.Methods:Using 2021 Global Burden of Disease(GBD)data(1980–2021),we analyzed deaths of despair mortality trends in 29 CEECA countries.We employed Joinpoint regression to identify significant trend changes and conducted stratified analyses by cause,gender,and age group.Results:The CEECA deaths of despair crisis began as an alcohol and suicide driven phenomenon concentrated in middle-aged men(50–74 years)during the 1990s,with mortality rates for alcohol use disorders and self-harm surging annually by 30.35%(p=0.002)and 13.44%(p=0.001),respectively,between 1991 and 1994.It has since evolved,marked by a contrasting and emerging threat in the 21st century:a rising proportion of drug-related deaths among the younger(15–49 years)male cohort,where the share of drug use disorders increased from 6.9%in 2000 to 11.8%in 2008.Conclusion:The deaths of despair crisis in the CEECA region is not a past event but an ongoing,evolving phenomenon.Its changing nature demands a shift in public health focus from solely historical drivers to new,generation-specific threats,particularly the rise of drug-related despair among youth.展开更多
This study attempts to investigate the factors determining COVID-19 deaths during the pandemic across countries by employing a rich dataset sourced from 94 countries updated till 6 February,2022.For empirical analysis...This study attempts to investigate the factors determining COVID-19 deaths during the pandemic across countries by employing a rich dataset sourced from 94 countries updated till 6 February,2022.For empirical analysis,the study makes use of cross-sectional linear regression technique in the first part and after required diagnostic tests use 2SLS regression technique for correcting possible endogeneity bias in the second part.Findings from the study indicate that factors like total reported cases,population size,population over 70 years of age,extreme poverty,and human development index play significant role in determining COVID-19-related death.Further,to check the robustness of the findings the present study employed LASSO regression.Findings from the study highlight the possibility of government intervention to devise appropriate policies to control COVID-related incidence and death.展开更多
Introduction:Climate factors play an important role in the transmission of viruses,such as influenza viruses,MERS-CoV,and SARS-CoV-1.This study aimed to determine the relationship between changes in temperature,humidi...Introduction:Climate factors play an important role in the transmission of viruses,such as influenza viruses,MERS-CoV,and SARS-CoV-1.This study aimed to determine the relationship between changes in temperature,humidity,rainfall,and SARS-CoV-2 contagion.Five ecologically and climatically distinct regions were considered—Karachi,Lahore,Islamabad,Peshawar,and Gilgit-Baltistan.Method:Data on daily COVID-19 cases and deaths were retrieved from government officials,while meteorological information was collected from Pakistan Meteorological Department.Statistical analysis was performed using SPSS version 20 and the Spearman rank correlation test was used to analyze the correlation between the meteorological factors and COVID-19 cases and deaths.Result:Positive correlation of COVID-19 incidence was observed with all the temperature ranges(maximum,minimum and average)and negative correlation was seen with humidity,DTR and rainfall.COVID-19 deaths were positively associated with temperature and were negatively associated only with humidity.Linear regression showed that for every unit increase in humidity,there was a3.345 daily signifi-cant decrease in COVID-19 cases,while in Karachi for every unit increase in humidity,there remained a 10.104 daily significant increase in cases.In Gilgit-Baltistan,for every unit increase in average temperature and rainfall respectively,significant increases of 0.534 and 1.286 in daily cases were found.Conclusion:This study signifies the effect of climate factors on COVID-19 incidence and mortality rate,but climate factors are not the only variable and several other interlinked factors enhance the spread of COVID-19.Hence,effective mitigation policies,enhancing testing capacities,and developing public attitudes toward adopting precautionary measures are important to overcome this overwhelming pandemic.展开更多
基金Scientific Projects of Zhejiang Province,China under contract Nos 2004C23041 and 20080123
文摘A series of mass mortalities of the cultured blood clam, Tegillarca granosa, occurred in the Yueqing Bay of China from 2005 to 2009. An obligate intracellular prokaryote, designated as rickettsia-like organism （RLO）, was frequently found in the moribund or dead blood clam sample during ultra- structural examination. These organisms were usually round, ellipsoid or occasionally dumbbell- shaped, ranged from approximately 0.28 to 0.71 #m in size and had a trilaminar cell wall. Two reproductive modes of organisms, transverse binary fission and budding, were observed. The or- ganisms were able to form eosinophilic inclusions. Most inclusions were found within epithelial and connective tissues of the mantle, gills and digestive tube. The biological and morphological char- acteristics indicate that these organisms may belong to the family Rickettsiaceae. RLOs exhibited significant pathogenicity. Cytopathological examinations revealed extensive necrosis and destruc- tion in the infected cell. The degree of tissue destruction was positively related to the number of RLO inclusions in the tissues, and the cytopathological effects were positively related to the number of intracellular RLO. RLOs and their inclusions were discovered throughout different disease areas and in different time periods. The infection intensity of the RLOs was positively correlated with the mortality rate of clams. Therefore, RLO infection might be associated with mass mortalities of cultured blood clams in the Yueqing Bay.
