High Death Rate Research Articles

Pemeriksaan Kadar Glukosa, Asam Urat Dan Kolesterol STIKes Salewangang Maros

The Ministry of Health stated that non-communicable diseases cause high death rates every year and can affect individuals of various ages and countries throughout the world. Non-communicable diseases include heart disease, diabetes mellitus and diseases of kidney function. To overcome these health problems, preventive measures are needed that aim to improve the nation's quality of life. This is stated in the Presidential Instruction which is part of the meaning of Germas, namely regular health checks which are useful for facilitating early detection of diseases or health problems. The examinations carried out are divided into 2, namely laboratory examinations (blood examination, blood sugar levels, fat levels, kidney function/uric acid, liver function, and electrolytes) and physical examinations (ECG, etc.). The aim of community service is to provide an overview of current blood sugar levels, uric acid, cholesterol levels and body flexibility in the spine for Lecturers and Staff of Stikes Salewangan Maros and community members around the campus. The method involves checking blood sugar levels, uric acid and cholesterol as well as assessing body flexibility. The results obtained were that 60 (98%) respondents had normal blood sugar levels, 39 (64%) respondents had normal uric acid levels, 32 (52.5%) had cholesterol < 200 mg/dl, and 51 (83%) .6 %) shows excellent flexibility. Conclusion. Most of the respondents had normal blood sugar levels, uric acid levels, cholesterol levels and the majority of respondents showed excellent flexibility.

Ferroptosis in lung cancer: dual role, multi-level regulation, and new therapeutic strategies.

Lung cancer is a highly prevalent malignant tumor worldwide, with high incidence and death rates. Recently, there has been increasing recognition of the role of ferroptosis, a unique cell death mechanism, in lung cancer. This review aims to summarize the current research progress on the relationship between ferroptosis and lung cancer. It also provides a comprehensive analysis of the regulatory processes of ferroptosis in various stages, including epigenetics, transcription, post-transcription, translation, and post-translation. Additionally, the review explores the dual nature of ferroptosis in lung cancer progression, which presents interesting therapeutic possibilities. On one hand, ferroptosis can promote the escape of immune surveillance and reduce the efficacy of treatment in the early stages of tumors. On the other hand, it can counter drug resistance, enhance radiosensitivity, and promote immunotherapy. The article also discusses various combination treatment strategies based on the mechanism of ferroptosis. Overall, this review offers a holistic perspective on the role of ferroptosis in the onset, progression, and treatment of lung cancer. It aims to contribute to future research and clinical interventions in this field.

Palladium Metal Nanocomposites Based on PEI-Functionalized Nitrogen-Doped Graphene Quantum Dots: Synthesis, Characterization, Density Functional Theory Modeling, and Cell Cycle Arrest Effects on Human Ovarian Cancer Cells.

In this study, the synthesis, characterization, density functional theory calculations (DFT), and effect of polyethylenimine (PEI)-functionalized nitrogen-doped graphene quantum dots (PEI N-GQDs) and their palladium metal nanoparticles nanocomposites (PdNPs/PEI N-GQDs) on cancer cells were extensively investigated. The focus also includes investigating their cytotoxic and apoptotic effects on ovarian cancer cells, which pose a serious risk to women's health and have high death rates from delayed diagnosis, inadequate response to treatment, and decreased survival. Graphene quantum dots and their palladium nanocomposites were differentially effective against ovarian cancer cell lines. In particular, the smaller particle size and morphology of PdNPs/PEI N-GQDs nanocomposites compared with PEI N-GQDs probably enhance their activity through highly improved uptake by cells. These findings emphasize the importance of particle size in composite drugs for efficient cancer treatment. DFT results revealed that the Pd-containing nanocomposite, with a smaller highest occupied molecular orbital-lowest unoccupied molecular orbital gap, exhibited higher reactivity and anticancer effects in human ovarian cancer cell line, OVCAR-3. Significantly, the application of nanocomposites to ovarian cancer cells initiated apoptosis, offering valuable insights into the intricate interplay between nanomaterials and cancer biology.

