Percent Of Deaths Research Articles

Assessment of accuracy of BISAP score as a predictor of severe acute pancreatitis: a retrospective study

Background: The prevalence of acute pancreatitis (AP) has increased in the past 20 years. Most patients with AP experience a clinical course that is mild and self-limited. However, 10% to 20% of patients develop a rapidly progressive inflammatory response necessitating prolonged length of hospital stay and high rates of morbidity and mortality. There are various scoring systems already in place to assess the severity of acute pancreatitis. However, they have significant drawbacks. Since the BISAP score offers the advantages of being inexpensive, rapid, and simple, we conducted this study to gauge its usefulness. Methods: This study enrolled 138 patients with AP admitted in surgical wards of McGann District Teaching Hospital, during a time period between January 2022 to June 2022, meeting the various inclusion criteria. Results: We found that the percentage of severity, necrosis, organ failure, death, and hospital stay increased as the BISAP score increased. In terms of sensitivity and specificity, the accuracy of the BISAP score for predicting severe acute pancreatitis was 76.2% and 63.4%. According to our study, patients with severe acute pancreatitis had BISAP scores of 3 or above. Conclusions: BISAP can be used to identify the patients who are at risk, and this information can serve as an early guidance for appropriate and necessary therapy, improving patient outcomes. Present study concludes the increased accuracy of BISAP score for risk stratification.

Racial and ethnic differences and COVID-19 pandemic-related changes in drug overdose deaths in North Carolina

PurposeTo examine racial and ethnic differences and COVID-19 pandemic-related changes in key characteristics of drug overdose deaths in North Carolina. MethodsWe used North Carolina State Unintentional Drug Overdose Reporting System data to describe specific drug-involvement, bystander presence, and naloxone administration for drug overdose deaths by race and ethnicity during pre-COVID-19 (May 2019–February 2020) and COVID-19 periods (March 2020–December 2020). ResultsFor all racial and ethnic groups, drug overdose death rates and the percentage with fentanyl and alcohol involvement increased from the pre-COVID-19 to COVID-19 period, with fentanyl involvement highest among American Indian and Alaska Native (82.2%) and Hispanic (81.4%) individuals and alcohol involvement highest among Hispanic individuals (41.2%) during the COVID-19 period. Cocaine involvement remained high among Black non-Hispanic individuals (60.2%) and increased among American Indian and Alaska Native individuals (50.6%). There was an increase in the percentage of deaths with a bystander present from the pre-COVID-19 to COVID-19 period for all racial and ethnic groups, with more than half having a bystander present during the COVID-19 period. There was a decrease in the percentage of naloxone administered for most racial and ethnic groups, with the lowest percentage among Black non-Hispanic individuals (22.7%). ConclusionsEfforts to address increasing inequities in drug overdose deaths, including expanded community naloxone access, are needed.

Correlations and Timeliness of COVID-19 Surveillance Data Sources and Indicators - United States, October 1, 2020-March 22, 2023.

When the U.S. COVID-19 public health emergency declaration expires on May 11, 2023, national reporting of certain categories of COVID-19 public health surveillance data will be transitioned to other data sources or will be discontinued; COVID-19 hospitalization data will be the only data source available at the county level (1). In anticipation of the transition, national COVID-19 surveillance data sources and indicators were evaluated for purposes of ongoing monitoring. The timeliness and correlations among surveillance indicators were analyzed to assess the usefulness of COVID-19-associated hospital admission rates as a primary indicator for monitoring COVID-19 trends, as well as the suitability of other replacement data sources. During April 2022-March 2023, COVID-19 hospital admission rates from the National Healthcare Safety Network (NHSN)† lagged 1 day behind case rates and 4 days behind percentages of positive test results and COVID-19 emergency department (ED) visits from the National Syndromic Surveillance Program (NSSP). In the same analysis, National Vital Statistics System (NVSS) trends in the percentage of deaths that were COVID-19-associated, which is tracked by date of death rather than by report date, were observable 13 days earlier than those from aggregate death count data, which will be discontinued (1). During October 2020-March 2023, strong correlations were observed between NVSS and aggregate death data (0.78) and between the percentage of positive SARS-CoV-2 test results from the National Respiratory and Enteric Viruses Surveillance System (NREVSS) and COVID-19 electronic laboratory reporting (CELR) (0.79), which will also be discontinued (1). Weekly COVID-19 Community Levels (CCLs) will be replaced with levels of COVID-19 hospital admission rates (low, medium, or high) which demonstrated >99% concordance by county during February 2022-March 2023. COVID-19-associated hospital admission levels are a suitable primary metric for monitoring COVID-19 trends, the percentage of COVID-19 deaths is a timely disease severity indicator, and the percentages of positive SARS-CoV-2 test results from NREVSS and ED visits serve as early indicators for COVID-19 monitoring. Collectively, these surveillance data sources and indicators can support monitoring of the impact of COVID-19 and related prevention and control strategies as ongoing public health priorities.

