Annual Decrease Research Articles

Global trend analysis of diabetes mellitus incidence, mortality, and mortality-to-incidence ratio from 1990 to 2019

Diabetes Mellitus (DM) is a common chronic disease and a public health challenge worldwide. The present study aimed to analyze the trend in DM incidence, mortality, and mortality-to-incidence ratio (MIR) world over 30 years. The age-standardized DM incidence and mortality rates for both genders and different countries of the world from 1990 to 2019 were extracted from the Global Burden of Disease (GBD) study and the Human Development Index (HDI) was obtained for all countries from the United Nations Development Program (UNDP) database. The mean trends for the indicators for developing countries, developed countries, and all countries were evaluated using Generalized Estimating Equations (GEE) and the spline model. The estimates showed that the global mean trend of DM incidence from 1990 to 2019 followed an upward trend with an annual increase of 3.73 cases per 100,000 people. The global mean of DM mortality followed an upward trend with an annual increase of 0.43 cases until 2005 followed by a downward trend after this year with an annual decrease of 0.14 and the global mean MIR followed a downward trend during the same period with an annual decrease of 0.001 per 100,000 people. Besides, the mean incidence of DM in developing countries followed an upward trend similar to the trend in developed countries. Additionally, the mean mortality rate due to DM in developing countries increased with a slope of 0.62 until 2005 and then decreased with a slope of 0.02, and the mean MIR trend in the developed and developing countries showed a downward trend. Thus, developed countries followed a relatively faster decrease in MIR than developing countries.The data from the present study show the increased incidence of DM has made it one of the most important health concerns in the world, and if this issue is not addressed, this disease can cause more concerns for communities in the coming years. This being so, more DM prevention and control programs need to be put into practice.

Snowmelt‐Radiation Feedback Impact on Western U.S. Streamflow

AbstractOngoing runoff declines in the Colorado River Basin have been shown to be predominately driven by decreasing albedo from warming‐driven snow‐cover loss, especially in late‐spring (hereafter snowmelt‐radiation feedback). Here, we explore the feedback's impact on annual runoff sensitivity to warming across the western U.S. (WUS) using hydrologic model simulations. For 1°C uniform warming, we show that runoff is most sensitive to warming in modestly snow‐covered, interior mountain headwaters, especially the Rocky Mountains. Runoff sensitivities are most associated with the snowmelt‐radiation feedback in basins with runoff coefficients between 0.2 and 0.6, where runoff sensitivity increases with more snow and lower winter temperature. In aggregate, ∼48% of WUS runoff sensitivity is attributable to the snowmelt‐radiation feedback and is especially pronounced in the warming‐sensitive river basins (annual runoff decreases >5%/°C). We also show that the feedback's impact decreases with increasing temperature, which has unresolved implications for streamflow declines in a less‐snow future.

Gynaecological cancer incidence and mortality trends in a Brazilian State with medium human development index: A 22-year analysis

ObjectiveThis study aimed to analyse trends in incidence and mortality rates of gynaecological cancer (GC) in Sergipe, a medium Human Development Index (HDI) state in northeastern Brazil during 1996–2017. MethodsData were obtained from the Population-based Cancer Registry of Aracaju and Brazilian Mortality Information System database. We included vulvar (VUC), vaginal (VAC), cervical (CC), uterine (UC; C54-C55), ovarian (OC), placental (PC), and unspecified female genital organ cancers. Crude rates, and age-standardised incidence and mortality rates (ASIR and ASMR, respectively) were calculated using a denominator of 100,000 women. We assessed changes in trends using the annual percentage change (APC) and the average APC (AAPC), using the Joinpoint Regression Program. ResultsFrom 1996–2017, GC ASIR exhibited a declining trend (AAPC: −3.1), while ASMR increased (AAPC: 2.1). CC had the highest ASIR and ASMR over the years, ranging from 11.6 to 34.3 cases and 4.2–9.0 deaths per 100,000, respectively. Annual decreases in ASIR were observed for CC (AAPC: −5.2) and VAC (AAPC: −5.5). OC saw an increase in mortality rates (AAPC: 1.9; 1996–2017), and CC experienced an increase during 1996–2003 (APC: 6.9). VUC displayed a substantial rise in ASMR from 2001 to 2009 (APC: 27.1), followed by a decrease (APC: −11.3). An increase in mortality trends for UC was observed during 1996–2004 (APC: 10.0), while its ASIR remained relatively unchanged over the years. ConclusionWhile overall GC incidence trends declined, mortality rates either increased or failed to decrease significantly. Therefore, additional efforts are required to enhance prevention, diagnosis, and treatment strategies, aimed at reducing and managing the burden of GC in the future.

