Percent Of Deaths Research Articles

Genetic Diversity, Virulence Factors and Antibiotic Resistance of Listeria monocytogenes from Food and Clinical Samples in Southern Poland.

Listeriosis is one of the most serious foodborne diseases under surveillance, with an overall mortality rate in the EU currently being high at 18.1%. Therefore, this study aims to investigate Listeria monocytogenes strains isolated from clinical and food samples for susceptibility to antimicrobials, presence of virulence factors, and genetic diversity. Species were identified using the MALDI-TOF, resistance to 11 antibiotics was determined according to EUCAST guidelines, and multiplex PCR was used for serotyping and detecting virulence genes. Strains were genotyped using the PFGE method. Clinical strains showed full sensitivity to all tested antibiotics. In total, 33.3% of strains from food products were found to be resistant to ciprofloxacin and 4.2% to tetracycline. Most of the tested isolates (79.2%) belonged to serotype 1/2a-3a, and the rest (20.8%) belonged to serotype 4ab-4b,4d-4e. Five virulence genes (prfA, hlyA, plcB, inlA, and lmo2672) were detected in all strains studied. The llsX gene was the least common, in 37.5% of clinical strains and 18.75% of strains isolated from food products. Among the analyzed strains, 13 strains displayed unique PFGE profiles. The other 11 strains belong to 3 clusters of pulsotypes: cluster 1 (2 strains), cluster 2 (6 strains), and cluster 3 (2 strains). The percentage of hospitalizations and deaths of Polish patients with listeriosis indicates the seriousness of this disease, especially in an aging society, while the molecular testing of clinical strains has been rarely performed, which makes it difficult to determine the source of infection.

Effectiveness of Insecticide Treated Mosquito Nets on the Death of Anopheles subpictus Mosquitoes

The prevalence of malaria in East Nusa Tenggara based on positive diagnosis results containing malaria parasites and symptoms in the 2013 - 2015 period decreased but has not yet reached the National Strategic Plan target, namely in 2013 it was 21 per 1,000 population (o/oo), in 2014 it was 14 o/oo, and in 2015 it became 8 o/oo (NTT Health Office, 2016). In 2017 there was a spike in malaria cases to 211,409 cases (API = 44.96 o/oo). Kupang Regency with 1,108 cases (API = 24.87 o/oo). Malaria cases in the Tarus Community Health Center work area are the eighth highest, namely 7 cases. This study aims to analyze the effectiveness of insecticide-treated bed nets on the death of Anopheles subpictus mosquitoes. The variables observed were the length of time the mosquito net was used, the frequency of washing the mosquito net, the method of washing the mosquito net, and the percentage of Anopheles subpictus mosquito deaths. The effectiveness of insecticide-treated bed nets on the death of Anophles subpictus mosquitoes with usage time < 3 years (100%), usage time 3 – 5 years (70%) and usage time > 5 years (40%). The effectiveness of insecticide-treated bed nets that have never been washed reaches 100% mortality within 24 hours of observation. Meanwhile, mosquito nets with a washing frequency of 1 – 10 times (70%) kill mosquitoes, and a washing frequency of > 10 times (50%). The method of washing mosquito nets carried out by the community in the Puskesmas Working Area is 100% using detergent. In the control group that used mosquito nets that did not contain insecticide, no Anopheles subpictus mosquito deaths occurred (0%). Suggestions for health workers to increase education regarding the correct use of mosquito nets, so that a higher level of effectiveness of mosquito nets is obtained as a means of personal protection in avoiding mosquito bites.

Comparative study of fetal doppler versus non stress test as predictor of perinatal outcome in high risk pregnancy between 36 to 42 weeks

Pregnancy is a unique physiologically event in a women’s life. The main aim of the study was to compare the efficacy of the Doppler velocimetry versus non stress test in relation to perinatal outcome in high risk pregnancies between 36 to 42 weeks.This comparative prospective study was carried out on 200 antenatal patients between 36-42 weeks of pregnancy in Department of Obstetrics & Gynaecology Smt Kashibai Navle Medical College and Hospital a tertiary care center from December 2016 to July 2018.All cases were divided into four groups based on NST and Doppler velocimetry of umbilical artery. Abnormal Doppler studies were found in 12% women. 14% had abnormal NST. Apgar score < 7 at 5 minutes were in 19 fetuses, out of these 15 had abnormal Doppler velocimetry. Average birth weight was low in Group D (1.2kg), where both the tests were abnormal. NICU admissions were 5% in Group A and 100% in Group B and D, where Doppler was abnormal. Mean gestational age was also low in group D. Highest perinatal mortality and neonatal morbidity was seen in women with abnormal umbilical artery Doppler. 6 neonatal deaths occur in Group D and 1 in Group B. In the present study, umbilical artery sensitivity for predicting perinatal morbidity and mortality is 46.1, specificity is 94, PPV is 93 and NPV is 54.Highest percentage of perinatal complications and perinatal deaths were seen in groups with abnormal Doppler velocimetry. Group D had the worst perinatal outcome.