Nipah Virus Disease: An Updated Review

The Nipah virus (NiV) is a member of the Paramyxoviridae family of zoonotic viruses that is extremely contagious and potentially fatal. The Nipah virus was first discovered in 1999 during an outbreak in Malaysia. Since then, it has periodically caused outbreaks throughout South and Southeast Asia, especially in Bangladesh and India, and it continues to be a serious public health concern. The virus is primarily transmitted to humans through direct contact with infected fruit bats, which serve as natural reservoir hosts for the Nipah virus. Human-to-human transmission can also happen when infected people's body fluids come into close contact with one another. The Nipah virus has a high death rate that varies depending on the outbreak and can cause a variety of clinical presentations, including encephalitis, severe respiratory illnesses, and asymptomatic infections. Fever, headache, dizziness, drowsiness, and confusion are common signs of Nipah virus infections, which may lead to the rapid onset of coma in the patient. The Nipah virus does not presently have a specific antiviral treatment; instead, infection control methods and supportive care are the foundation of management to stop the virus from spreading. Nipah virus outbreaks must be stopped with an approach that includes community involvement, public health education, and surveillance of both human and animal populations. Additionally, efforts are directed toward developing vaccines as a more potent form of prevention. The Nipah virus is a clear reminder of the continuous threat that newly emerging infectious diseases pose, as well as the necessity of having strong surveillance systems and quick response times in place to lessen the effects that these outbreaks have on public health.

Comparative Evaluation of ELISA and Real-time PCR Tests to Detect COVID-19

Background: Considering the wide spread of covid-19 and its high death rate, it is very important to find a sensitive and accurate diagnostic method. Thus, this study compared two main diagnostic approaches; PCR and ELISA, to detect COVID-19. Methods: Fifty patients admitted to Baghiyatalah Hospital were examined to detect COVID-19 RNA by Real-time PCR method, as well as for the presence of IgG and IgM antibodies by ELISA method. The results were statistically analysed by SPSS software. Results: The mean age of patients is 38.4 years old. The percentage of positive cases of COVID-19 in the studied patients according to PCR and ELISA tests was 66% and 70%, respectively. There was a statistically significant difference between positive cases of COVID-19 detected by PCR and ELISA with emerging fever, weakness, and lethargy . The diagnostic value of ELISA versus PCR showed that the sensitivity, specificity, positive likelihood ratio, and true positive rate were 100%, 88.2%, 8.5, and 94.29%, respectively. Conclusion: Although the sensitivity of detection in Real-time PCR is higher than that in ELISA, there is a high agreement between the two methods when used for diagnosis of COVID-19.

Impact of Incomplete Revascularization After PCI in Left Main Disease: The EXCEL Trial.

The importance of complete revascularization after percutaneous coronary intervention (PCI) in patients with left main coronary artery disease is uncertain. We investigated the clinical impact of complete revascularization in patients with left main coronary artery disease undergoing PCI in the EXCEL trial (Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization). Composite rates of death or myocardial infarction (MI) following PCI during 5-year follow-up were examined in 903 patients based on core laboratory definitions of anatomic and functional complete revascularization, residual SYNTAX score (The Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery), and residual Jeopardy Score (rJS). The risk of death or MI did not vary based on anatomic, functional, or residual SYNTAX score complete revascularization but did differ according to the rJS (5-year rates 17.6%, 19.5%, and 38.9% with rJS 0, 2, and ≥4, respectively; P=0.006). The higher rate of death or MI with rJS≥4 versus rJS≤2 was driven conjointly by increased mortality (adjusted hazard ratio, 2.29 [95% CI, 1.11-4.71]; P=0.02) and spontaneous MI (adjusted hazard ratio, 2.89 [95% CI, 1.17-7.17]; P=0.02). The most common location for untreated severe stenoses in the rJS≥4 group was the left circumflex artery (LCX), and the post-PCI absence, compared with the presence, of any untreated lesion with diameter stenosis ≥70% in the LCX was associated with reduced 5-year rates of death or MI (18.9% versus 35.2%; hazard ratio, 0.48 [95% CI, 0.32-0.74]; P<0.001). The risk was the highest for residual ostial/proximal LCX lesions. Among patients undergoing PCI in EXCEL trial, incomplete revascularization according to the rJS was associated with increased rates of death and spontaneous MI. Post-PCI untreated high-grade lesions in the LCX (especially the ostial/proximal LCX) drove these outcomes. URL: https://www.clinicaltrials.gov; Unique identifier: NCT01205776.