Inpatient substitution approaches to medical care and their impact on the dynamics of the prevalence of varicose veins

Introduction. The conducted epidemiological studies show a significant socio-economic burden borne by modern society due to the high prevalence of varicose veins of the lower extremities among the able-bodied population of developed countries. Aim. Assessment ofthe influence ofthe factor of widespread use of minimally invasive inpatient replacement technologies on the prevalence of varicose veins of the lower extremities in a large region of the Central Federal District of the Russian Federation under the conditions of transformation of approaches to the treatment of varicose veins of the lower extremities. Materials and methods. A retrospective study was conducted for 2011–2021 of statistical indicators of the work of medical organizations of the Yaroslavl region, namely: the total number of attached adult population, the dynamics of the number of attached population, the total number and dynamics of the number of patients with an established diagnosis of varicose veins of the lower extremities. Results and discussion. The total population weight of the sample in the Yaroslavl region for all periods of the study was 11 406 181 people. The fixed weighted average value of the prevalence of varicose veins of the lower extremities at the end of the year in the Yaroslavl region in the period 2011–2021, according to medical organizations providing medical care on a territorial-precinct basis, was 0.784% (CI: 0.779–0.789). At the same time, in 2011–2012 and 2018–2019, the frequency of varicose veins of the lower extremities event was higher than the average value, in 2013–2016 and 2020–2021. Conclusion. It has been established that over the past decade there has been an annual decrease in the prevalence of varicose veins of the lower extremities in the region. At the same time, there was an increase in the share of medical care provided to patients by non-governmental medical organizations. The latter in their activities are focused on hospital-substituting technologies in the treatment of this disease.

Haemoglobin thresholds for transfusion: how are we doing in the era of Choosing Wisely? A retrospective cohort study.

Clinical practice guidelines and the Choosing Wisely initiative launched in 2012 recommend a haemoglobin (Hb) threshold of 70-80 g/lfor red blood cell (RBC) transfusions in stable hospitalised patients. Data on transfusion practices and their trends in medical inpatients are limited. To address this gap, we investigated transfusion practices and their trends in general internal medicine and other clinics. This retrospective cohort study analysed data from all hospitalisations with RBC transfusions at a Swiss university hospital between 2012 and 2019. We included all first transfusion episodes if pretransfusion Hb was available. The primary endpoint was mean pretransfusion Hb; secondary endpoints included potentially inadequate transfusions (i.e., transfusions at Hb ≥80 g/l) and receipt of a single RBC unit. Trends in mean pretransfusion Hb over time were estimated using generalised estimating equations, and risk factors for potentially inadequate transfusions were identified using multivariable adjusted generalised estimating equations models. Of 14,598 hospitalisations with RBC transfusions, 1980 (13.6%) were discharged from general internal medicine. From 2012 to 2019, mean pretransfusion Hb decreased from 74.0 g/l to 68.8 g/l in general internal medicine (mean annual decrease -0.76 g/l, 95% confidence interval [CI] -0.51 to -1.02) and from 78.2 g/l to 72.7 g/l in other clinics (mean annual decrease -0.69, 95% CI -0.62 to -0.77; p for interaction 0.53). The overall proportion of potentially inadequate transfusions was 17.8% in general internal medicine and 24.1% in other clinics (p <0.001) and decreased over the study period from 26.9% to 5.5% in general internal medicine and from 37.0% to 15.2% in other clinics. In contrast, the proportion of cases receiving a single RBC unit increased (39.5% to 81.4% in general internal medicine, 42.7% to 66.1% in other clinics). Older age (adjusted odds ratio [aOR] 1.45, 95% CI 1.32-1.58 for ≥65 vs <65 years), having surgery (aOR 1.24, 95% CI 1.14-1.36), acute haemorrhage (aOR 1.16, 95% CI 1.02-1.33), chronic heart failure (aOR 1.17, 95% CI 1.04-1.32), ischaemic heart diseases (aOR 1.27, 95% CI 1.15-1.41), chronic pulmonary diseases (aOR 1.24, 95% CI 1.08-1.42), malignancy (aOR 1.11, 95% CI 1.01-1.21), and rheumatic disease (aOR 1.27, 95% CI 1.01-1.59) were risk factors for potentially inadequate transfusions. More restrictive transfusion practices were adopted in general internal medicine and other clinics over time, suggesting that guideline recommendations and the Choosing Wisely initiative may have been increasingly followed. Interventions to reduce potentially inadequate transfusions should target providers who care for older patients and those with surgery or chronic cardiac and pulmonary diseases.

