Crude Rate Research Articles

Tackling a worrisome rate of lost to follow-up among migrants with hepatitis B in French Guiana

ObjectivesManagement of Hepatitis B virus (HBV)-infected patients, whether they are receiving treatment or not, necessitates long-term follow-up. This study evaluated the rate of lost to follow-up (LTFU) among HBV-infected patients and the feasibility of a callback strategy to re-engage these patients in HBV care. Patients and methodsWe conducted a retrospective study involving HBV-infected patients attending the outpatient clinic at Cayenne Hospital, French Guiana. LTFU was defined as patients who had not attended the clinic for more than 18 months. A callback strategy was implemented to re-engage LTFU patients in HBV care. ResultsBetween 1st January 2015 and 31st December 2018, 203 HBV-infected patients were referred to the outpatient clinic; 95/203 (46.8 %) were LTFU, resulting in a crude LTFU rate of 2.6 (95 % CI, 2.1–3.2) per 100 person-years. At baseline, patients aged 30–40 years (aOR, 0.48; 95 %CI, 0.24–0.95) and those who initiated treatment (aOR, 0.26; 95 %CI, 0.10–0.60) were less likely to be LTFU. Through application of the callback strategy, 55/95 (58 %) patients were successfully contacted, and 46/55 (84 %) attended the outpatient clinic for a liver assessment. The EASL criteria for treatment eligibility were met by 3/46 (4 %) patients. Compared to non-LTFU patients, LTFU patients were more likely to be in informal employment (p = 0.03) and to be receiving state medical assistance (p < 0.01), and had lower levels of knowledge about their condition (p < 0.01). ConclusionsThe callback strategy to re-engage LTFU patients in HBV care is feasible and effectively identifies those eligible for antiviral therapy.

The empirical evidence of digital trends in more disadvantaged European Union regions in terms of income and population density

AbstractRemote rural and postindustrial regions are much more vulnerable to population drain in comparison with industrialized centers and capitals, due to obvious reasons such as meager job opportunities, difficulties in accessing public services in education, healthcare and transport, housing, entertainment, lack of integration with other territories and, finally, less advanced levels of digitalization. This represents an open challenge for the European Union within the framework of its Cohesion Policy. This paper analyzes the impact of digital trends, represented by the percentage of the population with access to internet and broadband and the percentage of individuals who buy goods and internet services (percentages provided by Eurostat) in less populated EU NUTS2 regions with lower income, on the crude population growth rate composed of natural changes in population and migratory flows and on the unemployment rate by applying panel data analysis. It has been possible to confirm that digitalization has a positive impact on natural changes in population in EU regions with lower economic development. On the contrary, the unemployment rate does not affect natural changes in population, but it does have a negative impact on migratory flows. The findings show that digitalization may contribute to reversing negative demographic trends in more disadvantaged EU regions in terms of income and population density.

Nonrestorative Sleep and Type 2 Diabetes Incidence: The Aichi Workers' Cohort Study.

The term "nonrestorative sleep (NRS)" refers to an unrefreshed feeling at wake-up and is a domain of poor sleep quality. Previous research has demonstrated that NRS is linked to a number of diseases and adverse health outcomes, but less is known regarding the link between NRS and diabetes, particularly in Japanese. We studied 3,665 middle-aged male participants of the Aichi Workers' Cohort Study who were followed-up from 2002 through 2019. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of incident type 2 diabetes mellitus (T2DM) in relation to NRS adjusted for potential confounding variables. During a median follow-up of 14.6 years, 421 type 2 diabetes cases were identified. Participants with NRS had a higher crude incidence rate of T2DM (11.2/1,000 person-years), compared to participants without NRS (9.3/1,000 person-years). In the fully adjusted model, individuals who reported having NRS had a significantly higher risk of developing T2DM (HR1.36; 95% CI, 1.10-1.67). The association was observed only in participants under 50 years old (HR 1.82; 95% CI, 1.36-2.43), not in the older (50 years or older) participants (P for interaction = 0.025). In contrast, stratified analyses by the presence of shift work, obesity, or sleep duration showed similar associations in all the strata. NRS was associated with higher risk of T2DM in middle-aged Japanese male workers independent of a variety of lifestyle factors and other sleep problems.

