BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal ...BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.展开更多
Cancer presents a major global public health challenge and requires comprehensive treatments such as surgery and chemotherapy.Chinese herbal medicine(CHM)has gained attention as a potential adjunct therapy,but its eff...Cancer presents a major global public health challenge and requires comprehensive treatments such as surgery and chemotherapy.Chinese herbal medicine(CHM)has gained attention as a potential adjunct therapy,but its efficacy remains uncertain.To evaluate this,researchers conducted a search of EMBASE,Web of Science,PubMed,and the Cochrane Library for relevant articles.They included 33 studies with 17 cohorts,assessed the quality using the Newcastle-Ottawa Scale,and performed statistical analyses with Review Manager and STATA software.The results showed that cancer patients receiving CHM had a significantly reduced mortality risk(relative risk=0.79,95%confidence interval=0.72–0.86;P<0.00001).Both the unadjusted hazard ratio(HR)and the adjusted HR indicated a substantially and consistently lowered mortality risk for CHM-treated patients(unadjusted:P=0.00,I2=98.1%,HR=0.57,95%confidence interval=0.52–0.62;adjusted:P<0.00001,I2=98%,HR=0.59,95%confidence interval=0.53–0.66).Subgroup analysis by tumor type showed that CHM reduced mortality risk in patients with respiratory and digestive cancers.In conclusion,CHM treatment,either alone or in combination with chemotherapy,significantly decreases mortality risk in cancer patients.However,these findings need further verification through large-scale,multicenter,high-quality,long-term trials.展开更多
ICU patients are vulnerable to medications,especially infusion medications,and the rate and dosage of infusion drugs may worsen the condition.The mortality prediction model can monitor the real-time response of patien...ICU patients are vulnerable to medications,especially infusion medications,and the rate and dosage of infusion drugs may worsen the condition.The mortality prediction model can monitor the real-time response of patients to drug treatment,evaluate doctors’treatment plans to avoid severe situations such as inverse Drug-Drug Interactions(DDI),and facilitate the timely intervention and adjustment of doctor’s treatment plan.The treatment process of patients usually has a time-sequence relation(which usually has the missing data problem)in patients’treatment history.The state-of-the-art method to model such time-sequence is to use Recurrent Neural Network(RNN).However,sometimes,patients’treatment can last for a long period of time,which RNN may not fit for modelling long time sequence data.Therefore,we propose to use the heterogeneous medication events driven LSTM to predict the outcome of the patient,and the Natural Language Processing and Gaussian Process(GP),which can handle noisy,incomplete,sparse,heterogeneous and unevenly sampled patients’medication records.In our work,we emphasize the semantic meaning of each medication event and the sequence of the medication events on patients,while also handling the missing value problem using kernel-based Gaussian process.We compare the performance of LSTM and Phased-LSTM on modelling the outcome of patients’treatment and data imputation using kernel-based Gaussian process and conduct an empirical study on different data imputation approaches.展开更多
BACKGROUND Acute myocardial infarction(AMI)combined with ventricular septal perforation(VSR)is still a highly fatal condition in the era of reperfusion therapy.The incidence rate has decreased to 0.2%-0.4%due to the p...BACKGROUND Acute myocardial infarction(AMI)combined with ventricular septal perforation(VSR)is still a highly fatal condition in the era of reperfusion therapy.The incidence rate has decreased to 0.2%-0.4%due to the popularization of percutaneous coronary intervention.However,the risk is significantly increased for those who fail to undergo revascularization in time,and the mortality rate remains high.The current core contradiction in clinical practice lies in the selection of surgical timing,and the disparity in medical resources significantly affects prognosis.There is an urgent need to optimize the identification of high-risk populations and individualized treatment strategies.AIM To investigate the clinical features,determine the prognostic factors,and develop a predictive model for 30-day mortality in patients with acute myocardial infarction complicated by ventricular septal rupture(AMI-VSR)residing in high-altitude regions.METHODS This study retrospectively analyzed 48 AMI-VSR patients admitted to a Yunnan hospital from 2017 to 2024,with the establishment of survival(n=30)and mortality(n=18)groups based on patients’survival status.Risk factors were identified by univariate and multivariate logistic regression analyses.A nomogram model was developed using R software and validated via receiver operating characteristic(ROC)analysis and calibration curves.RESULTS Age,uric acid(UA),interleukin-6(IL-6),and low hemoglobin(Hb)were independent risk factors for 30-day mortality(odds ratios:1.147,1.006,1.034,and 0.941,respectively;P<0.05).The nomogram demonstrated excellent discrimination(area under the ROC curve=0.939)and calibration(Hosmer-Lemeshowχ²=2.268,P=0.971).In addition,patients’poor outcomes could be synergistically predicted by IL-6 and UA,advanced age,and reduced Hb.CONCLUSION This study highlights age,UA,IL-6,and Hb as critical predictors of mortality in AMI-VSR patients at high altitudes.The validated nomogram provides a practical tool for early risk stratification and tailored interventions,addressing gaps in managing this high-risk population in resource-limited settings.展开更多
Based on the forming mechanism of seismic hazard risk, we established a seismic vulnerability curve on population and determined earthquake occurrence parameters. We then assessed the risk of seismic hazard mortality ...Based on the forming mechanism of seismic hazard risk, we established a seismic vulnerability curve on population and determined earthquake occurrence parameters. We then assessed the risk of seismic hazard mortality at the county level across China using the assessment model, and analyzed spatial patterns. We adopted past, present, and future disaster-breeding materials to assess the probability of earthquakes. In order to determine the earthquake parameters of 2355 counties accurately, we integrated history seismic intensities, seismic activity fault belts distributions and seismic peak ground acceleration. Based on data of seismic disasters from 1990 to 2009 in China, linear fitting between seismic intensities and mortalities was performed. And a vulnerability curve of seismic mortality, which was appropriate for seismic risk assessment, was established. Seismic mortality risks were assessed quantitatively at the county level using the model and the spatial patterns were analyzed. Seismic mortality risks of 2355 counties with intensities from Ⅴ to Ⅺ were analyzed thoroughly. This study indicates that under different seismic intensities, China’s eastern and central regions are generally confronted with higher risk than western regions. High-risk areas are scattered in Shandong and Jiangsu, northern Anhui and eastern Heilongjiang and Jilin, where populations are dense and the environment is conducive to disasters. Risk- free areas displayed patchy distributions nationwide, and patterns were mostly unchanged.展开更多
