Increase In Death Rate Research Articles

T-cell immunity to SARS-CoV-2: what if the known best is not the optimal course for the long run? Adapting to evolving targets.

Humanity did surprisingly well so far, considering how unprepared it was to respond to the coronavirus disease 2019 (COVID-19) threat. By blending old and ingenious new technology in the context of the accumulated knowledge on other human coronaviruses, several vaccine candidates were produced and tested in clinical trials in record time. Today, five vaccines account for the bulk of the more than 13 billion doses administered worldwide. The ability to elicit biding and neutralizing antibodies most often against the spike protein is a major component of the protection conferred by immunization but alone it is not enough to limit virus transmission. Thus, the surge in numbers of infected individuals by newer variants of concern (VOCs) was not accompanied by a proportional increase in severe disease and death rate. This is likely due to antiviral T-cell responses, whose evasion is more difficult to achieve. The present review helps navigating the very large literature on T cell immunity induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination. We examine the successes and shortcomings of the vaccinal protection in the light of the emergence of VOCs with breakthrough potential. SARS-CoV-2 and human beings will likely coexist for a long while: it will be necessary to update existing vaccines to improve T-cell responses and attain better protection against COVID-19.

Giving Condolences by Iraqi EFL Teachers: A Gender Perspective

The dreadful increase in death rates caused by the COVID-19 pandemic, deadly diseases and accidents are all issues that make people give condolences more than ever, and here comes the need to master the speech act of giving condolences to the EFL teachers. However, English teachers have not been called upon to give condolences, particularly in terms of gender. The objective of this study is twofold: (1) To identify the most common strategy by Iraqi EFL teachers and (2) to examine gender variations among these teachers. To this end, a production task was adapted from two related studies. The data were elicited from 39 male and 39 female English language teachers enrolled in the academic year 2020-2021. MS Excel and SPSS were utilized for descriptive and statistical analyses. The study yielded that the females significantly gave more sympathetic, empathetic, suggestive and advising, and combined condolences while the males significantly gave more offering assistance condolences probably based on expressions from their first language.

Pancreatic Cancer and its Attributable Risk Factors in East Asia, Now and Future.

The disease burden of pancreatic cancer in East Asia is at a high level, but the epidemiological characteristics of pancreatic cancer in the region have not been systematically studied. Joinpoint analysis was used to identify average annual percentage change (AAPC) and annual percentage change (APC) in mortality. Age-period-cohort models were used to analyze age-period cohort effects across countries. Bayesian age-period-cohort (BAPC) analysis was used to project the burden of disease for 2020-2030. Pancreatic cancer mortality in males in Japan (2012-2019, APC = -0.97) and Korea (2012-2019, APC = -0.91) has shown a decreasing trend since 2012 (P < .05). However, China (2016-2019, APC = 3.21), Mongolia (2015-2.019, APC = 2.37), and North Korea (2012-2019, APC = 0.47) showed a significant increase in pancreatic cancer in both genders (P < .05). Risk factors for pancreatic cancer in East Asia remained largely stable between 2010 and 2019. Mortality of pancreatic cancer due to smoking began to decline in areas with high socio-demographic index (SDI), and mortality of pancreatic cancer due to high body mass index and high fasting plasma glucose increased with SDI. The age-standardized mortality for pancreatic cancer in Chinese males is expected to exceed that of Japan and South Korea by 2030, but the disease burden of pancreatic cancer in Japan and South Korea remains at extremely high levels. Economically developed countries are beginning to show a decreasing trend in the burden of pancreatic cancer disease, and developing countries are experiencing a rapid increase in the age-standardized death rate (ASDR) of pancreatic cancer.

Twenty-Year Disparity Trends in United States Stroke Death Rate by Age, Race/Ethnicity, Geography, and Socioeconomic Status.

