Highest Number Of Deaths Research Articles

Mortality from cerebral stroke in the State of Pernambuco, Brazil: an ecological study

Introduction: cerebrovascular accident (CVA) is the second leading cause of death globally, characterized by cerebrovascular events due to dysfunctions in the cerebral blood supply. It can be ischemic or hemorrhagic and has high morbidity and mortality rates. In Brazil, it is the main cause of death, disabling many over 50 years of age and leading to around 40% of early retirements. Despite advances in initial treatment, mortality rates remain high, indicating flaws in prevention and treatment strategies. Therefore, the World Health Organization (WHO) emphasizes the need for immediate implementation of preventive and treatment measures for this condition. Objective: to evaluate the trend in the mortality coefficient and proportional mortality from stroke in the population of Pernambuco, from 2000 to 2021. Methods: This is an ecological time series study with data from the population of the state of Pernambuco, located in northeast region of Brazil, from 2000 to 2021. The eligibility criteria were deaths with a stroke occurring in the state of Pernambuco. Information on mortality, population estimates and number of deaths by sex and age group were extracted from the database of the Department of Informatics of the Unified Health System (DATASUS). For statistical analysis, it was calculated the mortality coefficient, proportional mortality, mean, standard deviation, skewness and kurtosis. The temporal trend of stroke was assessed by jointpoint regression. Results: Between 2000 and 2021, there were 39,410 deaths from stroke. Around 49.0% were male and 51.0% female. The female sex had an average of 913.45 in the number of deaths, being quantitatively higher than the average identified for the male sex of 877.04 deaths. The years with the highest number of deaths were 2006, 2007 and 2008, while 2018 had the lowest number. There was a progressive increase in the number of deaths from stroke from 2018 to 2021. There was a decline in the average annual percentage variation in the mortality rate for stroke in all groups studied, in addition to a drop in the average annual percentage of proportional mortality for stroke in the entire population. Throughout the period, there was a decline in the average annual percentage of proportional mortality from stroke in the entire population studied. Conclusion: In the period from 2000 to 2021 there was a greater number of deaths due to stroke in women in contrast to men in the population of Pernambuco, Brazil. Furthermore, there was a downward trend in stroke rates in both the mortality rate and proportional mortality. In the period from 2018 to 2021 there was a progressive increase in the mortality rate and proportional mortality from stroke.

Overview of the Indigenous health of the Yanomami ethnic group in Brazil: A Public Health Emergency.

The Indigenous population of the Yanomami ethnic group in Brazil is currently facing a public health emergency due to the high number of deaths, mainly of children. Taking that into consideration, this study aims to analyze this crisis impact on the health of this population in the period between 2018 and 2022. The data presented were collected from the report called Yanomami Mission ("Missão Yanomami") published by the Brazilian Ministry ofHealth and, from it, a descriptive analysis of the Indigenous individuals' health was carried out for (i) the geographical distribution; ii) the number of deaths; (iii) the child death rate; (iv) the deaths of Indigenous individuals from preventable causes; (v) the causes of preventable diseases related to hygiene and basic sanitation, and the distribution of diarrheal diseases according to age groups; (vi) evaluation of the nutritional classification; vii) the percentage (%)of the complete vaccination scheme, and (viii) the coverage of prenatal appointments of Indigenous pregnant women. The report included 31,017 individuals belonging to the Yanomami ethnic group, most of the participants were up to 39years old (N = 26,377; 85.0%) and men (N = 15,836; 51.1%). During the period described in the report, the number of deaths reached 1285/31,017 (4.1%). When analyzing the deaths, the most representative age groups were those of children under 1 year old (505/1285; 39.9%), from 1 to 4 years old (178/1285; 13.8%), and the elderly from 60 to 79 years old (150/1285; 11.6%). The Indigenous individuals from this ethnic group presented a child death rate ~ 1.5 to 3.5 higher than that of the total Indigenous population in the country. Regarding the child death rate, the neonatal component represented 57.8% of the deaths and, in 2022, 93.0% of the pregnant women had less than six prenatal appointments. This population shows a high number of deaths due to preventable causes (N = 538) and cases of illnesses associated with hygiene and sanitation, for example (N = 35,103 cases/notifications). As for vaccination, the full vaccination scheme targeting children below 5years old has not been met since 2018. In the Indigenous population of the Yanomami ethnic group, a high number of deaths was observed, which affected mainly individuals under 1 year old. Among the factors associated with the deaths, mainly in children under 5 years old, most cases have preventable causes, which could be reduced by proper action promoting their health and preventing diseases.