Background Acute myocarditis(AMC)can cause poor outcomes or even death in children.We aimed to identify AMC risk factors and create a mortality prediction model for AMC in children at hospital admission.Methods This w...Background Acute myocarditis(AMC)can cause poor outcomes or even death in children.We aimed to identify AMC risk factors and create a mortality prediction model for AMC in children at hospital admission.Methods This was a single-center retrospective cohort study of AMC children hospitalized between January 2016 and January 2020.The demographics,clinical examinations,types of AMC,and laboratory results were collected at hospital admission.In-hospital survival or death was documented.Clinical characteristics associated with death were evaluated.Results Among 67 children,51 survived,and 16 died.The most common symptom was digestive disorder(67.2%).Based on the Bayesian model averaging and Hosmer–Lemeshow test,we created a final best mortality prediction model(acute myocarditis death risk score,AMCDRS)that included ten variables(male sex,fever,congestive heart failure,left-ventricular ejection fraction<50%,pulmonary edema,ventricular tachycardia,lactic acid value>4,fulminant myocarditis,abnormal creatine kinase-MB,and hypotension).Despite differences in the characteristics of the validation cohort,the model discrimination was only marginally lower,with an AUC of 0.781(95%confidence interval=0.675–0.852)compared with the derivation cohort.Model calibration likewise indicated acceptable fit(Hosmer‒Lemeshow goodness-of-fit,P¼=0.10).Conclusions Multiple factors were associated with increased mortality in children with AMC.The prediction model AMCDRS might be used at hospital admission to accurately identify AMC in children who are at an increased risk of death.展开更多
Coping with extreme climate events and its related climatic disasters caused by climate change has become a global issue and drew wide attention from scientists, policy-makers and public. This paper calculated the exp...Coping with extreme climate events and its related climatic disasters caused by climate change has become a global issue and drew wide attention from scientists, policy-makers and public. This paper calculated the expected annual multiple climatic hazards intensity index based on the results of nine climatic hazards including tropical cyclone, flood, landslide, storm surge, sand-dust storm, drought, heat wave, cold wave and wildfire. Then a vulnerability model involving the coping capacity indicator with mortality rate, affected population rate and GDP loss rate, was developed to estimate the expected annual affected population, mortality and GDP loss risks. The results showed that： countries with the highest risks are also the countries with large population or GDP. To substantially reduce the global total climatic hazards risks, these countries should reduce the exposure and improving the governance of integrated climatic risk; Without considering the total exposure, countries with the high mortality rate, affected population rate or GDP loss rate, which also have higher or lower coping capacity, such as the Philippines, Bangladesh and Vietnam, are the hotspots of the planning and strategy making for the climatic disaster risk reduction and should focus on promoting the coping capacity.展开更多
Objective To investigate the risk factors associated with early mortality of the rapid two-stage arerial switch operation,which has a significantly higher overall mortality than that of ASO procedure for D-TGA with an...Objective To investigate the risk factors associated with early mortality of the rapid two-stage arerial switch operation,which has a significantly higher overall mortality than that of ASO procedure for D-TGA with an intact ventricular septum. Methods The data we reviewed involving patients who underwent rapid two-stage switch operations from September,2002 to September,2007 in our center,13 patients were male and 8展开更多
The article by Wu et al highlights the growing incidence of esophageal tumor patients,particularly in China,where the high frequency and death rate are significant problems.The article also examined the impact of heal...The article by Wu et al highlights the growing incidence of esophageal tumor patients,particularly in China,where the high frequency and death rate are significant problems.The article also examined the impact of health insurance on treatment availability and patient outcomes,demonstrating that the type of insurance can affect the financial burden on patients.This study investigates the effects of different types of health care coverage,namely Urban Employee Basic Medical Insurance vs Urban-Rural Resident Basic Medical Insurance,and the personal spending ratio on treatment decisions and survival outcomes.The database used is derived from esophageal tumor patient continuation from Chongqing University Hospital in China.A total of 2543 patients were included in the study,allowing for the formation of research cohorts.Patient information included demographic characteristics.The study followed various processes to maintain consistency,including data sources,inclusion and exclusion criteria,follow-up duration,health insurance,and statistical analysis.The average age at diagnosis ranged from 57-74 years,and predominantly included men,married people,and those of Han ethnic background,comprising 2088 and 2519 individuals,respectively.Upon controlling for age,sex,relationship status,country of origin,pathological evaluation,tumor stage,and biochemical indicators,individuals who had Urban Employee Basic Medical Insurance exhibited a higher propensity to opt for radiotherapy,chemotherapy,immunotherapy,and targeted therapy compared to those covered by the Urban-Rural Resident Basic Medical Insurance.During the follow-up phase of the study,a total of 1438 deaths were documented,with 1106 ascribed to esophageal cancer.Additionally,individuals with Urban-Rural Resident Basic Medical Insurance had a significantly elevated risk of esophageal cancer,particularly mortality,compared to those without Urban-Rural Resident Basic Medical Insurance.展开更多
Coronavirus disease 2019(COVID-19)has become a worldwide pandemic.Hospitalized patients of COVID-19 suffer from a high mortality rate,motivating the development of convenient and practical methods that allow clinician...Coronavirus disease 2019(COVID-19)has become a worldwide pandemic.Hospitalized patients of COVID-19 suffer from a high mortality rate,motivating the development of convenient and practical methods that allow clinicians to promptly identify high-risk patients.Here,we have developed a risk score using clinical data from 1479 inpatients admitted to Tongji Hospital,Wuhan,China(development cohort)and externally validated with data from two other centers:141 inpatients from Jinyintan Hospital,Wuhan,China(validation cohort 1)and 432 inpatients from The Third People’s Hospital of Shenzhen,Shenzhen,China(validation cohort 2).The risk score is based on three biomarkers that are readily available in routine blood samples and can easily be translated into a probability of death.The risk score can predict the mortality of individual patients more than 12 d in advance with more than 90%accuracy across all cohorts.Moreover,the Kaplan-Meier score shows that patients can be clearly differentiated upon admission as low,intermediate,or high risk,with an area under the curve(AUC)score of 0.9551.In summary,a simple risk score has been validated to predict death in patients infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2);it has also been validated in independent cohorts.展开更多
