Information System Database Research Articles

Impact of Land Use and Land Cover Change on Deforestation in the Central Taraba State: A Geographic Information System and Remote Sensing Analysis

Deforestation, the widespread clearance of forests for various land uses, has become a significant global environmental issue with far-reaching consequences. Deforestation in the study area was identified, categorized, assessed, and interpreted using Landsat 5, 7, and 8 from the years 2008, 2014, and 2020, respectively. A geographic information system (GIS) database of land use and land cover categories and their changes were created. The results showed that several anthropogenic human activities, including agriculture and wood harvesting, were driving a general retreat of the forest area. The study further shows that between 2008 and 2020, forest area decreased by 8.5% with an annual rate of 0.33%, other vegetative areas increased by 2% with an annual rate of 0.077%, and non-vegetative areas increased by 1.5% with an annual rate of 0.58%. The hotspot map shows that the rate at which the reserve is deteriorating and the conversion of the forest area to other vegetation and bare ground are only a matter of time. The study recommended that the government should adopt rigorous policies to protect forest reserves from unauthorized habitation by encouraging the use of alternative firewood fuel sources to reduce the pressure on the forest.

Contemporary disparities in progression to orchiopexy for cryptorchidism as reported in the Pediatric Health Information System (PHIS) database

When evaluating the timeliness of orchiopexy for cryptorchidism, health disparities are apparent among Hispanic and African American males and those with public insurance. Since the publication of these data, the COVID-19 pandemic has stressed our healthcare system and significantly affected the provision of pediatric urology care. We sought to assess if certain groups were disproportionately affected in progression to orchiopexy after the diagnosis of cryptorchidism during and after the pandemic in US freestanding children's hospitals. Using the PHIS database, pediatric patients ≤5 years who underwent orchiopexy between January 2018 and December 2022 were retrospectively analyzed. Exclusion criteria included prematurity, retractile testes, and testicular torsion. Primary outcomes were age at orchiopexy and the proportion of individuals undergoing timely orchiopexy for cryptorchidism. Over the study period 3140 patients ≤5 years old underwent orchiopexy for cryptorchidism. Non-Hispanic Blacks and Hispanics were significantly less likely to have timely orchiopexy and underwent orchiopexy 2.13 and 3.60 months later compared to whites (p<0.01). As compared to pre-COVID-19, during the pandemic the proportion of patients who had timely surgery was higher and the median age was significantly lower (p=0.01 and p<0.01, respectively) in white patients only. Over the study period, patients with public insurance were less likely to have timely orchiopexy and underwent orchiopexy 2.94 months later (p<0.01) than patients with private insurance. Compared to during the pandemic, post-pandemic a significantly lower proportion of publicly insured patients have since undergone timely orchiopexy (p=0.04). Patients in the West were less likely to have timely orchiopexy and had a higher age at time of orchiopexy (p<0.01) than other regions. However, in the West during the pandemic, the proportion of children who had timely surgery was higher compared to pre-and post-COVID-19 (p<0.01). Overall, regardless of insurance status, race, or location, a significant proportion of patients did not undergo timely orchiopexy. During the pandemic white patients had a lower median age and an increased proportion underwent timely orchiopexy, despite the number of orchiopexies remaining constant. Disparities in the post-COVID-19 era have been further exacerbated for publicly insured patients, who a significantly lower proportion of have since undergone timely orchiopexy. Specific efforts are required across the United States to increase timely orchiopexy for all boys. Progression to timely orchiopexy remains low for all boys in the era surrounding COVID-19; certain groups appear to be more adversely affected.

Impact of timing of immunotherapy and cytoreductive nephrectomy on outcomes in metastatic renal cell carcinoma: Results from the CKCis database.

