Increase In Death Rate Research Articles

Explainable Machine Learning Model for Chronic Kidney Disease Prediction

More than 800 million people worldwide suffer from chronic kidney disease (CKD). It stands as one of the primary causes of global mortality, uniquely noted for an increase in death rates over the past twenty years among non-communicable diseases. Machine learning (ML) has promise for forecasting such illnesses, but its opaque nature, difficulty in explaining predictions, and difficulty in recognizing predicted mistakes limit its use in healthcare. Addressing these challenges, our research introduces an explainable ML model designed for the early detection of CKD. Utilizing a multilayer perceptron (MLP) framework, we enhance the model’s transparency by integrating Local Interpretable Model-agnostic Explanations (LIME), providing clear insights into the predictive processes. This not only demystifies the model’s decision-making but also empowers healthcare professionals to identify and rectify errors, understand the model’s limitations, and ascertain its reliability. By improving the model’s interpretability, we aim to foster trust and expand the utilization of ML in predicting CKD, ultimately contributing to better healthcare outcomes.

Country and continent-wise trends in mortality rates of ovarian cancer from 1980-2021: An analysis of GBD study 2021.

148 Background: Ovarian cancer is one of the major causes of cancer related deaths in women worldwide. Early detection, primarily via ultrasound , can result in lower mortality and morbidity. We present a comprehensive evaluation derived from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, depicting the ovarian cancer associated mortality pattern from 1980 to 2021. Methods: Data were methodically retrieved from the Global Burden of Diseases (GBD) study, which included age-standardized death rates, Years of Lost Life (YLL), and disability-adjusted life years (DALYs). The dataset was stratified globally and categorized by continent, with Africa divided into Northern, Southern, Eastern, Western, and Central regions, and by World Bank income levels. Joinpoint Regression was employed to determine average annual percentage changes (AAPC). Results: Globally, the Age standardized death rates (ASDR) for ovarian cancer had an overall decline from 1980 to 2021. In 1980, the ASDR was 4.64 (95% UI: 4.3-5.14), and it declined to 4.05 (AAPC: -0.315; 95% CI: -0.35 to -0.27) in 2021. Globally, the disability-adjusted life-years (DALYs) rate was 132.4 (95% UI: 121.3–145.6) per 100,000 people in 1990, and it decreased to 115.14 (AAPC: -0.44; 95% CI: -0.52 to -0.36) in 2021. From 1990 to 2021, the age-standardized years of life lost (YLL) showed a uniform drop with an AAPC of -0.36 (95% CI: -0.40 to -0.31). However, in continent wise analysis, while the Americas and Europe had continuously declining ASDRs, Asia and Africa had an increasing trend throughout the predetermined time frame. From 1980 to 2021, America had an AAPC of -0.67 (95% CI: -0.69 to -0.65). Similarly, Europe also had a decreasing trend from 1980 to 2021 with an AAPC of -0.48 (95% CI: -0.50 to -0.45). The AAPC for Africa was 1.203 (95% CI: 1.19 to 1.21), showing a greater incline compared to the other continents. The AAPC for Asia was 0.54 (95% CI: 0.527 to 0.563). During further analysis of the African region, we observed that southern and eastern Africa had the highest ASDRs. According to World Bank income levels, low-income and lower-middle-income countries had increasing death rates, while high and upper-middle income countries had decreasing death rates from 1980 to 2021. Conclusions: The study disclosed a global decline in ovarian cancer fatality rates from 1980 to 2021. Although significant progress has been made in the Americas and Europe, mortality rates have risen in Asia and Africa, with southern and eastern Africa exhibiting particularly high rates. An increase in death rates is also observed in low- and lower-middle-income countries, contrasting with an overall decrease globally and in high-income nations.

