Cause Of Death Research Articles

Sociodemographic and Pathological Study of Sudden Death Among Neonates and Infants: An Autopsy Based Study

Children dying within the first year of life is referred to as infant mortality and is an important key indicator for a country’s health and standard of living. Every year, there is an estimated 4.5 million infant deaths around the world, accounting for almost 75% of deaths in children younger than 5 years. The studies based on infant deaths are relatively less in number worldwide.This study investigates the sociodemographic and pathological aspects of infant deaths through autopsy data. The objective of the study was to evaluate the pathology and causes of infant/neonatal deaths and analyze related social and demographic factors. A cross-sectional descriptive autopsy study was conducted at the Government Medical College, Kozhikode, covering 66 medicolegal infant death cases from April 2018 to October 2022. Data were collected via questionnaires and analyzed using SPSS software. Respiratory infections (37.14%) were the leading cause of infant deaths, while perinatal complications and congenital abnormalities each accounted for 25% of neonatal deaths. Most deaths occurred in the postneonatal period (77.1%), predominantly among male infants (63%) from rural areas (84.3%). Key findings included consolidation and bronchopneumonia in lung examinations. Significant associations were found with various factors, including the period of infancy, delivery type, co-sleeping history, and prior hospitalizations. Birth weight and histopathological lung findings were linked to sudden infant death syndrome (SIDS).

Associations of the Healthy Beverage Index (HBI) and the risk of Breast Cancer (BrCa): a case–control study

BackgroundBreast cancer (BrCa) is one of the leading causes of cancer-related deaths. There are several factors for getting BrCa, including some changeable factors related to lifestyle like unhealthy dietary patterns, so modifying them can prevent one third of the complications and deaths caused by BrCa. Therefore, we decided to investigate the relationship between Healthy Beverage Index (HBI) and the risk of BrCa.MethodsIn this hospital-based case–control study, 253 patients with BrCa and 267 non-BrCa controls were enrolled. Food consumption was recorded to calculate the HBI score using a semi-quantitative Food Frequency Questionnaire (FFQ). Additionally, by using binary logistic regression analysis with adjustment for confounders, the relationship between HBI and the risk of BrCa were assessed. HBI was established by Duffey et al. and is used to evaluate the overall quality of beverage intake and identify changes in consumption.ResultsMean ± SD of age and BMI of the study participants were 47.92 ± 10.33 years and 29.43 ± 5.51 kg/m2, respectively. Patients with BrCa considerably outperformed controls in terms of waist circumference (WC), age at first pregnancy, history of abortion, and number of children(Pvalue < 0.05). Compared with those in the lowest quartile of HBI, subjects in the highest quartile had higher intake of energy, carbohydrate, protein, fat, fiber, sodium, potassium, calcium, magnesium, zinc, vitamin C, E, B9, fruits, vegetables, fish and nut as well as lower BMI and WC (Pvalue < 0.05). After adjustment for potential confounders, individuals in highest compared to lowest quartile of HBI had significantly lower risk of BrCa for total population (odds ratio (OR): 0.40; 95% confidence interval (95%CI): 0.21–0.76, Pvalue < 0.05), premenopausal (OR: 0.38; 95% CI: 0.16–0.92, Pvalue = 0.013), and postmenopausal (OR: 0.27; 95% CI: 0.10–0.78, Pvalue = 0.023).ConclusionFindings of this study suggested that higher HBI score decreased the risk of BrCa. However, further investigation is needed.

Genetic profile of ferroptosis in non-small cell lung carcinoma and pharmaceutical options for ferroptosis induction.

Lung cancer (LC) is the leading cause of cancer-related deaths and the second most commonly diagnosed malignancy worldwide. Lung adenocarcinoma (LUAD) and lung squamous cell LC (LUSCC) are the most common subtypes of non-small cell LC (NSCLC). Early diagnosis of LC can be challenging due to a lack of biomarkers. The overall survival (OS) of patients with NSCLC is still poor despite the enormous efforts that have been made to develop novel treatments. Understanding fundamental molecular and genetic mechanisms is necessary to develop new therapeutic approaches for NSCLC. A recently identified type of programmed cell death known as ferroptosis is one potential approach. Ferroptosis causes oxidative damage and the death of cancerous cells by peroxidizing unsaturated phospholipids and accumulating reactive oxygen species (ROS) in an iron-dependent manner. Ferroptosis-related gene (FRG) signatures have recently been evaluated for their ability to predict patient OS and prognosis. These analyses show FRGs are involved in cancer progression, and may serve as promising biomarkers for tumor diagnosis and therapy. Moreover, we summarize the current pharmaceutical options of ferroptosis induction and their underlying molecular mechanism in LC. Therefore, this review aims to provide a comprehensive summary of FRG-based prognostic models, their associated metabolic and signaling pathways, and promising therapeutic options for ferroptosis induction in NSCLC.

