Mortality In Population Research Articles

Risk Factors for Natural Cause Mortality in Schizophrenia

Schizophrenia is associated with premature mortality from mostly natural causes. Decreased cognitive functioning has been identified as a determinant of mortality in the general population. However, there have been few prospective studies of this issue in persons with schizophrenia. To examine whether lower cognitive functioning is a risk factor for natural cause mortality in schizophrenia. This prospective cohort study included persons with schizophrenia or schizoaffective disorder enrolled between February 1, 1999, and December 31, 2022, at a nonprofit psychiatric system in Baltimore, Maryland. Participants were evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and other clinical measures. Natural cause mortality. Associations of cognitive function, obesity, tobacco smoking, and medical conditions with natural cause mortality were evaluated using Cox proportional hazards regression models. Of the 844 participants enrolled (mean [SD] age, 39.6 [12.1] years; 533 male [63.2%]), 158 (18.7%) died of natural causes during a median follow-up of 14.4 years (range, 7.0 days to 23.9 years). The most significant factor associated with mortality was lower cognitive functioning as measured by the RBANS (Cox coefficient, -0.04; 95% CI, -0.05 to -0.03; z = -5.72; adjusted P < .001). Additional factors independently associated with mortality included the diagnosis of an autoimmune disorder (hazard ratio [HR], 2.86; 95% CI, 1.83-4.47; z = 4.62; adjusted P < .001), tobacco smoking (HR, 2.26; 95% CI, 1.55-3.30; z = 4.23; adjusted P < .001), diagnosis of chronic obstructive pulmonary disease (HR, 3.31; 95% CI, 1.69-6.49; z = 3.48; adjusted P = .006), body mass index as a continuous variable (HR, 1.06; 95% CI, 1.02-1.09; z = 3.30; adjusted P = .01), diagnosis of a cardiac rhythm disorder (HR, 2.56; 95% CI, 1.40-4.69; z = 3.06; adjusted P = .02), and being divorced or separated (HR, 1.80; 95% CI, 1.22-2.65; z = 2.97; adjusted P = .02). An RBANS score below the 50th percentile displayed a joint association with being a smoker, having an elevated body mass index, and having a diagnosis of an autoimmune or a cardiac rhythm disorder. In this prospective cohort study, lower cognitive functioning was a risk factor for natural cause mortality in schizophrenia. Efforts should be directed at methods to improve cognitive functioning, particularly among individuals with additional risk factors.

WP4.14 - Association of Socioeconomical Status and Disparity In Paediatric Burn: Results From The Global Burden Of Disease Study 2019

Abstract Background Burn represents a significant contributor to both morbidity and mortality in the paediatric population and is closely related to socioeconomic and geographic factors but is often overlooked. This study aims to estimate the unbalanced distributions, temporal trends and quality of care in paediatric burn. Methods Data focusing on paediatric population (&amp;lt;20 years old) was sourced from the Global Burden of Disease (GBD) Study 2019 stratified by Socio-demographic Index (SDI) and WHO region, including incidence, mortality and disability-adjusted life-years (DALYs). Joinpoint regression analysis and principal component analysis were conducted to compute the temporal trend and quality of care (QCI) index respectively. Result In 2019, 3,719,806 paediatric burn cases were reported, resulting in 23,986 deaths and 2,240,311 DALYs globally. Over 40% of deaths and DALYs attributable to burn occur in the African region, despite the region accounting for around 20% of the total incidence. The age-standardised incidence rate (ASIR) from 2010-2019 was 0.419 per 100,000 but death (ASDR) and DALYs (ASDALYs) were reduced at the rate of 3.04 per 100,000 and 2.92 per 100,000 respectively. The global QCI for paediatric burn was 88 with a proportional trend observed across SDI quintiles Significant association in between SDI scores and gender disparity and quality of care was observed. Conclusion This study highlights the significant burden of paediatric burn and its disproportionate global distribution. Preventive measures, enhancing access to quality healthcare, and addressing the social and economic determinants of burn should be addressed in future studies.