In 2017, the Centers for Disease Control and Prevention (CDC) issued an alert that, after decades of consistent decline, the stroke death rate levelled off in 2013, particularly in younger individuals and without clear origin. The objective of this analysis was to understand whether social determinants of health have influenced trends in stroke mortality. We performed a longitudinal analysis of county-level ischemic and hemorrhagic stroke death rate per 100,000 adults from 1999 to 2018 using a Bayesian spatiotemporally smoothed CDC dataset stratified by age (35-64 years [younger] and 65 years or older [older]) and then by county-level social determinants of health. We reported stroke death rate by county and the percentage change in stroke death rate during 2014-2018 compared with that during 2009-2013. We included data from 3,082 counties for younger individuals and 3,019 counties for older individuals. The stroke death rate began to increase for younger individuals in 2013 (p < 0.001), and the slope of the decrease in stroke death rate tapered for older individuals (p < 0.001). During the 20-year period of our study, counties with a high social deprivation index and ≥10% Black residents consistently had the highest rates of stroke death in both age groups. Comparing stroke death rate during 2014-2018 with that during 2009-2013, larger increases in younger individuals' stroke death rate were seen in counties with ≥90% (vs <90%) non-Hispanic White individuals (3.2% mean death rate change vs 1.7%, p < 0.001), rural (vs urban) populations (2.6% vs 2.0%, p = 0.019), low (vs high) proportion of medical insurance coverage (2.9% vs 1.9%, p = 0.002), and high (vs low) substance abuse and suicide mortality (2.8 vs 1.9%, p = 0.008; 3.3% vs 1.5%, p < 0.001). In contrast to the younger individuals, in older individuals, the associations with increased death rates were with more traditional social determinants of health such as the social deprivation index, urban location, unemployment rate, and proportion of Black race and Hispanic ethnicity residents. Improvements in the stroke death rate in the United States are slowing and even reversing in younger individuals and many US counties. County-level increases in stroke death rate were associated with distinct social determinants of health for younger vs older individuals. These findings may inform targeted public health strategies.

Association of Community Vulnerability and State Gun Laws With Firearm Deaths in Children and Adolescents Aged 10 to 19 Years

Firearm-related injuries are the leading cause of death among children and adolescents in the US. For youths aged 10 to 19 years, 64% of firearm-related deaths are due to assault. Understanding the association between the rate of death due to assault-related firearm injury and both community-level vulnerability and state-level gun laws may inform prevention efforts and public health policy. To assess the rate of death due to assault-related firearm injury stratified by community-level social vulnerability and state-level gun laws in a national cohort of youths aged 10 to 19 years. This national cross-sectional study used the Gun Violence Archive to identify all assault-related firearm deaths among youths aged 10 to 19 years occurring in the US between January 1, 2020, and June 30, 2022. Census tract-level social vulnerability (measured by the Centers for Disease Control and Prevention social vulnerability index [SVI]; categorized in quartiles as low [<25th percentile], moderate [25th-50th percentile], high [51st-75th percentile], or very high [>75th percentile]) and state-level gun laws (measured by the Giffords Law Center gun law scorecard rating; categorized as restrictive, moderate, or permissive). Youth death rate (per 100 000 person-years) due to assault-related firearm injury. Among 5813 youths aged 10 to 19 years who died of an assault-related firearm injury over the 2.5-year study period, the mean (SD) age was 17.1 (1.9) years, and 4979 (85.7%) were male. The death rate per 100 000 person-years in the low SVI cohort was 1.2 compared with 2.5 in the moderate SVI cohort, 5.2 in the high SVI cohort, and 13.3 in the very high SVI cohort. The mortality rate ratio of the very high SVI cohort compared with the low SVI cohort was 11.43 (95% CI, 10.17-12.88). When further stratifying deaths by the Giffords Law Center state-level gun law scorecard rating, the stepwise increase in death rate (per 100 000 person-years) with increasing SVI persisted, regardless of whether the Census tract was in a state with restrictive gun laws (0.83 in the low SVI cohort vs 10.11 in the very high SVI cohort), moderate gun laws (0.81 in the low SVI cohort vs 13.18 in the very high SVI cohort), or permissive gun laws (1.68 in the low SVI cohort vs 16.03 in the very high SVI cohort). The death rate per 100 000 person-years was higher for each SVI category in states with permissive compared with restrictive gun laws (eg, moderate SVI: 3.37 vs 1.71; high SVI: 6.33 vs 3.78). In this study, socially vulnerable communities in the US experienced a disproportionate number of assault-related firearm deaths among youths. Although stricter gun laws were associated with lower death rates in all communities, these gun laws did not equalize the consequences on a relative scale, and disadvantaged communities remained disproportionately impacted. While legislation is necessary, it may not be sufficient to solve the problem of assault-related firearm deaths among children and adolescents.