文摘The growth parameters and mortalities of five species of Synodontis in the lower river Benue at Makurdi,Benue State were studied from January,2016 to December,2018.The asymptotic length(L∞)calculated for the five species ranged from 18.80cm in S.clarias females to 37.04cm in S.membranaceus females.The t0 values were all negative in the combined sexes of S.clarias,S.omias,S.gambiensis and S.membranaceus.In both combined sexes of S.membranaceus and S.schall,the t0 values were positive.The growth rate(K)was low in S.clarias and S.omias(0.301-0.497,0.171-0.310)respectively and higher in S.membranaceus(0.310-0.640),S.schall females(0.430-0.580);S.schall males(0.573),S.gambiensis(0.500-0.571).Growth performance index(Ø’)was 2.212 in S.gambiensis and 2.946 in S.schall combined.Natural Mortality(M)ranged from 0.5422 in S.omias females to 1.3340 in S.membranaceus males.Fishing Mortality(F)was 0.8214 in S.omias combined and 3.0934 in S.membranaceus females.Total mortality(Z)ranged from 1.52 in S.omias combined to 4.078 in S.membranaceus combined.Mean Exploitation(E)ratios was 0.61 in S.clarias,0.64 in S.omias,0.53 in S.gambiences,0.70 in S.membranaceus,and 0.66 in S.schall.The rate at which these species survived in the River was low(from 0.147,in S.omias combined,to 1.482 in S.membranaceus combined).
文摘Introduction: The National Central Cancer Registry(NCCR) of China collected population-based cancer registration data from all cancer registries in China. This study aimed to compile national cancer incidences and mortalities in 2011 and estimate cancer incident new cases and cancer deaths.Methods: In 2014, there were 234 cancer registries that submitted records of new cancer cases and cancer deaths that occurred in 2011 to the NCCR. All datasets were evaluated based on the criteria of data quality of the NCCR. The data of 177 registries was of suicient quality and was compiled to evaluate cancer statistics in 2011. The pooled data were stratiied by area, sex, age group, and cancer type. Cancer incident cases and deaths were estimated using age-standardized rates(ASR) and the Chinese population. All incidences and mortalities were age-standardized to the 2000 Chinese standard population and Segi's population.Results: The estimates of new cancer incident cases and cancer deaths were 3,372,175 and 2,113,048 in 2011, respectively. The crude incidence was 250.28/1,00,000(277.77/1,00,000 for males and 221.37/1,00,000 for females). The ASRs of incidence by the Chinese standard population(ASRIC) and by the world standard population(ASRIW) were 186.34/1,00,000 and 182.76/1,00,000, respectively, with a cumulative incidence(0–74 years old) of 21.20%. Cancers of the lung, female breast, stomach, liver, colorectum, esophagus, cervix, uterus, prostate, and ovary were the most common cancers, accounting for approximately 75% of all new cancer cases. Lung, liver, gastric, esophageal, colorectal, female breast, pancreatic, brain, and cervical cancers and leukemia were the leading causes of cancer death, accounting for approximately 80% of all cancer deaths. Cancer incidence, mortality, and spectrum were all diferent between urban and rural areas and between males and females.Conclusions: The population covered by the cancer registries greatly increased from 2010 to 2011. The data quality and representativeness of cancer registries have gradually improved. Cancer registries have an irreplaceable role in research on cancer prevention and control. The disease burden of cancer is increasing, and the health department must implement efective measures to contain the increased cancer burden in China.