A review of the use of CT pulmonary angiography in pregnant and postpartum women at an academic centre

Background Pulmonary embolism (PE) is a common cause of maternal death during pregnancy and the puerperium yet data on its prevalence in middle-income countries is lacking. Methods We examined the medical records and CTPA (computed tomography pulmonary angiography) images of 67 women in an obstetric high care unit during pregnancy and the puerperium. We aimed to determine the prevalence of PE in a high-risk obstetric population undergoing CTPA, assess associated clinical features in this cohort, and determine the prevalence of alternative CT findings. Results CTPA detected PE in 11 women (16.42%) and alternative CT findings in 46 (68.6%). Women with PE had a lower systolic blood pressure than those without PE ( P = 0.001). Multiple gestation, preterm rupture of membranes, and gestational diabetes were linked to higher PE prevalence. Conclusions This study, set in an upper middle-income country, demonstrated a higher CTPA yield for PE and alternative diagnoses than in international literature, emphasising context-specific assessments.

Pattern of Drowning among Autopsies Conducted at Baroda Medical College and S.S.G Hospital

Drowning kills at least 3,72,000 people every year and is the 3rd leading cause of unintentional deaths. In addition to the human tragedy, drowning represents a huge economic problem with direct and indirect costs, including many Disability-Adjusted Life Years. In India, there is limited knowledge about the epidemiology of drowning.The objective of the study was to study the incidence, manner and epidemiology of deaths due to drowning in and around Vadodara region.The present study was conducted from May 2022 to April 2023 in Government Medical College, Baroda on 82 cases to study the various epidemiological parameters of drowning. In this study period, 1989 cases of post-mortem examination were done out of which 82 cases were of drowning deaths. A maximum number of cases were seen in the age group of 21–30 years with 43% cases of males, dominating the study population. 62% of deaths were accidental in nature and occurred during the rainy season. The most common place of occurrence of drowning was river (38%) followed by water canal (31%). Soddening of hands and feet was the most common external feature of drowning followed by the presence of froth at mouth and nostril. Drowning is a most ignored public hazard worldwide with serious implications for the society. Public awareness regarding safety measures and drowning prevention strategies suitable to the needs of geographical region should be adapted.

Excess mortality during COVID-19 pandemic in Bangladesh - evidence from a rural survey.

The coronavirus disease 2019 (COVID-19) had a profound impact worldwide. In Bangladesh, the official number of deaths for COVID-19 was around 29 000. However, many countries including Bangladesh experienced substantial underreporting of COVID-19 deaths due to lack of complete national civil registration system. This study aims to estimate excess mortality in 2020, identify risk factors, and determine leading causes of death in Bangladesh. In February 2021, we conducted a cross-sectional household survey in Sitakunda, a subdistrict of Chattogram, identifying deaths from January 2018 to December 2020. Excess mortality was quantified using the p-score and incidence rate ratio (IRR) utilising Poisson segmented regression. We employed the InterVA-5 algorithm to attribute causes of death. Proportional distribution and cause-specific mortality rates (CSMR) per 100 000 individuals were compared between pre-pandemic and pandemic periods. Among 1748 deaths from 25 669 households, we found 1.4 (95% confidence interval (CI) = 1.2-1.4) times excess mortality in 2020 compared to 2018-2019. Leading causes of death in 2020 included cardiac disease (CSMR = 121.0, CI = 115.8-127.3), stroke (CSMR = 108.0, CI = 102.6-114.0), and acute respiratory infection (CSMR = 61.0, CI = 55.1-66.5), all displaying significantly higher mortality rates than in previous years. Older age (IRR = 1.6), less education (IRR = 1.8), and lower socio-economic groups (IRR = 2.1) had higher mortality rates in 2020 compared to pre-pandemic years. Our study suggests high rural excess mortality during COVID-19 including cardiac disease, stroke and acute respiratory infection as the leading causes of deaths. We require targeted strategies to identify high-risk patients with comorbidity and social vulnerabilities that contribute to mortality to guide the preparedness strategy for future pandemics.