416 Background: Immunotherapy-based systemic treatment (ST) is the standard of care for most patients diagnosed with metastatic renal cell carcinoma (mRCC). Cytoreductive nephrectomy (CN) has historically shown benefit for select patients with mRCC but its role and timing are not well-understood in the era of immunotherapy. The primary objective of this study is to assess patient outcomes in patients who received ST only, CN followed by ST (CN-ST) and ST followed by CN (ST-CN). Methods: The Canadian Kidney Cancer information system (CKCis) database was queried to identify patients with de novo mRCC who received immunotherapy-based ST for mRCC between January 2014 to June 2023. These patients were classified into three categories as described above. Cox proportional hazards models were used to assess the impact of the timing of ST and CN on overall survival (OS) and progression free survival (PFS), after adjusting for IMDC risk group. Complications of ST and CN for these cohorts were collected. Results: A total of 588 patients were included in this study. 331 patients received ST only, 215 patients received CN-ST and 42 patients received at least one dose of ST prior to CN. Patient and disease characteristics including age, gender, performance status, IMDC risk category, comorbidity, histology, type of ST and metastatic sites are reported and globally well-balanced. OS analysis favoured patients who received ST-CN (hazard ratio [HR] 0.30, 95% confidence interval [CI] 0.13-0.68) and CN-ST (HR 0.68, CI 0.47-0.97) over patients who received ST only. PFS analysis showed a similar trend for ST-CN (HR 0.45, CI 0.26-0.77) and CN-ST (HR 0.9, CI 0.68-1.17). The most common cause of ST delay or cessation was treatment toxicity, followed by progression of disease. The most common perioperative complication was bleeding, followed by infection. Conclusions: This study examined baseline features and outcomes associated with the use and timing of CN and ST using real world data through the CKCis database. Patients selected to receive CN after ST seem to have improved outcomes. There were no appreciable differences in ST toxicity or perioperative complications across groups. Limitations include the small number of patients in the CN-ST group and residual confounding and selection bias that may influence the outcomes in patients undergoing CN.

Regional Feature Product Development Management Using Data Management Using Networked Websites in Assisted Villages in Realizing the Tridharma of Politeknik Negeri Medan

This research aims to carry out database management according to market needs and predetermined entities/variables, to be used as data storage for profiles of assisted villages based on superior village products and to redesign a web-based information system that presents profiles of assisted villages based on superior products and village connectivity. the. The research method used in database design and information system design uses descriptive qualitative methods by conducting focus group discussions with P3M Polmed administrators and conducting in-depth interviews with six village heads/secretaries in designing the prototype. This research produces a design for a networked website-based information system with the addition of creating the location and knowing the distance between one village and another, which presents a profile of the target village based on superior products that can be accessed via a network of websites and produces a mandatory output in the form of a book with an ISBN.

Association between regional critical care capacity and the incidence of invasive mechanical ventilation for coronavirus disease 2019: a population-based cohort study

BackgroundCoronavirus disease 2019 (COVID-19) has exposed critical care supply shortages worldwide. This study aimed to investigate the association between regional critical care capacity and the incidence of invasive mechanical ventilation following novel COVID-19 during the pandemic in Japan, a country with a limited intensive care unit (ICU) bed capacity of a median of 5.1 ICU beds per 100,000 individuals.MethodsThis population-based cohort study used data from the CRoss Icu Searchable Information System database and publicly available databases provided by the Japanese government and Japanese Society of Intensive Care Medicine. We identified patients recently diagnosed with COVID-19, those who received invasive mechanical ventilation, and those who received extracorporeal membrane oxygenation (ECMO) between February 2020 and March 2023. We analyzed the association between regional critical care capacity (ICU beds, high-dependency care unit (HDU) beds, resource-rich ICU beds, and intensivists) and the incidence of invasive mechanical ventilation, ECMO, and risk-adjusted mortality across 47 Japanese prefectures.ResultsAmong the approximately 127 million individuals residing in Japan, 33,189,809 were recently diagnosed with COVID-19, with 12,203 and 1,426 COVID-19 patients on invasive mechanical ventilation and ECMO, respectively, during the study period. Prefecture-level linear regression analysis revealed that the addition of ICU beds, resource-rich ICU beds, and intensivists per 100,000 individuals increased the incidence of IMV by 5.37 (95% confidence interval, 1.99–8.76), 7.27 (1.61–12.9), and 13.12 (3.48–22.76), respectively. However, the number of HDU beds per 100,000 individuals was not statistically significantly associated with the incidence of invasive mechanical ventilation. None of the four indicators of regional critical care capacity was statistically significantly associated with the incidence of ECMO and risk-adjusted mortality.ConclusionsThe results of prefecture-level analyses demonstrate that increased numbers of ICU beds, resource-rich ICU beds, and intensivists are associated with the incidence of invasive mechanical ventilation among patients recently diagnosed with COVID-19 during the pandemic. These findings have important implications for healthcare policymakers, aiding in efficiently allocating critical care resources during crises, particularly in regions with limited ICU bed capacities.Registry and the registration no. of the study/trial The approval date of the registry was August 20, 2020, and the registration no. of the study was lUMIN000041450.