Epidemiology of typhoid fever in the Philippines during the last six decades from 1960-2019: a profile and its trend

Regardless of the numerous reviews and publications on typhoid fever in the Philippines, it continues to be an issue regarding public health. Using data obtained from the Philippine Health Statistics (PHS), this study examined trends in typhoid fever mortality across an interval of six decades in the Philippines. The mortality and morbidity rates of typhoid fever were analyzed to discover trends of change for each year, age group, sex, and area. The Microsoft Excel software tool became used for all data analysis. The results show a decrease in typhoid fever fatality rates in the Philippines over the previous year. In terms of sex-specific deaths, males outnumbered females. The individuals aged 70 and older have the highest death rates when it comes to age-specific mortality rates. In the Philippines, Region I also has the highest mortality rate from typhoid fever. For instance, the Autonomous Region of Muslim Mindanao (ARMM) has the lowest mortality rate from typhoid fever. The highest average morbidity rate is in the Cordillera administrative region (CAR), while the lowest is in Region IVB. To eliminate typhoid fever in the next few years and to completely combat typhoid fever throughout the years, educational campaign awareness or intimate knowledge must be conducted locally and globally.

Predicting Vulnerabilities in the Delivery of Secure Healthcare Supply Chain Services

The COVID-19 pandemic exposed the weaknesses in healthcare supply chains, leading to shortages, increased costs, and untrustworthy vendors. This has put patients at risk for treatment delays, worse care, and higher death rates. The healthcare supply chain's dependence on single sourcing has made these issues worse. Geopolitical conflicts, climatic catastrophes, data privacy issues, cybersecurity threats, and counterfeit goods are emerging risks. Resilient solutions are needed due to the complex ecosystem of manufacturers, wholesalers, regulatory organizations, and healthcare providers. Supply Chain Resilience (SCRES) is crucial for uninterrupted healthcare services, with redundancy, visibility, and adaptability being key components. Future research directions include blockchain integration, data analytics, and regulatory frameworks to improve resilience. Successful mitigation solutions require understanding interdependence, resilience measurements, and behavioral elements. Addressing these vulnerabilities is crucial for patient safety and healthcare effectiveness.

Abstract B031: High risk no specific molecular profile (HR-NSMP) endometrial cancer can be stratified into three subgroups based on tumor grade and estrogen receptor status with differing clinicopathologic characteristics and outcomes