Postmortem diphenhydramine blood concentrations in children.

Diphenhydramine has been available for decades in non-prescription formulations for the treatment of allergic reactions, insomnia and symptomology associated with colds. In addition, dimenhydrinate, a precursor to diphenhydramine, is available in preparations for the treatment of nausea and vomiting. Diphenhydramine and other first-generation antihistamines are being replaced by second- and third-generation antihistamines which are associated with fewer side effects, notably the lack of drowsiness; however, there are still a variety of therapeutic uses that have persisted in both adults and children. In this study, postmortem blood concentrations of diphenhydramine were determined, by liquid chromatography tandem mass spectrometry, in seven children with concentrations ranging from 0.051 to 2.6 mg/L. The cause of death in two cases was attributed, at least in part, to diphenhydramine toxicity while diphenhydramine detection in five cases was considered incidental to the cause of death.

Patients with coronary atherosclerosis had an altered ratio of monocyte subpopulations in the blood, which was associated with an inflammatory cell response

Coronary artery disease (CAD) is one of the leading causes of death in developed countries. Experimental data confirm the role of monocytes in the development of CAD. Three main subpopulations of circulating blood monocytes are known: classical CD14++CD16- (~80%), intermediate CD14+CD16+ (~5%) and non-classical CD14+CD16++(~15%). It is believed that each of the subpopulations of monocytes performs different functions. There are studies that demonstrate that classical monocytes respond more to the bacterial presence, whereas non-classical ones respond to the viral one. However, the functions of monocyte subpopulations have not been fully studied. Previously, we demonstrated that circulating monocytes of the blood of patients with atherosclerosis had increased proinflammatory activity. We decided to find out how the ratio of monocyte subpopulations in the blood is related to the inflammatory response of cells in atherosclerosis. The aim of our work was to investigate the relationship of the inflammatory response of primary monocytes with the distribution of monocyte subpopulations relative to the total pool of monocytes in healthy and sick CAD. The study included 20 men aged 46 to 70 years, 10 of them without CAD and 10 patients with CAD. A coronary angiography was performed, according to the results of which the patients were divided into patients with coronary atherosclerosis with detected stenosis in 2 or more arteries (CAD) and healthy ones without stenosis in the arteries. Next, blood was taken to study circulating monocytes. Monocyte subpopulations were detected by flow cytometry from the leukocyte fraction using antibodies against CD14- FITC and CD16-PB450-A. Immediately after isolation, monocytes were stimulated with LPS with a final concentration of 1 ug/mL, and a supernatant was selected 24 hours later for further enzyme immunoassay. The inflammatory response was assessed by the secretion of cytokines TNFα, IL-1β, IL-6, IL-8, IL-10, and CCL2 using ELISA. The monocytes of CAD patients had an altered inflammatory response in response to LPS stimulation compared to patients without CAD. This was manifested in increased secretion of IL-1β and TNF, and decreased secretion of CCL2 and IL-6. An increase in the number of intermediate and non-classical monocytes in patients with CAD was associated with changes in the inflammatory response of cells to the secretion of cytokines IL-1β and CCL2. It can be assumed that pathological changes in the representation of monocyte subpopulations in the bloodstream may be one of the causes of chronic inflammation in the walls of the arteries, contributing to the progression of atherosclerotic lesions.

Correlation of exercise blood pressure levels with concomitant cardiovascular disease.