The Etiology of Abnormal TSH in Veterans Cared by a VA Medical Center – One High Serum Thyrotropin is Associated with Higher 5-Years Mortality

Objective: By analyzing the etiology of abnormal TSH in randomly selected veteran patients, we set our heart on improving future clinical care/management of the clinical/subclinical hyper- and hypothyroidism in the aging veteran population. Methods: A total of 1100 patients’ charts in alphabetical order were selected. Excluded cases of insufficient information, 897 patients’ charts were reviewed and analyzed for causes of abnormal TSH. Among them, 602 for the cause of low TSH (below 0.55 uU/mL) and 295 for high TSH (above 4.78 uU/mL) were reviewed retrospectively. Findings: Among the 1100 patients selected, 680 (61.8%) were 60 y or older (female=44, 6.8%); 420 were under 60 y (female=80, 19.0%); significantly more female patients were found in the younger age group (P&lt;0.001). After excluding patients with insufficient data, the most common cause of suppressed TSH is iodine-induced, CT iodinated contrast and betadine use caused 35.0% in the older group (n=126) compared to 23.6% in the younger group(n=57) (P = 0.027). The significant difference is that older veterans received more contrast CTs (P &lt; 0.05 compared to the younger group). In both age groups with concurrent FT4 study, we found four high FT4 among 90 studies, 4.4% overt hyperthyroidism. The second most common cause of suppressed TSH is due to thyroid hormone (TH) replacement in the older group (119 patients, 33.1%) with age &gt; 60y, significantly more frequent compared to the younger group, P&lt;0.001. There is significantly more overt hyperthyroidism, 27.8/%, than the iodine-load induced suppression of TSH, P&lt;0.001, due to 17 patients on TSH suppression therapy after total thyroidectomy for thyroid cancer. Among the 295 patients with elevated TSH, the most common cause of high TSH was due to hypothyroidism on T4 replacement: a total of 128 (59.3%) in the older group (N=216) is, similar to 47 (59.5%) in the younger group (N=79). In both age groups, there were 139 patients with concomitant FT4 measurement; 17 overt hypothyroidism were found, 12.2%. No significant difference is seen in the two age groups. The next most common causes of elevated TSH are CT contrast infusion, 23 (10.6%) in the older group and 7 (8.9%) in the younger group. We find high TSH is associated with a higher death rate of 101/238 (42.4%) in a 5-year follow-up (from 2016 to 2021), as compared to low TSH of 68/238 (28.6%), in the older age group, p&lt;0.03； both were significantly higher than the age- and sex-matched general US population, 19.7%, P&lt;0.01. Conclusion: Even though most, ~ 90%, were subclinical, the suppressed and elevated TSH are associated with severe consequences in CV/CNS and immune-suppression complications in aging veterans. Therefore, cautious use (and more frequent check of TSH) of TH replacement and CT contrast in aging veterans is recommended. The alarming increase in the 5-year death rate in older patients with elevated TSH deserves further study.