Global feature capture and spatially-aware neural networks for predicting CO2-flooding performance in heterogeneous low-permeable reservoirs

CO2-flooding can enhance crude oil recovery rates by reducing the viscosity of crude oil, improving the mobility ratio between crude oil and water, and leveraging the swelling effects of crude oil components. Furthermore, it facilitates the sequestration of greenhouse gases, leading to the realization of carbon capture, utilization, and storage (CCUS), which holds significant strategic importance for mitigating climate change, safeguarding ecological environments, and achieving sustainable development. Consequently, predicting CO2-flooding performance in heterogeneous low-permeability reservoirs holds crucial significance in sustainable energy production. However, the drawbacks of numerical simulation techniques, such as extensive computational resource consumption and prolonged simulation durations, have prompted extensive research into the utilization of artificial intelligence technologies. Prevalent approaches often treat the problem as a time series issue, which proves inadequate for reservoirs lacking historical production data. Furthermore, this methodology is unable to fully exploit the complex implicit relationships between various factors and the prediction target. Our study proposes a novel method for predicting the performance, which stands apart from previous approaches by not treating the problem as a time series issue, eliminating the need for historical production data for each prediction, and can predict various production variables such as gas production, oil production, water production, etc. in a universal manner. We combine enhanced MultiScale Non-local Neural Networks with ConvNet to handle sparse well network matrices with injection-production parameters. Additionally, we employ MultiScale convolutional networks with spatial attention mechanism to address formation permeability fields with spatial distribution features. Experimental results demonstrate the superiority of our approach in accuracy, achieving a prediction accuracy of over 97%. This research provides an innovative and flexible method, making significant contributions to the intelligentization and sustainable development of the petroleum industry, aligned with global efforts to both reduce carbon emissions and neutralize the existing ones.

Incidence of and predictive factors for lung cancer in patients with rheumatoid arthritis: A retrospective long-term follow-up study.

To determine the incidence and predictive factors of lung cancer in rheumatoid arthritis (RA). We conducted a retrospective follow-up study of patients who were diagnosed with RA at our institution between April 2001 and December 2022. Pulmonary complications were evaluated using high-resolution computed tomography at RA diagnosis. Patients were followed until the diagnosis of lung cancer, diagnosis of other malignancies, death, loss to follow-up, or the end of the study. Among 771 RA patients, 3.5% were diagnosed with combined pulmonary fibrosis and emphysema (CPFE), 4.9% with interstitial lung disease (ILD) alone, and 6.0% with emphysema alone. During follow-up (mean of 9.3 years), the crude incidence rates of lung cancer per 1,000 patient-years were 2.9 in all patients, 47.8 in CPFE patients, 10.5 in ILD patients, 11.9 in emphysema patients, and 0.8 in patients without these complications. The standardized incidence ratios (95% confidence intervals [CI]) compared with the general population were 2.53 (1.29-3.77) for male patients and 0.89 (0.57-1.16) for female patients. In Fine-Gray regression analysis, adjusted hazard ratios (95% CI) of lung cancer were 13.48 (3.14-57.85) for CPFE, 6.42 (1.42-29.09) for ILD alone, and 4.65 (1.18-18.30) for emphysema alone versus without these complications, and 1.02 (1.01-1.04) per additional 1 pack-year for smoking history. These factors were not associated with the risk of other malignancies. Close monitoring of lung cancer is needed for RA patients with smoking history and pulmonary complications, especially CPFE.

Global epidemiology of liver cancer 2022: An emphasis on geographic disparities.

Liver cancer remains the sixth most commonly diagnosed cancer and the third leading cause of cancer-related deaths worldwide, causing a heavy burden globally. An updated assessment of the global epidemiology of the liver cancer burden that addresses geographical disparities is necessary to better understand and promote healthcare delivery. Data were extracted from the GLOBOCAN 2022 database, including the number, crude, and age-standardized rates of incidence and mortality at the global, country, continent, and human development index (HDI) regional levels. Age-standardized rates (incidence and mortality) per 100,000 person-years were adjusted based on the Segi-Doll World standard population. The mortality-to-incidence ratios (MIR) for each region and country were calculated. The HDI and gross national income (GNI) for 2022 were obtained, and a Pearson correlation analysis was conducted with the incidence, mortality, and MIR. In 2022, approximately 866,136 new liver cancer cases and 758,725 related deaths were recorded worldwide, with a global MIR of 0.86. Males had a disproportionately higher burden than females across all levels, and the highest burden was observed in the elderly population. Geographically, the regions with the highest incidence rates included Micronesia, Eastern Asia, and Northern Africa, and the regions with the highest mortality rates included Northern Africa, Southeastern Asia, Eastern Asia, and Micronesia. Notably, Mongolia had a strikingly high burden compared to other countries. The highest MIR was observed in North America and the lowest in Africa. Negative associations of HDI and GNI with liver cancer mortality and MIR were identified, irrespective of sex. The current liver cancer burden underscores the presence of remarkable geographic heterogeneity, which is particularly evident across countries with varying HDI levels, highlighting the urgent need to prioritize health accessibility and availability to achieve health inequities.