Background A flame burn is an injury of body tissues,including respiratory tract damage,due to exposure to a flame or its dense smoke.Flame burns cause some of the most physically and psychologically devastating forms...Background A flame burn is an injury of body tissues,including respiratory tract damage,due to exposure to a flame or its dense smoke.Flame burns cause some of the most physically and psychologically devastating forms of trauma.Compared to scald burns,flame burn patients have a higher mortality rate and a higher frequency of multiorgan failure.The purpose of this research was to investigate the trends,complications,and mortality risk factors of flame burns at the Department of Plastic and Burn Surgery(DPBS)of the People’s Hospital of China Three Gorges University(PHCTGU).Methods A retrospective analysis of 48 flame burn patients—accounting for 8.3%of the 576 burn victims admitted for burns at the PHCTGU from February 1,2010,to September 30,2019—was performed after collecting information from the Burns Registry of the said hospital.Results The proportion of patients with flame burns was 8.3%(n=48).The mean total body surface area(TBSA)affected was 27.6%.The mean duration of hospitalization was 32.5 days.The etiologies of the flame burns were as follows:gas explosions(21,43.8%),ethanol(8,16.7%),charcoal fire(7,14.6%),petrol explosions(4,8.3%),wooden houses(4,8.3%),and others,including dust,cigarette lighter,and burning incense,accounting for 8.3%of cases(4).Finally,42(87.5%)patients were treated and discharged,and 6(12.5%)patients died.Complications included scarring in 38(90.5%)patients,severe scar contractures on different parts of the body in 25(60.0%)patients,scar ulcer in 6(14.3%)patients,keloids in 3(7.1%)patients,and scar cancer in 1(2.4%)patient.Multiple complications occurred in the same patient.The only risk factor for mortality that was identified was TBSA(P=0.043).Conclusions Our study revealed that a small population(8.3%)was injured by flame burns,but 6 deaths were recorded.Society must continually enhance safeguard procedures to flames and strengthen education to protect life and avoid severe complications.展开更多
OBJECTIVE:To confirm the long-term outcomes of stroke patients and determine predicting factors for death,recurrence of vascular events and poor outcome(either recurrence or death) after the use of combined TCM therap...OBJECTIVE:To confirm the long-term outcomes of stroke patients and determine predicting factors for death,recurrence of vascular events and poor outcome(either recurrence or death) after the use of combined TCM therapy.METHODS:This was a retrospective hospital-based cohort study and was performed in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine in Tianjin.All subjects with stroke consecutively admitted to an inpatient ward of the Acupuncture Department from January 1,2008,to December 31,2008 were retrospectively followed through one year.The main outcomes were either a recurrence of vascular events,,mortality or both.Risk factors were recorded from medical records.Multivariate regression models were used to analyze predictors.The following independent variables were used:age,gender,hypertension,ischemic heart disease,atrial fibrillation,diabetes mellitus,carotid arterial lesions and history of stroke.RESULTS:Four-hundred and five patients were included.The 1-year mortality rate was 11.11%.23.70% of the patients had a recurrent vascular event,and 30.86% suffered a poor outcome.Multiple logistic regression analysis found that previous stroke,and advanced age were predictors of death within one year,Recurrence of vascular events was associated with carotid arterial lesions,history of diabetes and previous stroke.Long-term poor outcome was predicted by advanced age,history of diabetes,and previous stroke.CONCLUSION:Age,previous stroke,carotid arterial lesions and diabetes history seem to have different impacts on the three outcomes within one year.Our findings provide important data for planning future hospital register studies of stroke patients in TCM hospitals.展开更多
Introduction:Pulse pressure(PP),an indicator of aortic stiffening,may be associated with adverse cardiovascular outcomes.However,the relationship between PP levels and mortality risk in the Chinese population remains ...Introduction:Pulse pressure(PP),an indicator of aortic stiffening,may be associated with adverse cardiovascular outcomes.However,the relationship between PP levels and mortality risk in the Chinese population remains unclear.Methods:A total of 102,311 participants aged 40 and above were recruited in this prospective study in Beijing during 2010–2012,and followed up until 2021.Blood pressure measurements and related factors were collected at baseline.All-cause and cardiovascular or cerebrovascular disease(CCVD)related deaths were identified as endpoints.Results:Compared with the lowest quartile of PP(<40 mmHg),mortality risk increased by 9.8%–23.9%among individuals with PP in the second through fourth quartiles,with particularly elevated risk among females,adults aged 60–74 years,and overweight or obese individuals.The association between PP and CCVD-specific mortality risk was attenuated but remained statistically significant among people with PP≥60 mmHg.Conclusions:Death risk increased with rising PP levels in middle-aged and elderly populations in Beijing.These findings emphasize the need to develop comprehensive and effective PP management strategies to reduce mortality.展开更多
In order to discover the risk factors for 30-day mortality in bloodstream infections（BSI） caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and...In order to discover the risk factors for 30-day mortality in bloodstream infections（BSI） caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and the characteristics of this condition.A total of 64 patients with BSI caused by Enterococcus spp.who were treated in our hospital between 2006 and 2015 were included in the study.The clinical features of patients,microbiology,and 30-day mortality were collected from the electronic medical records database and analyzed.The results showed that there were 38 patients infected by Enterococcus faecalis（E.faecalis）,24 by Enterococcus faecium（E.faecium）,1 by Enterococcus casseliflavus（E.casseliflavus）,and 1 by Enterococcus gallinarum（E.gallinarum）.A Charlson comorbidity score ≥5,corticosteroid treatment,placement of catheters or other prosthetic devices and history of antibiotic use were found more frequently in E.faecium BSI patients than in E.faecalis patients（P=0.017,P=0.027,P=0.008 and P=0.027,respectively）.Furthermore,the univariate and multivariate analysis showed that corticosteroid treatment（OR=17.385,P=0.008）,hospital acquisition（OR=16.328,P=0.038）,and vascular catheter infection（OR=14.788,P=0.025） were all independently associated with 30-day mortality.Our results indicate that E.faecalis and E.faecium are two different pathogens with unique microbiologic characteristics,which cause different clinical features in BSI,and the empiric antimicrobial treatments are paramount for patients with enterococcal BSI.展开更多
The RAND Corporation reported that insufficient sleep causes an economic loss of $138 billion (2.92% of GDP) in Japan every year. In this study, we investigated the sleep improvement effect of a novel innovative sleep...The RAND Corporation reported that insufficient sleep causes an economic loss of $138 billion (2.92% of GDP) in Japan every year. In this study, we investigated the sleep improvement effect of a novel innovative sleeping mattress called “AiR SI” (Nishikawa Co., Ltd.) to find a simple method to solve the problem of sleep deprivation. We conducted a 2-week randomized, open-label, crossover, self-controlled study in 14 healthy adults in their 30s to 50s (control: 1 week, AiR SI: 1 week), with sleep quality as the primary endpoint as well as salivary components (cortisol, melatonin) and autonomic nervous function (sympathetic nerve, parasympathetic nerve) as secondary endpoints. Trends toward improvement in sleep were suggested for all the endpoints, regardless of differences in the subject background. The results suggested that the use of AiR SI for 1 week not only improved sleep but normalized both the endocrine and autonomic functions as well. We conclude that, by using a sleeping mattress with a high sleep improvement effect, the user may easily achieve higher labor productivity and have a lower mortality risk. Eliminating sleep deprivation with a sleeping mattress may lead to a reduction in national economic losses and ultimately produce significant economic effects.展开更多