Excess Mortality Among Patients in the Veterans Affairs Health System Compared With the Overall US Population During the First Year of the COVID-19 Pandemic

During the first year of the COVID-19 pandemic, there was a substantial increase in the rate of death in the United States. It is unclear whether those who had access to comprehensive medical care through the Department of Veterans Affairs (VA) health care system had different death rates compared with the overall US population. To quantify and compare the increase in death rates during the first year of the COVID-19 pandemic between individuals who received comprehensive medical care through the VA health care system and those in the general US population. This cohort study compared 10.9 million enrollees in the VA, including 6.8 million active users of VA health care (those with a visit in the last 2 years), with the general population of the US, with deaths occurring from January 1, 2014, to December 31, 2020. Statistical analysis was conducted from May 17, 2021, to March 15, 2023. Changes in rates of death from any cause during the COVID-19 pandemic in 2020 compared with previous years. Changes in all-cause death rates by quarter were stratified by age, sex, race and ethnicity, and region, based on individual-level data. Multilevel regression models were fit in a bayesian setting. Standardized rates were used for comparison between populations. There were 10.9 million enrollees in the VA health care system and 6.8 million active users. The demographic characteristics of the VA populations were predominantly male (>85% in the VA health care system vs 49% in the general US population), older (mean [SD], 61.0 [18.2] years in the VA health care system vs 39.0 [23.1] years in the US population), and had a larger proportion of patients who were White (73% in the VA health care system vs 61% in the US population) or Black (17% in the VA health care system vs 13% in the US population). Increases in death rates were apparent across all of the adult age groups (≥25 years) in both the VA populations and the general US population. Across all of 2020, the relative increase in death rates compared with expected values was similar for VA enrollees (risk ratio [RR], 1.20 [95% CI, 1.14-1.29]), VA active users (RR, 1.19 [95% CI, 1.14-1.26]), and the general US population (RR, 1.20 [95% CI, 1.17-1.22]). Because the prepandemic standardized mortality rates were higher in the VA populations prior to the pandemic, the absolute rates of excess mortality were higher in the VA populations. In this cohort study, a comparison of excess deaths between populations suggests that active users of the VA health system had similar relative increases in mortality compared with the general US population during the first 10 months of the COVID-19 pandemic.

Longitudinal study of COVID-19 stay-at-home orders' impact on deaths of despair in the United States, January 2019 to December 2020.

The COVID-19 pandemic led to increase in mental health problems and substance misuse. Yet, little is known about its impact on rates of deaths of despair (death by suicide and drug overdose). Our objective was to determine the impact of COVID-19 stay-at-home orders on deaths of despair using population-level data. We hypothesized that the longer duration of stay-at-home orders would increase rates of deaths of despair. Utilizing quarterly suicide and drug-overdose mortality data from the National Center for Health Statistics from January 2019 through December 2020, we estimated fixed-effects models to examine the effects of the duration of stay-at-home orders as differentially implemented in 51 jurisdictions in the United States on each outcome. Controlling for seasonal patterns, the duration of jurisdictional-level stay-at-home order was positively associated with drug-overdose death rates. The duration of stay-at-home orders was not associated with suicide rates when adjusting for calendar quarter. Findings suggest an increase in age-adjusted drug-overdose death rates in the United States from 2019 to 2020 possibly attributable to the duration of jurisdictional COVID-19 stay-at-home orders. This effect may have operated through various mechanisms, including increases in economic distress and reduced access to treatment programs when stay-at-home orders were in effect.

Projected Global Trends in Ischemic Stroke Incidence, Deaths and Disability-Adjusted Life Years From 2020 to 2030.

We projected global trends in ischemic stroke from 2020 to 2030 according to age, sex, and socio-demographic index (SDI) quintile. Estimated annual percentage changes (EAPCs) were used to project trends in the incidence of deaths from and disability-adjusted life years (DALYs) due to ischemic stroke between 2020 and 2030. EAPCs were computed using generalized additive models and data from the Global Burden of Disease study during the 1990 to 2019 period. The global age-standardized incidence rate of ischemic stroke was projected to increase to 89.32 per 100 000 population in 2030 (EAPC=0.89), whereas the associated global age-standardized death and DALY rates were projected to decrease to 18.28 (EAPC, -3.58) and 500.37 per 100 000 (EAPC=-1.75), respectively, in 2030. The projections indicated a higher age-standardized incidence rate of ischemic stroke among women than among men in 2030 (90.70 versus 87.64 per 100 000). The incidence rate of ischemic stroke was projected to increase across all age groups and SDI quintiles between 2020 and 2030. At the national level, the greatest increase in the age-standardized incidence rate of ischemic stroke between 2020 and 2030 was projected to occur in Cyprus (EAPC=4.16), followed by Palestine (EAPC=3.50) and South Africa (EAPC=2.64). Additionally, the projections suggested increases in the age-standardized death and DALY rates due to ischemic stroke for countries in low-SDI quintiles (EAPC=3.68 and EAPC=5.30, respectively). The projections indicated that the incidence rate of ischemic stroke will increase both sexes, all age groups, and all SDI quintiles and in some countries between 2020 and 2030. Furthermore, countries with a low SDI should be aware of potential increases in the age-standardized death and DALY due to ischemic stroke.