Abstract Introduction: Recent publications have identified ‘low risk’ (LR-NSMP) and ‘high risk’ no specific molecular profile (HR-NSMP) endometrial cancers (ECs). Although LR-NSMP (low grade (G1/2) estrogen receptor (ER) positive tumors have extremely low rates (&amp;lt;2%) of death from disease and are considered candidates for de-escalation of adjuvant therapy, little is known about the newly defined entity of HR-NSMP (G3 and/or ER-negative), including optimal management, with 27% of HR-NSMP patients dying from their disease We aimed to perform in-depth characterization of a cohort of HR-NSMP ECs to identify additional prognostic or predictive features that may inform management. Methods: Clinicopathologic data collection, immunohistochemistry (IHC), and next generation sequencing was performed on a cohort of 148 HR-NSMP ECs testing for associations with outcomes. Three subgroups of HR-NSMP were assessed: i) low grade without any ER expression (G1/2ER-, n=40), ii) high grade with ER (G3ER+, n=67), and iii) high grade without ER expression (G3ER-, n=41). Results: In a univariate analysis, advanced stage (III/IV), positive lymph node (LN) status, no LN assessment, and PIK3CA mutations were associated with inferior progression-free survival (PFS), disease specific survival (DSS), and overall survival (OS). HR-NSMP patients with positive LNs had a hazard ratio (HR) of death of 7.55 (95% CI: 3.41−16.73) compared to node negative. Additionally, patients with no LN assessment had an increased risk of death with a HR of 2.33 (95% CI: 1.12−4.85) compared to node negative. Within the three HR-NSMP subgroups, the worst OS (HR 7.06, CI 4.12-12.09, p&amp;lt; 0.001), DSS (HR 20.43, CI 10.14-41.19, p&amp;lt; 0.001), and PFS (HR 3.69, CI 1.59-8.63, p&amp;lt;0.001) were observed in patients with both adverse features (G3ER-). PIK3CA mutations were found in 32.7% of all HR-NSMP tumors tested (G1/2ER- 45.5%, G3ER+ 42.3%, G3ER- 6.7%) and associated with inferior OS (HR 4.84, CI 1.21-19.41, p=0.014), DSS (HR 4.84, CI 1.21-19.41, p=0.014), and PFS (HR 3.22, CI=1.08-9.66, p=0.028). There was a trend towards decreased OS and DSS in HR-NSMP patients with overexpression of HER2 IHC. L1CAM IHC overexpression and CTNNB1 mutation status were not associated with outcomes when assessed across all HR-NSMP or within subgroups. Conclusion: Among HR-NSMP ECs, the worst clinical outcomes were observed in patients harboring both high grade and ER negative tumors. In contrast to LR-NSMP ECs where patients who had no lymph node assessment had excellent outcomes mirroring node negative status, HR-NSMP patients who had no nodal assessment had a high rate of recurrence and death from disease suggesting the importance of comprehensive staging in this cohort. PIK3CA appears to be a prognostic stratification feature within HR-NSMP and represents a potential therapeutic pathway. More work is needed to understand the association of HER2 expression and ER status and whether HER2 -targeted therapies represent actionable opportunities for these patients. Citation Format: Andrea Neilson, Amy Jamieson, Derek Chiu, Samuel Leung, Amy Lum, Jennifer Pors, Stefan Kommoss, Aline Talhouk, David G. Huntsman, Naveena Singh, C. Blake Gilks, Jessica N. McAlpine. High risk no specific molecular profile (HR-NSMP) endometrial cancer can be stratified into three subgroups based on tumor grade and estrogen receptor status with differing clinicopathologic characteristics and outcomes [abstract]. In: Proceedings of the AACR Special Conference on Endometrial Cancer: Transforming Care through Science; 2023 Nov 16-18; Boston, Massachusetts. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(5_Suppl):Abstract nr B031.

The Rationale for Using Fixed-Dose Combination Therapy in the Management of Hypertension in Colombia: A Narrative Review.

Hypertension is a major risk factor for cardiovascular disease and the leading cause of death in Colombia. While the rate of hypertension awareness in Colombia is generally high, rates of treatment initiation, adherence, and blood pressure (BP) control are suboptimal. Major international hypertension guidelines recommend starting treatment with a combination of antihypertensive agents, and the use of a single-pill combination (SPC) to maximize adherence. In contrast, Colombian hypertension guidelines recommend starting treatment with diuretic monotherapy in most patients, and only initiating combination therapy in those with BP > 160/100 mmHg. Therefore, the aim of the current narrative review is to examine the rationale for using SPCs to treat hypertension in Colombia, in the context of the major issues for BP controlthere. There is evidence of widespread therapeutic inertia in hypertension management, particularly in primary care, in Colombia. Moreover, combination therapy, angiotensin-converting enzyme inhibitors, and long-acting calcium channel blockers, which are internationally recommended as first-line drug therapies, are underutilized there. Adherence to antihypertensive therapy is low in Colombia and may be enhanced by use of SPCs as well as better patient education and follow-up. While there are promising national initiatives to improve BP management, more needs to be done by individual physicians. Antihypertensive SPCs are available on the national essential medicines list and may help to overcome some of the problems with suboptimal adherence, therapeutic inertia, and low rates of BP control that contribute to the high cardiovascular death rate in Colombia.