Pemanfataan Sistem Informasi Database Online Perpustakaan Universitas Terbuka (UT) Sebagai Sumber Informasi

The title of this article is Utilization of the Open University Library's Online Database Information System as a Source of Information. This article aims to explain the reasons for the benefits of information systems in online databases in libraries and to find out about digital libraries. So it is important to utilize information sources easily, users can search for information more easily, users can search catalogs from outside the library. Leveraging information systems is not about automating some regularly performed tasks, but about creating new information flows that are integrated into a systematic integration system. However, there are still many problems in library management, including difficulty accessing the necessary information, lack of resources, and lack of effective and efficient management. When faced with these challenges, the use of databases is the best solution for libraries. Databases help libraries better manage and store information resources, making it easier for readers to access the information they need.

P606 A Retrospective Observational Study of Patterns of Biologic Drug Change in Inflammatory Bowel Disease

Abstract Background The treatment of inflammatory bowel disease (IBD) has evolved over the past two decades. Due to the recent introduction of multiple new biologics, it is crucial to understand the temporal patterns of drug change. This study aimed to examine the patterns of biological drug change over time and identify predictors of change in a cohort of patients with IBD. Methods We performed a retrospective study of patients diagnosed with IBD who were initiated on biologics and followed up at King Abdulaziz University (KAU) hospital, Jeddah, Saudi Arabia between June 2017, and October 2022. The KAUH inflammatory bowel disease information system (IBDIS) database was used to identify eligible patients. The study's primary objective was to describe biologics drug change patterns. Secondary outcomes included identifying predictors of drug change and time to discontinue biologics. Uni- and multi-variable odds ratios (ORs) were used to determine the predictors of drug change. Results A total of 910 patients who were registered in the IBDIS database were screened; 475 patients fulfilled the study criteria. 67% had CD, and 53.3% were males. The mean age at diagnosis was 22.6 (11.0) years. The most selected first and second choice of biologic was adalimumab (58.2% and 39.1%, p&amp;lt;0.001) and infliximab (37.6% and 48.9%, p=0.004) for both CD and UC, respectively. Ustekinumab was the primary third choice for CD (65.4%), while vedolizumab was the third choice for UC (83.3%). The proportions of patients who switched from first- and second-line adalimumab, infliximab, and vedolizumab were 52.3% and 20.9%, 37.6% and 39.9%, and 10.1% and 18.3%, respectively. On multiple regression analysis, a history of venous thromboembolism (VTE) (OR=3.60, 95% CI=1.20-11.71, p=0.025) and active smoking (OR=0.34, 95% CI=0.12-0.82, p=0.026) were associated with drug change for all patients. When stratified by disease subtype, drug change was associated with a diagnosis made between age 17 and 40 years (OR=0.46, 95% CI=0.23-0.90, p=0.024) and EIMs (OR=2.07, 95% CI=1.16-3.76, p=0.015) in CD while selecting vedolizumab as first biologic (OR=0.30, 95% CI=0.09-0.92, p=0.041), male gender (OR=2.40, 95% CI=1.04-5.73, p=0.043), and history of VTE (OR=7.32, 95% CI=0.23-49.97, p=0.031) were associated with drug change in UC. Conclusion Despite introducing several new biologics, anti-TNF therapies remain the preferred first and second choice of biologics for patients with IBD. The use of adalimumab is associated with the highest risk of switch. Multiple predictors of drug change over time exist for both diseases. The selection of vedolizumab as the first biologic for UC is associated with a lower risk of drug change.