The present study investigates the effects of subjective well-being(SWB)on mortality risk using a large sample from the Chinese Longitudinal Healthy Longevity Study conducted in 1998,2000,2002,2005,2008,2011 and 2014....The present study investigates the effects of subjective well-being(SWB)on mortality risk using a large sample from the Chinese Longitudinal Healthy Longevity Study conducted in 1998,2000,2002,2005,2008,2011 and 2014.SWB is measured by life satisfaction,positive affect and negative affect.We found that positive affect,negative affect,life satisfaction and the change of life satisfaction significantly have predicted mortality risks of the older people with control of social demographic characteristics,physical health,social support,cognitive ability,and social participation.The higher the positive affect,the lower the negative affect,the improvement the life satisfaction,the lower the mortality risk.Marital status plays a decisive role in the influence of life satisfaction on the mortality risk.The married persons have lower mortality risk even if they rate their life bad.In further analyses,we found that the effects of SWB on mortality risk were underestimated in short-term study compared with those in long-term study.SWB is essentially a time-dependent variable and changes with age,so treating SWB as time-independent variable underestimated its impact on mortality risk.展开更多
Household consumption in China is associated with substantial PM_(2.5)pollution,through activities directly(i.e.,fuel use)and/or indirectly(i.e.,consumption of goods and services)causing pollutant emissions.Urban and ...Household consumption in China is associated with substantial PM_(2.5)pollution,through activities directly(i.e.,fuel use)and/or indirectly(i.e.,consumption of goods and services)causing pollutant emissions.Urban and rural households exhibit different consumption preferences and living areas,thus their contributions to and suffering from air pollution could differ.Assessing this contrast is crucial for comprehending the environmental impacts of the nation’s ongoing urbanization process.Here we quantify Chinese urban and rural households’contributions to ambient PM_(2.5)pollution and the health risks they suffer from,by integrating economic,atmospheric,and health models and/or datasets.The national premature deaths related to long-term exposure to PM_(2.5)pollution contributed by total household consumption are estimated to be 1.1 million cases in 2015,among which 56%are urban households and 44%are rural households.For pollution contributed indirectly,urban households,especially in developed provinces,tend to bear lower mortality risks compared with the portions of deaths or pollution they contribute.The opposite results are true for direct pollution.With China’s rapid urbanization process,without adequate reduction in emission intensity,the increased indirect pollution-associated premature deaths could largely offset that avoided by reduced direct pollution,and the indirect pollution-associated urban–rural inequalities might become severer.Developing pollution mitigation strategies from both production and consumption sides could help with reducing pollution-related mortality and associated urban-rural inequality.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
Background:This study aimed to investigate the clinical characteristics of 21 deaths and evaluate potential factors affecting disease severity and mortality risk in patients with coronavirus disease(COVID-19).Methods:...Background:This study aimed to investigate the clinical characteristics of 21 deaths and evaluate potential factors affecting disease severity and mortality risk in patients with coronavirus disease(COVID-19).Methods:This retrospective analysis assessed clinical data of 21 patients who died owing to COVID-19.Disease severity and mortality risk were assessed using Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ);Sepsis-related Organ Failure Assessment(SOFA);multilobular infiltration,hypo-lymphocytosis,bacterial coinfection,smoking history,hypertension and age(MuLBSTA);and pneumonia severity index(PSI)scores.Results:The mean age of the patients was 66±14 years and 15(71.4%)patients were men.Sixteen(76.2%)patients had chronic medical illnesses.Twelve(57.1%)patients were overweight.Decreased lymphocyte proportions were observed in 17(81.0%)patients on admission.Elevated D-dimer levels were observed in 11(52.4%)patients,and the levels significantly increased when pneumonia deteriorated.The initial APACHE II and SOFA scores demonstrated that 18(85.7%)and 13(61.9%)patients,respectively,were in the middle-risk level.MuLBSTA and PSI scores after admission were associated with higher risks of mortality in 13(61.9%)patients.Most patients developed organ failure and subsequently died.Conclusions:Older,overweight,male patients with a history of chronic illnesses and continuously decreased lymphocyte proportions and increased D-dimer levels might have higher risks of death owing to COVID-19.The combination of general scoring(SOFA)and pneumonia-specific scoring(MuLBSTA and PSI)systems after admission might be sensitive in assessing the mortality risk of patients with COVID-19 who are in critical condition.展开更多
基金Supported by the Chongqing Science and Health Joint Medical Research Project,No.2024MSXM065.
文摘BACKGROUND Oesophageal cancer is a significant health concern worldwide,with high inci-dence and mortality rates.In China,the disease burden is particularly high,accounting for a substantial proportion of oesophageal cancer cases and related deaths worldwide.AIM To explore the relationship between the mortality rate of oesophageal cancer patients and insurance type,out-of-pocket ratio,and the joint effects of insurance type and out-of-pocket ratio.METHODS The χ^(2) test was used to analyze patients’demographic and clinical characteristics.Multivariate logistic regression,the Cox proportional hazard model,and the competitive risk model were used to calculate the cumulative hazard ratios(HRs)of all-cause death and oesophageal cancer-specific death among patients with different types of insurance and out-of-pocket ratios.RESULTS Compared with patients covered by basic medical insurance for urban and rural residents,patients covered by urban employee basic medical insurance for urban workers(UEBMI)had a 23.30%increased risk of oesophageal cancer-specific death[HR=1.233,95%confidence interval(CI):1.093-1.391,P<0.005].Compared with patients in the low out-of-pocket ratio group,patients in the high out-of-pocket ratio group had a 25.80%reduction in the risk of oesophageal cancer-specific death(HR=0.742,95%CI:0.6555-0.84,P<0.005).With each 10%increase in the out-of-pocket ratio,the risk of oesophageal cancer-specific death decreased by 10.10%in patients covered by UEBMI.However,the risk of oesophageal cancer-specific death increased by 26.90%in patients in the high out-of-pocket ratio group.CONCLUSION This study reveals the relationships of the specific mortality rate of patients with oesophageal cancer with the out-of-pocket ratio and medical insurance types as well as their combined effects.This study provides practical suggestions and guidance for the formulation of relevant policies in this area.