Decision Support System Based on Deep Learning with Big Data for Pneumonia Prediction

A bacterial, viral, or fungal infection of the lungs causes pneumonia in humans. It is the primary cause of global decline. Around 27% of deaths worldwide are attributable to this illness. A World Health Organisation report states that this serious infectious disease claims the lives of almost 2.5 million people annually. Early detection of chest illness, including pneumonia, can reduce the likelihood that the condition will worsen by allowing for the proper course of treatment. Accurate CT scans and CXR (chest X-ray) reports are renowned for being exact methods of diagnosis and prediction. This approach is trustworthy and non-invasive, and it can be used as a screening tool when a disease diagnosis is necessary. Nevertheless, research has demonstrated that even highly trained radiologists regularly fail to correctly identify pneumonia disease in its early stages. The severity of the sickness and the death rate increase as a result of diagnostic delays. Machine learning has affected every aspect of human life in the twenty-first century. It has a significant effect on the medical field in terms of early diagnosis of serious illnesses. Therefore, an intelligent health care system based on artificial intelligence (AI) was presented in this work for the early and accurate diagnosis of pneumonia disease.

Whether COVID-19 Affected Hospital Death Rate in Split - Dalmatia County, Croatia

The main aim of this study was to examine whether the COVID-19 pandemic affected hospital death rate. A cross-sectional comparative study using two different periods, pre-COVID-19 (March 2019 to February 2020) and the COVID-19 era (March 2020 to February 2021) was employed to explore the possibilities of COVID-19 influencing hospital death rate in Split and Dalmatian County, Croatia. Data from the National Public Health Information System was used in this research. The indicators were statistically analyzed. The study showed that in the COVID-19 era, there was a significantly higher hospital death rate in comparison to the pre-COVID-19 era (z=-14.084; p<0.001), mainly due to the significant increase in hospital death rate from respiratory diseases. The Intensive Care Unit and the Infectious Diseases Department showed a significantly higher hospital death rate among hospital department. Among deaths with confirmed COVID-19, deaths from respiratory diseases were significantly more positive (z=23.975, p<0.001). The results of the study showed that COVID-19 had an impact on hospital death rate in Split-Dalmatia County. Given that the study analysed the first year of the pandemic, additional research will be needed over a wider period to get a more detailed insight of the impact of COVID-19 on hospital death rate in Croatia, as well as in other regions.

Nrf1 Reduces COX-2 Expression and Maintains Cellular Homeostasis After Cerebral Ischemia/Reperfusion By Targeting IL-6/TNF-α Protein Production.

Neuroinflammation has been considered involved in the process of cerebral ischemia-reperfusion injury (CIRI). Transcription factors play a crucial role in regulating gene transcription and the expressions of specific proteins during the progression of various neurological diseases. Evidence showed that transcription factor nuclear factor erythroid 2-related factor 1 (NFE2L1, also known as Nrf1) possessed strong biological activities including antioxidant, anti-inflammatory and neuroprotective properties. However, its role and potential molecular mechanisms in CIRI remain unclear. In our study, we observed a significant elevation of Nrf1 in the cerebral cortex following cerebral ischemia-reperfusion in rats. The Nrf1 downregulation markedly raised COX-2, TNF-α, IL-1β, and IL-6 protein levels during middle cerebral artery occlusion/reperfusion in rats, which led to worsened neurological deficits, higher cerebral infarct volume, and intensified cortical histopathological damage. In subsequent in vitro studies, the expression of Nrf1 protein increased following oxygen-glucose deprivation/reperfusion treatment on neurons. Subsequently, Nrf1 knockdown resulted in a significant upregulation of inflammatory factors, leading to a substantial increase in the cell death rate. Through analyzing the alterations in the expression of inflammatory factors under diverse interventions, it is indicated that Nrf1 possesses the capacity to discern variations in inflammatory factors via specific structural domains. Our findings demonstrate the translocation of the Nrf1 protein from the cytoplasm to the nucleus, thereby modulating the protein expression of IL-6/TNF-α and subsequently reducing the expression of multiple inflammatory factors. This study signifies, for the first time, that during cerebral ischemia-reperfusion, Nrf1 translocases to the nucleus to regulate the protein expression of IL-6/TNF-α, consequently suppressing COX-2 expression and governing cellular inflammation, ultimately upholding cellular homeostasis.

Trends in oesophageal cancer mortality in Montenegro, 1990-2018.