Association between Weight Change and Incidence of Dyslipidemia in Young Adults: A Retrospective Cohort Study of Korean Male Soldiers.

Recent lifestyle changes have increased the prevalence of dyslipidemia in Korea. Young men are known to have a low awareness of dyslipidemia and a lack of motivation to maintain their weight. However, the association between weight change and dyslipidemia in young adults has not been thoroughly examined. Data from the Armed Forces Medical Command Defense Medical Information System database were used. In this study, 15,068 soldiers who underwent private and corporal health examinations between May 2020 and April 2022 were included. The difference in weights between the two different health examinations was used to quantify weight change. Four components of the lipid profile were used to assess dyslipidemia during the corporal health examination. After adjusting for relevant covariates, weight gain was associated with increased risk of dyslipidemia (adjusted odds ratio [OR], 1.38 [95% confidence interval, CI, 1.15 to 1.64] for the 5% to 10% weight gain group; and OR, 2.02 [95% CI, 1.59 to 2.55] for the ≥10% weight gain group), whereas weight loss was associated with decreased risk (adjusted OR, 0.82 [95% CI, 0.68 to 0.98] for the 5% to 10% weight loss group; and OR, 0.38 [95% CI, 0.27 to 0.53] for the ≥10% weight loss group). In subgroup analysis based on the participants' baseline body mass index, smoking status, regular exercise habits, and hypertension status, there were no significant differences between the subgroups. Weight change was associated with dyslipidemia in Korean male soldiers. The findings suggest that limiting weight gain in young adults by encouraging a healthy lifestyle may help prevent dyslipidemia.

Development and application of Chinese medical ontology for diabetes mellitus

ObjectiveTo develop a Chinese Diabetes Mellitus Ontology (CDMO) and explore methods for constructing high-quality Chinese biomedical ontologies.Materials and methodsWe used various data sources, including Chinese clinical practice guidelines, expert consensus, literature, and hospital information system database schema, to build the CDMO. We combined top-down and bottom-up strategies and integrated text mining and cross-lingual ontology mapping. The ontology was validated by clinical experts and ontology development tools, and its application was validated through clinical decision support and Chinese natural language medical question answering.ResultsThe current CDMO consists of 3,752 classes, 182 fine-grained object properties with hierarchical relationships, 108 annotation properties, and over 12,000 mappings to other well-known medical ontologies in English. Based on the CDMO and clinical practice guidelines, we developed 200 rules for diabetes diagnosis, treatment, diet, and medication recommendations using the Semantic Web Rule Language. By injecting ontology knowledge, CDMO enhances the performance of the T5 model on a real-world Chinese medical question answering dataset related to diabetes.ConclusionCDMO has fine-grained semantic relationships and extensive annotation information, providing a foundation for medical artificial intelligence applications in Chinese contexts, including the construction of medical knowledge graphs, clinical decision support systems, and automated medical question answering. Furthermore, the development process incorporated natural language processing and cross-lingual ontology mapping to improve the quality of the ontology and improved development efficiency. This workflow offers a methodological reference for the efficient development of other high-quality Chinese as well as non-English medical ontologies.

A National Study on the Comparative Burden of Pedestrian Injuries from Falls Relative to Pedestrian Injuries from Motor Vehicle Collisions.