Associations between different insulin resistance indices and the risk of all-cause mortality in peritoneal dialysis patients

BackgroundInsulin resistance (IR) is prevalent in individuals undergoing peritoneal dialysis (PD) and is related to increased susceptibility to coronary artery disease and initial peritonitis. In recent investigations, correlations have been found between indices of IR and the incidence of all-cause mortality in various populations. However, such correlations have not been detected among individuals undergoing PD. Hence, the present study’s aim was to explore the connections between IR indices and the incidence of all-cause mortality in PD patients.MethodsPeritoneal dialysis patients (n = 1736) were recruited from multiple PD centres between January 2010 and December 2021. Cox proportional hazards and restricted cubic spline regression models were used to evaluate the connections between the triglyceride–glucose (TyG) index, triglyceride–glucose/body mass index (TyG–BMI), and triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio and the occurrence of all-cause mortality. All three IR indices were integrated into the same model to assess the predictive stability. Furthermore, a forest plot was employed to display the findings of the subgroup analysis of PD patients.ResultsOverall, 378 mortality events were recorded during a median follow-up time of 2098 days. Among PD patients, a higher TyG index, TyG–BMI, and TG/HDL-C ratio were identified as independent risk factors for all-cause mortality according to Cox proportional hazards analyses (hazard ratio (HR) 1.588, 95% confidence interval (CI) 1.261–2.000; HR 1.428, 95% CI 1.067–1.910; HR 1.431, 95% CI 1.105–1.853, respectively). In a model integrating the three IR indices, the TyG index showed the highest predictive stability. According to the forest plot for the TyG index, no significant interactions were observed among the subgroups.ConclusionSignificant associations were found between the TyG index, TyG–BMI, and TG/HDL-C ratio and the incidence of all-cause mortality among PD patients. The TyG index may be the most stable of the three surrogate IR markers. Finally, a correlation was identified between IR and the risk of all-cause mortality in patients undergoing PD.

Disparity in trends and characteristics of early onset colorectal cancer: analysis from the National Inpatient Sample, 2016 to 2021

Introduction Colon cancer is the second most common cause of death in the United States. With an increasing number of patients diagnosed at younger ages, the disease remains a significant burden. However, recent data on early onset patients admitted with colon cancer are still limited. Methods We utilized the 2016 to 2021 National Inpatient Sample to investigate trends and characteristics of colon cancer hospitalizations. Nonelective participants were divided into early onset and normal-age groups, with a cut point of 50 years old. In addition, we also investigated factors associated with the risk of inpatient mortality in the study population. Results There were 26,903 early onset nonelective colon cancer hospitalizations in the population group, amounting to 11.91% of total colon cancer hospitalizations. No significant changes or trends were seen from 2016 to 2021. Compared to the normal-age population group, there was a disproportionate number of Blacks, Hispanics, and Asian Americans, as well as those with obesity and tobacco usage. Conclusion Some demographic factors and comorbidities disproportionately affect early onset colon cancer patients when compared to the normal-age population group. Further investigations are necessary to combat the growing incidence of early onset colon cancer.

Association of Vitamin E Intake with All-Cause Mortality Among Individuals with Rheumatoid Arthritis: A Cohort Study from the NHANES 1999-2018

Background The relationship between dietary vitamin E intake and mortality rates among rheumatoid arthritis (RA) patients remains a relatively uncharted territory in nutritional epidemiology, underscoring an important gap in research. Objectives This study is to explore the potential association between dietary vitamin E intake and all-cause mortality in the RA patient population. Methods This longitudinal cohort study analyzed 2,906 RA patients aged 20 years or older who participated in the National Health and Nutrition Examination Survey from 1999 to 2018. Comprehensive data on mortality, dietary vitamin E intake, and pertinent confounding variables were systematically collected and analyzed using Cox regression and spline curve fitting to analyze the potential association. Results Following the adjustment for confounding factors, a significant inverse relationship was identified between dietary vitamin E intake and the risk of all-cause mortality in patients with RA. The adjusted hazard ratios (HRs) for the second (Q2), third (Q3), and fourth (Q4) quartiles of vitamin E intake were 0.85, 0.60, and 0.68, respectively. Non-linear modeling indicated a threshold effect characterized by a curve that associated dietary vitamin E intake with mortality risk (p = 0.016). An intake threshold of 7.097 mg/day was identified, below which each unit increment in vitamin E intake was associated with a 11.1% decrease in all-cause mortality risk (HR = 0.889). Conversely, for intakes surpassing this threshold, no significant relationship with mortality risk was detected (HR = 1.0038). Conclusion The findings of this study indicate a beneficial relationship between elevated dietary vitamin E intake and a reduced risk of all-cause mortality in RA patients. The dose-response relationship exhibits a non-linear pattern, featuring a critical inflection point at an intake of approximately 7.097 mg/day.