Changes in the Place of Death and Implications for End-of-Life Care Policy: A Population-Based Observational Study.

Background: Death in hospital rather than at home is becoming more prevalent, even among terminally ill patients receiving home-based care. Identifying trends in places of death is crucial to care policy, especially for aging populations as in Taiwan. Aim: To identify changes in the places of natural death of Taiwanese individuals for various causes of death. Design: A population-based observational study was conducted. Setting: Anonymous data for the period 2000-2020 from the Death Database of Taiwan's National Center for Health Statistics Data were obtained and analyzed. Results: In 2000, 60.1% of natural deaths occurred in the home, whereas in 2020, this percentage was only 36.8%; conversely, the percentage of deaths in hospital increased from 34.4% in 2000 to 56.1% in 2020. Deaths in a nursing home or long-term care facility were found to account for only 3.8% of all natural deaths in 2020. Dementia was the cause of death for which the proportion of institutional deaths was highest, although this proportion was <10% for most years. We applied the joinpoint regression model to estimate trend changes in places of death. During the study period, the places of death in Taiwan changed significantly, the average annual percent changes for hospital deaths over the 21-year period was 2.54% (confidence interval [CI]: 2.04 to 3.03), and for home deaths was -2.69% (CI: -3.26 to -2.13). Conclusions: The detailed findings of this national study can offer insight into potential future clinical burdens and lead to better health policy decisions for Taiwan.

Global burden of tracheal, bronchus, and lung cancer attributable to occupational carcinogens in 204 countries and territories, from 1990 to 2019: results from the global burden of disease study 2019

Background Occupational-related cancers are a substantial global health issue. The largest proportion of occupational-related cancers is tracheal, bronchus, and lung (TBL) cancer. This study aimed to explore the geographical and temporal trends in occupational carcinogens related to TBL cancer. Methods Data on TBL cancer attributable to occupational carcinogens were collected from the Global Burden of Disease Study 2019. Numbers and age-standardized rates (ASRs) of deaths, disability-adjusted life years (DALYs), and corresponding average annual percentage change (AAPC) were evaluated and stratified by geographic location, socio-demographic index (SDI) quintiles, age, and sex. Results Globally, ASRs of deaths and DALYs in TBL cancer attributable to occupational carcinogens showed a downward trend (AAPC = − 0.69%, − 1.01%) while increases were observed in the low, low-middle, and middle SDI quintiles. Although males accounted for 82.4% and 81.5% of deaths and DALYs in 2019, respectively, it showed an upward trend of ASRs in females (AAPC = 0.33%, 0.02%). Occupational exposure to asbestos, silica and diesel engine exhaust were the top three causes of age-standardized TBL cancer deaths and DALYs. Over the past three decades, the percentage of age-standardized TBL cancer deaths and DALYs attributable to occupational asbestos and silica exposure decreased by 18.24, 6.71 and 20.52%, 4.00% globally, but increased significantly in lower SDI regions, while the burden attributable to occupational diesel engine exhaust exposure increased by 32.76, 37.23% worldwide. Conclusions Occupational exposure remains an important risk factor for TBL cancer. The burden of TBL cancer attributable to occupational carcinogens showed obvious heterogeneity which decreased in higher SDI but increased in lower SDI regions. The burden of males was significantly higher than females, but the females showed an increasing trend. Occupational exposure to asbestos was the main causes of the burden. Therefore, effective prevention and control measures tailored to local conditions are necessary.

Global, regional, and national burden of oral cancer and its attributable risk factors from 1990 to 2019.

This study aims to provide a theoretical basis for the prevention of oral cancer by analyzing the epidemiological trends of oral cancer. The data on oral cancer from 1990 to 2019 were extracted from the Global Burden of Disease 2019 database. The incidence, mortality, disability-adjusted life years (DALYs), and age-standardized rate as well as attributable risk factors of oral cancer were used for the analysis. Estimated annual percentage change (EAPC) was calculated to describe the changes in age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). The global ASIR of oral cancer showed an increasing trend from 1990 to 2019. ASIR in high SDI regions showed a decreasing trend during the studied period, with high SDI regions having the lowest ASMR in 2019. In 2019, the highest ASIR, ASMR, and ASDR were detected in South Asia. At the national level, Pakistan had the highest ASMR and ASDR in 2019. The increasing disease burden was observed in younger populations aged below 45 during the studied period. Smoking and alcohol use still exerted profound impacts on the oral cancer burden, with South Asia having the greatest increase in the percentage of deaths due to oral cancer attributable to chewing tobacco from 1990 to 2019. In conclusion, there is a large variability in the temporal and spatial burden of oral cancer, and it is essential for priority countries to take targeted intervention policies and measures to reduce the disease burden of oral cancer. In addition, the oral cancer burden caused by attributable risk factors should also receive close attention.