Pedestrian injuries from falls are an understudied cause of morbidity. Here, we compare the burden of pedestrian injuries from falls occurring on streets and sidewalks with that from motor vehicle collisions. Data on injurious falls on streets and sidewalks, and pedestrian-motor vehicle collisions, to which Emergency Medical Services responded, along with pedestrian and incident characteristics, were identified in the 2019 National Emergency Medical Services Information System database. In total, 118,520 injurious pedestrian falls and 33,915 pedestrians-motor vehicle collisions were identified, with 89% of the incidents occurring in urban areas. Thirty-two percent of pedestrians struck by motor vehicles were coded as Emergent or Critical by Emergency Medical Services, while 19% of pedestrians injured by falls were similarly coded. However, the number of pedestrians whose acuity was coded as Emergent or Critical was 2.1 times as high for injurious falls as compared with pedestrians-motor vehicle collisions. This ratio was 3.9 for individuals 50years and older and 6.1 for those 65years and older. In conclusion, there has been substantial and appropriate policy attention given to preventing pedestrian injuries from motor vehicles, but disproportionately little to pedestrian falls. However, the population burden of injurious pedestrian falls is significantly greater and justifies an increased focus on outdoor falls prevention, in addition to urban design, policy, and built environment interventions to reduce injurious falls on streets and sidewalks, than currently exists across the USA.

Reducing non-revenue water in Luxor-Egypt using GIS

Unaccounted for Water, referring to all losses from the water system, illegal or otherwise, frequently exceeds 40% of all water produced. This represents a major strain on utility operations and budgets. A large amount of Unaccounted for Water indicates large losses in the revenue of the utilities. Deficiency in financial resources normally leads to a deficiency in the performance of the utility. This deficiency in performance may affect the operation and maintenance of treatment plants and network components. The main objective is to reduce Unaccounted for Water rates. The multi-stage systematic process involves measuring water flow, leak detection, installing and fixing meters, reducing illegal connections, and increasing billing and collections, and developing Geographic Information System layers and databases for all of them. Another objective is to connect Geographic Information System maps with Billing, hydraulic systems, hotline systems, etc. After choosing a pilot area, we review similar activities, conduct field visits, and hold meetings, prepare the timeline schedule, prepare, and implement base maps and the water network, analyze, and compare end-line results, and report the results. A high reduction in the Unaccounted for Water percentage is expected due to fixing the discovered leaks. The issue of Unaccounted for Water, encompassing losses from the system, whether legal or illegal. This places a significant burden on both utility operations and budgets. A substantial volume of Unaccounted for Water signifies considerable revenue losses for the utilities, and the financial constraints often translate into performance deficiencies within the utility. We formulated a methodology aimed at assisting utilities in lowering Unaccounted for Water rates. This structured, multi-stage process includes activities such as measuring water flow, implementing leak detection measures, installing, and repairing meters, minimizing illegal connections, and enhancing billing and collection.

ANALYSIS OF BRAZILIAN STATES' ADHERENCE TO THE AT SCHOOL HEALTH PROGRAM

The School Health Program (PSE) is a Primary Health Care (PHC) program formulated in an intersectoral way, articulating PHC professionals and schools to develop actions aimed at Brazilian schoolchildren. To adhere to the PSE, it is necessary to link PHC health teams with Oral Health teams and the Term of Commitment validated by health and education managers. This study aimed to verify the adherence of Brazilian states to the PSE as a strategic tool for integrating health and education for the development of citizenship and the qualification of Brazilian public policies. Research was carried out through a descriptive analysis of data contained in public databases of the Primary Care Health Information System (SISAPS) and the Brazilian Institute of Geography and Statistics (IBGE). It was observed that for the 2021-2022 Cycle, Piauí showed the highest percentage of adherence considering the number of municipalities, Minas Gerais showed more students benefiting considering absolute numbers and São Paulo is the state with the highest number of students enrolled in elementary education and the number of students benefiting. The PSE showed adherence above 80% in all Brazilian states, presenting itself as a strategic tool for integrating health and education for the development of citizenship and the qualification of Brazilian public policies.

Prevalence of acquired and transmitted HIV drug resistance in Iran: a systematic review and meta-analysis.