Association between blood heavy metal element and all-cause mortality in asthmatic adults: a cohort study

Asthma start, development, and exacerbation have all been linked in numerous studies to exposure to a variety of metal elements. However, there is still a dearth of epidemiological data linking heavy metal exposure to death in asthmatics. The investigation included 2432 eligible adults with asthma. The study examined the possible correlation between blood heavy metal levels and all-cause mortality. This was done by utilizing Cox proportional hazards models, restricted cubic spline (RCS), threshold effect models, and CoxBoost models. Subgroup analyses were conducted to investigate the associations between blood metal levels and all-cause mortality among distinct asthmatic populations. An inverse association was found between blood selenium and all-cause mortality in asthmatics, while blood manganese showed a positive association with all-cause mortality. However, there were no significant connections found between blood lead, cadmium, mercury, and all-cause mortality via multivariate Cox proportional hazard models. In model 3, after accounting for all factors, all-cause mortality dropped by 10% for every additional 10 units of blood selenium (μg/L) and increased by 6% for every additional unit of blood manganese (μg/L). The RCS and threshold effect model found a U-shaped correlation between blood selenium, blood manganese, and all-cause mortality. The lowest all-cause mortality among asthmatics was observed when blood selenium and manganese were 188.66 μg/L and 8.47 μg/L, respectively. Our investigation found a U-shaped correlation between blood selenium levels, blood manganese levels, and all-cause mortality in asthmatic populations. Optimizing dietary selenium intake and effectively managing manganese exposure could potentially improve the prognosis of asthma.

Neurological Symptoms and Cause of Death Among Young Children in Low- and Middle-Income Countries

The emergence of acute neurological symptoms in children necessitates immediate intervention. Although low- and middle-income countries (LMICs) bear the highest burden of neurological diseases, there is a scarcity of diagnostic and therapeutic resources. Therefore, current understanding of the etiology of neurological emergencies in LMICs relies mainly on clinical diagnoses and verbal autopsies. To characterize the association of premortem neurological symptoms and their management with postmortem-confirmed cause of death among children aged younger than 5 years in LMICs and to identify current gaps and improve strategies to enhance child survival. This cross-sectional study was conducted between December 3, 2016, and July 22, 2022, at the 7 participating sites in the Child Health and Mortality Prevention Surveillance (CHAMPS) network (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa). Minimally invasive tissue sampling was performed at the CHAMPS sites with specimens from deceased children aged younger than 5 years. This study included deceased children who underwent a premortem neurological evaluation and had a postmortem-confirmed cause of death. Data analysis was performed between July 22, 2022, and January 15, 2023. Descriptive analysis was performed using neurological evaluations from premortem clinical records and from postmortem determination of cause of death (based on histopathology, microbiological testing, clinical records, and verbal autopsies). Of the 2127 deaths of children codified during the study period, 1330 (62.5%) had neurological evaluations recorded and were included in this analysis. The 1330 children had a median age of 11 (IQR, 2-324) days; 745 (56.0%) were male and 727 (54.7%) presented with neurological symptoms during illness before death. The most common postmortem-confirmed neurological diagnoses related to death were hypoxic events (308 [23.2%]), meningoencephalitis (135 [10.2%]), and cerebral malaria (68 [5.1%]). There were 12 neonates with overlapping hypoxic events and meningoencephalitis, but there were no patients with overlapping meningoencephalitis and cerebral malaria. Neurological symptoms were similar among diagnoses, and no combination of symptoms was accurate in differentiating them without complementary tools. However, only 25 children (18.5%) with meningitis had a lumbar puncture performed before death. Nearly 90% of deaths (442 of 511 [86.5%]) with neurological diagnoses in the chain of events leading to death were considered preventable. In this cross-sectional study of children aged younger than 5 years, neurological symptoms were frequent before death. However, clinical phenotypes were insufficient to differentiate the most common underlying neurological diagnoses. The low rate of lumbar punctures performed was especially worrying, suggesting a challenge in quality of care of children presenting with neurological symptoms. Improved diagnostic management of neurological emergencies is necessary to ultimately reduce mortality in this vulnerable population.

Association between the systemic inflammation response index and mortality in the asthma population.