Trends in Diffuse Large B-Cell Lymphoma Mortality in the United States: A Comprehensive Review from 2000 to 2020

Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of Non-Hodgkin Lymphoma (NHL), accounting for approximately 30% of all cases. While NHL mortality rates have shown a downward trend over the last two decades, comprehensive investigations into DLBCL mortality trends and disparities across racial, ethnic, gender, and geographical categories in the United States are notably scarce. Methods: Utilizing the Centers for Disease Control and Prevention's (CDC) WONDER database we identified all patients who died from NHL and DLBCL from 2000 to 2020. Age-adjusted mortality rates per 100,000 persons (AAMR) were calculated and standardized to the 2000 US census data. The National Cancer Institute (NCI) Joinpoint Regression Program was used to analyze these data to calculate annual percent changes (APCs) and average annual percent changes (AAPCs). Statistically significant changes were confirmed when the confidence interval for the APC or AAPC did not encompass zero. Additionally, subgroup analyses were conducted based on race, ethnicity, gender, and geographic location. Results: The study identified 434,419 NHL and 46,252 DLBCL deaths. NHL mortality showed a statistically significant average annual decrease of 2.5% (95% CI: -2.7 to -2.4). DLBCL mortality trends varied, initially decreasing from 2000 to 2008, then notably increasing from 2008 to 2011, and subsequently rising moderately from 2011 to 2020. This pattern culminated in a statistically significant overall average annual increase of 3.5% (95% CI: 0.4 to 6.7) in DLBCL mortality. Subgroup analyses revealed that males, Blacks, and Asians or Pacific Islanders experienced the most marked upward trends in DLBCL mortality. Both metropolitan and non-metropolitan areas reported an increase in DLBCL mortality, with metropolitan areas showing a more pronounced rise. Conclusion: Representing the most comprehensive analysis of DLBCL mortality trends to date, our study revealed intriguing disparities among the subgroups we investigated, along with an upward trend in mortality rates that departs from previously reported data. The divergence could be attributed, in part, to the expansive population coverage of the database we utilized and the use of death certificates, which may present discrepant results from other cancer registries. These findings underscore the necessity for ongoing research, guiding the development of targeted intervention strategies for DLBCL and informing efforts to bridge the identified disparities.

Development of new approaches to the preservation of soil fertility in rice agricultural landscapes

To a large extent, the suitability of soil for cultivation of agricultural crops is determined by the amount of humus content. The constant exploitation of agricultural lands leads to their degradation, namely, to a decrease in the agro-resource potential of lands, deterioration of the agrophysical and agrochemical properties of soils, as well as to significant losses of soil organic matter, in particular, humus and no less important other nutrients. As a result of the studies performed, the reliability of which is confirmed by the methods of field experience according to B.A. Dospekhov, it is proved that the proposed environmentally friendly rice cultivation technology does not reduce soil fertility, while with traditional technologies, the annual decrease in humus is 1.0-1.5%. It has been established that maintaining the moisture content of the root-inhabited soil layer at the level of 60-70% of the moisture content creates optimal conditions that make it possible to directly influence the processes of ammonification and nitrogen fixation. Effective control of the moisture level in the layer up to 10 cm allows to accumulate in it 50-75% more ammonia nitrogen and 25% phosphorus than with the basic technology and 15-25% and 46%, respectively, with the herbicide-free technology. The obtained correlations prove the relevance of our research on the introduction of a combined environmentally friendly rice cultivation technology, which makes it possible to maintain redox reactions in the soil within the required range by controlling the moisture content of the root layer of the soil. The use of the proposed method of rice cultivation will allow workers in the rice-growing sector of Russia not only to maintain, but also to improve the ameliorative state of the soil, which will ensure guaranteed high yields of rice.

Longitudinal changes in renal parenchymal volume and function status after partial nephrectomy: a retrospective cohort study.

The ipsilateral renal parenchymal volume (RPV) experiences a sharp decrease shortly after partial nephrectomy (PN), mainly due to surgical remove or devascularization of kidney tissue. However, the subsequent change of RPV and its association with glomerular filtration rate (GFR) fast decline remains unknown. Our objective was to investigate the change of ipsilateral RPV and renal function status from new baseline (1-12 months after PN) to latest follow-up (≥1 year) after PN, and to explore factors associated with ipsilateral RPV decrease rate and correlation between RPV decrease and GFR fast decline. A retrospective review of 367 patients with PN was conducted. Three-dimensional reconstruction of computed tomography (CT)/MRI images was performed for RPV calculation. Spectrum score was used to assess the degree of acute kidney injury (AKI) in the operated kidney after PN. GFR decline greater than 3ml/min/1.73m 2 /year was defined as GFR fast decline. One hundred fourteen patients underwent abdominal surgery was used as control. Predictive factors for subsequent decrease of RPV rate and GFR fast decline were evaluated by linear and logistic regression, respectively. With a median interval time of 21.1 (interquartile range:13.8-35.5) months, median ipsilateral RPV significantly decreased from 118.7 (interquartile range:100.7-137.1) ml at new baseline to 111.8 (IQR: 92.3-131.3) ml at latest follow-up. The interval time [β: 1.36(0.71-2.01), P <0.001] and spectrum score [β: 5.83 (2.92-8.74), P <0.001] were identified as independent predictors of ipsilateral RPV decrease rate. GFR fast decline was observed in 101 (27.5%) patients. Annual ipsilateral RPV decrease rate [odds ratio:1.67 (1.05-2.67), P =0.03] and overweight [odds ratio:1.63 (1.02-2.60), P =0.04] were independent predictors of GFR fast decline. Ipsilateral RPV experienced a moderate but significant decrease during follow-up after PN, especially in those with severer acute kidney injury. The presence of GFR fast decline was found to be associated with reduction of ipsilateral RPV, particularly in overweight individuals.