More Than an Opioid Crisis: Population Health and Economic Indicators Influencing Deaths of Despair

Using a pooled cross‐section regression, the study analyzes state‐level data on deaths of despair as a function of population health, economic, and demographic indicators identified in the academic literature. There is an urgent need to identify and address factors associated with suicides and deaths attributed to the use of alcohol, opioids, and other drugs and referred to as deaths of despair. According to provisional death data posted on the Centers for Disease Control and Prevention (CDC) website, in the 12‐months preceding April 30, 2021, drug overdose deaths increased 28.5 percent compared to the previous year, and alcohol‐related deaths rose 34 percent from pre‐pandemic levels. These recent increases in death rates are in addition to the rise in suicides and deaths attributable to the use of alcohol, opioids, and other drugs over the past decade. Given the complex, interactive, and synergistic nature of deaths of despair, an approach that incorporates perspectives from public health, economics, and sociology could prove advantageous.

Association of the COVID-19 Pandemic and Changes in Patterns of Cancer-Related Mortality in the United States.

This study examined changes in patterns of cancer-related deaths during the first year of the coronavirus disease 2019 pandemic in the United States. We identified cancer-related deaths, defined as deaths attributable to cancer as the primary cause (underlying cause) or deaths with cancer documented as one of the multiple contributing factors (contributing cause) from the Multiple Cause of Death database (2015-2020). We compared age-standardized cancer-related annual and monthly mortality rates for January-December 2020 (first pandemic year) to January-December 2015-2019 (prepandemic) overall and stratified by sex, race/ethnicity, urban rural residence, and place of death. We found that the death rate (per 100,000 person-years) with cancer as the underlying cause was lower in 2020 compared with 2019 (144.1 v 146.2), continuing the past trend observed in 2015-2019. By contrast, the death rate with cancer as a contributing cause was higher in 2020 than in 2019 (164.1 v 162.0), reversing the continuously decreasing trend from 2015 to 2019. We projected 19,703 more deaths with cancer as a contributing cause than expected on the basis of historical trends. Mirroring pandemic peaks, the monthly death rates with cancer as a contributing cause first increased in April 2020 (rate ratio [RR], 1.03; 95% CI, 1.02 to 1.04), subsequently declined in May and June 2020, and then increased again each month from July through December 2020 compared with 2019, with the highest RR in December (RR, 1.07; 95% CI, 1.06 to 1.08). Death rates with cancer as the underlying cause continued to decrease in 2020 despite the increase in death rates with cancer as a contributing cause in 2020. Ongoing monitoring of long-term cancer-related mortality trends is warranted to assess effects of delays in cancer diagnosis and receipt of care during the pandemic.

Peripheral Blood Genes Crosstalk between COVID-19 and Sepsis.