文摘Background: There are many reports from different parts of the world addressing different aspects of surgical mortality. However, none has been done in this centre as it relates to orthopaedics and trauma admissions. Such data are invaluable to health planning and epidemiological monitoring. Objective: To retrospectively review all mortalities arising from orthopaedics and trauma admission as they present to Irrua specialist Teaching Hospital (ISTH) Irrua from Jan 2005-Dec 2014. Method: Medical records of case mortalities among orthopaedic and trauma admissions over ten years (Jan 2005-Dec 2014) were retrospectively reviewed. Results: Over this period, 2129 admissions and 45 deaths were recorded, with an overall crude mortality rate of 2.11%. No death was recorded among the paediatric age group. Thirty-four patients (75.56%) died from trauma (fracture) related diagnosis, majority of which were from head injury followed by infection 5 (11.11%), tumours 4, (8.89%) and disc herniation 2 (4.44%). Males were more affected 77.78% and median age at death was 44 years. Medical co-morbidities were found in 37.77% of the deceased patients. Conclusion: Patients with trauma related cases particularly head injuries, topped the list of mortalities. Young and middle aged adult males were most affected. Need for manpower development, investment in diagnostic and therapeutic facilities and preventive measures is emphasised.
文摘Background: Studies have suggested epidemiological transition in the mortality pattern in Nigeria from communicable to non-communicable diseases of which Diseases of the cardiovascular system (DCVS) is prime. DCVS is?thus a growing public health concern but its mortality profile is under-studied?in Port Harcourt. This study was therefore designed to review the mortality profile of DCVS in Port Harcourt. Methodology: A retrospective case controlled study of deaths ascribed to DCVS at the University of Port Harcourt Teaching Hospital (UPTH) between January 2012 and December 2017. The composite diseases were grouped using the ICD10 scheme and analyzed using SPSS version 23. Minitab version 16 was used for trend analysis. Results: Of the overall 1902 deaths recorded within the period, 566 (29.8%) were cardiovascular system related. Of these, 301 (53.3%) were males and 265 (46.7%) were females. The elderly of 50 - 99 years were most commonly affected (65.5% of the mortalities). Cerebrovascular accidents (CVA) accounted for 322 deaths (56.9%);various types of shock caused 116 deaths (20.5%) while?congestive cardiac failure (CCF) accounted for 114 deaths (20.1%). Pulmonary?embolism, myocardial infarction, carotid aneurysm, and hypertensive encephalopathy caused 1.8%, 0.4%, 0.2%, and 0.2% deaths respectively. Peak annual mortality of 143 (25.3%) was recorded in 2013. Although the trend of mortality was undulating, there was an overall increase in annual incidence over the years.?Conclusion: DCVS constitute the commonest systemic cause?of death in Port Harcourt. Governmental and donor agencies involved in public health policy planning and implementation should scale-up strategies for the prevention and control of DCVS in order to stem the rising tide of associated mortalities.
文摘A study on the evaluation of the effectiveness of three traditional methods of protecting guinea fowl from mortality was carried out at CRA-SS （Centre de Recherche Agronomique de la Savane S6che） in northem Togo. Guinea fowl were divided into 5 batches, of which 3 batches received prophylactic medical treatment including plant decoctions, the 4th batch was followed by a medical prophylaxis program as a control group and the 5th batch considered as a negative control, has not received any prophylactic treatment. The results showed that a mortality rate of 25% for the reference lot and two other batches which received plant decoctions （Euphorbia poissonii or Khaya senegalensis） were recorded against a rate of 87.5% in the batch of guinea fowl which received the decoction of Pteleopsis suberosa. Meanwhile, regardless of weight growth, daily average gain （GMQ） or food consumption, no significant difference was observed （p 〉 0.05） between the guinea fowl that received a baseline health monitoring and those having taken the decoction orE. poissonii. On the other hand, the values recorded in these two batches of guinea fowl differed statistically from those in the guinea fowl that received the decoction of K. senegalensis. Although the decoction of K. senegalensis has a protective effect in guinea fowl, the growth of guinea fowl has been slowed down. On the basis of these results, it appears that two endogenous practices tested （K. senegalensis or E. poissonii） have positive effects. However, it would be desirable to carry out a toxicity test in order to determine the recommended doses.