Hypertension is a fatal but preventable risk factor for cardiovascular disease and an important cause of death from cardiovascular disease. Exercise training has a definite clinical effect on blood pressure control. However, inappropriate exercise is ineffective and may also cause disease. The aim of this study was to evaluate the possible factors influencing blood pressure level in an exercise treadmill test and its relationship with accompanying clinical diseases. Five hundred sixty-four patients who underwent exercise treadmill test were selected and divided into the abnormal exercise blood pressure group (n = 156, age 60.46 ± 9.2 years) and normal exercise blood pressure group (n = 408, age 56.57 ± 8.8 years) according to whether the peak exercise systolic blood pressure was more than or equal to 180 mm Hg. General clinical data and associated clinical diseases were collected from both groups. The prevalence of hypertension and coronary atherosclerotic heart disease in the abnormal exercise blood pressure group was significantly higher than that in the normal exercise blood pressure group (all P < .05). At the same time, the smoking rate and glycohemoglobin level of the patients with abnormal exercise blood pressure were significantly increased (all P < .05), but there was no statistically significant difference in age, sex, body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and other indicators between the 2 groups (all P > .05). Patients with abnormal exercise blood pressure response have a higher prevalence of hypertension and coronary heart disease. Exercise blood pressure level may be an important factor affecting patients' cardiovascular prognosis.

Co-occurrence of Intimate Partner Violence and Suicide Mortality Among Adolescents and Young Adults in the United States

PurposeSuicide is the second leading cause of death among people ages 10–24 in the United States (US). Intimate partner violence (IPV) is also prevalent, and studies suggest that IPV is associated with youth suicide risk. However, limited research has investigated such associations. We conducted an in-depth analysis of youth suicides that were preceded by or coincided with IPV (i.e., IPV-related) to characterize how decedents were involved in IPV, IPV types experienced, and prior legal systems involvement. MethodsUsing US National Violent Death Reporting System (2014–2018) data for suicide decedents aged 7–24 (n = 15,430 deaths), we manually reviewed case narratives for IPV-related suicides (n = 882) and coded details concerning IPV circumstances. We conducted bivariate analyses to compare IPV-related suicides to other (non-IPV) youth suicides and examined differences in antecedent circumstances between IPV perpetrators (n = 651) and victims (n = 81) using multivariable logistic regression. ResultsAmong IPV-related suicides, most decedents were male and were described as IPV perpetrators. Physical IPV was most frequently reported. Compared to decedents with a history of IPV perpetration, decedents with a history of IPV victimization were more often female and younger. Narratives of IPV victim decedents had higher odds of reporting physical IPV; narratives of IPV perpetrator decedents had higher odds of reporting psychological IPV. DiscussionFuture research should explore the relationship between IPV perpetration and suicide and potential impacts on surviving partners. Research and practice should seek to develop effective assessments and interventions for young people that address IPV and suicide risk simultaneously.

Two-Dimensional MXene (Ti3C2Tx)-based Nano-Photosensitizers for Enhanced Photothermal Ablation of Tumor Cells

Cancer remains one of the leading causes of death globally, accounting for approximately one in every six deaths. Traditional cancer therapies, including surgery, chemotherapy, chemoimmunotherapy, and radiation, face numerous challenges and limitations. In this context, we explore the advantages of photothermal therapy (PTT) using two-dimensional (2D) MXene-based nanocomposites for cancer treatment. MXenes, composed of abundant and non-toxic elements, such as titanium (Ti), carbon (C), fluorine (F), and oxygen (O), demonstrate low toxicity and are promising candidates in photothermal cancer therapies. Their ultrathin planar nanostructure, high photothermal conversion efficiency, strong near-infrared (NIR) responsiveness, and chemically modifiable surfaces enhance their therapeutic potential. Recent innovations include the development of folic acid-functionalized Au@c-Ti3C2 nanostructures, a skin-mountable electrostimulation patch (eT-patch), ionic gels containing MXene (Ti3C2Tx), and composite scaffolds made of MXene, collagen, silk fibroin, and quercetin. These MXene-based photosensitive compounds offer efficient targeting and selective treatment of cancer cells, highlighting their significant role in advancing cancer therapies.

Bayesian Model Projecting Cardiovascular Disease Related Mortality Trends in the United States.