Mortality (Dis)Similarities in the Context of Demographic Aging: The Countries of Ex-Yugoslavia

Generally, mortality declines at all ages, with varying intensities, as a result of heterogeneous factors affecting human lifespan. This paper considers switching regression estimation for six ex-Yugoslavian countries with the specification of a time-varying transition probability model of crude death rate. A two-state Markov switching means VAR estimates are used in which the mean growth rate of crude death rate is subject to regime switching, where the errors follow a constant transition probability. The UN data were employed consisting of the crude mortality rate series containing the log difference of yearly crude mortality rate in the six countries of ex-Yugoslavia for 1990–2021. The results show that the estimates of coefficients on the intercept in the mean equation both differ from zero in Bosnia &amp; Herzegovina, Serbia, Montenegro, and Slovenia and are with opposite and statistically significant signs only for Montenegro and Slovenia. The transition probability summaries show a higher probability of remaining in the first high regime state for Macedonia, Serbia, and Bosnia &amp; Herzegovina (0.96, 0.94, and 0.87, respectively). The higher probability of remaining in the second low-medium regime state was found in Slovenia, Croatia, and Montenegro (0.96, 0.87, and 0.56, respectively). The appropriate expected durations in the first regime are approximately 26.41, 16.19, and 7.78 years for Macedonia, Serbia, and Bosnia &amp; Herzegovina, and 28.30, 7.80, and 2.28 years were the corresponding expected durations in the second regime for Slovenia, Croatia, and Montenegro.

Trends in Stage-Specific Kidney Cancer Incidence in Kazakhstan, 2005-2019.

The aim is to analyze the incidence of kidney cancer over a 15-year period, considering factors such as stage, age, sex, and morphological verification in the regional context in Kazakhstan. The retrospective study was done using descriptive and analytical methods of oncoepidemiology. The extensive, crude and age-specific incidence rates are determined according to the generally accepted methodology used in sanitary statistics. The data were used to calculate the average percentage change (APС) using the Joinpoint regression analysis to determine the trend over the study period. Among the meticulously documented 15,277 cases, a conspicuous male predominance was noted, comprising 53.7% of cases compared to 46.3% in females, with peak incidences observed within the 50-69 age cohorts. The average age at diagnosis exhibited a progressive rise over the study period, with discernible variations observed in age-specific incidence rates, particularly pronounced within the 60-84 age brackets. Noteworthy temporal trends indicated a consistent uptick in crude incidence rates, with distinct regional disparities manifesting higher rates in northern regions relative to their southern and western counterparts. Stratification by cancer stage unveiled a significant surge in stages I-II cases alongside a concomitant decrement in stage III incidences, complemented by reductions in stage IV occurrences and instances of unspecified disease stages. Morphological verification rates displayed regional variations, with an overarching ascending trajectory across most regions, albeit exceptions noted, notably in the Kyzylorda region. Our study identified a rise in kidney cancer incidence in Kazakhstan, likely reflecting global trends driven by increased risk factor exposure and incidental imaging findings. Regional disparities and varied stage distributions highlight the complexity of kidney cancer epidemiology. Despite advancements in early detection, delayed diagnosis persists, necessitating improved surveillance and diagnostic practices.

Epidemiology of Q Fever in Southeast Europe for a 20-Year Period (2002–2021)