There is no systematic review on the prevalence of HIV drug resistance (HIVDR) in Iran. We aimed to estimate the prevalence of HIVDR among people living with HIV (PLHIV) in Iran. We assessed HIVDR prevalence in antiretroviral therapy (ART) naïve PLHIV (i.e., those without a history of ART) and PLHIV receiving ART. We systematically searched Scopus, PubMed, Web of Science, Embase, Iranian databases (Iranian Medical Research Information System, Magiran, and Scientific Information Database), the references of studies, and Google Scholar until March 2023. A random-effects model was used to calculate a point estimate and 95% confidence interval (95% CI) for the prevalence of HIVDR in PLHIV. Among 461 potential publications, 22 studies were included in the meta-analysis. The pooled prevalence of acquired HIVDR in PLHIV receiving ART was 34% (95% CI: 19, 50) for nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), 27% (95% CI: 15, 41) for non-nucleoside reverse transcriptase inhibitors (NNRTIs), and 9% (95% CI: 3, 18) for protease inhibitors (PIs). The pooled prevalence of acquired HIVDR in treatment failure PLHIV was 50% (95% CI: 31, 69) for NRTIs, 49% (95% CI: 29, 69) for NNRTIs, 11% (95% CI: 2, 24) for PIs, and 1% (95% CI: 0, 4) for integrase inhibitors (INIs). The pooled prevalence of transmitted HIVDR in ART-naïve people was 3% (95% CI; 1, 6) for NRTIs, 5% (95% CI: 2, 9) for NNRTIs, and 0 for PIs and INIs. The prevalence of HIVDR was relatively high in both ART-naïve PLHIV and those receiving ART. Without universal pretreatment HIVDR testing and more frequent routine HIV viral load testing among PLHIV who are on ART, the HIVDR prevalence might increase in PLHIV in Iran.

МЕТОДИКА ВИЯВЛЕННЯ КІБЕРІНЦИДЕНТІВ SIEM-СИСТЕМОЮ В БАЗАХ ДАНИХ ІНФОРМАЦІЙНО-КОМУНІКАЦІЙНИХ СИСТЕМ ВІЙСЬКОВОГО ПРИЗНАЧЕННЯ

With the integration of information and communication systems into military operations, the issue of their cyber defense is becoming increasingly important. The main target for cyberattacks are databases that mostly contain confidential information. One of the most effective approaches to ensuring cybersecurity of databases of military information and communication systems is to use the intelligent capabilities of a SIEM system. SIEM allows real-time monitoring, analysis and response to potential cyber incidents. The article proposes a methodology for detecting cyber incidents by a SIEM system in databases of military information and communication systems. The main emphasis is placed on the multi-level protection of databases, which includes protection at the operating system level, the database level and the database management system, as well as the network level of protection. In order to improve the efficiency of cyber incident detection at the level of SIEM data analysis, an improved methodology based on fuzzy logic is used. Improvement of the methodology is achieved by introducing weights of antecedents in fuzzy rules, which allows, in some cases, to identify cyber incidents more accurately compared to existing models and methods. The weights of the antecedents of fuzzy rules are determined using the method of pairwise comparisons based on the rankings made on the 9-point Saaty scale. A decision-making algorithm for identifying cyber incidents based on the analysis of fuzzy rules and the weights of their antecedents is presented. An example of calculating the weights of antecedents of fuzzy rules using the method of pairwise comparisons based on rank estimates is given.