基金supported by grants from National Natural Science Foundation of China (82402543)National High Level Hospital Clinical Research Funding (2022-PUMCH-B-109)+2 种基金CAMS Innovation Fund for Medical Sciences (CIFMS)(2021-I2M-1-020)Opening Foundation of Agile and Intelligent Computing Key Laboratory of Sichuan ProvinceSpecial Research Fund for Central Universities,Peking Union Medical College (3332024120)
文摘BACKGROUND:Sepsis is a highly heterogeneous organ dysfunction syndrome.There is limited evidence regarding phenotypes and clinical outcomes in sepsis patients with initial normal lactate levels.We sought to identify the lactate-based clinical phenotypes and outcomes of sepsis patients.METHODS:The Medical Information Mart for Intensive Care IV(MIMIC-IV)and eICU databases were used to conduct a retrospective cohort study.Adult sepsis patients were included.Lactate was measured via blood gas,and the same assay type was used across both databases.Serial lactate measurements were analyzed via a two-point classification system based on the highest values recorded during two consecutive 24-hour periods following ICU admission.The fi rst measurement window(T1)comprised the initial 24 h post-admission,whereas the second window(T2)covered 24-48 h post-admission.The lactate diff erence was defi ned as the numerical change between the highest lactate level at T2 and the highest level at T1.The time interval between these two measurements was fi xed,with T2 commencing immediately after T1,together encompassing the fi rst 48 h post-ICU admission.A normal lactate level was defi ned as≤2 mmol/L,and an elevated level was defi ned as>2 mmol/L.Sepsis patients were stratifi ed into four trajectory phenotypes:(1)normal-normal(N-N);(2)normal-elevated(N-E);(3)elevated-normal(E-N);and(4)elevated-elevated(E-E).The primary outcome was in-hospital mortality.RESULTS:This study enrolled 6,926 sepsis patients.The clinical phenotypes of the sepsis patients were as follows:N-N(24.4%),N-E(3.8%),E-N(36.4%),and E-E(35.3%).The in-hospital mortality rates of sepsis patients with the four phenotypes from the MIMIC-IV and eICU databases were as follows(N-N:18.9%vs.17.6%,P=0.66;N-E:35.3%vs.29.2%,P=0.45;E-N:16.6%vs.14.2%,P=0.14;E-E:43.6%vs.37.8%,P=0.01).After adjusting for age,sex,Sequential Organ Failure Assessment(SOFA)score,vasopressor therapy,and infection sites,the N-E phenotype was associated with a higher risk of in-hospital mortality(odds ratio[OR]1.44;95%confidence intervals[95%CI]1.11-1.86;P=0.006;adjusted OR 1.61;95%CI 1.23-2.11;P<0.001).The E-N phenotype was associated with the most favorable outcomes for in-hospital mortality in the multivariable analysis(adjusted OR 0.41;95%CI 0.36-0.46;P<0.001).The E-E phenotype was associated with the highest risk of in-hospital mortality in the overall cohort(adjusted OR 3.00;95%CI 2.67-3.37;P<0.001).CONCLUSION:In sepsis patients with normal initial lactate levels,serial lactate measurements could be valuable for prognostic assessment.