This study aimed to assess epidemiological trends of Q fever in six countries of Southeast Europe by analysing surveillance data for 2002–2021 period. In this descriptive analysis, we collected and analysed data on confirmed human Q fever cases, obtained from the national Public Health Institutes of Bosnia and Herzegovina, Croatia, Greece, Montenegro, North Macedonia and Serbia. Overall, 2714 Q fever cases were registered during the 20-year period. The crude average annual notification rate was 0.82 (± 2.06) (95% CI: 0.47–1.16) per 100,000 inhabitants, ranged from 0.06 (± 0.04) (95% CI: 0.04–0.08) /100,000 in Greece to 2.78 (± 4.80) (95% CI: 0.53–5.02) /100,000 in the Republic of Srpska (entity of Bosnia and Herzegovina). Significant declining trends of Q fever age standardized rates were registered in Croatia, the Federation of Bosnia and Herzegovina, North Macedonia and Serbia, with an average annual change of -30.15%; -17.13%; -28.33% and − 24.77%, respectively. An unequal spatial distribution was observed. The highest average age-specific notification rate was reported in the 20–59 age group (0.84 (± 0.40) (95% CI: 0.65–1.02) /100,000). Most cases (53.69%) were reported during the spring. Q fever remains a significant public health threat in this part of Europe. The findings of this study revealed the endemic maintenance of this disease in the including countries, with large regional and subnational disparities in notification rates. A downward trend was found in Q fever notification rates across the study countries with the average notification rate higher than in the EU/EEA, during the same period.

Effects of Four Crude Oil Degrading Bacteria Strains on the Physicochemical Parameters of Water from River Erhioke, in Kokori, Delta State, Nigeria

This study investigated the effect of four crude oil degrading bacteria strains (Pseudomonas putidastrainAY001, Alcaligenes aquatilis B61, Winkia neuii B12 and Enterococcus casseliflavus AAOO-1) on the physicochemical parameters of water from River Erhoike, in Kokori, Delta State, Nigeria using appropriate standard methods. Results obtained show that The pH ranged between 6.3 and 7.3, the dissolved oxygen ranged between 5.80±0.10 and 10.00±0.20, the highest total petroleum hydrocarbon degradation rate was 70% and results showed that .Pseudomonas putida strainAY001 which had 70% crude oil degradation rate ranked the best among others, making it good indigenous bacteria with a great potential to perform bioremediation of hydrocarbon polluted environment

Bell's palsy and COVID-19: A cohort study with historical rate comparison

IntroductionDuring the SARS-CoV-2 pandemic, immune-mediated neurological events have been described in patients vaccinated against the virus or who have overcome the disease. Among these events is Idiopathic peripheral facial palsy or Bell’s palsy. ObjectivesTo study the incidence of Bell's Palsy in the ENT emergency department of a tertiary hospital in Catalonia during the SARS-CoV-2 pandemic. MethodsRetrospective historical cohort comparison study of patients diagnosed with Bell's palsy between January 2018 and December 2021. Crude incidence rates were calculated as the total number of events divided by person time at risk per 100.000 person-years. Observed (2020, 2021) and historical (2018, 2019) rates were compared using standardized incidence rates with corresponding 95% confidence intervals. ResultsOf the total number of ENT emergency department visits from 2018 to 2021 (22.658), there were 247 cases of Bell's palsy. The incidence rate of Bell's palsy in the pre-pandemic group was 12,2 and 10,9 per 100.000 person-years for 2018 and 2019, respectively. The 2020 standardized incidence rate of Bell's palsy was 0,70 [95% CI 0,49–1,01] and 1,25 [95% CI 0,93–1,67] for 2021. No significant differences were evident between the two groups. ConclusionIn our cohort, no association was found between vaccination or COVID-19 infection and the development of Bell's Palsy.

Mortality Rate and Years of Life Lost Due to Ischemic Heart Disease in Southern Iran between 2004 and 2019: A Population-Based Study.

Cardiovascular diseases (CVDs) account for one-third of all deaths worldwide. In this cross-sectional study, we extracted all death records from the Electronic Death Registration System categorized as ischemic heart disease (IHD) based on age, gender, and the year of death according to ICD-10 for this cross-sectional analysis. The Fars province is situated in southern Iran with a population of about 4 million. An analysis of years of life lost (YLL) resulting from premature death from IHD was conducted using the World Health Organization's 2015 YLL framework. The trend of the YLL rates was investigated using joinpoint regression. In the Fars province, IHD was the cause of 46969 deaths throughout a 16-year study period, (2004 to 2019). Among these, 26,503 (56.4%) were men. The crude death rates per 100000 population for men and women were 84.2 and 66.5, respectively. The total YLL due to premature death due to IHD, during the 16-year study period, was 287625 in male, 209665 in female. The joinpoint regression showed a declining trend in the YLL rate associated with premature death. Annual Percent Change (APC) was -0.6% (95% CI -6.9 to 6.1, P=0.851) for males and -1.5% (95% CI -5.2 to 2.2, P=0.418) for females. The trends of the standardized mortality rate, YLL, and crude mortality rate held steady throughout a 16-year period. Planning for comprehensive primary and secondary prevention and increasing public knowledge of IHD are necessary.