Двухукосное использование многолетних кормовых агроценозов в условиях северных регионов России

Abstract. The purpose of the research is to study cereal-legume agrocenoses with long-term two-cutting use in the conditions of the northern territories of the Arkhangelsk region. Methods. The studies were carried out according to generally accepted methods in the period from 2019 to 2022. in a field experiment on soddy-podzolic sandy loamy soil. The object of research is perennial agrocenoses of perennial grasses. Results. The prospects for the use of cane fescue in a two-component grass mixture in the conditions of the northern region of Russia have been established. Agrophytocenoses, created in a mixture of this crop with red clover, allow for three years of two-cutting use to consistently obtain from 10.19 to 11.71 t/ha of dry matter with a content of exchange energy and crude protein of 90.53 - 129.01 GJ and 1 ,13 - 1.51 tons. There is a negative trend - an annual decrease in the participation of red clover in the phytocenosis. So, if in the first year of life in the structure of the crop of green mass contained up to 73% of red clover, then by the third year of the two-cutting use of the herbage, this value decreased to an average of 17%. Blue alfalfa in herbage with cereal grasses in the first year of life proved to be a promising crop with good plant development and content in the crop structure from 59% to 67%, but after the first overwintering, its content in the phytocenosis biomass decreased to 6–8%, and in in subsequent years, it completely fell out of the herbage. Scientific novelty. For the first time in the natural and climatic conditions of the north of the Arkhangelsk region, grass stands created from reed fescue mixed with red clover of local selection were studied. The features of growth and development of fodder crops in such agrocenoses for 3 years of two-cutting use were revealed, the productivity and nutritional value of the green mass was assessed.

Impact of worsening renal function (WRF) and baseline chronic kidney disease (CKD) on clinical outcomes in patients with chronic coronary syndromes (CCS); insights from the REAL-CAD study

Abstract Background The impact of worsening renal function (WRF) and baseline chronic kidney disease (CKD) on clinical outcomes in patients with chronic coronary syndromes (CCS) in the era of modern PCI and optimal medical therapy is still unknown. Methods The REAL-CAD study is a prospective, multicenter, randomized trial either high-dose (pitavastatin 4 mg/day) or low-dose (pitavastatin 1 mg/day) statin therapy in 12,118 patients with CCS. The primary endpoint was composite of cardiovascular-death, nonfatal myocardial infarction and stroke, or unstable angina requiring emergency hospitalization (MACCE). CKD was defined as estimated glomerular filtration rate [eGFR]&amp;lt;60mL/min/1.73m2. WRF was defined as an annual decrease in eGFR &amp;gt;20% in the first year and Pre-WRF was defined as decrease in eGFR &amp;lt;20%. After excluding 1,247 patients who had MACCE, censored or missing eGFR within 1-year, 10,871 patients were examined. P &amp;lt; 0.05 was considered as statistically significant. Results Of the 12,118 baseline-patients, 4,340 had baseline-CKD (estimated glomerular filtration rate [eGFR]&amp;lt;60mL/min/1.73m2) and the remaining 7,778 had baseline-non-CKD (eGFR≥60mL/min/1.73m2). Five-year MACCE significantly deteriorated from 5.5% in non-CKD to 9.5% in CKD (p&amp;lt;0.0001). Of the 10,871 patients, 577 patients had WRF, 6014 patients showed Pre-WRF and the remaining 4280 patients maintained Non-WRF. In CKD patients, WRF was independent predictor for 4-year MACCE as compared to Non-WRF (hazard ratio [HR] 1.67; 95% confidence interval [CI], 1.03 to 2.73; P=0.039). In Non-CKD patients, Pre-WRF was significant predictor for 4-year MACCE as compared to Non-WRF (HR,1.40; 95%-CI,1.03-to-1.91; P=0.032). Conclusions Baseline-CKD was independent predictor for 5-year MACCE in patients with CCS. While WRF was independent predictor for 4-year MACCE in CKD patients, Pre-WRF was also predictor for 4-year MACCE in Non-CKD patients (NCT01042730).