The Influence Of Knowledge Towards Physicians’ Intention To Use Powered Air-Purifying Respirators As Advanced Personal Protective Equipment Mediated By Health Belief Model During Covid-19 Pandemic

The COVID-19 has become a devastating occurrence and an urgent intervention for public health in Indonesia. Until the beginning of 2021, Indonesia has the highest number of healthcare workers deaths in Asia and fifth in the world. One of the reasons that resulted in a high number of deaths is due to the lack of personal protective equipment (PPE) to be worn in high-risk environments. Powered Air-Purifying Respirator (PAPR) is one of the most advanced protective equipment and recommended by many countries for their healthcare workers in handling COVID-19 pandemic. This research is conducted to predict Indonesian physicians’ intention to use PAPR as advanced PPE using the Health Belief Model. This research is a correlational study and a quantitative research using statistical tests in processing the data collected from online questionnaires. The findings collected from 163 respondents demonstrated that physicians in Indonesia have the intention to use PAPR as advanced PPE against COVID-19 based on their knowledge, perceived susceptibility, perceived severity, and perceived benefits of using PAPR. Perceived barriers do not have a significant influence towards physicians’ intention to use. The impact of knowledge to intention to use mediated by perceived benefits has the strongest correlation. This empirical model has moderate predictive accuracy with medium predictive relevance, therefore it could be developed and tested on an extended population. There are few managerial implications that could be recommended for hospital managers, public health administrators, and medical device suppliers to encourage physicians’ behavior. Several recommendations are given for further research development.
 Keywords: Health Belief Model, Knowledge, Perceived Susceptibility, Perceived Benefits, Perceived Severity, Perceived Barriers, Powered Air-Purifying Respirator, Protective Personal Equipment

Factors associated with acute respiratory infection and healthcare-seeking behaviour among primary caregivers in Bangladesh: a study based on MICS 2019

IntroductionMore than 80% of deaths due to preventable and treatable causes among under 5 (U5) children occur in the sub-Saharan Africa and the South-Asia, pneumonia remains one of the most...

[Epidemiological and clinical features of newly reported advanced schistosomiasis cases in Sichuan Province from 2011 to 2022].

To analyze the epidemiological characteristics of newly reported advanced schistosomiasis cases in Sichuan Province, so as to provide the evidence for analyzing the causes and formulating targeted control measures of newly reported advanced schistosomiasis cases. Individual case investigation forms for advanced schistosomiasis cases were collected from the Sichuan Provincial Epidemic Annual Report System from 2011 to 2022, and patients' demographics, previous medical history and liver parenchymal grading were retrieved. All advanced schistosomiasis cases' medical records were reviewed, and the subtypes of schistosomiasis-endemic villages where the cases' household registration were, floating population, survival and death and time of death were collected. A total of 321 newly reported advanced schistosomiasis cases were found in Sichuan Province from 2011 to 2022, with a male to female ratio of 0.99 to 1. There were 274 cases at ages of over 50 years (85.4%), with the highest proportion seen at ages of 60 to 69 years (87 cases, 27.1%), and splenomegaly was the most common type (180 cases, 56.1%), with no dwarfism type detected. The highest number of cases was reported in 2011 (78 cases), followed by in 2022 (74 cases), and the highest number of cases were reported in Meishan City (199 cases, 62.0%), Dongpo District (131 cases, 40.8%), and hilly subtype areas (136 cases, 42.4%). As of the end of 2022, there were 111 deaths due to advanced schistosomiasis, with the highest number of deaths seen in 2018 (25 deaths), and the highest mortality was seen among patients with the ascites type (41.2%). There were 47 (37.3%), 40 (59.5%) and 4 (23.5%) cases with grade III liver parenchyma among patients with splenomegaly, ascites, and colonic proliferation types, respectively, and there was a significant difference in the grading of III liver parenchyma among three types of patients (H = 12.092, P < 0.05), with more severe liver parenchyma injuries seen among patients with the ascites type than among those with splenomegaly and colonic proliferation type (Z = 24.262 and 44.738, both Padjusted values < 0.05). There have been newly reported advanced schistosomiasis cases in Sichuan Province during recent years, and patients with the ascites type should be given a high priority among advanced schistosomiasis cases in Sichuan Province. Intensified clue surveys are needed for early identification and treatment of advanced schistosomiasis cases, so as to increase the survival rate and improve the quality of life.