Geographic Variation in First Lower Extremity Amputations Related to Diabetes and/or Peripheral Arterial Disease

BackgroundTo assess trends of first cases of lower extremity amputation (LEA) related to diabetes and/or peripheral arterial disease (PAD), according to areas of residency and neighbourhood material and social deprivation quintiles, in the province of Quebec, Canada. MethodsUsing the Quebec Integrated Chronic Disease Surveillance System, we calculated crude and age-standardized annual incidence rates of first LEA (total, minor, and major) among adults 40 years of age and older with diabetes and/or PAD in fiscal years 2006 and 2019. Area of residency was compiled in 3 categories: (1) Montreal and other census metropolitan areas; (2) midsize agglomerations (10,000-100,000 inhabitants); and (3) small towns and rural areas (< 10,000 inhabitants). We also stratified according to neighbourhood material and social deprivation quintiles. One-year and 5-year all-cause mortality after first LEA were compared according to area of residency. ResultsAmong the 10,275 individuals who had a first LEA, age-standardized LEA rates remained stable between 2006 and 2019, whereas major LEA rates declined in all geographical areas and minor LEA rates increased (31.6%) in small towns and rural areas. In 2019, age-standardized LEA rates were higher in midsize agglomerations and small towns and rural areas compared with census metropolitan areas. Age-standardized LEA rates in 2019 were higher among the most deprived quintile compared with the most privileged quintile for material and social deprivation. No difference was observed in mortality after first LEA according to area of residency. ConclusionsThere are health disparities in the burden of diabetes and PAD related to first LEA in the province of Quebec. To improve preventive care and reduce the burden of LEA, targeted actions should be taken among the most deprived groups and rural settings.

Effect of Treatment Delivery Schedule for Patients With Early-Stage Non-Small Cell Lung Cancer Treated With Stereotactic Ablative Radiation Therapy: A Population-Based Analysis

PurposeThe optimal stereotactic ablative body radiotherapy (SABR) delivery schedule in stage I non-small cell lung cancer (NSCLC) remains unclear. This population-based study investigated grade ≥ 2 toxicity rates, local failure (LF), and overall survival (OS) in patients treated with 48 Gy in 4 fractions scheduled every other day (QOD) versus daily with weekends (QDW) and consecutive daily without weekends (QD). Materials and MethodsBetween January 2019 and June 2022, treatment records using 48 Gy in 4 fractions were extracted from a provincial cancer registry and grouped by delivery as QOD, QDW, or QD. Toxicity events were recorded using CTCAE v5.0. The Kaplan-Meier method was used to compute OS while LF was calculated using cumulative incidence methods with death as a competing risk. Cox regression analyses and Fine-Gray modelling was used to assess for variables associated with OS and LF, respectively. ResultsOf 404 patients meeting study criteria, 190, 111, and 103 received QOD, QDW, and QD SABR, respectively. More patients receiving QDW SABR were medically inoperable and more patients receiving QD SABR had tumors abutting the chest wall. Median follow-up was 29.5 months (interquartile range [IQR] 19.2-38.4). Overall toxicity was low, with crude rates of acute and late grade ≥ 2 toxicity not being statistically different among the groups. No grade 4 or 5 toxicities were recorded. LF rates at 24 months were not different at 7.5% (95% confidence interval [CI] 3.7-11.3), 9.5% (95% CI 3.9-15.1), and 11.0% (95% CI 4.9-17.2) for the QOD, QDW, and QD groups, respectively (p = 0.60). QDW and QD schedules were not associated with LR. Similarly, no significant differences in median OS were found among the QOD, QDW, and QD groups at 47.5 months (95% CI 39.26-55,74), 52.7 (95% CI 34.7-70.7), and 49.0 months (95% CI 31.6-66.4), respectively. QDW and QD schedules were not associated with OS. ConclusionsThis population-based study demonstrated no statistically significant differences in grade ≥ 2 toxicity rates, LF, and OS for stage I NSCLC patients treated with lung SABR using 48 Gy in 4 fractions delivered QOD, QDW, and QD. Patient convenience and optimization of resources may be considered when choosing a lung SABR treatment delivery schedule.