基金supported by the National Natural Science Foundation of China(No.82060519,81760519,81560429)the Yunnan Provincial Department of Science and Technology-Yunnan University of Chinese Medicine Applied Basic Research Joint Special Key Project(2019FF002(-011))+3 种基金Yunnan Province 10,000 people plan young top-notch talents(YNWR-QNBJ-2018-212)Yunnan Provincial Department of Science and Technology-Yunnan University of Chinese Medicine Applied Basic Research Joint Special Project(202301AZ070001-062)State Administration of Traditional Chinese Medicine High-level Chinese Medicine Key Discipline Construction Project“Dai Medicine”Yunnan Science and Technology Talent and Platform Program(202105AG070012).
文摘Cancer presents a major global public health challenge and requires comprehensive treatments such as surgery and chemotherapy.Chinese herbal medicine(CHM)has gained attention as a potential adjunct therapy,but its efficacy remains uncertain.To evaluate this,researchers conducted a search of EMBASE,Web of Science,PubMed,and the Cochrane Library for relevant articles.They included 33 studies with 17 cohorts,assessed the quality using the Newcastle-Ottawa Scale,and performed statistical analyses with Review Manager and STATA software.The results showed that cancer patients receiving CHM had a significantly reduced mortality risk(relative risk=0.79,95%confidence interval=0.72–0.86;P<0.00001).Both the unadjusted hazard ratio(HR)and the adjusted HR indicated a substantially and consistently lowered mortality risk for CHM-treated patients(unadjusted:P=0.00,I2=98.1%,HR=0.57,95%confidence interval=0.52–0.62;adjusted:P<0.00001,I2=98%,HR=0.59,95%confidence interval=0.53–0.66).Subgroup analysis by tumor type showed that CHM reduced mortality risk in patients with respiratory and digestive cancers.In conclusion,CHM treatment,either alone or in combination with chemotherapy,significantly decreases mortality risk in cancer patients.However,these findings need further verification through large-scale,multicenter,high-quality,long-term trials.
基金This research is supported by Natural Science Foundation of Hunan Province(No.2019JJ40145)Scientific Research Key Project of Hunan Education Department(No.19A273)Open Fund of Key Laboratory of Hunan Province(2017TP1026).
文摘ICU patients are vulnerable to medications,especially infusion medications,and the rate and dosage of infusion drugs may worsen the condition.The mortality prediction model can monitor the real-time response of patients to drug treatment,evaluate doctors’treatment plans to avoid severe situations such as inverse Drug-Drug Interactions(DDI),and facilitate the timely intervention and adjustment of doctor’s treatment plan.The treatment process of patients usually has a time-sequence relation(which usually has the missing data problem)in patients’treatment history.The state-of-the-art method to model such time-sequence is to use Recurrent Neural Network(RNN).However,sometimes,patients’treatment can last for a long period of time,which RNN may not fit for modelling long time sequence data.Therefore,we propose to use the heterogeneous medication events driven LSTM to predict the outcome of the patient,and the Natural Language Processing and Gaussian Process(GP),which can handle noisy,incomplete,sparse,heterogeneous and unevenly sampled patients’medication records.In our work,we emphasize the semantic meaning of each medication event and the sequence of the medication events on patients,while also handling the missing value problem using kernel-based Gaussian process.We compare the performance of LSTM and Phased-LSTM on modelling the outcome of patients’treatment and data imputation using kernel-based Gaussian process and conduct an empirical study on different data imputation approaches.
基金Supported by Science and Technology Department of Yunnan Province-Kunming Medical University,Kunming Medical Joint Special Project-Surface Project,No.202401AY070001-164Yunnan Provincial Department of Science and Technology Science and Technology Plan Project-Major Science and Technology Special Projects,No.202405AJ310003+1 种基金Yunnan Provincial Department of Science and Technology Science and Technology Plan Project-Key Research and Development Program,No.202103AC100004Yunnan Province Science and Technology Department Key Research and Development Plan,No.202103AC100002.
文摘BACKGROUND Acute myocardial infarction(AMI)combined with ventricular septal perforation(VSR)is still a highly fatal condition in the era of reperfusion therapy.The incidence rate has decreased to 0.2%-0.4%due to the popularization of percutaneous coronary intervention.However,the risk is significantly increased for those who fail to undergo revascularization in time,and the mortality rate remains high.The current core contradiction in clinical practice lies in the selection of surgical timing,and the disparity in medical resources significantly affects prognosis.There is an urgent need to optimize the identification of high-risk populations and individualized treatment strategies.AIM To investigate the clinical features,determine the prognostic factors,and develop a predictive model for 30-day mortality in patients with acute myocardial infarction complicated by ventricular septal rupture(AMI-VSR)residing in high-altitude regions.METHODS This study retrospectively analyzed 48 AMI-VSR patients admitted to a Yunnan hospital from 2017 to 2024,with the establishment of survival(n=30)and mortality(n=18)groups based on patients’survival status.Risk factors were identified by univariate and multivariate logistic regression analyses.A nomogram model was developed using R software and validated via receiver operating characteristic(ROC)analysis and calibration curves.RESULTS Age,uric acid(UA),interleukin-6(IL-6),and low hemoglobin(Hb)were independent risk factors for 30-day mortality(odds ratios:1.147,1.006,1.034,and 0.941,respectively;P<0.05).The nomogram demonstrated excellent discrimination(area under the ROC curve=0.939)and calibration(Hosmer-Lemeshowχ²=2.268,P=0.971).In addition,patients’poor outcomes could be synergistically predicted by IL-6 and UA,advanced age,and reduced Hb.CONCLUSION This study highlights age,UA,IL-6,and Hb as critical predictors of mortality in AMI-VSR patients at high altitudes.The validated nomogram provides a practical tool for early risk stratification and tailored interventions,addressing gaps in managing this high-risk population in resource-limited settings.