Abstract WP230: Global Burden of Stroke and Its Attributable Risk Factors in High Income North America From 1990-2019: A Systematic Analysis for the Global Burden of Disease Study 2019

Background: Stroke ranks as the 2 nd leading cause of mortality, following ischemic heart disease, within the spectrum of cardiovascular-related deaths. Method: Employing the Global Burden of Disease tool, Stroke prevalence, incidence, mortality, and Disability-Adjusted Life Years (DALYs) by age, sex, and year across the High-Income North America (HINA) countries from 1990-2019. Result: The overall prevalence of stroke increased from 4,796,172 (with a 95%UI:4,289,092-5,345,234) in 1990 to 7,703,036 (95% UI: 6,967,262-8,537,862) in 2019. The annual percentage of change (APC) demonstrated an increment of 22% in incidence, 21% in DALYs, and 23% in mortality from 1990-2019. Notably, the most substantial APC in mortality was observed in Mexico, at 74% from 1990-2019, whereas the lowest increase was seen in the United States at 23% during the same period. Notably, all countries exhibited a significant reduction in the burden of stroke from 1990-2019. Within the age groups, the highest number of deaths, 37,559, occurred among individuals aged 85-89, whereas the highest incidence, 64,422, was noted in the 70-74 age group. In terms of DALYs, the 75-79 age group accounted for 516,753 in 2019. Throughout the assessed period, males bore a greater burden than females. High blood pressure emerged as the leading attributable cause of stroke-related deaths, contributing to 89,009 fatalities in 2019. Conclusion: The burden of stroke within High-Income North America embodies intricate dimensions spanning health, economics, and society. This study underscores the imperative for targeted interventions that address the distinctive challenges posed by stroke within this specific region.

A Study on Spatial Distribution of HIV/AIDS Using Histogram and Geographic Information System

Background: The high prevalence of human immunodeficiency virus (HIV) infections has become a devastating publi6c health problem. In response, many governments have taken measures to reduce the transmission of HIV and the number of deaths from HIV/acquired immunodeficiency syndrome (AIDS). This study aims to investigate spatial distribution of HIV/AIDS cases and deaths from AIDS in Vietnam in 2017 with the help of a histogram and Geographic Information System (GIS). Materials and Methods: Datasets of HIV/AIDS cases and deaths from AIDS in Vietnam in 2017 were first collected from website of the Vietnam Ministry of Health. Histogram was then used to study distribution of HIV/AIDS cases and deaths from AIDS. It will go on to analyze the spatial distribution of HIV/AIDS cases and deaths from AIDS. Finally, the results will be discussed and concluded. Results: It was found that a high number of HIV/AIDS cases was mainly concentrated in the provinces of the north central region, Da Nang and some provinces in the south of Vietnam. High number of deaths due to AIDS was mainly concentrated in the provinces/cities of the northeast and north central regions of Vietnam. Meanwhile, low and very low numbers of deaths due to AIDS were mainly found in the south central and south-central regions of Vietnam. Conclusion: Histogram and GIS-based mapping technique can be useful tools for mapping spatial distribution of HIV/AIDS cases and deaths from AIDS. Findings in this study can also provide an insight into the spread patterns of HIV/AIDS. Keywords: Spatial distribution, HIV/AIDS, Infectious diseases, Deaths, Histogram, Geographic Information System.

Prevalence and trend of multiple coronary artery disease risk factors and their 5-year incidence rate among adult population of Kerman: results from KERCADR study

BackgroundCoronary artery diseases (CADs) are the most important non‑communicable diseases (NCDs), which cause the highest number of deaths around the world. Hypertension (HTN), dyslipidemia (DL), diabetes mellitus (DM), obesity (OB), low physical activity (LPA), smoking, opium consumption (OC) and anxiety are the most important CAD risk factors, which are more dangerously present in combination in some patients.MethodsA total of 5835 people aged 15 to 75 years were enrolled in the phase 1 (2012) and followed up to the phase 2 (2017) of the population-based Kerman coronary artery diseases risk factors study (KERCADRS). The prevalence and pattern of different combinations of CAD risk factors (double to quintuple) and their 5-year incidence rates were assessed.ResultsThe prevalence of single CAD risk factors (RFs) in phase 2 was 50.2% (DL), 47.1% (LPA), 28.1% (abdominal obesity), 21.2% (OB), 16.5% (HTN), 9.2% (smoking), 9.1% (OC), and 8.4% (DM). The most frequent combination of risk factors was LPA plus DL (23.9%), metabolic syndrome (19.6%), and DL plus OB (17.8%). The 5-year incidence rates of multiple comorbidities (in persons per 100 person-years) was DL plus LPA (2.80%), HTN plus DL (1.53%), and abdominal obesity (AOB) plus DL (1.47%). The most participants (84.4%) suffered from at least one RF, while 54.9% had at least two and 29.9% had at least three RFs.ConclusionThe results showed that a large portion of the study population suffers from multiple CAD RFs. The findings underscore the importance of identifying multiple CAD risk factors to reduce the overall burden of these NCDs.