Oesophageal cancer (OC) is a significant public health issue, despite the decreasing trends in OC mortality rates observed globally in the past decades. The objective of our study is to analyze the pattern of OC mortality in Montenegro between 1990 and 2018 and contribute to the development of a national long-term strategy for the prevention and control of this malignancy. The data on OC death cases in Montenegro between 1990 and 2018 were collected. The mortality rates were standardized according to the World Standard Population. The Joinpoint, Linear and Poisson regressions were applied to analyze the OC mortality trend. Joinpoint regression analysis showed an increase in death rates for men and the overall level which were not statistically significant. However, the number of cases increases significantly with an average annual percentage change (AAPC) increase of 2.6% for the overall level [AAPC (95% CI)=2.6 (1.0-4.2); P = 0.002] at the expense of the increase in men, which on average was 2.6% annually [AAPC (95%CI) = 2.6 (1.2-4.1); P = 0.001]. The age groups 55-64 and 65-74 have the highest percentage of deaths cases from OC with 30.6% and 31.4%, respectively. Montenegro has witnessed a recent increase in the number of deaths from OC, although the mortality rates remain stable. National strategies to further reduce mortality rates for OC are necessary. Individuals aged 55-64 and 65-74 need specific attention during the ongoing monitoring of this cancer.

Evolution of an epidemic: Understanding the opioid epidemic in the United States and the impact of the COVID-19 pandemic on opioid-related mortality.

We conduct this research with a two-fold aim: providing a quantitative analysis of the opioid epidemic in the United States (U.S.), and exploring the impact of the COVID-19 pandemic on opioid-related mortality. The duration and persistence of the opioid epidemic lends itself to the need for an overarching analysis with extensive scope. Additionally, studying the ramifications of these concurrent severe public health crises is vital for informing policies to avoid preventable mortality. Using data from CDC WONDER, we consider opioid-related deaths grouped by Census Region spanning January 1999 to October 2022 inclusive, and later add on a demographic component with gender-stratification. Through the lens of key events in the opioid epidemic, we build an interrupted time series model to reveal statistically significant drivers of opioid-related mortality. We then employ a counterfactual to approximate trends in the absence of COVID-19, and estimate excess opioid-related deaths (defined as observed opioid-related deaths minus projected opioid-related deaths) associated with the pandemic. According to our model, the proliferation of fentanyl contributed to sustained increases in opioid-related death rates across three of the four U.S. census regions, corroborating existing knowledge in the field. Critically, each region has an immediate increase to its opioid-related monthly death rate of at least 0.31 deaths per 100,000 persons at the start of the pandemic, highlighting the nationwide knock-on effects of COVID-19. There are consistent positive deviations from the expected monthly opioid-related death rate and a sizable burden from cumulative excess opioid-related deaths, surpassing 60,000 additional deaths nationally from March 2020 to October 2022, ∼70% of which were male. These results suggest that robust, multi-faceted measures are even more important in light of the COVID-19 pandemic to prevent overdoses and educate users on the risks associated with potent synthetic opioids such as fentanyl.

Death trends for 2010 - 2022 for members of a large private medical scheme in South Africa.

In the absence of more recent national data on underlying causes of death in South Africa (SA), we examined mortality trends from 2010 to 2022 among members of a large private medical scheme. This analysis sheds light on the health profile of this specific demographic. To investigate trends in Discovery Health Medical Scheme (DHMS) members' death rates and underlying cause of death patterns between 2010 and 2022. All-cause deaths were compared across years accounting for demographic changes, by analysing age- and sex-standardised rates using 2019 age and sex population weightings. We used underlying cause-of-death data from death notifications. The 2019 age- and sex-standardised death rate was lower than the 2010 rate by 10%, with a steady decline experienced between 2010 and 2019. We have seen reduced age- and sex-standardised death rates from HIV/AIDS during this period, and despite the high prevalence, reduced age- and sex-standardised death rates from non-communicable diseases. Malignant neoplasms and cardiovascular disease have been and remained the two leading causes of death for Discovery Health Medical Scheme (DHMS) clients between 2012 and 2022. Age- and sex- standardised death rates, however, reached historic high levels during the first 2 years of the COVID-19 pandemic in SA. In 2020, overall age- and sex-standardised death rates for DHMS members increased to 542 deaths per 100 000 life years, which was higher than pre-pandemic levels. Age- and sex-standardised death rates went on to reach their highest level in the history of the scheme in 2021, at 767 deaths per 100 000 life years. Age- and sex-standardised death rates, however, had returned to near 2019 (pre-pandemic) levels by 2022, at 477 deaths per 100 000 life years. Males experienced a higher increase in age-standardised death rates during 2020 and remained at an increased risk of death in 2022 compared with pre-pandemic levels. When COVID-19 -related deaths are excluded, the age-standardised rates for both females and males in 2022 was lower than observed in the pre-pandemic years. While the low mortality experience could be related to competing causes and mortality displacement, further analysis over a longer period is needed to confirm this. DHMS experienced the highest level of age- and sex-standardised death rates during 2020 and 2021, the initial 2 years of the COVID-19 pandemic. Most of this increase was explained by COVID-19 deaths.