Changes in physical performance after Fontan operation: a follow-up study

Abstract Background Maximal oxygen consumption (peak VO2) is markedly compromised in patients with Fontan circulation compared to healthy subjects. In addition to the natural aging process, adaptive mechanisms inherent to univentricular physiology may further contribute to a decline in peak VO2 over time. These patients may have limitations in their ability to engage in physical activity, which may exacerbate the decline in peak VO2. This study aims to quantify the impairment of functional capacity over time in patients in the late postoperative period of Fontan operation and the relationship with a sedentary lifestyle. Method We studied 46 patients, 57% female, with a median age of 28 (24 - 35) years and 17 (15 - 21) years after Fontan surgery. Maximum and submaximal variables were analyzed from two standardized cardiopulmonary exercise tests (CPET) on a treadmill and performed with a range of five (4 - 9) years between them. All patients' physical activity levels were ranked using the short version of the International Physical Activity Questionnaire (IPAQ), comparing the functional capacity between active and sedentary patients. Clinical and surgical data were extracted from medical records. We performed a descriptive analysis of the demographic, clinical, and surgical data and a comparative analysis between the variables of the first and second CPET. The annual change was calculated by dividing the differences between the last and first tests by the time interval between them. Maximal variables were analyzed only for patients who achieved a maximum test (respiratory exchange ratio was equal to or greater than ≥ 1.1, heart rate &amp;gt; 85% of the predicted, and signs of intense effort. Results Among the 46 patients in the study, 40 performed maximum CPET. The characteristics of patients are shown in Table 1. There was an annual decrease in peak VO2 of 0.42 (1.17- -0.71) mL/kg/min and 0.72 (-2.14 - 0.71) % of predicted VO2. Impaired submaximal parameters occurred in all patients. There was an increased number of sedentary subjects on the second test compared with the first (p=0.009) (Table 2). Comparing the functional capacity of inactive patients with active, we found lower values in peak VO2: 23.1 (20.8-25.1) vs. 35.1 (32.0-35.4) mL/kg/min (p&amp;lt;0.001) and in a percentage of predicted 62 (59-67) vs. 84 (76-97) % (p=0.012). When analyzing the ejection fraction of the systemic ventricle by most recent echocardiogram and brain natriuretic peptide (BNP) plasmatic level, these variables were not significantly changed. Conclusion Functional capacity decreased over time in the studied population, represented mainly by a significant annual loss in peak VO2 and the predicted age values. Reduced functional capacity was observed in the inactive patients compared with active. No change in ventricular function was identified, as well as in BNP plasmatic level over time.Table_1Table_2

Abstract 16756: Trends of Cardiovascular Deaths in Patients With Melanoma From 2005 to 2019: An Analysis Based on SEER Program Database

Introduction: Melanoma is the fifth most common cancer diagnosis in the United States. With recent advances in treatment modalities, including immune checkpoint inhibitors (ICIs), targeted therapies, there has been improvement in survival among melanoma patients. However, increasing resistance and treatment related adverse effects (TrAEs) are being reported including cardiovascular side effects. Objectives: To evaluate the trend of cardiovascular specific death rate among patients with melanoma. Methods: We used Surveillance, Epidemiology, and End Results (SEER) Program database 17 registries from 2000 to 2019 and SEER*Stat Version 8.4.1 software to analyze the data using the rate session. Joinpoint software, version 4.7.1.0 was used to create log-linear time trends annually. Results: Our study included 301,632 patients with melanoma from 2005 to 2019. The annual percentage change (APC) of melanoma was 0.46% (95% CI -1.45 to 1.07, p&gt;0.05) annually from 2005 to 2011 and 3.33% (95% CI 1.79 to 4.27, p&lt;0.05) annually from 2011 to 2014 and the incidence rate decreased by 0.06% (95% CI -1.44 to 0.5, p&gt;0.05) annually from 2014 to 2019. Melanoma specific mortality rate increased annually by 2.03 % (95% CI 0.78 to 3.94, P &lt;0.05) from 2005 to 2013 and decreased by 5.49% annually (95% CI -8.65 to -3.65, P &lt;0.05) from 2013 to 2019. Cardiovascular disease specific mortality rate increased by 7.08% annually (95% CI 4.66 to 9.64, P &lt;0.05) from 2005 to 2019. (Figure 1) Conclusion: Our study shows that there has been an annual increase in cardiovascular specific mortality rate from 2005 to 2019, while there was annual decrease in melanoma specific mortality rate from 2013 to 2019. Increase in cardiovascular specific death rates could be due to the direct toxicity of newer therapies and prolonged survival, which further could be due to advancement in diagnostics and newer therapies.