11-Year Trend of Mortality from Fatal Road Traffic Injuries in The Center of Iran; a Cross-sectional Study.

Road traffic injuries (RTIs) are one of the major health problems in developed and developing countries. In Iran, RTIs are the first leading cause of years of life lost (YLL). So, the present study investigated the 11-year trend of RTI- related mortalities in Iran. This study was a population-based cross-sectional study. All-cause deaths as well as RTI-related mortalities' data were collected from the Civil Registration Organization (CRO) and Legal medical organization (LMO) of Isfahan during 2011-2021. The mid-year population, number of deaths due to RTIs, the crude and age-standardized mortality (per 100,000) of RTIs, and the percentage of proportional mortality by sex and year of accident during the study period were calculated and reported. Also, trend analysis was done using join point regression program. During the study period, 11,248 deaths occurred due to RTIs in Isfahan province. 8,894 cases were male (79.03%), the highest number of deaths in both male and female cases was reported in those aged 15-39 years. Among the males, trend of standardized mortality in 2011-2015 was decreasing (annual percentage changes = -6.76(CI 95%: -2.53, -15.03)), while in 2015-2021 it was increasing (annual percentage changes = 3.00 (CI 95%: 0.63, 9.87)). However, no significant trend was observed among females. The findings of the present study showed that the number and standardized mortality rate of RTIs decreased during the 11-year period. It seems that applying stricter policies, improving the quality of the roads of the province, improving the quality of cars, and increasing the number of hospital and pre-hospital medical facilities can play an effective role in reducing RTIs.

Optimal Trained Deep Learning Model for Breast Cancer Segmentation and Classification

Breast cancer is the most widespread cancer among women. Based on the International cancer research center analysis, the highest number of deaths among women is due to breast cancer. Hence, detecting breast cancer at the earliest may help the oncologist to make appropriate decisions. Due to variations in breast tissue density, there is still a challenge in precise diagnosis and classification. To overcome this challenge, a novel OTDEM-based breast cancer segmentation and classification is proposed with the following four stages: they are, preprocessing, segmentation, feature extraction and classification. The input image is passed to the initial stage using the CLAHE filter to enhance the image. Then the preprocessed image is given to the segmentation stage for the image sub-segments by correlation-based deep joint segmentation. Following that, the features such as statistical features, improved LGXP, texton features, and shape-based features are derived from the segmented image. Then the derived features are fed to the ensemble model that includes CNN, DBN, and BI-GRU classifier to finalize the classification outcome. Further, to enhance the performance of the ensemble model, the weight of BI-GRU is optimized via a new algorithm termed SIPOA. This ensures optimal training to make the model more appropriate in its classification process. Finally, the performance of the proposed work is validated over the traditional models concerning different performance measures.

Socio-Economic Vulnerability Assessment for Supporting a Sustainable Pandemic Management in Austria

The outbreaks of a new pandemic in 2019 let humankind face a new type of challenge. People and groups in vulnerable situations were especially affected. Increasing urbanization, climate change, and global travel raise the likelihood of pandemics. COVID-19 has shown that sustainable and well-planned pandemic management is necessary, which also includes and identifies people in vulnerable situations. In this study, a socio-economic vulnerability assessment (VA) for supporting improved pandemic/epidemic risk management at the municipality level in Austria was conducted. The VA provides a holistic overview of the vulnerability under pre-event conditions in Austria, which can be used to support pandemic management. Therefore, we calculated a composite indicator with expert-based weighting. The necessary indicators were defined through a literature review and an expert consortium consisting of practical and scientific members. As a result, an interactive map containing the vulnerability index (VI) for each municipality was created, making it possible to also assess underlying vulnerable factors to support decision-making. The applicability of the VA was shown in the relationship between a high VI in a municipality and a high number of deaths. A limiting factor to the VA was the missing data for health indicators for the whole of Austria. Hence, we provide a list with recommendations on which data should be collected to improve the VA in the future.