基金supported by grants from the National Key Research and Development Program of China(No.2023YFC3606300,No.2022YFC3600300)the National Natural Science Foundation of China(No.82325043)the National Key Research and Development Program of Hubei Province(2022BCA036)。
文摘Objective This study aims to investigate the joint associations of sarcopenia and social isolation with mortality risk.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey(CLHLS)and the UK Biobank,sarcopenia was diagnosed according to European and Asian Working Groups for Sarcopenia criteria.Social isolation was assessed using standardized questionnaires,including questions on solitude,frequency of social activities,contact with others,and marital status(for the CLHLS only).Results During the follow-up period,8,249 deaths occurred in the CLHLS and 26,670 deaths in the UK Biobank groups.While no significant interaction was observed between sarcopenia and social isolation in predicting all-cause mortality in the CLHLS cohort,the association between social isolation and mortality was stronger among individuals with sarcopenia in the UK Biobank(P-interaction=0.03,relative risk due to interaction:0.23,95%confidence interval[CI]:0.06–0.41).Further joint analyses showed that participants with sarcopenia and high levels of social isolation had the highest mortality risk(hazard ration[HR]:1.99;95%CI:[1.74–2.28]in the CLHLS and 1.69[1.55–1.85]in the UK Biobank)compared to those without either condition.Conclusion The combination of social isolation and sarcopenia synergistically increases the risk of mortality in middle-aged and older adults across diverse populations.
文摘Rowlands et al.1present an analysis of accelerometer data from the UK Biobank cohort,examining variations in the duration,intensity,and accumulation of moderate-intensity physical activity(MPA)and vigorous-intensity physical activity(VPA)sufficient to reduce the risk of all-cause mortality.In this study,the authors questioned if shorter durations(i.e.,1,2,3,4,5,10,15,and 20 min/day)of MPA and VPA performed continuously or accumulated throughout the day would equally reduce the risks of all-cause mortality as longer duration MPA and VPA recommended in the physical activity(PA)guidelines.
基金funded by the Shenzhen Science and Technology Program(JCYJ20230807112007014 to PG)the Shenzhen Key Medical Discipline Construction Fund(SZXK046 to PG).
文摘BACKGROUND:Serum osmolality is a prognostic indicator in critically ill patients.This study aimed to evaluate the association between high osmolality and 28-day mortality in patients with cardiac arrest(CA)admitted to the intensive care unit(ICU).METHODS:Baseline data of adult patients with CA who were admitted to the ICU from 2008 to 2019 were collected from the Medical Information Mart for Intensive Care(MIMIC)-IV.Patients were divided into survivor and non-survivor groups according to the 28-day prognosis.Serum concentrations of sodium,potassium,glucose,and urea nitrogen on the fi rst day of ICU admission were used to determine serum osmolarity.The primary endpoint of this study was 28-day all-cause mortality.Propensity score matching(PSM)analysis was performed to reduce bias between the survivor and nonsurvivor groups.RESULTS:Among the 798 included CA patients,the high osmolarity on the first day of ICU admission remained significantly associated with increased 28-day mortality(62.0%vs.35.5%,P<0.001)and reduced cumulative survival(log-rank P<0.05)after PSM.Cox regression identifi ed the high osmolarity on the fi rst day of ICU admission as an independent predictor.High serum osmolarity on the fi rst day of ICU admission eff ectively predicted 1-,3-,7-,and 28-day all-cause mortality,with the strongest predictive performance for 1-day mortality both before and after PSM(all P<0.05).CONCLUSION:In this study,elevated serum osmolarity on the first day of ICU admission was independently associated with increased 28-day mortality in CA patients and could serve as a prognostic marker.
基金supported by the special fund of the National Clinical Key Specialty Construction Program[(2022)301-2305].