E/e' Ratio as a Predictor of In-Hospital Complications and Clinical Outcomes of Acute Myocardial Infarction.

Introduction Acute myocardial infarction (AMI) is the leading cause of death worldwide. E/e' ratio can predict complications and mortality in the long term, but information on its effectiveness in in-hospital settings is limited. Identifying high-risk patients effectively is crucial for early management, which may improve overall clinical outcomes. This study evaluated the predictive value of the E/e' ratio of in-hospital complications and clinical outcomes of AMI. Methods Patients presenting with AMI to Batumi Referral Hospital, Georgia, between December 2023 and May 2024, were examined in this study. During the first 24 hours of hospitalization, all patients underwent two-dimensional echocardiograms. Early diastolic filling velocity (E) was measured by pulsed wave Doppler, and early mitral annulus velocity (e') was measured by tissue Doppler. Based on the ratio of the two measures, patients were divided into three groups: E/e'<8, E/e' 8-14, and E/e'>14. Results A total of 113 patients (92 males and 21 females) were included in the study. The average age of the patients was 62 years (SD = 11.71). Overall, 27 (23.8%) patients were diagnosed with ST-elevation myocardial infarction (STEMI) and 86 (76.2%) patients with non-ST-elevation myocardial infarction (NSTEMI). The E/e' ratio was normal (less than 8) in 39 (34.5%) patients (group A), increased to 8-14 in 46 (40.7%) (group B), and greater than 14 in 28 (24.8%) (group C). The percentage of deaths in group B was higher than that in group A (2.2% vs 0%), and in group C, it was significantly higher than that in group B (17.9% vs 2.2%) (p<0.05). The percentage of heart failure developed during hospitalization was higher in group B compared to group A (54.3% vs 2.6%), and it was significantly higher in group C compared to group B (67.9% vs 54.3%) (p<0.05). The percentage of arrhythmias developed during hospitalization was higher in group B compared to group A (13.0% VS 2.6%), and in group C, was significantly higher compared to group B (35.7% VS 13.0%) (p<0.05). The percentage of cardiogenic shock in group B was higher than that in group A (4.3% VS 0%), and in group C, it was significantly higher than group B (25.0% VS 4.3%) (p<0.05). No significant association was found between E/e' ratio and recurrent angina, nor was there a significant association between all-cause deterioration during hospitalization (p>0.05). Conclusions Both slightly and significantly elevated E/e' ratios are predictors of in-hospital complications and may be used to identify individuals at high risk of negative health outcomes.

Real-world effectiveness of sotrovimab in preventing hospitalization and mortality in high-risk patients with COVID-19 in the United States: A cohort study from the Mayo Clinic electronic health records.

To describe outcomes of high-risk patients with coronavirus disease 2019 (COVID-19) treated with sotrovimab, other monoclonal antibodies (mAbs), or antivirals, and patients who did not receive early COVID-19 treatment. We also evaluate the comparative effectiveness of sotrovimab versus no treatment in preventing severe clinical outcomes. This observational retrospective cohort study analyzed Mayo Clinic electronic health records. Non-hospitalized adult patients diagnosed with COVID-19 from May 26, 2021 and April 23, 2022 and at high risk of COVID-19 progression were eligible. The primary outcome was 29-day all-cause hospitalization and/or death. Outcomes were described for patients treated with sotrovimab, other mAbs, or antivirals, and eligible but untreated patients, and compared between sotrovimab-treated and propensity score (PS)-matched untreated cohorts. We included 35,485 patients (sotrovimab, 1369; other mAbs, 6488; antivirals, 133; high-risk untreated, 27,495). A low proportion of patients treated with sotrovimab (n = 33/1369, 2.4%), other mAbs (n = 147/6488, 2.3%), or antivirals (n = 2/133, 1.5%) experienced all-cause hospitalization or death. Among high-risk untreated patients, the percentage of all-cause hospitalization or death was 3.3% (n = 910/27,495). In the PS-matched analysis, 2.5% (n = 21/854) of sotrovimab-treated patients experienced all-cause hospitalization and/or death versus 2.8% (n = 48/1708) of untreated patients (difference, -0.4%; p = 0.66). Significantly fewer sotrovimab-treated patients required intensive care unit admission (0.5% vs 1.8%; difference, -1.3%; p = 0.002) or respiratory support (3.5% vs 8.7%; difference, -5.2%; p < 0.001). There was no significant difference in the proportion of sotrovimab-treated and PS-matched untreated patients experiencing 29-day all-cause hospitalization or mortality, although significantly fewer sotrovimab-treated patients required intensive care unit admission or respiratory support.