Evaluation of the Anti-Bacterial and Anti-Adherent Activity of Pogostemon Cablin’s Essential Oil Against Klebsiella Pneumoniae

Klebsiella pneumoniae is an example of a microorganism that does not belong to the oral biofilm in a state of health but is present in cases of infection, especially nosocomial infections. The high virulence and resistance of this bacterium to various forms of antimicrobial treatment represent a major concern in the hospital environment, as it is responsible for a high number of deaths of hospitalized patients under mechanical ventilation, so the search for new drugs that are effective in treating this bacterium is extremely important. Natural products, especially essential oils, have considerable therapeutic activities in antimicrobial treatments. A good example is Pogostemon cablin, which has antimicrobial, anti-adherent, and anti-inflammatory activities, among others. Thus, this research aimed to analyze the possible antimicrobial potential of the essential oil extracted from Pogostemon cablin against strains of Klebsiella pneumoniae, using the Minimum Inhibitory Concentration (MIC), which was determined using the microdilution technique in plates containing 96 sterile holes with positive control, the antimicrobial chloramphenicol. The Minimum Bactericidal Concentration (MBC) was read 48 hours after the MIC, using plates with 96 holes. After the reading, it was found that the essential oil of Pogostemon cablin had a 50% MIC of 512 μg/mL against the Klebsiella pneumoniae strains tested, making it a strong bacteriostatic. It was therefore possible to observe the antibacterial potential of Pogostemon cablin essential oil against the K. pneumoniae strains tested.

Mushroom poisoning outbreaks in Guizhou Province, China: a prediction study using SARIMA and Prophet models

Mushroom poisoning is a public health concern worldwide that not only harms the physical and mental health of those who are poisoned but also increases the medical and financial burden on families and society. The present study aimed to describe and analyze the current situations and factors influencing mushroom poisoning outbreaks in Guizhou province, Southwest China, between January 2012 and June 2022, and to predict the future trends of its occurrence. Our study provides a basis for the rational formulation of prevention and control and medical resource allocation policies for mushroom poisoning. The epidemiological characteristics and factors influencing mushroom poisoning incidence were analyzed using descriptive epidemiological methods and the chi-squared test, respectively. Then, future occurrence trends were predicted using the SARIMA and Prophet models. In total, 1577 mushroom poisoning incidents were recorded in Guizhou Province, with 7347 exposures, 5497 cases, 3654 hospitalizations, and 93 fatalities. The mortality rate was 4.45% in 1 ~ 6 years higher than other age groups. There were notable geographic and seasonal characteristics, with the number of occurrences much higher in rural areas (1198) than in cities (379), and poisoning cases were more common during the rainy season (June to September). The mortality rate of household poisoning cases was 1.86%, with the most deaths occurring in households. Statistically significant differences were observed in the incidence across various cities, periods, and poisoning locations (P < 0.05). Both models had advantages and disadvantages for prediction. Nevertheless, the SARIMA model had better overall prediction results than the Prophet model (R > 0.9, the residual plot of the prediction results was randomly distributed, and RMSESARIMA < RMSEProphet). However, the prediction result plot of the Prophet model was more explanatory than the SARIMA model and could visualize overall and seasonal trends. Both models predicted that the prevalence of mushroom poisoning would continue to increase in the future; however, the number of fatalities is generally declining. Seasonal patterns indicated that a high number of deaths from gooseberry mushroom poisoning occurred in October. The epidemiological trends of mushroom poisoning remain severe, and health education on related knowledge must be strengthened in rural areas, with June to October as the key prevention and control phase. Further, medical treatment of mushroom poisoning cases with clinical symptoms should pay attention to inquiries to check whether the mushroom is similar in appearance to the Amanita, particularly in October.

The increase in SARS-CoV-2 lineages during 2020-2022 in a state in the Brazilian Northeast is associated with a number of cases.