基金National Science and Technology Support Program (Grant NO.2008BAK50B05, 2008BAK50B06)
文摘Based on the forming mechanism of seismic hazard risk, we established a seismic vulnerability curve on population and determined earthquake occurrence parameters. We then assessed the risk of seismic hazard mortality at the county level across China using the assessment model, and analyzed spatial patterns. We adopted past, present, and future disaster-breeding materials to assess the probability of earthquakes. In order to determine the earthquake parameters of 2355 counties accurately, we integrated history seismic intensities, seismic activity fault belts distributions and seismic peak ground acceleration. Based on data of seismic disasters from 1990 to 2009 in China, linear fitting between seismic intensities and mortalities was performed. And a vulnerability curve of seismic mortality, which was appropriate for seismic risk assessment, was established. Seismic mortality risks were assessed quantitatively at the county level using the model and the spatial patterns were analyzed. Seismic mortality risks of 2355 counties with intensities from Ⅴ to Ⅺ were analyzed thoroughly. This study indicates that under different seismic intensities, China’s eastern and central regions are generally confronted with higher risk than western regions. High-risk areas are scattered in Shandong and Jiangsu, northern Anhui and eastern Heilongjiang and Jilin, where populations are dense and the environment is conducive to disasters. Risk- free areas displayed patchy distributions nationwide, and patterns were mostly unchanged.
基金Shanghai Top Priority Clinical Medical Center Project(No.2017ZZ01008-001).
文摘Background Acute myocarditis(AMC)can cause poor outcomes or even death in children.We aimed to identify AMC risk factors and create a mortality prediction model for AMC in children at hospital admission.Methods This was a single-center retrospective cohort study of AMC children hospitalized between January 2016 and January 2020.The demographics,clinical examinations,types of AMC,and laboratory results were collected at hospital admission.In-hospital survival or death was documented.Clinical characteristics associated with death were evaluated.Results Among 67 children,51 survived,and 16 died.The most common symptom was digestive disorder(67.2%).Based on the Bayesian model averaging and Hosmer–Lemeshow test,we created a final best mortality prediction model(acute myocarditis death risk score,AMCDRS)that included ten variables(male sex,fever,congestive heart failure,left-ventricular ejection fraction<50%,pulmonary edema,ventricular tachycardia,lactic acid value>4,fulminant myocarditis,abnormal creatine kinase-MB,and hypotension).Despite differences in the characteristics of the validation cohort,the model discrimination was only marginally lower,with an AUC of 0.781(95%confidence interval=0.675–0.852)compared with the derivation cohort.Model calibration likewise indicated acceptable fit(Hosmer‒Lemeshow goodness-of-fit,P¼=0.10).Conclusions Multiple factors were associated with increased mortality in children with AMC.The prediction model AMCDRS might be used at hospital admission to accurately identify AMC in children who are at an increased risk of death.
基金The Innovative Research Group Project of National Natural Science Foundation of China,No.41321001The National Basic Research Program(973 Program),No.2012CB955404The Program for Introducing Talents of Disciplines to Universities funded by the Ministry of Education and State Administration of Foreign Experts Affairs,China,No.B08008
文摘Coping with extreme climate events and its related climatic disasters caused by climate change has become a global issue and drew wide attention from scientists, policy-makers and public. This paper calculated the expected annual multiple climatic hazards intensity index based on the results of nine climatic hazards including tropical cyclone, flood, landslide, storm surge, sand-dust storm, drought, heat wave, cold wave and wildfire. Then a vulnerability model involving the coping capacity indicator with mortality rate, affected population rate and GDP loss rate, was developed to estimate the expected annual affected population, mortality and GDP loss risks. The results showed that： countries with the highest risks are also the countries with large population or GDP. To substantially reduce the global total climatic hazards risks, these countries should reduce the exposure and improving the governance of integrated climatic risk; Without considering the total exposure, countries with the high mortality rate, affected population rate or GDP loss rate, which also have higher or lower coping capacity, such as the Philippines, Bangladesh and Vietnam, are the hotspots of the planning and strategy making for the climatic disaster risk reduction and should focus on promoting the coping capacity.
文摘Objective To investigate the risk factors associated with early mortality of the rapid two-stage arerial switch operation,which has a significantly higher overall mortality than that of ASO procedure for D-TGA with an intact ventricular septum. Methods The data we reviewed involving patients who underwent rapid two-stage switch operations from September,2002 to September,2007 in our center,13 patients were male and 8
文摘The article by Wu et al highlights the growing incidence of esophageal tumor patients,particularly in China,where the high frequency and death rate are significant problems.The article also examined the impact of health insurance on treatment availability and patient outcomes,demonstrating that the type of insurance can affect the financial burden on patients.This study investigates the effects of different types of health care coverage,namely Urban Employee Basic Medical Insurance vs Urban-Rural Resident Basic Medical Insurance,and the personal spending ratio on treatment decisions and survival outcomes.The database used is derived from esophageal tumor patient continuation from Chongqing University Hospital in China.A total of 2543 patients were included in the study,allowing for the formation of research cohorts.Patient information included demographic characteristics.The study followed various processes to maintain consistency,including data sources,inclusion and exclusion criteria,follow-up duration,health insurance,and statistical analysis.The average age at diagnosis ranged from 57-74 years,and predominantly included men,married people,and those of Han ethnic background,comprising 2088 and 2519 individuals,respectively.Upon controlling for age,sex,relationship status,country of origin,pathological evaluation,tumor stage,and biochemical indicators,individuals who had Urban Employee Basic Medical Insurance exhibited a higher propensity to opt for radiotherapy,chemotherapy,immunotherapy,and targeted therapy compared to those covered by the Urban-Rural Resident Basic Medical Insurance.During the follow-up phase of the study,a total of 1438 deaths were documented,with 1106 ascribed to esophageal cancer.Additionally,individuals with Urban-Rural Resident Basic Medical Insurance had a significantly elevated risk of esophageal cancer,particularly mortality,compared to those without Urban-Rural Resident Basic Medical Insurance.
基金supported by the Special Fund for Novel Coronavirus Pneumonia from the Department of Science and Technology of Hubei Province(2020FCA035)the Fundamental Research Funds for the Central Universities,Huazhong University of Science and Technology(2020kfyXGYJ023).