Severe coronavirus disease 2019 (COVID-19) has led to a rapid increase in death rates all over the world. Sepsis is a life-threatening disease associated with a dysregulated host immune response. It has been shown that COVID-19 shares many similarities with sepsis in many aspects. However, the molecular mechanisms underlying sepsis and COVID-19 are not well understood. The aim of this study was to identify common transcriptional signatures, regulators, and pathways between COVID-19 and sepsis, which may provide a new direction for the treatment of COVID-19 and sepsis. First, COVID-19 blood gene expression profile (GSE179850) data and sepsis blood expression profile (GSE134347) data were obtained from GEO. Then, we intersected the differentially expressed genes (DEG) from these two datasets to obtain common DEGs. Finally, the common DEGs were used for functional enrichment analysis, transcription factor and miRNA prediction, pathway analysis, and candidate drug analysis. A total of 307 common DEGs were identified between the sepsis and COVID-19 datasets. Protein-protein interactions (PPIs) were constructed using the STRING database. Subsequently, hub genes were identified based on PPI networks. In addition, we performed GO functional analysis and KEGG pathway analysis of common DEGs, and found a common association between sepsis and COVID-19. Finally, we identified transcription factor-gene interaction, DEGs-miRNA co-regulatory networks, and protein-drug interaction, respectively. Through ROC analysis, we identified 10 central hub genes as potential biomarkers. In this study, we identified SARS-CoV-2 infection as a high risk factor for sepsis. Our study may provide a potential therapeutic direction for the treatment of COVID-19 patients suffering from sepsis.

Модель деятельности малочисленного пожарного подразделения провинции Вьетнама Тхань Хоа

PURPOSE. The article presents the situation with fires in Thanh Hoa Province (Vietnam), analyzes statistical data on death and injury of people in case of fires on the territories of the province counties and districts. Based on statistical data, a growing trend in death rates in counties (rural settlements) has been identified. Using statistical and mathematical analysis, an increase in death rates from exposure to hazardous factors during fires on the territories of counties in Thanh Hoa Province has been shown. The organizational structure of the fire service in Thanh Hoa Province has been studied. The activities of small fire departments and their role in ensuring fire safety of the province's territories have been considered. A model of the activities of small fire departments of the Ministry of Public Security of Thanh Hoa Province has been developed, both when responding to fires and in daily service as part of duty shifts. The conclusion provides a description of problematic issues and ways to solve them. METHODS. The main research methods are analysis and comparison of information obtained through the interaction of specialists from the Ministry of EMERCOM of Russia with employees of the Ministry of Public Security of the Socialist Republic of Vietnam. FINDINGS. The authors of the article confirm the relevance of the ongoing research related to the issues of death in fires in rural settlements of Thanh Hoa Province, Vietnam. Directions for further research into the activities of small provincial fire departments in cooperation with fire and rescue services of Vietnam have been identified. Based on the data obtained on the organization of fire department activities in Thanh Hoa Province, the database on the activities of fire and rescue services of different countries will be expanded. The study of current issues of fire safety, the exchange of scientific developments in the field of fire safety will provide new relevant and useful information for improving the fire safety system of our country. RESEARCH APPLICATION FIELD. The results obtained are recommended for implementation in the educational process of academic and scientific institutions of the Ministry of EMERCOM of Russia, as well as in practical activities of the Fire Service of Vietnam. CONCLUSIONS. The authors of the article show the need to conduct scientific research on the problematic issues of fire death in the counties of Thanh Hoa Province, associated with an increase in the number of victims in recent years. Conducted research into the activities of small fire departments protecting rural settlements of the province is aimed at solving the issues of rescuing people in case of fires.

ДИНАМИКА СМЕРТНОСТИ НАСЕЛЕНИЯ ОМСКОЙ ОБЛАСТИ ПО ОСНОВНЫМ КЛАССАМ ПРИЧИН СМЕРТИ ЗА 2014-2021 ГГ.