The Lethal Toxic Effect of Alcoholic Extract of Punica granatum Plant on Stages of The Southern Cowpea beetle Callosobruchus maculatus (Coleoptera: Bruchidae)

This study was conducted to find out the toxic effect of the southern cowpea weevil Callosobruchus maculatus stages when its food was treated with alcoholic extracts of Punica granatum peels. The study showed that the lowest percentage of hatching was 61.26% in the treatment of chickpea seeds with a concentration of 15% of P. granatum peel extract. The treatments had a clear effect on the harmful larval stage , and the highest significant percentage of death was 81.4% in cowpea seeds treated with a concentration of 25%, and all results were significantly different from the control treatment. the mortality rate significantly increased in the pupa stage, and it increased treatment significantly to 46.66% in the concentration of 25%, compared to the, control which amounted to 0%. To find out the effect of the extracts used in the study on the first generation individuals, the egg retention coefficient was calculated.

Retrospective Evaluation of the Vehicular Trauma Prevalence in Dogs (Based on the Data of the Rostov Region Veterinary Clinic Chain for the Period of 2018–2022)

Introduction. Vehicular trauma is one of the most common causes of canine trauma — at least 51% of the total number of the canine trauma according to the foreign statistics. The main risk group consists of the dog males aged from 1 to 3 years old. In Russia no research was conducted to analyse the prevalence of vehicular trauma in dogs that would allow determining the risk factors, the nature and severity of injuries, and making recommendations for the owners and veterinarians. This article proposes a retrospective evaluation of the vehicular trauma prevalence in dogs based on the data of the Rostov region veterinary clinic chain for the period of 2018–2022.Materials and Methods. For retrospective evaluation, the medical histories of patients of the “VitaVet” LLC veterinary clinic chain (Rostov region) were used as the material. The selection of medical histories was carried out from September 2022 to March 2023 in accordance with the following inclusion criteria: the presence of a vehicular trauma in the animal's anamnesis; diagnosis based on the physical examination, X-ray examination and ultrasound examination; absence of data on the other potentially life-threatening diseases in the animal medical history. The severity of dogs’ condition was evaluated according to five parameters of the ATT scale (Animal Trauma Triage) and the estimate shock index.Results. A retrospective evaluation of the vehicular trauma prevalence in dogs was carried out based on the data of 559 selected medical histories. Of these, 217 histories belonged to bitches (94% non-neutered) and 342 to dog males (98% non-neutered). It was revealed that the number of deaths in bitches was almost two times less in comparison with the male dogs (13% and 20.2% respectively). About 45% of vehicular trauma occurred in animals aged from 1 to 3 years old. The lowest percentage of deaths (6.15%) and the average ATT score (3.15±0.09) were found in bitches under one year old. In bitches aged from 1 to 3 years old, these parameters equalled to 10.74% mortality and 3.46±0.07 ATT score. Among male dogs, the lowest mortality percentage was found in males from 7 to 10 years old (11.11%), in animals under one year old it was 12.84%. The largest number of injured dogs was in the small dog breeds (63.69%), however in large dog breeds the percentage of deaths and the average ATT score were higher (54.8% and 4.34±0.3). The most common diagnoses resulting from the vehicular trauma were: femoral fracture, pelvic fracture, craniocerebral trauma, contusion, tibia fracture, vertebral fracture.Discussion and Conclusion. The results of the retrospective evaluation indicate that the young non-neutered dog males were most often subject to the vehicular trauma (dogs under the age of 3 years old were in the risk group). Mortality among the dog males was higher than among the bitches. The small dog breeds were more likely to get the vehicular trauma, whereas the percentage of deaths in large dog breeds was higher. The most common injuries observed during the period of research were the musculoskeletal disorders, this fully corresponds to the data published in the foreign scientific sources. Further expansion of the sample of research taking into account the data of the other veterinary clinic chains will create the opportunity for getting a more detailed picture in the research area.