TRPV4 modulation participates in paraoxon-induced brain injury via NMDA and NLRP3 regulation

ABSTRACT Background Organophosphorus pesticide poisoning can lead to severe brain damage, but the specific mechanisms involved are not fully understood. Our research aims to elucidate the function of the TRPV4 ion channel in the development of brain injury induced by paraoxon (POX). Methods In vivo, we examined the survival rate, behavioral seizures, histopathological alterations, NMDA receptor phosphorylation, as well as the expression of the NLRP3-ASC-caspase-1 complex and downstream inflammatory factors in the POX poisoning model following intervention with the TRPV4 antagonist GSK2193874. In vitro, we investigated the effects of GSK2193874 on NMDA-induced inward current, cell viability, cell death rate, and Ca2+ accumulation in primary hippocampal neurons. Results The treatment with the TRPV4 antagonist increased the survival rate, suppressed the status epilepticus, improved pathological damage, and reduced the phosphorylation level of NMDA receptors after POX exposure. Additionally, it inhibited the upregulation of NLRP3 inflammasome and inflammatory cytokines expression after POX exposure. Moreover, the TRPV4 antagonist corrected the NMDA-induced increase in inward current and cell death rate, decrease in cell viability, and Ca2+ accumulation. Conclusion TRPV4 participates in the mechanisms of brain injury induced by POX exposure through NMDA-mediated excitotoxicity and NLRP3-mediated inflammatory response.

Resilience in the time of crisis: A review of the maternal, perinatal and reproductive health effects of COVID-19 in South Africa.

The COVID-19 pandemic had a profound effect on the health sector globally and in South Africa (SA). To review the effects of COVID-19 on maternal, perinatal and reproductive health outcomes and service utilisation in SA. Three routine national data collection systems were sourced: the District Health Information System, the Saving Mothers reports of the National Committee on Confidential Enquiry into Maternal Deaths and the Saving Babies reports from the National Perinatal Morbidity and Mortality Committee using data from the Perinatal Problem Identification Program. There were 35% and 8% increases in maternal and stillbirth mortality rates, respectively, in 2020 and 2021, which correlated with the COVID-19 waves. However, in 2022, rates returned to pre-COVID levels. Antenatal visits and facility births showed little change, but there was a shift to more rural provinces. The use of oral and injectable contraceptives and termination of pregnancy services decreased markedly in 2020 and 2021, with a sustained shift to long-acting reversible contraceptives. The increase in maternal deaths was predominantly due to COVID-19 respiratory complications, but also an increase in obstetric haemorrhage. Stillbirths increased significantly (10%) for birthweights between 2 000 g and 2 499 g, categorised mostly as unexplained stillbirths or preterm labour, but no increase in neonatal deaths was observed. Administrative avoidable factors increased by 24% in the 2020 - 2022 triennium, but there was no increase in patient/community level or healthcare provider-related avoidable factors during the pandemic years. COVID-19 caused a marked increase in maternal death and stillbirth rates in 2020 and 2021 due to both direct effects of the virus and indirect effects on functioning of the health system. The continued, although modified, health-seeking behaviour of women and the rapid return to pre-COVID-19 mortality rates demonstrates enormous resilience in women and the health system.