文摘Coronavirus disease 2019(COVID-19)has become a worldwide pandemic.Hospitalized patients of COVID-19 suffer from a high mortality rate,motivating the development of convenient and practical methods that allow clinicians to promptly identify high-risk patients.Here,we have developed a risk score using clinical data from 1479 inpatients admitted to Tongji Hospital,Wuhan,China(development cohort)and externally validated with data from two other centers:141 inpatients from Jinyintan Hospital,Wuhan,China(validation cohort 1)and 432 inpatients from The Third People’s Hospital of Shenzhen,Shenzhen,China(validation cohort 2).The risk score is based on three biomarkers that are readily available in routine blood samples and can easily be translated into a probability of death.The risk score can predict the mortality of individual patients more than 12 d in advance with more than 90%accuracy across all cohorts.Moreover,the Kaplan-Meier score shows that patients can be clearly differentiated upon admission as low,intermediate,or high risk,with an area under the curve(AUC)score of 0.9551.In summary,a simple risk score has been validated to predict death in patients infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2);it has also been validated in independent cohorts.
文摘Background A flame burn is an injury of body tissues,including respiratory tract damage,due to exposure to a flame or its dense smoke.Flame burns cause some of the most physically and psychologically devastating forms of trauma.Compared to scald burns,flame burn patients have a higher mortality rate and a higher frequency of multiorgan failure.The purpose of this research was to investigate the trends,complications,and mortality risk factors of flame burns at the Department of Plastic and Burn Surgery(DPBS)of the People’s Hospital of China Three Gorges University(PHCTGU).Methods A retrospective analysis of 48 flame burn patients—accounting for 8.3%of the 576 burn victims admitted for burns at the PHCTGU from February 1,2010,to September 30,2019—was performed after collecting information from the Burns Registry of the said hospital.Results The proportion of patients with flame burns was 8.3%(n=48).The mean total body surface area(TBSA)affected was 27.6%.The mean duration of hospitalization was 32.5 days.The etiologies of the flame burns were as follows:gas explosions(21,43.8%),ethanol(8,16.7%),charcoal fire(7,14.6%),petrol explosions(4,8.3%),wooden houses(4,8.3%),and others,including dust,cigarette lighter,and burning incense,accounting for 8.3%of cases(4).Finally,42(87.5%)patients were treated and discharged,and 6(12.5%)patients died.Complications included scarring in 38(90.5%)patients,severe scar contractures on different parts of the body in 25(60.0%)patients,scar ulcer in 6(14.3%)patients,keloids in 3(7.1%)patients,and scar cancer in 1(2.4%)patient.Multiple complications occurred in the same patient.The only risk factor for mortality that was identified was TBSA(P=0.043).Conclusions Our study revealed that a small population(8.3%)was injured by flame burns,but 6 deaths were recorded.Society must continually enhance safeguard procedures to flames and strengthen education to protect life and avoid severe complications.
基金Supported by National Science and Technology Infrastructure Program of China(2006BAI04A02-2)National Basic Research Program of China(2012CB518505)Program of Natural Science Foundation of China(81173416)
文摘OBJECTIVE:To confirm the long-term outcomes of stroke patients and determine predicting factors for death,recurrence of vascular events and poor outcome(either recurrence or death) after the use of combined TCM therapy.METHODS:This was a retrospective hospital-based cohort study and was performed in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine in Tianjin.All subjects with stroke consecutively admitted to an inpatient ward of the Acupuncture Department from January 1,2008,to December 31,2008 were retrospectively followed through one year.The main outcomes were either a recurrence of vascular events,,mortality or both.Risk factors were recorded from medical records.Multivariate regression models were used to analyze predictors.The following independent variables were used:age,gender,hypertension,ischemic heart disease,atrial fibrillation,diabetes mellitus,carotid arterial lesions and history of stroke.RESULTS:Four-hundred and five patients were included.The 1-year mortality rate was 11.11%.23.70% of the patients had a recurrent vascular event,and 30.86% suffered a poor outcome.Multiple logistic regression analysis found that previous stroke,and advanced age were predictors of death within one year,Recurrence of vascular events was associated with carotid arterial lesions,history of diabetes and previous stroke.Long-term poor outcome was predicted by advanced age,history of diabetes,and previous stroke.CONCLUSION:Age,previous stroke,carotid arterial lesions and diabetes history seem to have different impacts on the three outcomes within one year.Our findings provide important data for planning future hospital register studies of stroke patients in TCM hospitals.
基金Ethical approval was obtained from the Beijing Center for Disease Prevention and Control(BJCDC)Institutional Review Board(Approval No.2019-12).
文摘Introduction:Pulse pressure(PP),an indicator of aortic stiffening,may be associated with adverse cardiovascular outcomes.However,the relationship between PP levels and mortality risk in the Chinese population remains unclear.Methods:A total of 102,311 participants aged 40 and above were recruited in this prospective study in Beijing during 2010–2012,and followed up until 2021.Blood pressure measurements and related factors were collected at baseline.All-cause and cardiovascular or cerebrovascular disease(CCVD)related deaths were identified as endpoints.Results:Compared with the lowest quartile of PP(<40 mmHg),mortality risk increased by 9.8%–23.9%among individuals with PP in the second through fourth quartiles,with particularly elevated risk among females,adults aged 60–74 years,and overweight or obese individuals.The association between PP and CCVD-specific mortality risk was attenuated but remained statistically significant among people with PP≥60 mmHg.Conclusions:Death risk increased with rising PP levels in middle-aged and elderly populations in Beijing.These findings emphasize the need to develop comprehensive and effective PP management strategies to reduce mortality.
基金funded by Shenzhen Scientific Research Program(No.JCYJ20150402152130173)Scientific Research Project of Shenzhen Health and Family Planning System(No.201601058)Scientific Research Program of Shenzhen Nanshan District of China(No.2015019,2015022,2016010)
文摘In order to discover the risk factors for 30-day mortality in bloodstream infections（BSI） caused by Enterococcus spp.strains,we explored the clinical and therapeutic profile of patients with Enterococcus spp.BSI and the characteristics of this condition.A total of 64 patients with BSI caused by Enterococcus spp.who were treated in our hospital between 2006 and 2015 were included in the study.The clinical features of patients,microbiology,and 30-day mortality were collected from the electronic medical records database and analyzed.The results showed that there were 38 patients infected by Enterococcus faecalis（E.faecalis）,24 by Enterococcus faecium（E.faecium）,1 by Enterococcus casseliflavus（E.casseliflavus）,and 1 by Enterococcus gallinarum（E.gallinarum）.A Charlson comorbidity score ≥5,corticosteroid treatment,placement of catheters or other prosthetic devices and history of antibiotic use were found more frequently in E.faecium BSI patients than in E.faecalis patients（P=0.017,P=0.027,P=0.008 and P=0.027,respectively）.Furthermore,the univariate and multivariate analysis showed that corticosteroid treatment（OR=17.385,P=0.008）,hospital acquisition（OR=16.328,P=0.038）,and vascular catheter infection（OR=14.788,P=0.025） were all independently associated with 30-day mortality.Our results indicate that E.faecalis and E.faecium are two different pathogens with unique microbiologic characteristics,which cause different clinical features in BSI,and the empiric antimicrobial treatments are paramount for patients with enterococcal BSI.