National survey on the current status of airway management in China

Apparently, understanding airway management status may help to reduce risk and improve clinical practice. Given these facts, our team conducted a second survey on the current status of airway management for mainland China following our 2016 national airway survey. The national survey was conducted from November 7 to November 28, 2022. An electronic survey was sent to the New Youth Anesthesia Forum, where Chinese anesthesiologists completed the questionnaire via WeChat. A total of 3783 respondents completed the survey, with a response rate of 72.14%. So far, in 2022, 34.84% of anesthesiologists canceled or delayed surgery at least once due to difficult airway. For the anticipated difficult airway management, 66.11% of physicians would choose awake intubation under sedation and topical anesthesia, while the percentage seeking help has decreased compared to the 2016 survey. When encountering an emergency, 74.20% of respondents prefer to use the needle cricothyrotomy, albeit less than a quarter have actually performed it. Anesthesiologists with difficult airway training experience reached 72.96%, with a significant difference in participation between participants in Tier 3 hospitals and those in other levels of hospitals (P < 0.001). The videolaryngoscope, laryngeal mask, and flexible intubation scope were equipped at 97.18%, 95.96%, and 62.89%, respectively. Additionally, the percentage of brain damage or death caused by difficult airways was significantly decreased. The study may be the best reference for understanding the current status of airway management in China, revealing the current advancements and deficiencies. The future focus of airway management remains on training and education.

Impact of the COVID-19 Pandemic on Cancer Death Locations in Japan: An Analysis of Excess Mortality Through February 2023.

The novel coronavirus disease 2019 (COVID-19) pandemic has significantly impacted end-of-life decisions for cancer patients in Japan, with disparities existing between preferred and actual care settings. Our study investigates the potential shifts in cancer death locations during the pandemic and if there were excess cancer deaths. Utilizing national mortality data from the Ministry of Health, Labour and Welfare from January 2012 to February 2023, we identified cancer deaths using International Classification of Disease, 10th revision codes. We assessed death locations, including medical institutions, nursing facilities, and homes. The Farrington algorithm was employed to estimate expected death counts, and the differences between observed and expected counts were denoted as excess deaths. From January 2018 to February 2023, there was consistently increase in the weekly observed cancer deaths. The presence of a definitive excess during the pandemic period remains uncertain. The percentage of deaths in medical institutions declined from 83.3% to 70.1%, while home deaths increased from 12.1% to 22.9%. Between April 2020 and February 2023, deaths in medical institutions frequently fell below the 95% prediction lower limit. Home deaths consistently exceeded the 95% prediction upper limit, with significant excess deaths reported annually. Our study found a shift in cancer death locations from medical institutions to homes in Japan during the COVID-19 pandemic. Our study did not confirm an overall increase in cancer deaths during this period. As with global trends, the profound shift from hospitals to homes in Japan calls for a comprehensive exploration to grasp the pandemic's multifaceted impact on end-of-life cancer care decisions.

Study of Adding Different Levels of Aqueous Extract of Cloves to Water and Its Effect on the Productive Traits of Broilers

This experiment was conducted in the poultry field belonging to the Agricultural Research and Experimentation Station at the College of Agriculture / Karbala for the period from 10/6/2022 until 11/9/20123. The current study aimed to demonstrate the effect of using different levels of aqueous extract of clove powder added to drinking water and its effect on some productive traits of broiler chickens. A cage with dimensions of 1.5 x 1 m, with 30 chicks for each treatment, with three replicates of the treatment (10 chicks for each replicate), and with four treatments, namely T1, the control treatment without any addition. As for treatments T2, T3, and T4, aqueous extract of clove powder was added to it in three concentrations (10, 20, and 30). ml/liter of drinking water, respectively. The results of the experiment indicated a significant improvement (p≤0.05) in the productive characteristics of the clove powder aqueous extract treatments. Treatment T4 (30 ml/liter of drinking water) witnessed a significant improvement (p≤0.05) in body weight and weight gain and an increase in the food conversion factor with a decrease Significant (p≤0.05) in the percentage of deaths, compared to the control treatment.