STATISTICAL ANALYSIS OF THE MODERN TRENDS IN NATURAL MOVEMENT OF POPULATION OF THE AUTONOMOUS REPUBLIC OF ADJARA

Iamze Surmanidze E-mail: Surmanidze.iamze@bsu.edu.ge Doctor in Business Administration Batumi Shota Rustaveli State University Batumi, Georgia https://orcid.org/0000-0002-4389-9250 Natalia Robitashvili E-mail: nato.robitashvili@bsu.edu.ge Doctor in Business Administration Batumi Shota Rustaveli State University Batumi, Georgia https://orcid.org/0000-0001-7645-649 Nino Kontselidze E-mail: n.kontselidze@bsu.edu.ge Ph.D. Student Batumi Shota Rustaveli State University Batumi, Georgia https://orcid.org/0000-0002-5683-4886 Abstract: The demographic policy of the country, among other things, includes important issues such as population reproduction, marriage-divorce, birth rate, death rate, and so on. Their discussion is also necessary in the regional context in order to assess the demographic resources of the region and to develop an adequate political approach based on it, which in turn considers the policy of demographic security. Regional demographics are always on the list of interest for both sociologists and economists. It is important to identify and study the peculiarities of demographic development in certain regions of the country, the problem of population decline and aging, its reproductive potential, on which both national demographic security and socio-economic development of the country (region) depend. The article examines the dynamics of the absolute indicators of natural movement for the Autonomous Republic of Adjara and its peculiarities in the regional context. In particular, the study of the dynamics of marriages and divorces legally registered in Adjara showed that in the recent years there has been a decrease in the number of marriages and an increase in the number of divorces due to socio-cultural and economic factors, as well as delays in marriage age. This trend will have a negative impact on the birth rate, because high rate of divorce played a certain role in the decline in the number of births and in the long run it will aggravate the demographic situation in Adjara. Despite the fact that natural increase was declining since 2014, it still had a positive mark, the birth rate exceeds the death rate. Declining trend of natural increase is due to many factors (biological, socio-economic, etc.). The largest decline in natural increase in 2019 compared to the previous year was observed in highland municipalities, which is caused by factors such as changes in age-sex structure, eco-migration, lack of jobs. A greater part in the declining number of births is caused by changes in reproductive behavior and less was due to age structure. Adjara is characterized by high natural increase compared to other regions of Georgia. In order to better assess the natural movement, the crude birth rate, death rate and natural increase were calculated. Calculations have shown that the general ratios of natural movement have changed slightly in recent years and are almost stable. The crude rate of natural increase is highest in Adjara and it is higher than the critical risk limit (0.0-1.0 per mille). Birth and mortality rates were also found beyond the critical risk limit (13 per mille). Unlike other regions of Georgia, depopulation is not observed in Adjara. The dynamics of the economy of the natural movement of the population of Adjara shows that the replacement of the mother generation requires the birth of more than one girl by one woman, or reproduction at the expense of more human turnover and not at the expense of efficiency ("lower costs"). One of the factors in population reproduction, such as the sex ratio at birth, is gradually decreasing and largely approaching normal value (105-107). Another study of natural movement - the dynamics of mortality - has shown that the death toll of women of childbearing age is quite small and declining, giving a promising forecast for the future in terms of increasing birth rate. The study of demographic aging of the population in the region showed that Adjara has moved from the initial level of aging to the average level (according to criteria of J. Beaujeu Garnier & R. Rosset’s Demographic Aging scale), which is mainly caused by the outflow of the working age population from the country (external migration). However, unlike other regions of Georgia, Adjara has the lowest rate of demographic aging. Although the demographic situation in Adjara is better than the general situation in the country, we can not call it positive and hopeful in the long run, because there is an increase in the number of divorces, a decrease in natural increase, demographic aging, a decrease in the economy. Based on the conclusions, it can be said that the modern trends in natural movement of the population of Adjara are generally unfavorable, which will have a negative impact on the demographic and socio-economic development of the region in the future. Therefore, it is necessary to pursue a timely and adequate demographic policy in order to avoid a severe demographic crisis in the future. Keywords: Reproduction, marriage, divorce, childbirth, natural increase, aging level. JEL classification: J11, J12, J13, J14

United States marijuana legalization and opioid mortality trends before and during the first year of the COVID-19 pandemic.