As future cardiovascular disease mortality trends have public health implications, we aimed to project ischemic heart disease (IHD), cerebrovascular disease (CeVD), and heart failure (HF) mortality rates for adults (40-79 years). In this population-level study, we linked the yearly mortality rates (per 100 000 US residents) (2000-2019) with IHD, CeVD, or HF as the primary cause of death from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research with the midyear US population estimates (2000-2035) for adults (40-79 years). We calculated the observed age-standardized mortality rates (2000-2019) (per 100 000 residents) (aSMR) and fitted Bayesian age-period-cohort models to project aSMR for IHD, CeVD, and HF up to 2035 in the United States. Between 2019 (last year of observed data) and 2035 (last year of projected results), the US population (40-79 years) will increase by 16% and age. The IHD aSMR will reduce from 111.9 (in 2019) to 81.8 (66.7-96.9) in 2035, an effect observed for all age groups. The CeVD aSMR will remain comparable between 2019 (37.4) and 2035 (38.6 [30.7-46.5]). The HF aSMR will increase from 16.5 in 2019 to reach 30.9 (13-48.8) in 2035; such increases were observed in all age groups. In the United States, between 2020 and 2035, the aSMR for IHD is expected to decrease, for CeVD will remain stable, and for HF will increase substantially. These data can inform resource allocation for future public health initiatives.

Red Wine Consumption and the Impact on Cardiovascular Health: The Methodological Barriers of Observational Study Design.

Cardiovascular disease (CVD) is the leading cause of death among communicable and noncommunicable diseases, and its prevalence is going to rise even more by 2030. The discovery of different "functional" foods containing a plethora of bioactive compounds is considered an ally in the effort to reduce the global CVD burden in the context of primary prevention. It has been about 3 decades since the observation that red wine consumption in French population could lead to lower coronary heart disease risk despite the high dietary consumption of saturated fats, known as the "French paradox." Since then, numerous epidemiological studies, mainly observational, have emerged in order to investigate this association with great enthusiasm. However, due to the nature of these studies, the scientific community has raised concerns about the methodological approach of the studies and thus the generalization of their results. Therefore, the current review aims to summarize some of the major methodological issues deriving from observational studies on the association between red wine consumption and cardiovascular health and to highlight the importance of higher quality study design in the general effort of drawing safer conclusions on this topic.

Purslane Leaf Extract (Portulaca oleracea) as a Cholesterol Control Herbal Tea Mixture

Cholesterol is one of the essential molecules in humans. An imbalance in cholesterol levels in the body, such as high levels of triglycerides and low-density lipoprotein (LDL) or total cholesterol, can contribute to one of the leading causes of death in Indonesia. Diseases caused by high cholesterol levels include cardiovascular diseases, atherosclerosis, hypercholesterolemia, hyperlipidemia, coronary heart disease, hypertension, and stroke [6,9,14]. As a result, additional intake from sources like omega-3-rich supplements or herbal remedies is recommended. Historically, plant-based treatments have been used as pharmacological therapies. Researchers have explored the use of purslane (Portulaca oleracea) leaves, which contain unsaturated fatty acids and antioxidants, including omega-3 fatty acids, vitamins A and C, and minerals such as magnesium and potassium, offering cardiovascular benefits. The researchers utilized purslane extract as an herbal tea blend, serving as a natural alternative to supplements in capsule form, which may be more expensive. In extract form, purslane leaves are hygienically processed and mixed with herbal tea, creating a convenient health drink for daily consumption. The purslane leaf extract was obtained through method maceration using 96% food-grade ethanol. Proximate tests were conducted to assess total energy, energy from fat, ash content, moisture content, carbohydrates (by difference), total fat, and protein content [5,24]. Sensory evaluation was conducted by semi-trained panelists to assess the color, aroma, and taste of herbal tea blends containing purslane leaf extract. This evaluation aimed to collect subjective feedback from potential consumers regarding the organoleptic characteristics of the product.

Deciphering the Role of Copper Homeostasis in Atherosclerosis: From Molecular Mechanisms to Therapeutic Targets

Cardiovascular disease (CVD) is a leading cause of death globally, with atherosclerosis (AS) playing a central role in its pathogenesis as a chronic inflammatory condition. Copper, an essential trace element in the human body, participates in various biological processes and plays a significant role in the cardiovascular system. Maintaining normal copper homeostasis is crucial for cardiovascular health, and dysregulation of copper balance is closely associated with the development of CVD. When copper homeostasis is disrupted, it can induce cell death, which has been proposed to be a novel form of “cuproptosis”, distinct from traditional programmed cell death. This new form of cell death is closely linked to the occurrence and progression of AS. This article elaborately describes the physiological mechanisms of copper homeostasis and explores its interactions with signaling pathways related to AS. Additionally, we focus on the process and mechanism of cell death induced by imbalances in copper homeostasis and summarize the relationship between copper homeostasis-related genes and AS. We also emphasize potential therapeutic approaches, such as copper balance regulators and nanotechnology interventions, to adjust copper levels in the body, providing new ideas and strategies for the prevention and treatment of CVD.