Calf morbidity and mortality rates Associated risk factors in smallholder dairy farms in Kembata Tembaro zone, Southern Ethiopia

A study was carried out in the Kembata Tembaro Zone of Southern Ethiopia, focusing on both prospective cohort and cross-sectional surveys. The objective was to measure the rates of calf sickness and death and to pinpoint the factors that contribute to these conditions. Over 180 days, 140 newborn calves from selected small-scale dairy farms were studied. The study evaluated the prevalence of illness, mortality, and specific diseases by calculating incidence rates. Results indicated a 41.7% risk of illness and a 9.5% mortality rate among calves. Factors such as the calf's condition at birth, birth location/environment, the surface on which the calf was born, timing of the first colostrum intake, maternal parity, calf breed, and the breeding service technique significantly influenced mortality rates. Similarly, these factors were also significantly linked to the crude morbidity rate. Calves born naturally were at a lower risk of sickness (HR=0.6, p=0.001) compared to those assisted. Calves born indoors had a lower risk of sickness (HR=0.9, p=0.008) than those born outdoors. Calves that received colostrum within six hours of birth had a lower risk of sickness (HR=0.6, p=0.009) than those that received it later. Additionally, the study found that the floor of the birth place, the mother's parity, the breed of the calf, and the technique of the breeding service were additional risk factors for calf sickness. The time of the first colostrum intake, the mother's parity, and the calf's birth condition were also significant risk factors for calf death.

Glucagon-Like Peptide-1 Receptor Agonists and Risk of Parkinson's Disease in Patients with Type 2 Diabetes: A Population-Based Cohort Study.

Previous studies have suggested that glucagon-like peptide-1 receptor agonists (GLP-1RAs) may have a disease-modifying effect in the development of Parkinson's disease (PD), but population studies yielded inconsistent results. The aim was to compare the risk of PD associated with GLP-1RAs compared to dipeptidyl peptidase 4 inhibitors (DPP4i) among older adults with type 2 diabetes (T2D). Using U.S. Medicare administrative data from 2016 to 2020, we conducted a population-based cohort study comparing the new use of GLP-1RA with the new use of DPP4i among adults aged ≥66 years with T2D. The primary endpoint was a new diagnosis of PD. A stabilized inverse probability of treatment weighting (sIPTW)-adjusted Cox proportional hazards regression model was employed to estimate the hazard ratio (HR) and 95% confidence intervals (CI) for PD between GLP-1RA and DPP4i users. This study included 89,074 Medicare beneficiaries who initiated either GLP-1RA (n = 30,091) or DPP4i (n = 58,983). The crude incidence rate of PD was lower among GLP-1RA users than DPP4i users (2.85 vs. 3.92 patients per 1000 person-years). An sIPTW-adjusted Cox model showed that GLP-1RA users were associated with a 23% lower risk of PD than DPP4i users (HR, 0.77; 95% CI, 0.63-0.95). Our findings were largely consistent across different subgroup analyses such as sex, race, and molecular structure of GLP-1RA. Among Medicare beneficiaries with T2D, the new use of GLP-1RAs was significantly associated with a decreased risk of PD compared to the new use of DPP4i. © 2024 International Parkinson and Movement Disorder Society.

The impact of sociodemographic, health status and resources, macroeconomic, and environmental factors on infant mortality rates in Qatar, Kingdom of Saudi Arabia, and the United Arab Emirates.

This study aims to study the impact of sociodemographic (SD), health status and resources (HSR), macroeconomic (ME), and Environmental (EV) factors on the infant mortality rate (IMR) in Qatar, Kingdom of Saudi Arabia (KSA), and the United Arab Emirates (UAE) and from 1990 to 2022. A retrospective time-series study employing yearly data was conducted. A generalized least squares model was utilized to construct an exploratory model of IMR determinants for each country. In SD, the risk of IMR may be increased with a higher crude birth rate, adolescent fertility rate, and married women percentage. In HSR, immunization coverage shows a significant effect in preventing neonatal diseases and reducing IMR. In ME, the effect of parents' employment seems contradicted among the three countries. In EV, greenhouse emissions have also had contradictory effects among the three countries, suggesting a complex relationship with IMR. Some were consistent with global findings, whereas others contradicted the prevailing narrative. This study highlights the need for tailored public health interventions addressing socio-demographic, healthcare, and environmental contexts to effectively reduce IMR and enhance infant health outcomes.