文摘BACKGROUND:This study aims to develop and validate a machine learning-based in-hospital mortality predictive model for acute aortic syndrome(AAS)in the emergency department(ED)and to derive a simplifi ed version suitable for rapid clinical application.METHODS:In this multi-center retrospective cohort study,AAS patient data from three hospitals were analyzed.The modeling cohort included data from the First Affiliated Hospital of Zhengzhou University and the People’s Hospital of Xinjiang Uygur Autonomous Region,with Peking University Third Hospital data serving as the external test set.Four machine learning algorithms—logistic regression(LR),multilayer perceptron(MLP),Gaussian naive Bayes(GNB),and random forest(RF)—were used to develop predictive models based on 34 early-accessible clinical variables.A simplifi ed model was then derived based on fi ve key variables(Stanford type,pericardial eff usion,asymmetric peripheral arterial pulsation,decreased bowel sounds,and dyspnea)via Least Absolute Shrinkage and Selection Operator(LASSO)regression to improve ED applicability.RESULTS:A total of 929 patients were included in the modeling cohort,and 210 were included in the external test set.Four machine learning models based on 34 clinical variables were developed,achieving internal and external validation AUCs of 0.85-0.90 and 0.73-0.85,respectively.The simplifi ed model incorporating fi ve key variables demonstrated internal and external validation AUCs of 0.71-0.86 and 0.75-0.78,respectively.Both models showed robust calibration and predictive stability across datasets.CONCLUSION:Both kinds of models were built based on machine learning tools,and proved to have certain prediction performance and extrapolation.
基金supported by a grant from the Central Level Public Welfare Research Institutes Basic Research Expenses of Chinese Academy of Medical Sciences(No.2023-RW320-05)。
文摘According to the 2024 global cancer data from GLOBOCAN,liver cancer ranks the 6th most common malignancy and the 3rd leading cause of cancer-related mortality worldwide[1].Among these cases,hepatocellular carcinoma(HCC)accounts for approximately 85%−90%[2,3].Its incidence and mortality rates remain persistently high worldwide.However,China has the highest incidence and mortality rates of the disease in the world[4].And the majority of patients are diagnosed at intermediate or advanced stages.Thus,identifying novel tumor biomarkers for early detection and implementing precision therapy has long been a key focus of research.
文摘Objective To determine whether frailty is a risk factor for hospitalization and mortality in older adults enrolled in the "Chronic Heart Failure Program" at a hospital in Lima, Peru, between 2018–2021.Methods This was an ambispective cohort study. A total of 85 older adults participating in the Chronic Heart Failure Program at Guillermo Almenara National Hospital were included. Each had an initial frailty assessment, forming two cohorts: frail and non-frail older adults. Medical records were reviewed, and patients were followed for one year to track events of interest(hospitalization and mortality). Overall survival and risk factors for hospitalization and death were determined.Results During follow-up, 15.3% of the older adults died, and frailty was identified in 58.8% of the patients. Overall survival using the Kaplan-Meier method was 96.5% at 3 months after entering the Chronic Heart Failure Program;92.9% at 6 months;and85.9% at one year. Multivariate analysis using Poisson regression found that frailty was not a risk factor for hospitalization(a RR =0.92;95% CI: 0.42–2.03). Survival analysis using the Cox proportional hazards model showed that frailty was also not a risk factor for mortality after one year of follow-up(a HR = 1.32;95% CI: 0.27–6.53).Conclusions Our research does not confirm frailty as a risk factor for hospitalization or mortality in older adults enrolled in the“Chronic Heart Failure Program” after one year of follow-up.
基金supported by the Natural Science Foundation of Chongqing,No.CSTB2023NSCQ-mSX0561(to WL).
文摘Effective treatment methods for stroke,a common cerebrovascular disease with a high mortality rate,are still being sought.Exosome therapy,a form of acellular therapy,has demonstrated promising efficacy in various diseases in animal models;however,there is currently insufficient evidence to guide the clinical application of exosome in patients with stroke.This article reviews the progress of exosome applications in stroke treatment.It aims to elucidate the significant potential value of exosomes in stroke therapy and provide a reference for their clinical translation.At present,many studies on exosome-based therapies for stroke are actively underway.Regarding preclinical research,exosomes,as bioactive substances with diverse sources,currently favor stem cells as their origin.Due to their high plasticity,exosomes can be effectively modified through various physical,chemical,and genetic engineering methods to enhance their efficacy.In animal models of stroke,exosome therapy can reduce neuroinflammatory responses,alleviate oxidative stress damage,and inhibit programmed cell death.Additionally,exosomes can promote angiogenesis,repair and regenerate damaged white matter fiber bundles,and facilitate the migration and differentiation of neural stem cells,aiding the repair process.We also summarize new directions for the application of exosomes,specifically the exosome intervention through the ventricular-meningeal lymphatic system.The review findings suggest that the treatment paradigm for stroke is poised for transformation.