Arizona and COVID-19: Four-Year Experience 2020-23

It had been four years since COVID-19 first appeared in Arizona on January 22, 2020. The state is about the same size as Italy. Since Arizona Governor Doug Ducey had declared a State of Emergency to combat COVID-19 on March 11, 2020, the state had gone through three Reopening Phases. ABC and NBC News reported that the state had the highest new cases per capital in the world during Arizona’s Reopening Phase 2 winter surge in 2020. The state had been in Reopening Phase 3 (final phase) since March 5, 2021. Arizona had the highest death rate per capital of all the 50 states in 2021-22 reported by the Centers for Disease Control and Prevention (CDC). The study examined four years of the state’s COVID-19 pandemic. On December 27, 2023, the four-year totals were 2,540,562 COVID-19 cases, 149,121 hospitalizations, and 33,900 deaths. During the first three years, the case numbers rose (590,745 in 2020, 827,573 in 2021, and 988,649 in 2022), but in the fourth year, the case number had dropped significantly (168,918 in 2023). There were seven case surges during the four years. Arizona had been in the endemic phase of the virus for the past six months. The new normal was not zero cases, but a low number of severe cases, manageable hospitalization numbers, and low number of deaths.

Analysis of Factors Influencing Covid-19 Mortality Rate in Indonesia

Coronavirus disease 2019(Covid-19) which is caused by the SARS-CoV-2 virus, has a major impact on the high death rate. The positive confirmation rate is directly proportional to the Covid-19 death rate. The vaccination program is carried out to reduce the spread, reduce morbidity, mortality and achieve immunity from the SARS-CoV-2 virus. The aim of the research is to determine the effect of positive confirmation rates and vaccination rates on the Covid-19 death rate in Indonesia.The research is an observational study with a cross sectional approach.The population in this study were all patients with confirmed Covid-19. The samples were patients who were confirmed to have Covid-19 from February 2021 to March 2022. The analysis technique used was multiple linear regression. The research results show that the positive confirmation rate (p = 0.000) has a positive effect on the Covid-19 death rate, while the vaccination rate (p =0.278) and the second vaccination rate (p = 0.8619) had no effect on the Covid-19 death rate. It can be concluded that there is a positive and significant relationship between the number of positive confirmations and the Covid-19 death rate. The number of first and second vaccinations is not related to the Covid-19 death rate

Role of Plant derived-medicine for controlling Cancer

This review paper has highlighted a list of plants containing active phytochemicals with anticancer potential, as well as data supporting their use in cancer therapy, animal models, and their pharmacological properties. Cancer is among the leading causes of morbidity and mortality worldwide. Cancer is a disease characterized by abnormal cell division and proliferation that result from disruption of molecular signals that control these processes. Cancer is the abnormal, uncontrolled division of cells in the body. The cancer cells when malignant, invade various parts of the body through the bloodstream. The spread of cancer from its cells or tissue of origin to another healthy part of tissues or organs is called metastasis. Some of the regular characteristics of cancers are apoptosis, angiogenesis, multiple replication, growth signal production, insensitivity to signals of anti-growth and metastasis. These features make cancer cells to have continuous growth, long time survival and the potential to invade normal cells. Moreover, if these activities are not blocked, cancer cells will continue to increase, overwhelm and finally kill the patient with cancer. Oncology is the study of cancer. An oncologist is a doctor who treats cancer and provides medical care for a person diagnosed with cancer. An oncologist may also be called a cancer specialist. Today, despite considerable efforts, cancer still remains an aggressive killer worldwide. The success rate of these therapies is diminished by toxicities, drug resistance, recurrence and treatment failure. A significant challenge associated with cancer is that treatment is as much an art as it is a science. Therefore, there is a constant demand to develop new, effective, and affordable anticancer drugs. Several factors, such as environmental factors, habitual activities, genetic factors, etc., are responsible for cancer. Many cancer patients seek alternative and/or complementary treatments because of the high death rate linked with cancer and the adverse side effects of chemotherapy, radiation therapy, immunotherapy, surgery, and stem cell therapy. Medicinal plants could also possess effective anticancer compounds that may be used as adjuvants to existing chemotherapy to improve efficacy and/or reduce drug-induced toxicity; such as chemotherapy-induced nausea and vomiting to improve patients’ quality of life. Cell death is caused by the whole plant extracts via apoptosis. However, majority of plant extracts have been researched for cancer prevention rather than treatment, resulting in low efficacy and uptake in practice. Prevention is certainly an attractive cancer management strategy. Thus it might be possible to reduce the process of carcinogenesis with regular use of these plants along with a healthy lifestyle.