The Implication of Elevated Serum Myoglobin Level in Acute Diabetic Complications of Ketoacidosis and Hyperglycemic Hyperosmolar State: A Real-World Study.

To investigate the implications of elevated myoglobin (MYO) in acute diabetic conditions of diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). This study integrates in-patient data from Shanghai Pudong Hospital from 2019 to 2023. Laboratory data were compared between stable T2D patients (without acute diabetic complications), DKA, and HHS patients. The multilinear regression explored variables relevant to the elevated MYO in DKA and HHS. The dynamics of MYO, the survival rate, and associated risk factors in HHS were determined. Except for triglyceride, procalcitonin, low-density lipoprotein, islet cell autoimmune antibodies, N-terminal Pro-brain natriuretic peptide (NT-ProBNP), and brain natriuretic peptide (BNP), there were significant differences in age, gender distribution, duration of diabetes, type of diabetes, and other referred laboratory data (p<0.05). The age, gender, creatine kinase (CK), estimated glomerular filtration rate (eGFR), and free triiodothyronine (FT3) in DKA, whereas osmolar, uric acid (UA), and cardiac troponin I (cTNI) in the HHS, were significant determinants of elevated MYO, respectively (p<0.05). The dynamic of MYO in HHS was in line with the survival trend, where the percentage of death was 29.73%, and aging with higher procalcitonin levels was a key risk factor. Besides, the cumulative survival rates between patients with or without bone fracture or muscle injury were substantially different. This real-world study demonstrated DKA and HHS potentially have unique causes for increased MYO. By utilizing the appropriate regression parameters, we could forecast the progression of increased MYO in groups of DKA and HHS, while based on risk factors of aging, severity of infection, and different MYO sources, we could predict the prognosis of HHS.

Epidemiology of Neonatal Sepsis in Haiti

Introduction: Neonatal sepsis (NS) is a global public health concern, particularly affecting developing countries. Challenges in diagnostics, more specifically, culture and antimicrobial susceptibility testing hinder effective management of the disease. Objective: This study aims to evaluate the burden, describe the management, and assess the evolution of NS in a hospitalized pediatric population in Haiti. Methods: A retrospective cohort study from January 2013 to December 2018 at La Paix University Hospital was conducted. All-cause hospitalizations and deaths were extracted from hospital’s Neonatology Unit records and were used to derive data regarding hospitalization and death among patients under 28 days with NS. Clinical and laboratory data were extracted from the patients’ medical records. Results: Out of 2,424 post-childbirth hospitalizations, 1,590 involved sepsis. The percentage of hospitalization due to NS was approximately 69% and the percentage of deaths, 65%. The mean age of patients with NS was 3.75 days (0 - 22 days), with a slight male predominance (55%, p &lt; 0.001). Peaks were observed from May to August (p = 0.02). Early NS cases (NS in patients aged less than 7 days) were most prevalent (86%, p &lt; 0.001). Specimen culture and antimicrobial susceptibility testing was less frequent (7%) than complete blood count usage (65%). Findings regarding blood count included leukopenia (3%), thrombocytopenia (30%). A positive CRP and acute renal failure were noted in 76% and 21.7% of cases, respectively. The average hospital stay was 7.3 days. With regards to treatment, 73% of patients received a 2-drug antimicrobial therapy (ampicillin-gentamycin) and 22% received a 3-drug antimicrobial therapy (ampicillin-gentamycin-cefotaxime). Of all newborns hospitalized for NS, 49% received empirical antibiotic therapy within 3 hours of admission. Conclusions: This research highlights NS as a public health emergency in Haiti. The study advocates for improved access to culture and antibiotic susceptibility testing and emphasizes the impact of timely antibiotic administration. The findings of this study serve as a baseline for informing policymakers and medical practitioners dedicated to improving existing conditions of neonates in Haiti. Suggested targeted interventions include preventive measures during prenatal visits, strengthening laboratory capacities, improving infection prevention and control measures, and developing antimicrobial stewardship programs.

Significance of Pathologic Response in Patients With Early and Locally Advanced Breast Cancer Treated With Neoadjuvant Chemotherapy in a Middle-Income Country. A Real-World Historical Cohort.