SARS-CoV-2 has caused a high number of deaths in several countries. In Brazil, there were 37 million confirmed cases of COVID-19 and 700,000 deaths caused by the disease. The population size and heterogeneity of the Brazilian population should be considered in epidemiological surveillance due to the varied tropism of the virus. As such, municipalities and states must be factored in for their unique specificities, such as socioeconomic conditions and population distribution. Here, we investigate the spatiotemporal dispersion of emerging SARS-CoV-2 lineages and their dynamics in each microregion from Sergipe state, northeastern Brazil, in the first 3 years of the pandemic. We analyzed 586 genomes sequenced between March 2020 and November 2022 extracted from the GISAID database. Phylogenetic analyses were carried out for each data set to reconstruct evolutionary history. Finally, the existence of a correlation between the number of lineages and infection cases by SARS-CoV-2 was evaluated. Aracaju, the largest city in northeastern Brazil, had the highest number of samples sequenced. This represented 54.6% (320) of the genomes, and consequently, the largest number of lineages identified. Studies also analyzed the relationship between mean lineage distributions and mean monthly infections, daily cases, daily deaths, and hospitalizations of vaccinated and unvaccinated patients. For this, a correlation matrix was created. Results revealed that the increase in the average number of SARS-CoV-2 variants was related to the average number of SARS-CoV-2 cases in both unvaccinated and vaccinated individuals. Thus, our data indicate that it is necessary to maintain epidemiological surveillance, especially in capital cities, since they have a high rate of circulation of resident and non-resident inhabitants, which contributes to the dynamics of the virus.

Analyzing Mortality Patterns and Location of Death in Patients With Malignant Esophageal Neoplasms: A Two-Decade Study in the United States.

Background Esophageal neoplasm carries significant implications for end-of-life care. Despite medical advancements, disparities in the location of death persist. Understanding the factors influencing the place of death for esophageal neoplasm patients is crucial for delivering patient-centered care. Objectives The primary objective of this study is to inspect and evaluate mortality patterns in patients with malignant esophageal neoplasms over the past two decades. Materials and methods Using the CDC-WONDER database, the authors analyzed 309,919 esophageal neoplasm-related deaths. Data was categorized by age, gender, race, and location of death, enabling a detailed examination of the factors influencing the place of death. Result This analysis revealed significant disparities in death locations. Age, gender, race, and geographic region all played substantial roles in determining where esophageal neoplasm patients spent their final moments. Notably, males consistently experienced higher mortality rates across all settings. Geographic disparities indicated varying mortality rates by census region, with the Southern region reporting the highest rates. Racial disparities were also evident, with white individuals having the highest number of deaths. Conclusion This study underscores the importance of recognizing and addressing disparities in the place of death among esophageal neoplasm patients in the United States. By shedding light on the demographic influences on end-of-life decisions, it paves the way for more targeted and patient-centered approaches to end-of-life care for this patient population.

Survival in multiple myeloma and SARS-COV-2 infection through the COVID-19 pandemic: Results from the EPICOVIDEHA registry.

Patients affected by multiple myeloma (MM) have an increased risk of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection and subsequent coronavirus (20)19 disease (COVID-19)-related death. The changing epidemiological and therapeutic scenarios suggest that there has been an improvement in severity and survival of COVID-19 during the different waves of the pandemic in the general population, but this has not been investigated yet in MM patients. Here we analyzed a large cohort of 1221 patients with MM and confirmed SARS-CoV-2 infection observed between February 2020, and August 2022, in the EPICOVIDEHA registry from 132 centers around the world. Median follow-up was 52days for the entire cohort and 83days for survivors. Three-hundred and three patients died (24%) and COVID-19 was the primary reason for death of around 89% of them. Overall survival (OS) was significantly higher in vaccinated patients with both stable and active MM versus unvaccinated, while only a trend favoring vaccinated patients was observed in subjects with responsive MM. Vaccinated patients with at least 2 doses showed a better OS than those with one or no vaccine dose. Overall, according to pandemic waves, mortality rate decreased over time from 34% to 10%. In multivariable analysis, age, renal failure, active disease, hospital, and intensive care unit admission, were independently associated with a higher number of deaths, while a neutrophil count above 0.5×109 /L was found to be protective. This data suggests that MM patients remain at risk of SARS-CoV-2 infection even in the vaccination era, but their clinical outcome, in terms of OS, has progressively improved throughout the different viral phases of the pandemic.

A 22-Year Study to Assess Disparities in Place of Death Among Patients With Diabetes.