Analysis of Strategies and Effectiveness of Big Data Technology for Business Decision Optimization

Abstract Business decision-making is a decision-making process that relies heavily on business data, and with the continuous improvement of information technology, the level of intelligence of business decision-making has been increasing. The paper suggests relevant optimization strategies for business decision-making and creates an intelligent business decision-making process that utilizes big data. This paper mainly applies the association rule mining algorithm based on big data to business decision-making, extracting valuable information for business decision-makers from a large database of business information systems. In order to verify the operational efficiency of the improved algorithm, the traditional Apriori algorithm, FP-Growth algorithm, HBE-Apriori algorithm, and the improved algorithm are compared at the same time, and the results of the experiments show that the improved algorithm’s operational efficiency in the process of finding the maximal frequent itemset is significantly improved compared with the other three algorithms, which provides a basis for the analysis of the effectiveness of the optimization of business decision-making. The example of optimization of business decisions through big data technology found that after the optimization of business decision optimization, the asset quality and solvency of the enterprise are improved, and the operating capacity is unchanged due to the low operating capacity of the total assets of the enterprise. This paper’s method for optimizing business decisions based on association rules is shown to be feasible.

Mortality related to sickle cell disease and COVID-19 in Brazil, 2020.

The ability to cause death is the definitive measure of an infectious disease severity, particularly one caused by a novel pathogen like severe acute respiratory syndrome-CoV-2 (COVID-19). This study describes sickle cell disease-related mortality issues during the COVID-19 pandemic in Brazil. The provisional 2020 mortality data originated from the public databases of the Mortality Information System and were investigated using the multiple-cause-of-death methodology. In 2020, 688 sickle cell disease-related deaths occurred, of which 422 (61.3%) had an underlying cause of death and 266 (38.7%) had an associated cause of death. Furthermore, 98 COVID-19-related deaths occurred, of which 78 were underlying cause of death among sickle cell disease associated (non-underlying) cause of death. Sickle cell disease-related deaths occurred mostly among young adults aged 25-49 years. COVID-19 deaths occurred at ages older than among sickle cell disease-related deaths. Majority of deaths happened in the southeast (42.3%) and northeast regions (34.0%), while COVID-19 deaths prevailed in the northeast region (42.9%). Regarding overall deaths, the leading underlying cause of death was sickle cell disease itself, followed by infectious and parasitic diseases (14.8%), owing to COVID-19 deaths, and diseases of the circulatory system (8.9%). Next, in males, diseases of the digestive system (4.8%) occurred, while, in females, maternal deaths succeeded, included in the chapter on pregnancy, childbirth, and the puerperium, accounting for 5.9% of female deaths. The leading overall associated (non-underlying) cause of deaths were septicemias (29.4%), followed by respiratory failure (20.9%), pneumonias (18.3%), and renal failure (14.7%). In Brazil, COVID-19 deaths produced trend changes in sickle cell disease-related causes of death, age at death, and regional distribution of deaths in 2020.

Factors influencing the positivity of diagnostic tests for congenital syphilis.

The objective of this study was to analyze the factors that influence the positivity of treponemal and non-treponemal tests in cases of congenital syphilis. This cross-sectional and correlational study was carried out from the analysis of the database of Disease and Notification Information System (SINAN, in Portuguese) using the data obtained through the Epidemiological Surveillance Group 29, with 639 notifications of congenital syphilis between 2007 and 2018. The data were analyzed by a descriptive and inferential analysis from logistic regression with a significance level of 5% (p≤0.05). The positivity of the treponemal test was higher by 4.5 times in infants living in rural areas and 19.6 times among those whose mothers obtained the diagnosis of syphilis after birth. The treponemal test showed positivity 3.2 times higher for the variable "having been diagnosed between 2007 and 2015" and 5.5 times higher for the variable "having been diagnosed with maternal syphilis in the postpartum period." This study shows that testing during prenatal care is essential for early diagnosis and prevention of syphilis complications.

Maternal health surveillance panel: a tool for expanding epidemiological surveillance of women's health and its determinants.