Breast cancer (BC) is the most frequent neoplasm in women in Colombia and is associated with a higher mortality rate than in other countries and regions. Neoadjuvant chemotherapy (NACT) has become a standard treatment in locally advanced BC and provides an opportunity to improve clinical outcomes in BC. This study aims to describe characteristics, treatment patterns, and outcomes after NACT in a cohort of Colombian patients with BC. We performed a retrospective cohort study. We included adult patients with BC treated with NACT. Clinical charts were retrospectively reviewed. Descriptive statistics and time to event for overall survival analyses were performed. Recursive partitioning was performed for survival curves to assess the complex relationship between survival times and other variables. Three hundred and fourteen patients were included for analysis. The pathologic complete response after neoadjuvant chemotherapy (ypCR) rate was 34.4%, with a higher ypCR in triple-negative BC (TNBC; 46.9%) and human epidermal growth factor receptor 2-positive BC (72.7%). Those who did not achieve ypCR had a higher percentage of death and relapse. The median follow-up was 4.9 years, with an 88.2% 5-year overall survival (OS). A total of 62.6% of the total patients identified were not treated with NACT, indicating a low utilization. Our global ypCR rate was higher when compared with similar studies in Colombia, likely because of differences in the NACT treatment regimens. ypCR was only associated with OS in the TNBC subgroup, emphasizing the importance of pursuing ypCR in these patients. We consider the use of NACT a valuable opportunity to implement innovative treatment approaches that improve outcomes in Colombian patients with BC.

Chondroprotection of articular cartilage integrity: Utilizing ultrasonic scalpel and hyperosmolar irrigation solution during cutting

ObjectivesUltrasonic (US) cutting of cartilage in orthopaedic surgery has received little attention despite its potential to reduce chondrocyte death which could enhance cartilage repair. We aimed to investigate whether an ultrasonically-vibrating scalpel to cut human articular cartilage could reduce chondrocyte death, and to determine if hyper-osmolarity could provide chondroprotection during the procedure. MethodsA scalpel (no. 15) was mounted on an ultrasonic transducer to resonate at 35 ​kHz with 30 ​μm vibrational displacement. Thirty-six fresh human femoral cartilage samples were divided into four groups based on ultrasonic activation (US or non-US) and saline osmolarity (300 or 600 mOsm/L). Cell viability was assessed using a live/dead cell assay and analysed quantitatively by confocal microscopy. Histology illustrated tissue surface changes at the cut site. ResultsThe overall chondrocyte death percentage at both the US and non-US cut sites showed comparable results (p ​> ​0.05) in both osmolarities. However, the zone of chondrocyte death was reduced by 31 ​± ​5% and 36 ​± ​6%, respectively, when comparing US cutting at 300 mOsm/L and 600 mOsm/L to the control group (non-US cutting; 300 mOsm/L) (p ​< ​0.05). The width of the cut was consistent at both sites, regardless of the method of cutting. ConclusionCutting human cartilage with US in the presence of 300 or 600 mOsm/L media was chondroprotective compared to normal (non-US) scalpel cutting in 300 mOsm/L medium. These results suggest chondroprotection can be achieved while cutting using a US scalpel and raised osmolarity, potentially improving cartilage regeneration and repair following injury.

The effect of text-messaging on the utilisation of health facilities among pregnant women during delivery in Cross River State, Nigeria

Objective: Uptake of skilled care during delivery is associated with positive maternal and neonatal health outcomes. Studies reveal Nigeria accounts for a significant percentage of global maternal deaths, which have been associated with poor skilled attendants at delivery. Text messaging has proven to be effective in promoting health facilities’ utilisation in Nigeria. Therefore, this research assessed the influence of text messaging intervention on the utilisation of health facilities during delivery in Cross River State Methods: Quasi-experimental research design was employed. A sample size of thirty per LGA in two LGAs was used. Participants were purposively selected and grouped into text messaging and Control Groups ). The experimental group received text briefs three times per week for four weeks, while the control group received regular ANC sessions. A structured and validated questionnaire with Cronbach’s alpha coefficients ranging from 0.76 to 0.81 was used for data collection. Data were analyzed using descriptive and inferential statistics at a 5% level of significance. Results: At baseline, the proportion of women who utilised HFs during delivery was 13.3% (experimental group) and 33.3% (control group). Furthermore, at the 8th-week follow-up, there was a significant difference (p &lt; 0.05) in T-M (76.7%), compared with CG (33.3%) with an increase of 63.4% for the T-M compared to CG (3.3%, p &gt; 0.05). Conclusion: T-M intervention improved the utilisation of HFs during delivery among PW. The study recommends that health workers should incorporate mobile T-M intervention strategy which has proven to be a useful tool during ANC.