Abstract 13023: Trends and Disparities in Cardiovascular Deaths in Non-Hodgkin Lymphoma: A Population-Based Retrospective Study in the United States From 1999 to 2020

Background: Non-Hodgkin lymphoma (NHL) survivors are at increased risks of cardiovascular disease related death (CVD) compared to the general population. Objective: This study sought to determine the longitudinal trends in mortality attributed to CVD with comorbid NHL by race, sex, and geographic location. Methods: We queried the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database among patients aged 18 and above from 1999 to 2020. Patients were identified when the primary causes of death were ischemic heart diseases (ICD 10 I20-I25), cerebrovascular diseases (I60-I69), or hypertensive disease (I10-I15), and NHL (C82-C85) was a contributing cause of death. We calculated age-adjusted mortality rates (AAMRs) per 1,000,000 individuals and determined the trends over time by estimating the annual percent change using the Joinpoint regression program. Results: In the 22-year study period, a total of 22,778 CVD with comorbid NHL were identified. Overall, there was a significant decrease in annual trends for the AAMRs of CVD from 6.91 per 1,000,000 individuals in 1999 to 4.12 per 1,000,000 individuals in 2020 (p&lt;0.05), with an annual percent decrease of 3.3. Overall, men recorded a higher AAMRs compared to women (6.76 vs 3.45, p&lt;0.05). When stratified by race, White individuals had the highest AAMRs (5.07), while the AAMRs for American African, Asian, American Indian individuals were 3.01, 2.77, and 2.48 per 1,000,000 individuals respectively. The AAMRs were higher in the rural region than in the urban region (4.97 vs 4.78, p&lt;0.05). Among all consensus regions, South region had the highest AAMRs. Conclusion: In conclusion, our study revealed a significant decrease in cardiovascular disease related deaths with comorbid NHL over the past two decades. It provides valuable insights into the effectiveness of management of comorbid CVD or CVD risk factors in patients with NHL.

Estimating the transboundary budget of sulfate aerosols in Northeast Asia with NASA MERRA aerosol reanalysis data

Using the Modern-Era Retrospective Analysis for Research and Applications Aerosol (MERRAero) reanalysis data, we conducted an estimation of the impact of transboundary-transported sulfate aerosols from China, specifically the Beijing–Tianjin–Hebei (BTH) region and Shandong province, on the sulfate concentrations in Korea between 2004 and 2020. Our analysis revealed that the ground-level sulfate concentration at six sites in Korea experienced a significant decrease of over 40%, from 7.16 μg m−3 to 3.7 μg m−3 after 2013. The MERRAero reanalysis data provided insights into a yearly reduction of 0.8 μg m−3 in sulfate concentration for the BTH and Shandong regions, while Korea showed an annual decrease of 0.2 μg m−3. Notably, the BTH and Shandong regions and Korea displayed the strongest correlation in sulfate concentrations with a one-day lag, particularly during the winter season. With the exception of summer, approximately 49.79 ton km−2 month−1 of sulfate was transported from the BTH and Shandong regions of China to Korea, resulting in a net increase of 9.8 ton km−2 month−1. The highest influx of sulfate occurred in spring at 70.06 ton km−2 month−1. Despite the clear declining trend in sulfate concentrations across the study region, the transboundary transport of sulfate from the BTH and Shandong regions of China to Korea did not exhibit a decreasing trend. This underscores the importance of thoroughly investigating the formation process of these aerosols through photochemical reactions during their long-distance transportation over northeast Asia, in addition to conducting a comprehensive examination of precursor emissions related to secondary aerosols.

Impact of Anti-VEGF Treatment and Patient Characteristics on Vision Outcomes in Neovascular Age-related Macular Degeneration: Up to 6-Year Analysis of the AAO IRIS® Registry

To evaluate anti-VEGF treatment patterns and the influence of patient demographic and clinical characteristics on up to 6-year vision outcomes in neovascular age-related macular degeneration. Retrospective, multicenter, noninterventional registry study with up to 6 years of follow-up. A cohort of 254 655 eyes (226 767 patients) with first anti-VEGF injection and at least 2 years of follow-up; 160 423 eyes had visual acuity (VA) data. Anonymized patient data were collected in the United States through the IRIS® Registry (Intelligent Research in Sight). Changes in VA from baseline; frequency of and gaps between intravitreal anti-VEGF injections; treatment discontinuations; switching anti-VEGF agents; and influence of baseline clinical and demographic characteristics on VA. After a mean VA increase of 3.0 ETDRS letters at year 1, annual decreases led to a net loss from baseline of 4.6 letters after 6 years. Patients with longer follow-ups had better baseline and follow-up VA. From a mean of 7.2 in year 1 and 5.6 in year 2, mean injections plateaued between 4.2 to 4.6 in years 3 through 6. Treatment was discontinued in 38.8% of eyes and switched in 32.3%. When adjusting for differences at baseline, every additional injection resulted in a 0.68 letter improvement from baseline to year 1; thus, multiple injections in a year have the potential to be clinically meaningful. Older age, male gender, Medicaid insurance, and not being treated by a retina specialist were associated with a higher likelihood of vision loss at year 1. Of the patients, 58.5% lost ≥ 10 letters VA at least once during follow-up, with 14.5% of patients experiencing sustained poor vision after a median of 3.4 years. After modest mean VA improvement with intravitreal anti-VEGF injections at year 1, patients netted a loss of VA by year 6. Injection frequency decreased over time, and this was paired with a relatively high rate of discontinuation. Modeling suggested that more frequent injections were associated with better VA. Difficulty with continuous adherence to frequent intravitreal injections may have contributed to undertreatment resulting in less-than-optimal vision outcomes. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

The impact after 20 years of an early detection program for severe retinopathy of prematurity in a Latin American city.