文摘The RAND Corporation reported that insufficient sleep causes an economic loss of $138 billion (2.92% of GDP) in Japan every year. In this study, we investigated the sleep improvement effect of a novel innovative sleeping mattress called “AiR SI” (Nishikawa Co., Ltd.) to find a simple method to solve the problem of sleep deprivation. We conducted a 2-week randomized, open-label, crossover, self-controlled study in 14 healthy adults in their 30s to 50s (control: 1 week, AiR SI: 1 week), with sleep quality as the primary endpoint as well as salivary components (cortisol, melatonin) and autonomic nervous function (sympathetic nerve, parasympathetic nerve) as secondary endpoints. Trends toward improvement in sleep were suggested for all the endpoints, regardless of differences in the subject background. The results suggested that the use of AiR SI for 1 week not only improved sleep but normalized both the endocrine and autonomic functions as well. We conclude that, by using a sleeping mattress with a high sleep improvement effect, the user may easily achieve higher labor productivity and have a lower mortality risk. Eliminating sleep deprivation with a sleeping mattress may lead to a reduction in national economic losses and ultimately produce significant economic effects.
文摘The present study investigates the effects of subjective well-being(SWB)on mortality risk using a large sample from the Chinese Longitudinal Healthy Longevity Study conducted in 1998,2000,2002,2005,2008,2011 and 2014.SWB is measured by life satisfaction,positive affect and negative affect.We found that positive affect,negative affect,life satisfaction and the change of life satisfaction significantly have predicted mortality risks of the older people with control of social demographic characteristics,physical health,social support,cognitive ability,and social participation.The higher the positive affect,the lower the negative affect,the improvement the life satisfaction,the lower the mortality risk.Marital status plays a decisive role in the influence of life satisfaction on the mortality risk.The married persons have lower mortality risk even if they rate their life bad.In further analyses,we found that the effects of SWB on mortality risk were underestimated in short-term study compared with those in long-term study.SWB is essentially a time-dependent variable and changes with age,so treating SWB as time-independent variable underestimated its impact on mortality risk.
基金supported by the National Natural Science Foundation of China(42075175)Shandong Provincial Natural Science Foundation(ZR2021QD119)+5 种基金the Fundamental Research Funds for the Central Universities(202113005,Ocean University of China)Postdoctoral Innovation Project of Shandong Provincethe Qingdao Postdoctoral Applied Research Projectsupported by the National Natural Science Foundation of China(72125010,72243011,and 71974186)the Fundamental Research Funds for the Central Universities(Peking University)Highperformance Computing Platform of Peking University.
文摘Household consumption in China is associated with substantial PM_(2.5)pollution,through activities directly(i.e.,fuel use)and/or indirectly(i.e.,consumption of goods and services)causing pollutant emissions.Urban and rural households exhibit different consumption preferences and living areas,thus their contributions to and suffering from air pollution could differ.Assessing this contrast is crucial for comprehending the environmental impacts of the nation’s ongoing urbanization process.Here we quantify Chinese urban and rural households’contributions to ambient PM_(2.5)pollution and the health risks they suffer from,by integrating economic,atmospheric,and health models and/or datasets.The national premature deaths related to long-term exposure to PM_(2.5)pollution contributed by total household consumption are estimated to be 1.1 million cases in 2015,among which 56%are urban households and 44%are rural households.For pollution contributed indirectly,urban households,especially in developed provinces,tend to bear lower mortality risks compared with the portions of deaths or pollution they contribute.The opposite results are true for direct pollution.With China’s rapid urbanization process,without adequate reduction in emission intensity,the increased indirect pollution-associated premature deaths could largely offset that avoided by reduced direct pollution,and the indirect pollution-associated urban–rural inequalities might become severer.Developing pollution mitigation strategies from both production and consumption sides could help with reducing pollution-related mortality and associated urban-rural inequality.
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.
基金supported by the Emergency Diagnostic&Therapeutic Center of Central China,Hubei Clinical Research Center for Emergency and Resuscitation,and Special Science and Technology Project of Hubei,China(No.2020FCA023).
文摘Background:This study aimed to investigate the clinical characteristics of 21 deaths and evaluate potential factors affecting disease severity and mortality risk in patients with coronavirus disease(COVID-19).Methods:This retrospective analysis assessed clinical data of 21 patients who died owing to COVID-19.Disease severity and mortality risk were assessed using Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ);Sepsis-related Organ Failure Assessment(SOFA);multilobular infiltration,hypo-lymphocytosis,bacterial coinfection,smoking history,hypertension and age(MuLBSTA);and pneumonia severity index(PSI)scores.Results:The mean age of the patients was 66±14 years and 15(71.4%)patients were men.Sixteen(76.2%)patients had chronic medical illnesses.Twelve(57.1%)patients were overweight.Decreased lymphocyte proportions were observed in 17(81.0%)patients on admission.Elevated D-dimer levels were observed in 11(52.4%)patients,and the levels significantly increased when pneumonia deteriorated.The initial APACHE II and SOFA scores demonstrated that 18(85.7%)and 13(61.9%)patients,respectively,were in the middle-risk level.MuLBSTA and PSI scores after admission were associated with higher risks of mortality in 13(61.9%)patients.Most patients developed organ failure and subsequently died.Conclusions:Older,overweight,male patients with a history of chronic illnesses and continuously decreased lymphocyte proportions and increased D-dimer levels might have higher risks of death owing to COVID-19.The combination of general scoring(SOFA)and pneumonia-specific scoring(MuLBSTA and PSI)systems after admission might be sensitive in assessing the mortality risk of patients with COVID-19 who are in critical condition.