Examining the Relationship Between Chronic Pain and Mortality in U.S. Adults

Chronic pain (CP) significantly impacts quality of life and increases noncommunicable disease risk, with recent U.S. data showing a 6.3% incidence rate, surpassing diabetes, depression, and hypertension. International studies suggest higher mortality in CP populations, yet prior U.S. data are inconclusive. To investigate CP's mortality risk, we analyzed National Health Interview Survey and National Death Index data. We hypothesized that individuals with CP and high-impact CP (HICP [≥1 activity limitation]) would exhibit higher mortality rates. National Health Interview Survey provided demographics, pain reporting, lifestyle, and psychosocial data matched with National Death Index mortality records. Chi-square analyses explored the relationships between CP/HICP and demographics, lifestyle factors, psychosocial variables, and mortality. Cox proportional hazards models assessed mortality risk between groups. The weighted sample was 245,899,776; 20% reported CP and 8% HICP, both groups exhibiting higher mortality rates than pain-free individuals (CP: 5.55%, HICP: 8.79%, total: 2.82%). Hazard ratios indicated nearly double the mortality risk for CP and 2.5 times higher risk for HICP compared to those without these conditions. Adjusting for lifestyle and psychosocial factors reduced mortality risk but remained elevated compared with non-CP individuals. Heart disease, malignant neoplasms, and chronic lower respiratory diseases accounted for a higher percentage of deaths in CP cases. CP individuals showed higher rates of smoking, alcohol consumption, obesity, inactivity, depression, anxiety, emotional problems, and sleep disturbances. CP and HICP significantly influence mortality outcomes, leading to excess deaths compared with pain-free individuals. Given the relationship between pain, lifestyle, psychosocial variables, and mortality, further investigations are needed into CP causation and prevention strategies. PerspectiveThis article presents evidence regarding the relationship between CP, HICP, and mortality. Additional findings are discussed regarding the impact of demographics, lifestyle, and psychosocial variables on mortality in those with versus without CP and HICP. These findings are crucial for informing future research, prevention, and healthcare management strategies.

Pulmonary haemorrhage and haemoptysis associated with bevacizumab-related treatment regimens: a retrospective, pharmacovigilance study using the FAERS database.

Background: Bevacizumab (BV) is widely used in routine cancer treatment and clinical therapy in combination with many other agents. This study aims to describe and analyse post-market cases of pulmonary haemorrhage and haemoptysis reported with different BV treatment regimens by mining data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database. Methods: Data were collected from the FAERS database between 2004 Q1 and 2023 Q1. Disproportionality analysis including the reporting odds ratio (ROR) was employed to quantify the signals of disproportionate reporting of pulmonary haemorrhage and haemoptysis adverse events (AEs) associated with BV-related treatment regimens. The demographic characteristics, time to onset and outcomes were further clarified. Results: A total of 55,184 BV-associated reports were extracted from the FAERS database, of which 497 reports related to pulmonary haemorrhage and haemoptysis. Overall, the median onset time of pulmonary haemorrhage and haemoptysis AEs was 43 days (interquartile range (IQR) 15-117 days). In the subgroup analysis, BV plus targeted therapy had the longest median onset time of 90.5 days (IQR 34-178.5 days), while BV plus chemotherapy had the shortest of 40.5 days (IQR 14-90.25). BV plus chemotherapy disproportionately reported the highest percentage of death (148 deaths out of 292 cases, 50.68%). Moreover, the BV-related treatments including four subgroups in our study demonstrated the positive signals with the association of disproportionate reporting of pulmonary haemorrhage and haemoptysis. Notably, BV plus chemotherapy showed a significant higher reporting risk in pulmonary haemorrhage and haemoptysis signals of disproportionate reporting in comparison to BV monotherapy (ROR 5.35 [95% CI, 4.78-6.02] vs. ROR 4.19 [95% CI, 3.56-4.91], p = 0.0147). Conclusion: This study characterized the reporting of pulmonary haemorrhage and haemoptysis, along with the time to onset and demographic characteristics among different BV-related treatment options. It could provide valuable evidence for further studies and clinical practice of BV.