Noncoding RNAs and programmed cell death in hepatocellular carcinoma: Significant role of epigenetic modifications in prognosis, chemoresistance, and tumor recurrence rate.

Hepatocellular carcinoma (HCC) is the most common type of liver cancer with a high death rate in the world. The molecular mechanisms related to the pathogenesis of HCC have not been precisely defined so far. Hence, this review aimed to address the potential cross-talk between noncoding RNAs (ncRNAs) and programmed cell death in HCC. All related papers in the English language up to June 2023 were collected and screened. The searched keywords in scientific databases, including Scopus, PubMed, and Google Scholar, were HCC, ncRNAs, Epigenetic, Programmed cell death, Autophagy, Apoptosis, Ferroptosis, Chemoresistance, Tumor recurrence, Prognosis, and Prediction. According to the reports, ncRNAs, comprising long ncRNAs, microRNAs, circular RNAs, and small nucleolar RNAs can affect cell proliferation, migration, invasion, and metastasis, as well as cell death-related processes, such as autophagy, ferroptosis, necroptosis, and apoptosis in HCC by regulating cancer-associated genes and signaling pathways, for example, phosphoinositide 3-kinase/Akt, extracellular signal-regulated kinase/MAPK, and Wnt/β-catenin signaling pathways. It seems that ncRNAs, as epigenetic regulators, can be utilized as biomarkers in diagnosis, prognosis, survival and recurrence rates prediction, chemoresistance, and evaluation of therapeutic response in HCC patients. However, more scientific evidence is suggested to be accomplished to confirm these results.

Association of maternal, obstetric, fetal, and neonatal mortality outcomes with Lady Health Worker coverage from a cross-sectional survey of >10,000 households in Gilgit-Baltistan, Pakistan.

Pakistan has among the highest rates of maternal, perinatal, and neonatal mortality globally. Many of these deaths are potentially preventable with low-cost, scalable interventions delivered through community-based health worker programs to the most remote communities. We conducted a cross-sectional survey of 10,264 households during the baseline phase of a cluster randomized controlled trial (cRCT) in Gilgit-Baltistan, Pakistan from June-August 2021. The survey was conducted through a stratified, two-stage sampling design with the objective of estimating the neonatal mortality rate (NMR) within the study catchment area, and informing implementation of the cRCT. Study outcomes were self-reported and included neonatal death, stillbirth, health facility delivery, maternal death, postpartum hemorrhage (PPH), and Lady Health Worker (LHW) coverage. Summary statistics (proportions and rates) were weighted according to the sampling design, and mixed-effects Poisson regression was conducted to explore the relationship between LHW coverage and maternal/newborn outcomes. We identified 7,600 women who gave birth in the past five years, among whom 13% reported experiencing PPH. The maternal mortality ratio was 225 maternal deaths per 100,000 live births (95% confidence interval [CI] 137-369). Among 12,376 total births, the stillbirth rate was 41.4 per 1,000 births (95% CI 36.8-46.7) and the perinatal mortality rate was 53.0 per 1,000 births (95% CI 47.6-59.0). Among 11,863 live births, NMR was 16.2 per 1,000 live births (95% CI 13.6-19.3) and 65% were delivered at a health facility. LHW home visits were associated with declines in PPH (risk ratio [RR] 0.89 per each additional visit, 95% CI 0.83-0.96) and late neonatal mortality (RR 0.80, 95% CI 0.67-0.97). Intracluster correlation coefficients were also estimated to inform the planning of future trials. The high rates of maternal, perinatal, and neonatal death in Gilgit-Baltistan continue to fall behind targets of the 2030 Sustainable Development Goals.