文摘Background In patients with coronary artery disease,age is of known significance in predicting outcomes.Data on clinical outcomes in patients≥85 years undergoing percutaneous coronary intervention(PCI)remain scarce.The study aim was to determine clinical characteristics,risk of adverse cardiovascular events,and mortality in patients aged≥85 years compared to those aged<85 undergoing PCI.Methods In this retrospective study,data were obtained from the nationwide Netherlands Heart Registration on patients undergoing PCI between January 1st,2017 and January 1st,2021.The primary endpoint was all-cause mortality at long-term followup.Results A total of 155,683 patients underwent PCI,of which 100,209(64.4%)acute coronary syndrome cases.Compared to patients aged<85 years,patients aged≥85 were more often female and showed a higher number of cardiovascular comorbidities,including impaired left ventricle ejection fraction and reduced kidney function.Mortality at short-term and long-term follow-up were significantly higher in those aged≥85(P<0.001).Patients aged≥85 were more likely to have a myocardial infarction within 30 days following the index intervention(0.9%vs.0.7%;P=0.024),though they less often underwent revascularization at longterm follow-up compared to patients aged<85(P<0.001).Conclusions The elderly(≥85 years)patient requiring PCI carries an extensive cardiovascular risk profile,translating in significant risk of recurrent cardiovascular events and increased mortality rate.Clinicians should carefully weigh perceived risks and potential benefits in the individual patient,considering the patients’age,cardiovascular risk profile,and associated risk of morbidity and mortality.
基金funded by the Santa Casa Neuroscience Awards—Prize Melo e Castro for Spinal Cord Injury Research(MC-18-2021)(to AJS and NAS)by the Wings for Life Spinal Cord Research Foundation(WFL-PT-14/23)(to NAS)+2 种基金funded by national funds through the Foundation for Science and Technology(FCT)—projects UIDB/50026/2020,UIDP/50026/2020,and EXPL/MED-PAT/0931/2021-http://doi.org/10.54499/EXPL/MED PAT/0931/2021supported by the Norte Portugal Regional Operational Programme(NORTE 2020)under the PORTUGAL 2020 Partnership Agreement through the European Regional Development Fund(ERDF)(to SM)the support given by the Portuguese Foundation of Science and Technology to SM(CEECIND/01902/2017-Doi:10.54499/CEECIND/01902/2017/CP1458/CT0024),and NAS(CEECIND/04794/2007)。
文摘The impact of spinal cord injury(SCI)on the immune system is increasingly recognized in a field traditionally focused on motor impairments.SCI can seriously affect the immune system by progressively disrupting the regulatory mechanisms that control immune responses.This dysregulation varies widely among patients and can evolve over time,ranging from systemic inflammatory responses to immunosuppression,greatly contributing to the morbidity and mortality of individuals with SCI(Bao et al.,2011;Brennan et al.,2024).
基金supported by the World Health Organization Global Youth Tobacco Survey(WPDHP1206671)the Global Health Capacity Building and Tobacco Control Project:Tobacco Epidemic Monitoring and Comprehensive Tobacco Control Intervention。
文摘Adolescent smoking constitutes a critical public health challenge as early initiation increases the risk of premature mortality and smoking-related chronic diseases due to longer exposure and higher cumulative tobacco use^([1]).Adolescents are especially prone to developing persistent smoking habits,with many adult smokers having started before the age of 18.In China,16.7%of secondary school students have tried smoking and 4.7%are current smokers,highlighting the critical need for targeted tobacco control interventions among the youth.
基金supported by grants from the National Research Foundation of Korea(NRF)under the Ministry of Science and Information and Communication Technology(grant number:RS-2023-00249082)Korea University(grant number:K2225791).