Relative burden of cancer and noncancer mortality among long-term survivors of differentiated thyroid cancer in the US

BackgroundLimited information is available regarding the relative risks of cancer-specific mortality and noncancer-specific mortality among long-term survivors with differentiated thyroid cancer (DTC).MethodsIn this retrospective study, nationwide data from the Surveillance, Epidemiology, and End Results database (1992-2020) were utilized. The Accelerated Failure Time Model was applied to calculate Survival Time Ratios (TR), with the primary focus on mortality resulting from DTC. The competing risks model was employed to investigate the relative risks of various outcomes in DTC patients with a survival duration of 5 years or more.ResultsIn our cohort, 279 patients succumbed to DTC, while 748 died from other diseases. Notably, in DTC cohorts, noncancer-specific mortality rates were consistently higher than DTC-specific mortality rates across different age groups and genders. The risk of DTC and noncancer-specific mortality varied based on the TNM stage. With more advanced disease stages, the risk of DTC and other cancer-specific mortality gradually increased. The cumulative mortality from other cancer-specific causes was consistently the lowest.ConclusionsIn long-term surviving DTC patients, noncancer-specific mortality outweighed DTC-specific mortality irrespective of age and gender. For stage I and II patients, increased attention should be directed toward noncancer-specific mortality in postoperative follow-ups. Conversely, for stage III and IV patients, greater consideration should be given to DTC-related causes of death. In addition, for stage III and IV DTC patients, the risk of death from other cancers was significantly higher than for stages I and II.

Common epidermal growth factor receptor mutations in north Indian patients with non-small cell lung carcinoma: evidence from real-time polymerase chain reaction.

Lung carcinoma was the ace cause of cancer deaths globally in 2022, with non-small cell lung carcinoma (NSCLC) accounting for 81% of the burden. Due to promising tyrosine kinase inhibitor (TKI) trials, NSCLC patients harboring epidermal growth factor receptor (EGFR) gene mutations are of interest. Our aim was to determine EGFR mutation prevalence in north India and its histologic and demographic correlations. We investigated the frequency of EGFR mutations in 40 patients with histologically confirmed NSCLC using real-time polymerase chain reaction. A 15% mutation frequency was observed in the study sample, involving 32 males and 8 females with a median age of 59 years. Squamous cell carcinoma (SCC) patients had only EXON20 (T790M, exon20 insertion) mutations, while adenocarcinoma patients had mutations in both EXON20 (T790M) and 21 (L858R) with mutation frequencies of 22% and 10%, respectively. 28% of the SCC patients were non-smokers, and 60% of these non-smokers had an EGFR mutation. South Indian and Asian studies have identified EXON19 (19-Del) and EXON21 (L858R) mutations as "common mutations" that account for nearly 80-90% of all mutations and respond well to TKIs. Interestingly, "common mutations" were found seldom in our study population, while the uncommon variants constitute 83% of all mutations, which we assume is due to diverse Indian genetics and ethnicity and co-existing signature mutations that involve the tyrosine kinase domain of EXON20. We suggest future genome-wide association studies to identify plausible genetic polymorphisms responsible for interethnic differences in EGFR mutation, which will contribute to better treatment and prevention of NSCLCs.

Unveiling novel prognostic biomarkers and therapeutic targets for HBV-associated hepatocellular carcinoma through integrated bioinformatic analysis.