To present the methodology used in the development of two products for maternal health surveillance and its determinants and discuss their possible uses. Based on a theoretical model of the determinants of maternal death and databases of Brazilian health information systems, two free products were developed: an interactive panel "surveillance of maternal health" and an educational material "Aparecida: a story about the vulnerability of Brazilian women to maternal death", both available on the website of the Brazilian Obstetric Observatory. More than 30 indicators were calculated for the period 2012-2020, containing information on socioeconomic conditions and access to health services, reproductive planning, prenatal care, delivery care, conditions of birth and maternal mortality and morbidity. The indicators related to severe maternal morbidity in public hospitalizations stand out, calculated for the first time for the country. The panel allows analysis by municipality or aggregated by health region, state, macro-region and country; historical series analysis; and comparisons across locations and with benchmarks. Information quality data are presented and discussed in an integrated manner with the indicators. In the educational material, visualizations with national and international data are presented, aiming to help in the understanding of the determinants of maternal death and facilitate the interpretation of the indicators. It is expected that the two products have the potential to expand epidemiological surveillance of maternal health and its determinants, contributing to the formulation of health policies and actions that promote women's health and reduce maternal mortality.

Epidemiology of Non-Emergent Cancer-Related Emergency Department Visits in Korea between 2016 and 2020.

As people living with cancer increase in the aging society, cancer-related emergency department (ED) visits are also increasing. This study aimed to investigate the epidemiologic characteristics of non-emergent cancer-related ED visits using a nationwide ED database. A cross-sectional study was conducted using the National Emergency Department Information System (NEDIS) database. All cancer-related ED visits between 2016 and 2020 were included. The study outcome was non-emergent ED visits, defined as patients triaged into non-emergent condition at both the time of arrival at ED and discharge from ED and were discharged without hospitalization. Among 1185871 cancer-related ED visits over 5 years, 19.0% (n=225491) were classified as non-emergent visits. While abdominal pain and fever are the top chief complaints in both emergent and non-emergent visits, non-emergent visits had high proportions of abdomen distension (4.8%), ascite (2.4%), and pain in lower limb (2.0%) compared with emergent visits. The cancer types with a high proportion of non-emergent visits were thyroid (32.4%) and prostate cancer (30.4%). Adults compared with children or older adults, female, medical aid insurance, urban/rural ED, direct-in compared with transfer-in, and weekend visit were associated with high odds for non-emergent visits. Approximately 20% of cancer-related ED visits may be potentially non-emergent. A significant number of non-emergent patients visited the ED due to cancer-related symptoms. To improve the quality of care for people living with cancer, the expansion of supportive care resources besides of ED, including active symptom control, is necessary.

Surgeon- and hospital-level variation in wait times for scheduled non-urgent surgery in Ontario, Canada: A cross-sectional population-based study.

Canadian health systems fare poorly in providing timely access to elective surgical care, which is crucial for quality, trust, and satisfaction. We conducted a cross-sectional analysis of surgical wait times for adults receiving non-urgent cataract surgery, knee arthroplasty, hip arthroplasty, gallbladder surgery, and non-cancer uterine surgery in Ontario, Canada, between 2013 and 2019. We obtained data from the Wait Times Information System (WTIS) database. Inter- and intra-hospital and surgeon variations in wait time were described graphically with caterpillar plots. We used non-nested 3-level hierarchical random effects models to estimate variation partition coefficients, quantifying the proportion of wait time variance attributable to surgeons and hospitals. A total of 942,605 procedures at 107 healthcare facilities, conducted by 1,834 surgeons, were included in the analysis. We observed significant intra- and inter-provider variations in wait times across all five surgical procedures. Inter-facility median wait time varied between six-fold for gallbladder surgery and 15-fold for knee arthroplasty. Inter-surgeon variation was more pronounced, ranging from a 17-fold median wait time difference for cataract surgery to a 216-fold difference for non-cancer uterine surgery. The proportion of variation in wait times attributable to facilities ranged from 6.2% for gallbladder surgery to 23.0% for cataract surgery. In comparison, surgeon-related variation ranged from 16.0% for non-cancer uterine surgery to 28.0% for cataract surgery. There is extreme variability in surgical wait times for five common, high-volume, non-urgent surgical procedures. Strategies to address surgical wait times must address the variation between service providers through better coordination of supply and demand. Approaches such as single-entry models could improve surgical system performance.