Comparisons of postoperative outcomes of laparoscopic versus open surgery using inverse probability of treatment weighting analysis: an evidence from Iran

BackgroundColorectal cancer has created a significant burden worldwide, including in Iran. Open and laparoscopic surgery are important treatment methods for this disease. The aim of this study is to compare postoperative outcomes of laparoscopic versus open surgery in Iran, with a particular emphasis on controlling confounding factors.MethodsTo control confounding factors in between-group comparisons of observational studies, a method based on propensity scores was used. The current study was conducted on 916 patients with colorectal cancer in the city of Shiraz between the years 2011 to 2022. The required data regarding treatment outcomes, type of surgery, demographic characteristics, and clinical factors related to cancer was extracted from the Colorectal Cancer Research Center of Shiraz University of Medical Sciences. To control confounding factors, we used the Inverse Probability of Treatment Weighting (IPTW) as one of the analytical approaches based on Propensity Score analysis. After IPTW analysis, univariate logistic regression was used for treatment effect estimation. Stata 17 was used for statistical analysis.ResultsAfter controlling for 24 clinical and demographic covariates, negative post-operative outcomes were significantly lower in laparoscopic than open surgery. There were significant differences between the two groups of surgery in the percentages of death due to cancer (P < 0.01), recurrence (P < 0.01), and metastasis (P < 0.05). The treatment effect univariate logistic regression analysis indicated that laparoscopic surgery reduced the risk of negative postoperative outcomes including death due to cancer (OR = 0.411, P < 0.01), recurrence (OR = 0.343, P < 0.01) and metastasis (OR = 0.611, P < 0.05) compared to open surgery.ConclusionsIn terms of postoperative outcomes including cancer-related mortality, recurrence, and metastasis, the laparoscopic surgery outperformed open surgery. Therefore, further development of laparoscopic surgery can lead to better health outcomes for the population and optimize the utilization of healthcare resources.

Assessing Racial and Ethnic Disparities in Timing of Pregnancy Related Deaths.

Existing research documents significant racial disparities in pregnancy-related deaths in the United States. Recently, the National Center for Health Statistics (NCHS) identified inconsistencies in maternal mortality data due to irregularities in previous data collection. Yet, corrections of the data still highlight stark differences across racial identity. Additionally, data indicates that while many people die during labor and delivery, a considerable percentage of people die up to a year postpartum. To assess disparities in the timing of pregnancy-related deaths using corrected data, we analyzed aggregated vital statistics data from 2015 to 2018 (n = 4,261). We present relative risk ratios from multinomial logistic regressions to examine the association between race and ethnicity and the timing of pregnancy-related deaths (pregnant at the time of death, 42 days post pregnancy, and 43 days to one-year post pregnancy). Results highlight significant differences in the distribution of timing of pregnancy-related deaths across nativity status and geographic region. Findings document a disproportionate percentage of pregnancy-related deaths among foreign-born people who give birth. Overall, results suggest extending our framing of postpartum care beyond a hospital stay.

Association between Complications and Death within 30 days after General Surgery

Objective: To determine the epidemiology of post-operative complications among general surgery patients, inform their relationships with 30-day mortality, and determine the attributable fraction of death of each postoperative complication. Background: The contemporary causes of post-operative mortality among general surgery patients are not well characterized. Methods: VISION is a prospective cohort study of adult non-cardiac surgery patients across 28 centres in 14 countries, who were followed for 30 days after surgery. For the subset of general surgery patients, a cox proportional hazards model was used to determine associations between various surgical complications and post-operative mortality. The analyses were adjusted for preoperative and surgical variables. Results were reported in adjusted hazard ratios (HR) with 95% confidence intervals (CI). Results: Among 7950 patients included in the study, 240 (3.0%) patients died within 30 days of surgery. Five post-operative complications (myocardial injury after non-cardiac surgery [MINS], major bleeding, sepsis, stroke, and acute kidney injury resulting in dialysis) were independently associated with death. Complications associated with the largest attributable fraction (AF) of post-operative mortality (i.e., percentage of deaths in the cohort that can be attributed to each complication, if causality were established) were major bleeding (n=1454, 18.3%, HR 2.49 95%CI 1.87-3.33, P&lt;0.001, AF 21.2%), sepsis (n=783, 9.9%, HR 6.52, 95%CI 4.72-9.01, P&lt;0.001, AF 15.6%), and MINS (n=980, 12.3%, HR 2.00, 95%CI 1.50-2.67, P&lt;0.001, AF 14.4%). Conclusion: The complications most associated with 30-day mortality following general surgery are major bleeding, sepsis, and MINS. These findings may guide the development of mitigating strategies, including prophylaxis for perioperative bleeding.