Background This study examines disparities in the place of death in patients in the United States with diabetes mellitus (DM) using data from the CDC WONDER (Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research) database covering a 22-year period (1999-2020). Looking at age, gender, ethnicity, and census location, among other variables, the study aims to understand trends and determinants of mortality at home or hospice care compared to mortality at a medical or nursing facilities. Materials and methods An online freely accessible mortality database, CDC WONDER database, was used to collect information regarding DM-related mortality, using the International Classification of Diseases, 11th Revision (ICD-11) code range E10-E14. To investigate patterns in location of death, the research population was split by census regions, racial categories, age groups, and gender. Statistical techniques such as univariate logistic regression and graphical representations were employed. Results Based on a study of 1,674,724 DM-related deaths, medical or nursing facilities recorded higher deaths (1,041,602) compared to home or hospice deaths (572,567). The highest number of deaths in home or hospice setting was recorded for the age group of 75-84 years (146,820), male gender (324,325), Census Region 3 (South) (225,636), and white race (458,690). Among the patients with death at home or a hospice center; the odds were highest for the age group of 55-64 years, male gender, Census Region 4 (West), and American Indian or Alaska Native race. Discussion The results showed a general upward trend in DM patients' deaths at home and in hospice care in the United States. Males, white people, and those in the age group of 75-84 years notably had the highest death rates. Regional differences also came into play, with the South showing the biggest trend in mortality. To better understand the underlying causes of these changes and to increase at-risk groups' access to healthcare facilities, more research is required. Conclusion There is an overall rising trend in home and hospice deaths in the United States for patients with DM, but with a steady dip between the years 2005 and 2010. Patient deaths from DM were categorized by age groups, gender, race, and census regions. The highest mortality trends are exhibited in whites, males, and those aged 75-84 years. Out of the census regions, the South has the highest mortality trend. Further studies could be carried out to determine the reasons for the rising trends in home or hospice deaths in the aforementioned groups and how to provide these groups with better access to healthcare facilities.

Global, Regional, and National Burden of COPD Attributable to Occupational Particulate Matter, Gases, and Fumes, 1990-2019: Findings from the Global Burden of Disease Study 2019.

A study aimed to estimate the burden of Chronic obstructive pulmonary disease (COPD) caused by occupational exposure to particulate matter, gases, and fumes in 204 countries from 1990 to 2019. Data on the deaths number, age-standardized mortality rates (ASMR), and age-standardized disability-adjusted life years (DALYs) rates (ASDR) of COPD attributable to occupational particulate matter, gases, and fumes were collected from the GBD study 2019. We also investigated the association between the ASDR and SDI. There were 517.7 thousand deaths [95% UI: 413.9 to 634.5] in 2019. The number of deaths increased from 1990 to 2019. The ASMR and ASDR were 6.61 (5.24 to 8.17) and 143.02 (118.56 to 168.69) in 2019, respectively, representing a 46% and 44.5% decrease since 1990. China had the highest number of deaths [200,748.4 (151,897.6 to 260,703.9)], while Nepal had the highest ASMR [39 (27.7 to 50)] and ASDR [724.5 (549 to 894.2)]. Males and females 75-79 and 80-84 years old had the highest number of COPD deaths. A negative correlation was observed when SDI > 0.4, whereas a positive correlation was found when SDI < 0.4. From 1990 to 2019, there was an increase in the number of deaths, but a decline in ASMR and ASDR globally. Besides, there was a heterogeneous burden of COPD attributable to occupational particulate matter, gases, and fumes across regions and countries. It is important to develop and implement strategies to prevent and reduce the burden of COPD attributable to occupational particulate matter, gases, and fumes.

Global Burden and Trends of Acute Myeloid Leukemia Attributable to High Body Mass Index in 38 OECD Countries between 1990-2019: A Benchmarking Systematic Analysis for the Global Burden of Disease Study 2019