To determine if marijuana legalization was associated with reduced opioid mortality. The United States (US) opioid mortality trend during the 2010-2019 decade was compared in states and District of Columbia (jurisdictions) that had implemented marijuana legalization with states that had not. Acceleration of opioid mortality during 2020, the first year of the coronavirus disease 2019 (COVID-19) pandemic, was also compared in recreational and medicinal-only legalizing jurisdictions. Joinpoint methodology was applied to the Centers for Disease Control and Prevention WONDER data. Trends in legalizing jurisdictions were cumulative aggregates. The overall opioid and fentanyl death rates and the percentage of opioid deaths due to fentanyl increased more during 2010-2019 in jurisdictions that legalized marijuana than in those that did not (pairwise comparison p = 0.007, 0.05, and 0.006, respectively). By 2019, the all-opioid and fentanyl death rates were 44 and 50 percent greater in the legalizing than in the nonlegalizing jurisdictions, respectively. When the COVID-19 pandemic hit in 2020, jurisdictions that implemented recreational marijuana legalization before 2019 had significantly greater increases in both overall opioid and fentanyl death rates than jurisdictions with medicinal-only legalization. For all-opioids, the mean (95 percent confidence interval) 2019-to-2020 increases were 46.5 percent (36.6, 56.3 percent) and 29.1 percent (20.2, 37.9 percent), respectively (p = 0.02). For fentanyl, they were 115.6 percent (80.2, 151.6 percent) and 55.4 percent (31.6, 79.2 percent), respectively (p = 0.01). During the past decade, marijuana legalization in the US was associated at the jurisdiction level with a greater acceleration in opioid death rate. An even greater increase in opioid mortality occurred in recreational-legalizing jurisdictions with the onset of the COVID-19 pandemic. Marijuana legalization is correlated with worsening of the US opioid epidemic.

Pooled and global burdens and trends of five common cancers attributable to diet in 204 countries and territories from 1990 to 2019: an analysis of the Global Burden of Disease Study.

Increasing evidence has shown that dietary behaviors are closely correlated with the carcinogenesis and progression of many types of cancer. However, few studies have assessed the global diet-related burden of cancer. This study aimed to estimate the pooled burdens and trends of five types of cancers attributable to dietary behaviors. Data regarding cancer attributable to dietary behaviors were extracted from the Global Burden of Disease study 2019, including the death cases and age-standardized death rates, and disability-adjusted life years (DALYs) estimated according to diseases, age, sex, the socio-demographic index (SDI) and location. According to the Global Burden of Disease study 2019, five types of cancer were affected by dietary behaviors: colon and rectum cancer; tracheal, bronchus and lung cancer; stomach cancer; esophageal cancer and breast cancer. Unhealthy dietary behaviors for cancer caused a total of 605.4 thousand deaths and 13951.3 thousand DALYs globally. The burden of cancer attributable to dietary risks was higher for men than for women. The highest age-standardized death rates in 2019 were observed in southern Latin America, and the lowest rates were observed in North Africa and the Middle East. The greatest increases in the age-standardized death rates, from 1990 to 2019, were found in Western Sub-Saharan Africa, with the greatest decreases in Central Asia. The highest attributable proportions of death or DALYs were colon and rectum cancer. The greatest diet-related cancer burden was observed in regions with a high-middle SDI. Global age-standardized deaths and DALYs rates attributable to diet-related cancer are considerable and cause a substantial burden. Successful population-wide initiatives targeting unhealthy dietary behaviors would reduce this burden.

The Used of Magnetic Resonance Imaging in Managing Intra-Abdominal Pregnancy: A Case Report

Most women will experience a normal pregnancy process. However, there are some complications that may occur during the pregnancy. Pregnancy outside of the uterus is also known as intra-abdominal pregnancy. Intra-abdominal pregnancy is among the complications during pregnancy that are commonly reported besides abortion, Pregnancy Induced Hypertension (PIH) and Gestational Diabetes Mellitus (GDM). These complications are believed to be the main cause of the increase in maternal and perinatal death rate. Therefore, the used of appropriate diagnostic imaging in management of obstetric cases should be focused. Thus this case study is intended to evaluate the used of Magnetic Resonance Imaging (MRI) in managing intra-abdominal pregnancy. The study focused on one case of abdominal pregnancy which continued into the second trimester. A 30-year-old woman, G2 P0+1 at 12-13 weeks’ gestation presented to public hospital complaining of recurrence epigastric pain with no history of vaginal bleeding. An MRI was performed and the mother was identified as having an intra-abdominal pregnancy. Urgent laparotomy done. Intraoperative noted heamoperitoneum with active bleed seen from the placenta that adhere to the omentum. Partial omentectomy was done. The fetus about 14 week’s gestation are seen and removed. Case studies have proven that the option to perform an MRI on a suspected intra-abdominal pregnancy can help provide information to establish an accurate diagnosis and appropriate patient care management. Therefore, the use of MRI is highly recommended for all cases that are expected to experience intra-abdominal pregnancy as to save the patient and as well as to avoid obstetric complications.