Mortality and Heart Transplantation After Hybrid Palliation of Hypoplastic Left Heart Syndrome: A Systematic Review and Meta-Analysis.

Newborns with hypoplastic left heart syndrome (HLHS) who are considered at increased risk for death following Norwood/Sano surgery often undergo hybrid palliation (HP) as initial surgery. We aimed to compile the HP experience in HLHS and its variants and assess the rates of, and risk factors for, death and heart transplantation. CINAHL, CINAHL PLUS, PubMed/MEDLINE, and SCOPUS were systematically searched for HP outcome studies of death or heart transplantation in HLHS between 1998 and 2022. Pooled incidence was estimated, and potential risk factors were identified using random-effects meta-analysis and reconstructed time-to-event data from Kaplan-Meier curves. Thirty-three publications were included in our review. Overall, of 1,162 patients 417 died and 57 underwent heart transplantation, resulting in a combined outcome of 40.7%, (474/1,162). There was a trend toward decreasing mortality risk across the stages of palliation. Pooled mortality between HP and comprehensive stage 2 palliation was 25%, after stage 2 up to Fontan palliation was 16%, and 6% post-Fontan. The incidence of death or heart transplantation was higher in high-risk patients-43% died and 10% received heart transplantation. Our systematic review and meta-analysis found high rates of death or heart transplantation in HP of HLHS patients between HP and Fontan surgeries. All patients should be closely followed during the initial interstage period, which is associated with the highest hazard. Prospective studies on appropriate patient selection, indications, and / or alternatives, as well as refining HP strategies for managing newborns with HLHS are needed to improve outcomes.

Racial/Ethnic Disparities in Pathologic Complete Response and Overall Survival in Patients With Triple-Negative Breast Cancer Treated With Neoadjuvant Chemotherapy.

Black women have higher rates of death from triple-negative breast cancer (TNBC) than White women. We hypothesized that pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) and overall survival (OS) may vary by race/ethnicity in patients with TNBC. We identified women 18 years and older with stage I-III TNBC who received NAC followed by surgery from the National Cancer Database (2010-2019). We excluded patients without race/ethnicity or pathology data. Primary outcomes were pCR rates and OS on the basis of race/ethnicity. Forty thousand eight hundred ninety women with TNBC met inclusion criteria (median age [IQR], 53 [44-61] years): 26,150 Non-Hispanic White (64%, NHW), 9,672 Non-Hispanic Black (23.7%, NHB), 3,267 Hispanic (8%), 1,368 Non-Hispanic Asian (3.3%, NHA), and 433 Non-Hispanic Other (1.1%, NHO) patients. Overall, 29.8% demonstrated pCR (NHW: 30.5%, NHB: 27%, Hispanic: 32.6%, NHA: 28.8%, NHO: 29.8%). Unadjusted OS was significantly higher for those with pCR compared with those with residual disease (5-year OS, 0.917 [95% CI, 0.911 to 0.923] v 0.667 [95% CI, 0.661 to 0.673], log-rank P < .001), and this association persisted after adjustment for demographic and tumor factors. The effect of achieving pCR on OS did not differ by race/ethnicity (interaction P = .10). However, NHB patients were less likely (odds ratio [OR], 0.89 [95% CI, 0.83 to 0.95], P = .001) and Hispanic patients were more likely (OR, 1.19 [95% CI, 1.08 to 1.31], P = .001) to achieve pCR than NHW patients. After adjustment for patient and disease factors, including achievement of pCR, Hispanic (hazard ratio [HR], 0.76 [95% CI, 0.69 to 0.85], P < .001) and NHA (HR, 0.64 [95% CI, 0.55 to 0.75], P < .001) race/ethnicity remained associated with OS. Odds of achieving pCR and OS in patients with TNBC appear to be associated with race/ethnicity. Additional research is necessary to understand how race/ethnicity is associated with rates of pCR and OS, whether related to socioeconomic factors or biologic variables, or both.