Background: Acute myeloid leukemia (AML) is a significant cause of mortality and disability, ranking 17th among leading causes of death and 15th among leading causes of disability among all cancers in Organization for Economic Co-operation and Development (OECD) countries. Current evidence suggests a potential association between a high body mass index (BMI) and an increased risk of AML and other cancers. However, the impact of high BMI on AML burden may vary due to factors such as geographical location, lifestyle, genetic predisposition, and changes in obesity rates over time. This study aimed to assess the burden of AML attributable to high BMI in 38 OECD countries from 1990 to 2019. Method: The methodology employed the Global Burden of Disease approach, analyzing AML deaths and disability-adjusted life years (DALYs) attributable to high BMI across age groups, sexes, and years in the 38 OECD countries using standardized methods and statistical modeling. The results were reported in absolute counts and age-standardized rates (per 100,000 person-years). Results: The study found that the total number of AML deaths attributable to high BMI increased from 1,625 (95% uncertainty interval (UI): 726-2,831) in 1990 to 4,295 (95% UI: 2,094-7,105) in 2019, while DALYs increased from 43,467 (95% UI: 19,649-75,434) to 96,289 (95% UI: 47,925-157,090) between 1990 and 2019. The age-standardized mortality rate (ASMR) rose from 0.13 (95% UI: 0.06-0.22) to 0.19 (95% UI: 0.09-0.31) cases per 100,000 during the same period, and the age-standardized DALYs rate (ASDALR) increased from 3.47 (95% UI: 1.57-6) to 4.83 (95% UI: 2.43-7.83) cases per 100,000 persons. Notably, Colombia experienced the highest increase in the annual percentage of change (APC) in total AML deaths (474%), followed by South Korea (398%), and Costa Rica (315%), while Latvia showed the lowest increase of 16% from 1990 to 2019. Concerning DALYs, Colombia had the highest APC increase (391%), followed by Costa Rica (268%) and Mexico (246%), while Latvia observed a 2% decrease in APC from 1990 to 2019. Switzerland and Denmark showed decreases in APC for ASMR (6% and 9%, respectively) from 1990 to 2019, and Finland, Japan, Denmark, and Switzerland demonstrated decreases in APC for ASDALR (4%, 6%, 18%, and 20%, respectively). The United States reported the highest number of AML deaths (1,575) and DALYs (35,063) attributable to high BMI in 2019. Individuals aged 70-74 years had the highest number of deaths (709, 95% UI: 356-1,168) and DALYs (13,762, 95% UI: 6,939-22,564) in 2019 in OECD countries. Additionally, males showed higher deaths and DALYs compared to females due between 1990 and 2019. Conclusion: The burden of AML attributed to high BMI has continued to rise in the majority of countries over the past three decades. As obesity is a modifiable risk factor, effective preventive strategies, counseling for high-risk individuals, and coordinated efforts by healthcare professionals and policymakers are essential to implement interventions across OECD countries. Given obesity's significance as a modifiable risk factor for various cancers, urgent action is needed to address this public health challenge.

Statewide Burden and Trends of Acute Myeloid Leukemia in the United States between 1990-2019: A Benchmarking Analysis for the Global Burden of Disease Study 2019

Background: Acute myeloid leukemia (AML) ranks as the 15th leading cause of death, accounting for 1.75% of all cancer-related deaths in the United States of America (USA) in 2019, following Myeloma. Despite its significance, statewide disparities in AML burden have not been previously studied. Thus, this research aimed to assess the burden and trends of AML across the USA over the last three decades, spanning from 1990 to 2019. Method: Employing the Global Burden of Disease methodology, we evaluated AML prevalence, incidence, mortality, and disability-adjusted life years (DALYs) using standardized approaches and statistical modeling. The results were presented in absolute counts and age-standardized rates (per 100,000 person-years). Results: The total number of AML prevalence cases rose from 10,124 (95% uncertainty interval (UI): 9,259-11,482) in 1990 to 21,370 (95% UI: 17,759-24,830) in 2019. Correspondingly, deaths increased from 6,849 (95% UI: 6,301-7,724) in 1990 to 13,620 (95% UI: 11,632-14,664) in 2019, while DALYs increased from 185,960 (95% UI: 171,985-210,122) in 1990 to 301,526 (95% UI: 268,606-323,608) in 2019. The age-standardized incidence rate (ASIR) rose from 2.75 (95% UI: 2.52-3.09) to 3.23 (95% UI: 2.71-3.73) cases per 100,000 from 1990 to 2019. Similarly, the age-standardized mortality rate (ASMR) increased from 2.20 (95% UI: 2.03-2.48) to 2.54 (95% UI: 2.19-2.72) cases per 100,000 during the same period. In 2019, the greatest AML incidence was observed in California (1,677), followed by Florida (1,268) and Texas (1,155), while the lowest incidence was observed in the District of Columbia (24). Regarding the annual percentage of change (APC), the highest percentage increase in deaths was observed in Nevada (328%), followed by Alaska (224%), while the District of Columbia had the lowest APC (6%) from 1990 to 2019. In terms of incidence, Nevada (332%) and Arizona (227%) had the highest APC during the same period. The age group of 70-74 years had the highest number of deaths (2,264) and incidence (2,665), as well as DALYs (43,918) in 2019. Notably, the older age groups exhibited the highest APC in deaths and incidence. Males had a higher burden of AML compared to females. Conclusion: Our study underscores significant disparities in AML burden across different states in the USA from 1990 to 2019. We have also identified that males and elderly individuals face a higher likelihood of AML burden. Consequently, policymakers must prioritize enhancing healthcare systems, advancing early diagnosis and treatment approaches, and promoting health education to reduce individual exposures to relevant risk factors.