Covid 19’s Social Quarantine-Moderated Self-Reported Mental Health and Substance Use Among US Adults

In 2019 the novel coronavirus spread quickly throughout the world. It was easily transmitted, resulting in a sudden increase in infection and death rates that overwhelmed hospitals. This sudden pandemic resulted in government and health officials mandating physical and social quarantines to decrease the spread of COVID-19. All these unexpected factors induced traumatic stress across the world. The impact of this trauma is seen to date, as many studies reported adverse mental health effects in an array of populations and researchers speculate these effects will continue long after COVID-19. The role of social quarantine as a moderating factor to these adverse mental health symptoms was assessed in a Qualtrics sample of 596 US adults. Participants completed a demographic survey, Adverse Childhood Experiences (ACEs) Questionnaire, COVID-19 Pandemic Mental Health Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7, International Trauma Questionnaire, Brief Resiliency Scale, and the Tobacco, Alcohol, Prescription Medication and Other Substances Tool. Hierarchical regressions with demographic and risk factors as predictors assessed the role of social quarantine as a moderator in predicting mental health symptoms. ACEs and risk factors were stronger predictors of mental health symptoms, but social quarantine added significant incremental variance in self-reported anxiety, depression, PTSD, complex PTSD, and substance use; β<em> </em>ranged for 0.24 to 0.30. Quarantine had a significant adverse impact on mental health symptoms among these adults. Fostering resilience and distress tolerance is a proposed clinical intervention.

Circumstances of unintentional fall-related adult deaths: Utah, 2010–2020

ObjectiveFall-related deaths have been on the rise nationwide. Our objective was to characterise the trend in unintentional fall-related adult deaths in Utah and evaluate the underlying and contributing causes associated...

SMOTE Variants and Random Forest Method: A Comprehensive Approach to Breast Cancer Classification

This research focused on using machine learning methods for breast cancer diagnosis, considering that breast cancer is the scariest disease for women because it can cause mortality. Not only that, but there is also an increase in breast cancer death rates in women yearly. Early prediction is the right solution to increase life expectancy and reduce mortality rates caused by breast cancer. However, breast cancer data has a problem, namely that the data is imbalanced, which harms the performance of the machine learning method itself. In the data, breast cancer had a Benign class (357 instances) more than the Malignant class (212 instances). Therefore, this study aimed to solve the problem of imbalanced data using the Smote variants and Random Forest approaches in breast cancer classification. The results of this study showed that the Smote approach with Random Forest had the best performance compared to Borderline Smote and Random Forest in the case of breast cancer data classification, where Smote with Random Forest produced an accuracy of 97.3%, sensitivity of 96.9%, and specificity of 97.8%. In comparison, Borderline Smote with Random Forest produced an accuracy of 96.4%, sensitivity of 95.6%, and specificity of 96.9%. The results of this study can contribute to predicting breast cancer using the proposed method, because it has been proven to have high accuracy.

Systemic Characterization of the Gut Microbiota Profile after Single Mild Ischemic Stroke and Recurrent Stroke in Mice.

It has been estimated that one in four stroke patients may have recurrent stroke within five years after they experienced the first stroke. Furthermore, clinical studies have shown that recurrent stroke negatively affects patient outcomes; the risk of disability and the death rate increase with each recurrent stroke. Therefore, it is urgent to find effective methods to prevent recurrent stroke. The gut microbiota has been proven to play an essential role after ischemic stroke, while sudden ischemia disrupts microbial dysbiosis, and the metabolites secreted by the microbiota also reshape the gut microenvironment. In the present study, we established a recurrent ischemic mouse model. Using this experimental model, we compared the survival rate and ischemic infarction between single MCAO and recurrent MCAO, showing that, when two surgeries were performed, the mouse survival rate dramatically decreased, while the infarction size increased. Fecal samples were collected on day 1, day 3 and day 7 after the first MCAO and day 9 (2 days after the second MCAO) for 16S sequencing, which provided a relatively comprehensive picture of the microbiota changes. By further analyzing the potential metabolic pathways, our data also highlighted several important pathways that were significantly altered after the first and recurrent stroke. In the present study, using an experimental mouse model, we showed that acute ischemic stroke, especially recurrent ischemia, significantly decreased the diversity of the gut microbiota.