Time-resolved fluoroimmunoassay for Aspergillus detection based on anti-galactomannan monoclonal antibody from stable cell line

Invasive Aspergillosis is a high-risk illness with a high death rate in immunocompromised people due to a lack of early detection and timely treatment. Based on immunology study, we achieved an efficient production of anti-galactomannan antibody by Chinese hamster ovary (CHO) cells and applied it to time-resolved fluoroimmunoassay for Aspergillus galactomannan detection. We first introduced dual promoter expression vector into CHO host cells, and then applied a two-step screening strategy to screen the stable cell line by methionine sulfoximine pressurization. After amplification and fermentation, antibody yield reached 4500 mg/L. Then we conjugated the antibodies with fluorescent microspheres to establish a double antibody sandwich time-resolved fluoroimmunoassay, which was compared with the commercial Platelia™ Aspergillus Ag by clinical serum samples. The preformed assay could obtain the results in less than 25 min, with a limit of detection for galactomannan of approximately 1 ng/mL. Clinical results of the two methods showed that the overall percent agreement was 97.7% (95% CI: 96.6%–98.4%) and Cohen's kappa coefficient was 0.94. Overall, the assay is highly consistent with commercial detection, providing a more sensitive and effective method for the rapid diagnosis of invasive aspergillosis.

FGF19-Based Mini Probe Targeting FGFR4 for Diagnosis and Surgical Navigation of Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is a frequent malignancy that has a high death rate and a high rate of recurrence following surgery, owing to insufficient surgical resection. Furthermore, HCC is prone to peritoneal metastasis (HCC-PM), resulting in a significant number of tiny cancer lesions, making surgical removal more challenging. As a potential imaging target, FGFR4 is highly expressed in tumors, especially in HCC, but is less expressed in the normal liver. In this study, we used computational simulation approaches to develop peptide I0 derived from FGF19, a particular ligand of FGFR4, and labeled it with the NIRF dye, MPA, for HCC detection. In surgical navigation, the TBR was 9.31 ± 1.36 and 8.57 ± 1.15 in HepG2 in situ tumor and HCC-PM models, respectively, indicating considerable tumor uptake. As a result, peptide I0 is an excellent clinical diagnostic reagent for HCC, as well as a tool for surgically resecting HCC peritoneal metastases.

Loneliness and fearfulness are associated with non-fatal drug overdose among people who inject drugs.

People who inject drugs (PWID) experience high rates of drug overdose death with the risk of mortality increasing after each non-fatal event. Racial differences exist in drug overdose rates, with higher rates among Black people who use drugs. Psychological factors may predict drug overdose. Cross-sectional data from a survey administered to PWID in Baltimore, MD enrolled in a social network-based intervention were analyzed. Linear regression methods with generalized estimating equations were used to analyze data from indexes and network members to assess for psychological factors significantly associated with self-reported number of lifetime drug overdoses. Factors associated with number of overdoses were assessed separately by race. Among 111 PWID enrolled between January 2018 and January 2019, 25.2% were female, 65.7% were Black, 98.2% reported use of substances in addition to opioids, and the mean age was 49.0 ± 8.3 years. Seventy-five individuals (67.6%) had a history of any overdose with a mean of 5.0 ± 9.7 lifetime overdoses reported. Reports of feeling fearful (β = 9.74, P = 0.001) or feeling lonely all of the time (β = 5.62, P = 0.033) were independently associated with number of drug overdoses. In analyses disaggregated by race, only the most severe degree of fearfulness or loneliness was associated with overdose among Black participants, whereas among White participants, any degree of fearfulness or loneliness was associated with overdose. In this study of PWID loneliness and fearfulness were significantly related to the number of reported overdose events. These factors could be targeted in future interventions.