As a novel indicator of inflammation, the relationship between the systemic immune-inflammation index (SIRI) and mortality in patients with asthma remains uncertain. Our study aimed to explore the association between SIRI and mortality in asthma patients. Data from the National Health and Nutrition Examination Survey (NHANES) for US adults from 2001 to 2018 were included in this study. Then, we divided all patients into three groups based on SIRI tertiles and used multivariable weighted Cox regression analysis, smoothing curve fitting, survival curve analysis, and subgroup analysis to investigate the relationship between SIRI and asthma. A total of 6,156 participants were included in the study, with each SIRI tertile consisting of 2052 individuals. Asthma patients with higher SIRI levels were older, had a higher level of education, were more likely to be married, and had a higher chance of being smokers. In Cox proportional-hazards models, the highest SIRI group showed higher hazard ratios (HRs) for all-cause mortality in individuals with asthma after adjusting for potential confounders. The restricted cubic spline analysis indicated a non-linear relationship between SIRI and all-cause mortality. The Kaplan-Meier survival curves showed that patients with higher SIRI levels had a higher risk of all-cause mortality. Subgroup analyses revealed SIRI's association with all-cause mortality across various demographics, including age, sex, race, education levels, smoking status, and marital status. Our study provides evidence for the relationship between SIRI and mortality in asthma patients. SIRI may potentially serve as a predictive tool for evaluating asthma mortality rates.

PTH may predict early mortality in incident patients on hemodialysis: results from a large cohort.

Parathyroid hormone (PTH) is merit as a risk factor for mortality in patients with chronic kidney disease in prevalent hemodialysis patients in a U shape. Most studies, however, do not focus on incident patients and those who died within the first 90days of therapy. We evaluated PTH as a risk factor for mortality in a large cohort population in Brazil. This is an observational cohort study that included 4317 adult patients who initiated hemodialysis between July 1st, 2012 and June 30, 2017. The main outcome was all-cause mortality. Fine-gray sub-distribution hazard models were used to evaluate survival in the presence of a competing event (kidney transplant). Median PTH levels of 252 (118, 479) pg/mL. There were 331 deaths during the first 90days of therapy (6.7%), 430 in a 1-year follow-up (10.7%) and 1282 (32%) during the 5-year study period. Deaths according to PTH < 150, 150-600 and > 600pg/mL corresponded to 38.1%, 33.0% and 28.5%, respectively (p < 0.001). In an adjusted model, patients who started dialysis with PTH < 150pg/mL had a higher mortality risk within the first 90days, but not in 1year and 5years after starting dialysis. Analyses in a subset of patients with a repeated PTH in 1year (N = 1954) showed that although persistent PTH low levels (< 150pg/mL) at 1year were significantly associated with all-cause mortality, this result was not sustained after multiple adjustments. PTH < 150pg/mL confers a high mortality risk in the first 90days of dialysis. If this result reflects poor nutritional conditions, it deserves further investigations.

A combination of osteosynthesis in proximal femur fracture and contralateral femoral neck local osteo-enhancement procedure (LOEP) in severe osteoporotic bone loss

Proximal femur fractures are among the main causes of mortality and morbidity worldwide in the elderly female population. Research efforts are currently focused on the development of a procedure that has immediate and long-term effectiveness, although pharmacological therapies are already capable of improving bone density and reducing the risk of fracture. A local bone enhancement procedure (LOEP) has been developed to facilitate bone augmentation. The procedure requires the preparation of an area of osteoporotic bone into which a triphasic, resorbable, calcium-based material is injected. Following the procedure, both the bone mineral density of the proximal femur and the bone resistance to compression and distraction forces acting on the femoral neck, which can cause fracture, are significantly improved. Ten women suffering from severe osteoporosis and intertrochanteric fracture underwent preliminary investigations after application of a local bone-strengthening procedure involving the use of AGN1 and nailing of the contralateral proximal femur. KEY WORDS: Proximal femur fracture, osteoporosis, local osteo-enhancement procedure (LOEP), proximal femoral nail (PFN).