To evaluate the effects of long-standing early detection program in the incidence and trends of severe retinopathy of prematurity (ROP) in Cali, Colombia. This was a retrospective cohort study of infants included in an ROP prevention, early detection, and prompt treatment program, from January 01, 2002, to December 31, 2021 (20 years). Infants with gestational age (GA) <37 weeks or birth weight (BW) <2000 g and those with known ROP risk factors were screened. The incidence of severe ROP was calculated, and the average annual percent change (AAPC) was estimated through a joinpoint model. 16,580 infants were screened, with an average GA and BW of 31.4 ± 2.8 weeks and 1526.5 ± 56.7 g, respectively. The incidence of severe ROP was 2.69% (446 cases, 95% confidence interval [95%CI]: 2.45%; 2.95%), with an average annual decrease of - 14% (AAPC, 95%CI: -16.3%; -11.6%) from 13.6% in 2002 to 0.7% in 2021. In infants with GA <32 weeks, the incidence was 5.21%. A significant reduction in the risk of ROP was observed with increasing GA and BW (P < 0.05). Among the cases with severe ROP, 6.5% (29/446) had a GA ≥32 weeks with a maximum of 37 weeks; only 0.4% (2/446) of the detected infants had a BW >2000 g. Awareness and screening as part of the early detection program to prevent ROP has shown a significant decline in the incidence of severe ROP over time. Screening infants with GA <32 weeks or BW <2000 g and preterm infants (<37 weeks) with risk factors may be a feasible decision for resource optimization.

Effects of the COVID-19 pandemic on life expectancy at birth at the global, regional, and national levels: A joinpoint time-series analysis.

Current estimates indicate that coronavirus disease 2019 (COVID-19) caused 14.9 million excess deaths in 2020 and 2021. Thus, estimating the change in life expectancy at birth due to the COVID-19 pandemic could aid in understanding its impact and implementing public health initiatives. We collected data on the life expectancy at birth of the combined population between 1990 and 2021 at the global, regional, and national levels from the 2022 Revision of World Population Prospects. In this time series study, we estimated the trend segments, the change of trend years (joinpoints), the annual percentage change (APC) in life expectancy at birth within each trend segment, and the average APC (AAPC) in life expectancy at birth during the full study period using joinpoint regression analysis. The global life expectancy at birth decreased from 72.8 years in 2019 to 71.0 years in 2021, with an annual decrease of 1.2% (95% confidence interval (CI) = 1.0, 1.5) during the 2019-2021 period, despite an overall increasing trend during the entire period from 1990 to 2021 (AAPC = 0.3%; 95% CI = 0.3, 0.4). We observed a significantly increasing trend in life expectancy at birth in all regions and nearly 87.7% (207/236) of the world's countries and areas during the entire period (1990-2021). All continental regions except Africa and Oceania experienced a significant decreasing trend in life expectancy at birth in 2019-2021, with an APC of -1.2% (95% CI = -1.5, -0.9) for Asia, -2.1% (95% CI = -2.7, -1.6) for Latin America and the Caribbean, -1.1% (95% CI = -1.6, -0.6) for Northern America, and -1.4% (95% CI = -1.9, -0.9) for Europe. Among all countries and areas, 107 countries and areas (45.3%) experienced a significant decreasing trend in life expectancy at birth in the most recent time segment, with 77 countries and areas (32.6%) experiencing a significant decreasing trend during the 2019-2021 period. The world experienced a significant decreasing trend in life expectancy at birth in 2019-2021, with a decrease of 1.8 years; all continental regions except Africa and Oceania and 77 countries and areas experienced a significant decreasing trend in life expectancy at birth. These decreasing trends at global, regional, and national levels during the 2019-2021 period reflected the COVID-19 pandemic's direct and indirect adverse effects on life expectancy at birth.