文摘Background:That Central and Eastern Europe and Central Asia(CEECA)experienced a major mortality crisis in the 1990s is a well-established finding,with most analyses focusing on singular causes like alcohol-related deaths.However,the utility of the integrated“deaths of despair”framework,which views alcohol,drug,and suicide deaths as a unified socio-economic phenomenon,remains under-explored in this context.Crucially,the long-term evolution of the composition of despair within the region remains a largely unexplored area of inquiry.Therefore,this study aims to analyze the long-term trends,changing composition,and regional heterogeneity of deaths from despair in the CEECA region from 1980 to 2021.Methods:Using 2021 Global Burden of Disease(GBD)data(1980–2021),we analyzed deaths of despair mortality trends in 29 CEECA countries.We employed Joinpoint regression to identify significant trend changes and conducted stratified analyses by cause,gender,and age group.Results:The CEECA deaths of despair crisis began as an alcohol and suicide driven phenomenon concentrated in middle-aged men(50–74 years)during the 1990s,with mortality rates for alcohol use disorders and self-harm surging annually by 30.35%(p=0.002)and 13.44%(p=0.001),respectively,between 1991 and 1994.It has since evolved,marked by a contrasting and emerging threat in the 21st century:a rising proportion of drug-related deaths among the younger(15–49 years)male cohort,where the share of drug use disorders increased from 6.9%in 2000 to 11.8%in 2008.Conclusion:The deaths of despair crisis in the CEECA region is not a past event but an ongoing,evolving phenomenon.Its changing nature demands a shift in public health focus from solely historical drivers to new,generation-specific threats,particularly the rise of drug-related despair among youth.
基金This research is supported by a seed money Grant provided by Maulana Azad National Institute of Technology,Bhopal under the Grant No.:DeanR&C/1420.
文摘This study attempts to investigate the factors determining COVID-19 deaths during the pandemic across countries by employing a rich dataset sourced from 94 countries updated till 6 February,2022.For empirical analysis,the study makes use of cross-sectional linear regression technique in the first part and after required diagnostic tests use 2SLS regression technique for correcting possible endogeneity bias in the second part.Findings from the study indicate that factors like total reported cases,population size,population over 70 years of age,extreme poverty,and human development index play significant role in determining COVID-19-related death.Further,to check the robustness of the findings the present study employed LASSO regression.Findings from the study highlight the possibility of government intervention to devise appropriate policies to control COVID-related incidence and death.
文摘Introduction:Climate factors play an important role in the transmission of viruses,such as influenza viruses,MERS-CoV,and SARS-CoV-1.This study aimed to determine the relationship between changes in temperature,humidity,rainfall,and SARS-CoV-2 contagion.Five ecologically and climatically distinct regions were considered—Karachi,Lahore,Islamabad,Peshawar,and Gilgit-Baltistan.Method:Data on daily COVID-19 cases and deaths were retrieved from government officials,while meteorological information was collected from Pakistan Meteorological Department.Statistical analysis was performed using SPSS version 20 and the Spearman rank correlation test was used to analyze the correlation between the meteorological factors and COVID-19 cases and deaths.Result:Positive correlation of COVID-19 incidence was observed with all the temperature ranges(maximum,minimum and average)and negative correlation was seen with humidity,DTR and rainfall.COVID-19 deaths were positively associated with temperature and were negatively associated only with humidity.Linear regression showed that for every unit increase in humidity,there was a3.345 daily signifi-cant decrease in COVID-19 cases,while in Karachi for every unit increase in humidity,there remained a 10.104 daily significant increase in cases.In Gilgit-Baltistan,for every unit increase in average temperature and rainfall respectively,significant increases of 0.534 and 1.286 in daily cases were found.Conclusion:This study signifies the effect of climate factors on COVID-19 incidence and mortality rate,but climate factors are not the only variable and several other interlinked factors enhance the spread of COVID-19.Hence,effective mitigation policies,enhancing testing capacities,and developing public attitudes toward adopting precautionary measures are important to overcome this overwhelming pandemic.