Significance. Mortality is one the most important statistical indicators characterizing level of sanitation. This demographic indicator is one of the most common in international health statistics. Of particular interest to health authorities are mortality rates from individual causes. Mortality rate from individual causes depends on prevalence of specific nosological forms of diseases and their lethality. The purpose of the study was to analyze rates and dynamics in mortality in the Omsk region by main class of death causes for the period from 2014 to 2021. Material and methods. Statistical processing of the research materials used methods of alternative (intensive indicators) and graphical analysis; indicators of dynamic series were calculated. Results. During the period from 2014 to 2021, the Omsk region registered a 35% increase in the crude death rate. Diseases of the circulatory system remained the leading cause of death in the Omsk region. Mortality from diseases of the nervous system increased 2.6 times. The COVID-19 pandemic is associated with a high mortality in the region in 2020, followed by a 3.2-fold increase in 2021, ranking second after diseases of the circulatory system. A decrease in mortality was recorded in the classes "Infectious and parasitic diseases" (by 18.8%), "Neoplasms" (by 7.1%), "Diseases of the respiratory system (by 29.0%), "Diseases of the digestive system" (by 10.4%), and "Accidents, injuries, poisoning" (by 29.1%). Conclusion. Statistically significant positive changes were registered during the analysis of dynamics in mortality due to infectious diseases, neoplasms, respiratory diseases, digestive diseases, and external causes. In the region, mortality due to diseases of the circulatory system was characterized by a stable trend and high rates. Negative trends have been noted in the dynamics in mortality associated with COVID-19, and diseases of the nervous system. A significant increase in mortality due to these causes apparently determines the negative trends in the medical and demographic component of the current development of the Omsk region.

MODELING AND ANALYSIS OF LOW-LEVEL TRANSMISSION ZIKV DYNAMICS VIA A POISSON POINT PROCESS ON SEXUAL TRANSMISSION ROUTE

In this project, we modeled the low-level ZIKV transmission that was reported in Thailand [? ]. The secondary sexual transmission route is modeled by a Poisson point process, which leads to an increasing and saturating contact rate. This nonlinear contact rate further induces backward and Hopf bifurcations. Oscillations bifurcating from the Hopf bifurcation demonstrate the low-level persistent ZIKV transmission with sharp outbreaks, which further show varying amplitudes and frequency by considering stochastic variations on the sexual transmission rate. Global stability analysis of the diseasefree equilibrium drives the disease elimination criteria for models considering vector transmission route only and considering both vector and sexual transmission routes. Bifurcation analyses prove the existence of forward and backward bifurcations, saddle-node bifurcation, and Bogdanov-Takens analytically, and further suggest the occurrence of cusp, Hopf, and general Hopf bifurcations numerically. One and two-dimensional bifurcation diagrams demonstrate the analytical results under the influence of both vector and sexual transmission rates. Sensitivity analysis suggests that an increase in mosquito death rate has the largest effect on the basic reproduction number, and an increase in human recovery rate has the most influence on decreasing human host prevalence.

Assessment of stillbirth rates during the different waves of the COVID pandemic

COVID-19 became a global pandemic at the beginning of 2020 with significant morbidity and mortality. There has been a documented increase in intrauterine fetal death (IUFD) rates during the pandemic as well as placental vascular malperfusion associated with COVID infection. As the pandemic enters its third year, this study aims to analyze the rates of IUFD as they relate to the waves and variants of infection during the pandemic.

Hurricane Florence and suicide mortality in North Carolina: a controlled interrupted time-series analysis

BackgroundNatural disasters are associated with increased mental health disorders and suicidal ideation; however, associations with suicide deaths are not well understood. We explored how Hurricane Florence, which made landfall in...

Evaluation of targeted oxidative stress induced by oxygen-ozone in vitro after ischemic induction

ABSTRACT Encephalic vascular accident, or stroke, is the most common pathology of the central nervous system in humans, the second leading cause of death and physical and cognitive disabilities, in developing countries. It presents as an ischemic (more common) or hemorrhagic form. Ozone therapy has been shown to be effective in neuromodulation, neuroprotection, and nerve regeneration. The present study aimed to evaluate the effect of targeted mild ozone after inducing cerebral ischemia in vitro. Neuroblastoma lineage cells (SH-SY5Y) and canine amniotic membrane stem cells were subjected to 24 hours of hypoxia in an incubator culture chamber. The cells were evaluated by MTT assay, colorimetric assay spectrophotometry, fluorescence microscopy, and flow cytometry. Treatment with low concentrations of ozone (2–10 µg/mL), indicated a possible neuroregenerative effect at low concentrations, correlated with lower levels of apoptosis and oxidative stress compared to cells not subjected to hypoxia. High concentrations of ozone (18–30 µg/mL) promoted an increase in rate of apoptosis and cell death. We developed a novel protocol that mimics ozone therapy for ischemic stroke, using ozonized culture medium after hypoxia induction. Although more studies are needed, we conclude that ozone has a dose-dependent hormetic effect and can reverse the effect of ischemia in vitro at low concentrations.