Качество атмосферного воздуха и риск развития болезней системы кровообращения у населения крупного города европейского севера

Cardiovascular diseases are the most frequent causes of premature mortality associated with ambient air quality. In the Arkhangelsk region, population mortality caused by diseases of the circulatory system is higher than the national average. The aim of this study was to assess ambient air quality in Arkhangelsk and associated health harm in adult population. The study relied on using data of ambient air monitoring in Arkhangelsk collected over 2011–2022. We analyzed average annual levels of 23 pollutants and primary incidence of diseases of the circulatory system (CVD) and calculated hazard quotients under chronic inhalation exposure (HQ), hazard index (HI) for the cardiovascular system, and the number of attributable deaths associated with exposure to PM10 and PM2.5. Over the analyzed period, the average long-term concentrations of most pollutants met hygienic standards. Average levels of formaldehyde, chromium, copper and benzene were found to exceed the MPL by 1.5–2.3 times. Hazard coefficients for formaldehyde (HQ = 2.3), copper (HQ = 1.8) and PM2.5 (HQ = 1.7) were established to be above their permissible value. The risk of developing general toxic effects is determined to be high (HI = 6.6) for the cardiovascular system. The main contribution to the risk level is made by copper and PM2.5. Attributable outcomes of primary cardiovascular incidence among the adult population of Arkhangelsk associated with exposure to PM10 and PM2.5 equaled 10.7 and 2.9 ‰ cases per year. The greatest harm under exposure to PM2.5 is due to the development of coronary artery disease and amounts to 1.9 ‰ cases per year.

Ambient air quality and risk of circulatory diseases for population of a large city in the European north of Russia

Cardiovascular diseases are the most frequent causes of premature mortality associated with ambient air quality. In the Arkhangelsk region, population mortality caused by diseases of the circulatory system is higher than the national average. The aim of this study was to assess ambient air quality in Arkhangelsk and associated health harm in adult population. The study relied on using data of ambient air monitoring in Arkhangelsk collected over 2011–2022. We analyzed average annual levels of 23 pollutants and primary incidence of diseases of the circulatory system (CVD) and calculated hazard quotients under chronic inhalation exposure (HQ), hazard index (HI) for the cardiovascular system, and the number of attributable deaths associated with exposure to PM10 and PM2.5. Over the analyzed period, the average long-term concentrations of most pollutants met hygienic standards. Average levels of formaldehyde, chromium, copper and benzene were found to exceed the MPL by 1.5–2.3 times. Hazard coefficients for formaldehyde (HQ = 2.3), copper (HQ = 1.8) and PM2.5 (HQ = 1.7) were established to be above their permissible value. The risk of developing general toxic effects is determined to be high (HI = 6.6) for the cardiovascular system. The main contribution to the risk level is made by copper and PM2.5. Attributable outcomes of primary cardiovascular incidence among the adult population of Arkhangelsk associated with exposure to PM10 and PM2.5 equaled 10.7 and 2.9 ‰ cases per year. The greatest harm under exposure to PM2.5 is due to the development of coronary artery disease and amounts to 1.9 ‰ cases per year.

1594P Cancer mortality in young population and estimated radon areas in Spain

1594P Cancer mortality in young population and estimated radon areas in Spain

In-Hospital Outcomes in the Brazilian Registry of Transcatheter Aortic Valve Implantation - 14-Year Analysis.

Transcatheter aortic valve implantation (TAVI) has had an exponential increase of its indication, being incorporated into the Brazilian Unified Public Health System in 2022, thus requiring assessment of its use in Brazil. To assess the factors associated with in-hospital mortality and non-fatal complications in both genders in the Brazilian Registry of Transcatheter Aortic Valve Implantation and New Technologies (RIBAC-NT) population. Analysis of the RIBAC-NT database from 2008 to 2022 was performed. Logistic models and machine learning were used for statistical assessment of the association between variables and outcomes. The software R was used and a 5% significance level, adopted. Analysis of 2588 patients (women, 51.2%; in-hospital death, 8.2%). Mortality was associated with procedural complications, of which major vascular complication (VC) and acute kidney injury (AKI) stood out (p<0.001). Major VC occurred in 6% of the patients, with 34% mortality; AKI occurred in 8.8%, with 13% mortality, which increased up to 8 times when AKI coexisted with other complications. Non-fatal complications occurred in 50.5% of all patients, affecting 63% of those with 1st generation (1G) bioprosthesis and 39% of those with 2nd generation (2G) bioprosthesis (p<0,001). Non-femoral access and heart rhythm influenced non-fatal complications in patients with 1G prostheses, while complications in patients with 2G prosthesis associated with the female gender (39.6% vs. 30.4%, p=0.003). In-hospital mortality in the RIBAC-NT population was directly associated with procedural complications, mainly major VC and AKI. The occurrence of non-fatal complications differed according to gender and bioprosthesis type.