Polysubstance mortality trends in White and Black Americans during the opioid epidemic, 1999–2018

BackgroundPsychoactive drug combinations are increasingly contributing to overdose deaths among White and Black Americans. To understand the evolving nature of overdose crisis, inform policies, and develop tailored and equitable interventions, this study provides a comprehensive assessment of polysubstance mortality trends by race and sex during the opioid epidemic.MethodsWe used serial cross-sectional US mortality data for White and Black populations from 1999 through 2018 to calculate annual age-adjusted death rates (AADR) involving any opioid, opioid subtypes, benzodiazepines, cocaine, psychostimulants, or combinations of these drugs, stratified by race and sex. Trend changes in AADR were analyzed using joinpoint regression models and expressed as average annual percent change (AAPC) during each period of the three waves of the opioid epidemic: 1999–2010 (wave 1), 2010–2013 (wave 2), and 2013–2018 (wave 3). Prevalence measures assessed the percent co-involvement of an investigated drug in the overall death from another drug.ResultsPolysubstance mortality has shifted from a modest rise in death rates due to benzodiazepine-opioid overdoses among White persons (wave 1) to a substantial increase in death rates due to illicit drug combinations impacting both White and Black populations (wave 3). Concurrent cocaine-opioid use had the highest polysubstance mortality rates in 2018 among Black (5.28 per 100,000) and White (3.53 per 100,000) persons. The steepest increase in death rates during wave 3 was observed across all psychoactive drugs when combined with synthetic opioids in both racial groups. Since 2013, Black persons have died faster from cocaine-opioid and psychostimulant-opioid overdoses. Between 2013 and 2018, opioids were highly prevalent in cocaine-related deaths, increasing by 33% in White persons compared to 135% in Blacks. By 2018, opioids contributed to approximately half of psychostimulant and 85% of benzodiazepine fatal overdoses in both groups. The magnitude and type of drug combinations with the highest death rates differed by race and sex, with Black men exhibiting the highest overdose burden beginning in 2013.ConclusionsThe current drug crisis should be considered in the context of polysubstance use. Effective measures and policies are needed to curb synthetic opioid-involved deaths and address disparate mortality rates in Black communities.

АНАЛІЗ ВІТЧИЗНЯНОГО РИНКУ ПРАЦІ В УМОВАХ ВІЙНИ

The article examines the economic and demographic factors characterizing the population. The population is the main carrier of the labor resource and entrepreneurial spirit. Thanks to its knowledge, skills and abilities, the economic resource of labor acquires special importance in the modern conditions of the knowledge economy. It becomes the most important of all factors of economic growth and development. An economically active population directly affects the functioning of the labor market in the economic system. The economic activity of the population depends on the processes of reproduction and migration. The level of employment, age and social structure of labor resources affects the country’s labor supply. All this determines the relevance of the research topic and requires a detailed analysis of problems related to the peculiarities of the functioning of the domestic labor market in the modern market economy. During the war in Ukraine, the labor market is faced with many problems that require urgent study and solution: population decline, birth rate reduction and death rate increase, aging of the nation, increase in unemployment rate, intensification of migration flows, etc. This situation is aggravated due to the reduction of production, the closure of many firms due to military operations. External forced migration has intensified in Ukraine, which causes significant psychological problems: anxiety, depression, fear, despair. It differs from labor migration in terms of duration and structure. Reconstruction and restoration of Ukraine after the war will require, first of all, human capital with its physical and mental abilities, powerful intellectual potential. It is extremely important to return migrants to their homeland, to include them in the economically active population of our country and to create a gross domestic product. In addition to migration policy, labor market regulation by the state should include appropriate demographic policy, employment policy, as well as social and personnel policy. The active policy of the state in the labor market involves the development of a mechanism for institutional, informational and legal support for the implementation of a unified strategy for human resources management.