The Clinical Significance of Light Chain Predominant Multiple Myeloma

Abstract Multiple Myeloma (MM) is a neoplastic clonal proliferation of terminally differentiated B- lymphocytes. It accounts for 1.6% of all cancers and about 10-15% of all hematological malignancies in the United States. Monoclonal immunoglobulins provide an indication of tumor burden in patients with plasma cell neoplasm. Recent development has shown that a proportion of intact immunoglobulin producing multiple myeloma secrete much higher amounts of free light chains than usual; i.e. light chain predominant multiple myeloma (LCPMM). About 18% of multiple myeloma secreting intact immunoglobulins secrete higher amount of free light compared to other intact immunoglobulin secreting myelomas and are associated with significantly poorer clinical outcomes. In this study, a retrospective investigation comparing the laboratory and clinical findings in conventional MM and LCPMM was undertaken. Three hundred and sixteen patients with conventional MM and seventy-one patients with LCPMM were studied. The results were remarkable for marked increase in death rate in the LCPMM group compared to the conventional MM group, 35.2% and 13.6% respectively; P-value .00001. The occurrence of dialysis was also markedly increased in the LCPMM group compared with the conventional MM; 18.3% vs. 3.5% P-value .00001. A markedly lower eGFR was observed in patients with LCPMM group compared to patients with conventional MM with an average value of 46.3 versus 69.4 ml respectively P value .0000003. In conclusion, light chain predominant plasma cell myeloma confers a significant disease burden, poor clinical outcomes and shorter survival. Further prospective trial will be helpful in understanding the pathogenesis, the course, and management of the disease. An assay for serum free monoclonal light chains has been described and could serve as a marker for minimal residual disease in such patients. We aim to further study the clinical impact of light chain predominant plasma cell myeloma (LCPMM) to increase the current knowledge of the disease and investigate therapeutic interventions.

Global Burden of Ischemic Stroke in Young Adults in 204 Countries and Territories.

To estimate the rates of incidence, death, and disability-adjusted life years (DALYs) of ischemic stroke in young adults aged 15-49 years and the relevant risk factors by sex, age group, and sociodemographic index (SDI) in 204 countries and territories. Data from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2019 study were used. The estimated annual percentage changes (EAPCs) were calculated to evaluate the temporal trends from 1990 to 2019. We also estimated the risk factors contributing to DALYs resulting from ischemic stroke. From 1990 to 2019, the global age-standardized incidence (EAPC = -0.97), death (EAPC = -0.11), and DALYs rates (EAPC = -0.55) of ischemic stroke in young adults decreased. The largest increases in age-standardized incidence, death, and DALYs rates were observed in the low and low-middle SDI quintiles. At the regional level, North Africa and the Middle East and Southeast Asia showed the largest increases in the age-standardized incidence, death, and DALYs rates of ischemic stroke. The age-standardized incidence rate was higher among young women than among young men in 2019. Globally, a high environmental temperature, high body mass index (BMI), and a high fasting plasma glucose contributed to the largest increases in age-standardized DALYs rates between 1990 and 2019. In the same period, the largest increases in the age-standardized DALYs rates in high-SDI and low-SDI regions were attributable to high environmental temperatures and alcohol use, respectively. The burden of ischemic stroke in young adults continues to increase in low-SDI regions such as North Africa and the Middle East and Southeast Asia. There were differences in the primary risk factors related to the burden of ischemic stroke in different SDI regions. Targeted implementation of cost-effective policies and interventions is an urgent need to reduce the burden of ischemic stroke in young adults.