Pain Intervention for Osteoporotic Compression Fracture, From Physical Therapy to Surgery: A Literature Review.

Osteoporotic vertebral compression fractures (OVCF) significantly contribute to increased morbidity and mortality in aging populations. When adjusted for age, South Korea has the highest global prevalence of OVCF, with rates of 544 per 100,000 men and 1,575 per 100,000 women. Moreover, patients with OVCF are at a heightened risk of additional fractures, with the risk of new vertebral fractures being up to 5-fold higher. Therefore, in treating patients with OVCF, it is essential to address the current symptoms and take preventive measures against further fractures. Although pharmacological treatment is crucial, it may be insufficient for all patients with OVCF, with more severe cases often requiring physical therapy or surgical intervention. This review aimed to explore effective physical therapy methods for patients with OVCF and summarize surgical techniques for high-risk older patients with various underlying conditions.

Association of inadequate sleep with mortality among persons who inject drugs

BackgroundInadequate sleep is associated with all-cause mortality in the general population. Substance use has adverse effects on sleep, and insomnia symptoms are common among people with HIV. Therefore, persons who inject drugs may face a heightened risk of adverse outcomes from inadequate sleep. We evaluated the association of inadequate sleep with mortality among persons who inject drugs in a long-standing community cohort. MethodsParticipants were from the AIDS Linked to the IntraVenous Experience (ALIVE) study, a cohort of persons who inject drugs in Baltimore, Maryland, USA. From 2005-2020, perceived sleep adequacy and duration were assessed semiannually using survey. Mortality data were obtained through linkage to the National Death Index-Plus. Cause of death was independently characterized and validated by three physicians. Hazards of all-cause and cause-specific mortality were evaluated using Cox regression accounting for repeated measurements. ResultsA total of 2633 participants were included, with a median age at entry of 45.8years; 32.5% were female, and 75% were Black. After adjustment for demographics, mental health, and comorbidities, inadequate sleep was associated with a 32% greater hazard of all-cause mortality (hazard ratio: 1.32, 95% confidence interval: 1.12-1.55) and a 67% greater hazard of HIV/infectious disease-related deaths (hazard ratio: 1.67, 95% confidence interval: 1.15-2.42). Short (<6 hours) and long (≥8 hours) duration of sleep were both associated with higher hazard of all-cause and chronic disease-related mortality (all p < .05). ConclusionsSleep plays a critical role in longevity in persons who inject drugs. Research is needed to determine whether interventions targeting sleep improve health and longevity in persons who inject drugs.

Trends in cancer and heart failure related mortality in adult US population: A CDC WONDER database analysis from 1999 to 2020

BackgroundWith the advent of novel chemotherapy, survival of patients with cancer has improved. However, people with cancer have an increased risk of heart failure (HF). Conversely, HF-related mortality may undermine survival among people with cancer. We aim to analyze the trends of mortality in people with HF and cancer in the adult US population. MethodsWe conducted an examination of death certificates sourced from the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database, from the years 1999 to 2020. Mortality in adults with HF and cancer was assessed. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change were reported. ResultsBetween 1999 and 2020, 621,783 deaths occurred from HF in people with cancer. The AAMR declined from 16.4 in 1999 to 11.9 in 2017, after which an increase to 14.5 was observed in 2020. Men had consistently higher overall AAMR as compared to women (men = 18.1 vs women = 9.9). Similar AAMR was observed between non-Hispanic (NH) Blacks/African Americans (13.9) and NH Whites (13.3), with lower in American Indian/Alaska Native (9.6) and Hispanics (7.4). Asian/Pacific Islanders reported the lowest AAMR (5.7). The Midwestern region reported the highest AAMR (14.8). We observed the highest AAMR amongst the older population (61.4). ConclusionThe mortality rates of people with HF and cancer are increasing in the adult U.S. population. This underscores the need for increased screening, aggressive management, and subsequent surveillance of people at risk or with manifested HF in people with cancer.

Associations of prognostic nutritional index with risk of all-cause and cardiovascular disease mortalities in persons with gestational diabetes mellitus: A NHANES-based analysis.