АНАЛІЗ ДИНАМІКИ НАРОДЖЕННЯ ДІТЕЙ З АУТОСОМНИМИ ТРИСОМІЯМИ ПО ХМЕЛЬНИЦЬКІЙ ОБЛАСТІ

In the face of challenging modern demographic conditions, the imperative of preserving human life is becoming increasingly urgent. Environmental pollution, a deteriorating ecological landscape, imbalanced nutrition, unhealthy lifestyles, the accumulation of hereditary defects, and a rising genetic burden collectively exert adverse effects on Ukraine's gene pool. This unfortunate scenario contributes to the increased rate of early child mortality and the birth of children with disabilities [7].&#x0D; The objective of this study was to analyze the trends in child births with Down, Edwards, and Patau syndromes while investigating the influence of maternal age on the incidence of these genetic anomalies in the Khmelnytskyi region from 2017 to 2021.&#x0D; We conducted an analysis of statistical data pertaining to newborns, utilizing information from the Main Statistical Office in the Khmelnytskyi region. This investigation was undertaken in collaboration with the medical and genetic consultation department of the KP "Khmelnytskyi City Perinatal Center." It involved a comprehensive review of outpatient records for patients born with Down, Edwards, and Patau syndromes, aimed at understanding the clinical condition of the infants and the course of pregnancy in their mothers.&#x0D; The analysis revealed that a total of 50,475 babies were born in the region over the course of five years. However, an annual decrease in the birth rate was observed, with an average reduction of 705 children per year. The incidence rate of newborns with Down syndrome, Edwards syndrome, and Patau syndrome ranged from 0.10% to 0.13%. During the research period, 45 children with Down syndrome were born in the Khmelnytskyi region. Cytogenetic analysis indicated that 39 of these children (87 %) had a complete trisomy, 4 had a mosaic form (9 %), and 2 (4 %) had a translocation form. Children with complete trisomy exhibited four or more phenotypic features simultaneously. In the region, 12 children were born with Edwards syndrome, including 9 with complete trisomy and 3 with a mosaic form. No newborns were identified with partial trisomy. Cases included both full-term and premature births, as well as instances of infant mortality. Two children with Patau syndrome were born (1 boy in 2017 and 1 girl in 2019), both with complete trisomy. They were born full-term but with low birth weight and multiple developmental disabilities, with one child surviving for 12 hours and the other for 31 hours.&#x0D; Upon analyzing the age of the parents of the probands, it was discovered that the majority (38 mothers, 64 %) were not within the age risk group for having a child with trisomy. This suggests that women of any age can be at risk of having a child with trisomy. Thus, there is a clear need for medical-genetic counseling and prenatal screening for every pregnant woman during the first trimester of pregnancy.

Effect of Carbon Dioxide Emission Reduction Policy on Air Quality Improvement in Jiangsu Province

Carbon emission peaking and air quality improvement is an urgent issue in the research of the atmospheric environment. Here, the emission factor method was used to compile the city-level greenhouse gas emission inventory of Jiangsu Province from 2010 to 2019, which was then combined with greenhouse gas-air pollutant synergy analysis and WRF-Chem air quality model simulation to analyze the synergistic gain of air quality improvement under different carbon emission reduction scenarios. The results revealed that the annual mean CO2 emission in Jiangsu Province from 2010 to 2019 was 701.74-897.47 Mt. Suzhou, Xuzhou, and Nanjing had the highest emissions (91.19-182.12 Mt·a-1); Yangzhou, Suqian, and Lianyungang had the lowest emissions (13.19-32.54 Mt·a-1); and majority of the cities had a continuous upward trend in the CO2 emissions. Energy activities were the main source of CO2 emissions, accounting for nearly 90%, whereas industrial production processes contributed to the remaining 10%. This study designed three types of CO2 emission reduction conditions according to different emission reduction priorities, namely, sector-wide collaborative, energy priority, and industrial priority. Each type of emission reduction condition included a different intensity of CO2 emission reduction (10%, 20%, and 40%). The condition-based simulation results demonstrated that, taking 2017 as the base year, the average annual decrease in PM2.5 concentration in sector-wide collaborative, energy priority, and industrial priority emission reduction was 6.7-21.1, 3.1-12.0, and 3.4-14.3 μg·m-3, respectively. Sector-wide collaborative emission reduction had the most notable improvement in PM2.5 pollution. Under the condition of the sector-wide collaborative emission reduction of 40%, the average annual PM2.5 concentration of all cities, excluding Xuzhou and Suqian, met the national Ⅱ standard (35 μg·m-3). The change responses of PM10, SO2, NO2, and CO were similar to that of PM2.5, but O3 pollution increased under the conditions of energy and industrial priorities.

Impact of Open-Source Community on Cryptocurrency Market Price: An Empirical Investigation

ABSTRACT Although the prices of cryptocurrencies remained volatile for the past decade, the factors that impact the price dynamics of the new type of investment instrument have not been fully identified yet. In this study, we recognize the dual nature of cryptocurrencies, that is, being a software program and a financial instrument, and examine the impact of software advancement on the price dynamics of cryptocurrencies. The open-source software (OSS) platform functionality enables social behaviors that we use as signals. Using data from the largest OSS platform, we establish the connection between open-source activities and the price movement of cryptocurrency. In particular, as project popularity (forks and watches) and users’ feedback (issues) increase, the market price increases by 4.3 percent, 2.4 percent, and 4.4 percent per annum, respectively. On the contrary, the number of code corrections (pull requests) is negatively related to prices leading to a 5 percent annual price decrease. Our results suggest that OSS contributions create a perfect selection mechanism, where higher quality projects receive more developers’ attention and user feedback, whereas lower quality projects do not, thus creating the separating equilibrium.