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths globally, with limited treatment options. The goal of this study was to use integrated bioinformatic analysis to find possible biomarkers for prognosis and therapeutic targets for hepatitis B (HBV)-associated HCC. Three microarray datasets (GSE84402, GSE121248, and E-GEOD-19665) from patients with HBV-associated HCC were combined and analyzed. We identified differentially expressed genes (DEGs) and performed pathway enrichment analysis. We constructed protein-protein interaction networks to identify hub genes. We identified a total of 374 DEGs, which included 90 up-regulated and 284 down-regulated genes. Pathway enrichment analysis revealed associations with cell cycle, oocyte meiosis, and the p53 signaling pathway for up-regulated DEGs. Twenty hub genes were identified, and 9 of them (ZWINT, MELK, DLGAP5, BIRC5, AURKA, HMMR, CDK1, TTK, and MAD2L1) were validated using the Cancer Genome Atlas data and Kaplan-Meier survival analysis. These genes were significantly associated with a poor prognosis in HCC patients. Our research shows that ZWINT, MELK, DLGAP5, BIRC5, AURKA, HMMR, CDK1, TTK, and MAD2L1 may be useful for predicting how HBV-associated HCC will progress and for finding new ways to treat it. In addition to these further studies are needed to elucidate the functions of the remaining 11 identified hub genes (RRM2, NUSAP1, PBK, CCNB1, CCNB2, BUB1B, NEK2, CENPF, ASPM, TOP2A, and BUB1) in HCC development and progression.

A Case for a Maternal Culturally Tailored Smoking Cessation Research Agenda

Background/Objectives: Despite national efforts, smoking rates during pregnancy remain high among certain demographics, particularly American Indian/Alaska Native and younger women. This study examines the causal link between maternal smoking, maternal and fetal mortality, and social determinants of health, highlighting disparities faced by Black, Indigenous, and People of Color (BIPOC) and American Indian/Alaskan Native (AIAN) pregnant persons. Methods: Data from various sources, including national reports and committee findings, were analyzed to assess trends in maternal smoking, mortality rates, and associated factors. While smoking rates among all groups have declined, disparities persist. Young women, BIPOC, and American Indian/Alaska Native women, and those with lower educational attainment, have higher smoking rates. Black women exhibit significantly higher maternal mortality rates, often linked to cardiac/coronary conditions. Stress, exacerbated by social determinants of health like poverty and housing insecurity, emerges as a key factor driving smoking behavior, particularly among African Americans. The leading causes of pregnancy-related deaths vary by race and ethnicity, with preventability noted in 80% of cases. Perinatal exposure to cigarette smoking is also identified as a leading cause of poor infant health outcomes, emphasizing the importance of addressing smoking behavior during and after pregnancy. Results: This report advocates for a comprehensive approach to reducing maternal and fetal mortality rates, with a focus on adapting existing smoking cessation programs to adopt culturally tailored agendas in order to address social and political determinants of health as well as behavioral drivers of tobacco use among pregnant persons.

Risk factors for suicide in patients with colorectal cancer: A Surveillance, Epidemiology, and End Results database analysis

BackgroundSpecific risk factors for suicide in patients with colorectal cancer have not been well established. Therefore, we aimed to assess factors associated with increased risk of suicide among patients with colorectal cancer. MethodsThis was a retrospective cohort analysis of consecutive patients with colorectal cancer. Patients who survived were compared with patients for whom suicide was registered as their cause of death. Data were extracted from the National Cancer Institute's Surveillance, Epidemiology, and End Results Research Database 2000–2020. Primary outcome was risk factors for suicide. ResultsIn total, 309,561 patients were included in the analysis; 160,095 (51.7%) were male. Suicide was the cause of death in 1,052 (0.34%). The suicide rate among patients with colorectal cancer decreased over time from 1% between 2000 and 2010 to 0.05% between 2011 and 2020 (P < .001). Male sex (odds ratio, 6.44; P < .001), non-Hispanic ethnicity (odds ratio, 2.84; P = .014), household income between $50,000 and $74,999 (odds ratio, 1.79; P = .008) or <$50,000 (odds ratio, 1.84; P = .030), and metastatic disease (odds ratio, 2.89; P = .001) were independent risk factors for suicide. Colorectal cancer diagnosis in the second half of the study (2011–2020) was associated with lower risk of suicide compared with the first half (odds ratio, 0.338; P < .001). ConclusionAmong patients with colorectal cancer, male patients of non-Hispanic ethnicity and income <$75,000 USD who presented with metastatic disease were at increased risk of suicide. This trend decreased in the last decade, especially compared with the suicide rate among all patients with cancer. On the basis of these findings, we recommend targeted screening of this group of patients with colorectal cancer for suicidality as part of routine oncologic care.