To investigate relationships between prognostic nutritional index (PNI) during pregnancy and risk of all-cause mortality (ACM) and cardiovascular disease (CVD) mortality in persons with gestational diabetes mellitus (GDM). A cross-sectional study was conducted using NHANES data from 2007 to 2018, and weighted Cox regression models were established. Restricted cubic spline analysis was used to unveil associations of PNI with risk of ACM and CVD mortalities in individuals with GDM. Receiver operating characteristic curve was employed for determination of threshold value for association of PNI with mortality. Sensitivity analysis was performed to verify the stability of the results. 734 GDM individuals and 7987 non-GDM individuals were included in this study. In GDM population, after adjusting for different categorical variables, PNI was significantly negatively correlated with ACM risk. Subgroup analysis showed that among GDM populations with no physical activity, moderate physical activity, parity of 1 or 2, negative correlation between PNI and risk of ACM was stronger than other subgroups. Sensitivity analysis results showed stable negative correlations between PNI and ACM and CVD mortality of total population, and between PNI and ACM of GDM. In individuals with GDM, PNI was negatively correlated with ACM risk, especially in populations with no physical activity, moderate physical activity, and parity of 1 or 2. PNI = 50.75 may be an effective threshold affecting ACM risk in GDM, which may help in risk assessment and timely intervention for individuals with GDM.

RHDV2 outbreak reduces survival and juvenile recruitment, causing European rabbit population collapse

AbstractInfectious diseases can cause considerable mortality in vertebrate populations, especially when a new pathogen emerges. Quantifying the impact of diseases on wild populations and dissecting the underlying mechanisms requires longitudinal individual monitoring combining demographic and epidemiologic data. Such longitudinal population studies are rare. Rabbit hemorrhagic disease (RHD) is one of the main causes of the decline in European wild rabbit (Oryctolagus cuniculus) populations. A new genotype of RHD virus (RHDV), called RHDV2 or GI.2, emerged in 2010, posing a new threat to previously weakened populations, particularly as this virus can infect individuals already immune to classical RHDV strains. Taking advantage of intensive monitoring from 2009 to 2014 by physical captures and microchip detections of a semi‐captive population of rabbits, we finely assessed the demographic impact of an initial RHDV2 outbreak that occurred in the population and identified the most affected demographic parameters. A multi‐event modeling analysis revealed decreased survival in both juveniles and adults in 2011 and 2012, suggesting an RHDV2 outbreak for two consecutive years. The short‐term survival benefit of vaccination against classical RHDV strains only during these years, and the recovery of carcasses with RHDV2 detection, supported this hypothesis. Variations in population vaccination coverage also explain the difference in adult survival between the two years of the outbreak. And the transient protective effect of vaccination could explain the prolonged duration of the outbreak. A brief episode of myxomatosis in 2011 seems to have had only a limited impact on the population. During outbreak years, in individuals not recently vaccinated, monthly juvenile survival crashed (0.55), and annual adult survival was three times lower than in normal years (0.21 vs. 0.69). The combination of successive juvenile and adult survival estimates for unvaccinated rabbits during the outbreak years resulted in a very low recruitment rate in the breeding population. Finally, RHDV2 outbreaks appear to have caused mortalities comparable to those caused by older classical RHDV strains and may have a strong demographic impact on wild populations of European rabbit. This work highlights the importance of long‐term observational and experimental studies to better understand the impact of epidemics on animal populations.

Population dietary-metabolic characteristics and mortality from major cardiovascular disease subtypes: the Seven Contries Study 60-year follow-up

Background and aimDuring the last few years, the Seven Countries Study of Cardiovascular Diseases (SCS) produced some new analyses dealing with the relationships of a dietary score, the pool of dietary fatty acids and serum cholesterol with major types of cardiovascular disease (CVD) mortality in 10 cohorts of 6 countries made of middle-aged men followed-up for 60 years until extinction. This sparse evidence is condensed here to provide a coherent view. Methods and resultsThe Mediterranean Adequacy Index (MAI, a dietary score whose high levels depict the characteristics of the Mediterranean Diet), was highly and significantly associated in an inverse way, at country levels, with the Atherogenicity (ATI) and the Thrombogenicity (THI) indexes that included a series of dietary fatty acids. These indexes were highly and significantly associated in a direct way with country baseline serum cholesterol levels. Countries with high serum cholesterol had largely higher death rates from coronary heart disease (CHD) and lower rates from other heart diseases of uncertain etiology and stroke. The reverse was observed in countries with low serum cholesterol. ConclusionThe chain of diet, dietary fatty acids and serum cholesterol seems to be responsible in various ways for the different distribution of major CVD mortality subtypes in extincted cohorts.