Long-Term Clinical and Ecological Impact of an Antimicrobial Stewardship Program on the Incidence of Carbapenem-Resistant Klebsiella pneumoniae Infections in a High-Endemic Hospital.

Carbapenem-resistant Klebsiella pneumoniae (CR-Kp) is currently a serious global concern. Antimicrobial stewardship programs (ASPs) are one of the key strategies to overcome this resistance. However, evidence about the long-term clinical and ecological impacts of ASPs is scarce. A multidisciplinary team conducted a multifaceted intervention in a CR-Kp endemic hospital over a 6-year period. We assessed the monthly long-term impacts of ASPs on carbapenem use, incidence density (ID), and crude death rates of hospital-acquired CR-Kp infections. Other variables potentially related to CR-Kp incidence and healthcare activity indicators were monitored. Carbapenem use showed a sustained reduction over the long term, with a difference of -66.19% (95% CI -87.03 to -45.34) between the expected pre-intervention trend consumption value and that obtained six years after starting the program. The ID of CR-Kp also decreased significantly and was maintained over the long term, with a relative reduction of -88.14% (95% CI; -100.4 to -75.85) at the end of the study period. The crude death rate of CR-Kp at 14 and 28 days decreased significantly after the intervention and remained steady after six years. Infection control indicator trends remained stable. This mixed ASP contributed to reducing the high incidence of infections and mortality rates of CR-Kp, achieving a sustained ecological and clinical effect.

Gender Disparities in Japanese Interventional Cardiology: Outcomes of Female Operators in Percutaneous Coronary Interventions

BackgroundGender disparity remains a significant global concern in interventional cardiology, and there is a lack of extensive research examining the outcomes of percutaneous coronary interventions (PCIs) performed by female interventionalists. ObjectivesThe aim of this study was to examine the practice patterns and outcomes of PCIs conducted by female interventionalists in Japan. MethodsThis retrospective observational study analyzed data from the Japanese Percutaneous Coronary Intervention registry between January 2019 and December 2021. The primary endpoint was in-hospital mortality and the secondary endpoint was the success rate of PCIs. ResultsA total of 447 female operators (7.3% of all operators) performed 35,211 PCIs (5.3%) during the study period. Female doctors treated a higher percentage of patients with ST-segment elevation myocardial infarction compared with their male counterparts (20.2% vs 17.7%; P = 0.001), whereas male doctors were more likely to perform PCIs for left main disease (4.9% vs 5.9%; P < 0.001) and lesions treated with rotational atherectomy (3.5% vs 4.9%; P < 0.001). The success rate of PCIs was higher for female interventionalists (97.8% vs 97.2%; P < 0.001). After conducting a risk-adjusted analysis, we found no significant difference in in-hospital mortality (adjusted OR: 0.896; 95% CI: 0.78-1.03; P = 0.12), or procedural complications associated with the operator's gender. ConclusionsOverall, female operators exhibited outcomes similar to their male counterparts in terms of adjusted procedural outcomes, and higher crude success rate in certain subgroups. These findings emphasize gender disparities and stress the need to increase gender diversity in interventional cardiology.

Comparison analysis of the burden and attributable risk factors of early-onset and late-onset colorectal cancer in China from 1990 to 2019.

The project intended to analyze the impact of burden and related risk factors of late-onset colorectal cancer (LOCRC) and early-onset colorectal cancer (EOCRC) in China, thus offering essential references for optimizing prevention and control strategies. Global Burden of Disease Study was employed to describe burden changes of EOCRC and LOCRC in China during 1990-2019, containing the numbers of incidence, deaths, prevalence, and disability-adjusted life years (DALYs), and to compare attributable deaths and DALYs risk factors in varying age and sex segments. The numbers and corresponding crude rates of incidence, deaths, prevalence, and DALYs of EOCRC and LOCRC in China during 1990-2019 demonstrated an upward trend across all age categories, with males being dramatically predominant. Overall, over time, the impact of a low-calcium diet and a low-fiber diet on mortality and DALY rates decreased, while the impact of other risk factors increased. In terms of gender, the risk factors affecting males changed greatly, with smoking, inadequate milk intake, and the low whole-grain diet being the main factors in 2019, while in 1990, the main factors were the low-calcium diet, smoking, and inadequate milk intake. The burden of colorectal cancer in China is concerning. Patients grouped by diagnostic age exhibit different characteristics, indicating the need for high-quality research in the future to achieve personalized medicine tailored to different population characteristics.