Development of kaligesing etawah crossbreed goat in Purworejo Central Java Province

This study aims to analyze the development of Kaligesing Etawah crossbreed goat in Purworejo Regency through community-based resource management approach, with the specific aims of assessing the condition of Kaligesing goat related to natural increase, examining the role of local government in determining the policy of developing Kaligesing goat in Purworejo, and recommending strategies in the development of Kaligesing goat through community-based resource management approach. The method used was a triangulation methods which include observation, survey and document study. The results showed that social-demographic such as education of farmers, goat ownership and land ownership were low level and natural increase of Kaligesing goat based on percentage of births per year and percentage of deaths per year was 45. 51%. The role of the government in determining the policy of developing Kaligesing goats in Purworejo is the Decree of the Purworejo Regency No. 188.4 of 1989 concerning the preservation of Kaligesing Goat, in addition to the Decree of the Minister of Agriculture of the Republic of Indonesia No. 2591 / Kpts / PD.400 / 7/2010 dated July 19, 2010, determination of Kaligesing Goat as a local strain of Central Java. The recommended strategies that need to be carried out are: strengthening the Kaligesing goat farmer group in terms of maintenance and marketing management, self-economic strengthening by establishing farmers’ cooperatives, establishing market information centers managed by groups or cooperatives to make it easier for farmers to obtain information about selling prices, popularize recording / livestock records so as to tighten the entry of breeds from outside the region, ensure the availability of feed land in areas that can grow feed crops and the processing and preservation of forage crops.

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Trends in cause of death among patients with renal cell carcinoma in the United States: a SEER-based study

BackgroundRenal cell carcinoma (RCC) survival has improved due to recent developments in RCC treatment. Therefore, other co-morbid conditions may have a more critical role. This study aims to explore the common causes of death in patients with RCC to improve the management and survival of RCC.MethodWe used the Surveillance, Epidemiology, and End Results (SEER) (1992–2018) database to get patients with RCC. We calculated the percentage of total deaths of six kinds of the cause of death (COD) and the cumulative incidence of death for each selected cause over survival time. The joinpoint regression was utilized to present the trend of mortality rate by COD.ResultsWe enrolled 107,683 cases with RCC. RCC was the leading cause of death in patients with RCC [25376(48.3%)], followed by cardiovascular diseases [9023(17.2%)], other cancers [8003 (15.2%)], other non-cancer diseases [4195 (8%)], non-disease cause [4023 (7.7%)], and respiratory diseases [1934 (3.6%)]. The proportion of patients who died of RCC decreased gradually over survival time, and this value decreased from 69.71% in 1992–1996 to 38.96% in 2012–2018. The non-RCC cause mortality rate showed an increasing trend, whereas a slight decrease was observed in RCC specific mortality rate. The distribution of such conditions varied across different patient populations.ConclusionRCC was still the primary COD of patients with RCC. However, non-RCC cause death was increasingly important among RCC patients in recent two decades. Cardiovascular disease and other cancers were crucial co-morbidities that required significant attention in the management of RCC patients.

Financial Burden of Acute Cerebrovascular Disease in United States Healthcare During 1993–2019 (P6-5.025)

<h3>Objective:</h3> To determine the financial burden of stroke on the national healthcare system for the past three decades. <h3>Background:</h3> Stroke is a leading cause of morbidity and mortality in the United States and has implications on the financial health of patients, families, and healthcare systems. <h3>Design/Methods:</h3> This is a retrospective study of inpatient subjects from 1993–2019 with cerebrovascular disease that was collected from the Healthcare Cost and Utilization Project (HCUP). Patients were evaluated for demographics, length of stay (LOS), mortality, and hospital charges. Statistical Z-testing was conducted for the analysis. <h3>Results:</h3> During the study period, 17,041,026 stroke subjects were studied, with 52.6% female and mean age of 70.62 (± 0.16) years old. The mean rate of stroke discharges per 100,000 persons was 194.46 (± 3.74), with an increase from 203 to 209 during the study (p = 0.22). The mean percentage of deaths was 9.52% (± 0.17), which decreased from 12.87% to 5.52% (p = 0.00). The mean LOS was 6.63 days (± 0.08), decreased from 9.54 to 6.90 during the study (p = 0.00). During the study period, the aggregated national bill was $710 billion. The mean hospital charges per patient were $43,954.23 (± 1,185.90) with an increase from $14,392.06 to $111,279.50 during the study period (p = 0.00). <h3>Conclusions:</h3> Our data show that the rate, LOS, and mortality of stroke have decreased, but its charges are increasing. The improvement in outcomes could be multifactorial such as establishment of comprehensive stroke centers and evolving treatment modalities. Ironically, the charges-per-patient increased nearly eight-fold with a national bill almost equal to the annual Medicare budget. Thus, the significance of preventive medicine, such as controlling hypertension, diabetes, and smoking cessation, cannot be understated. With such a dramatically increasing financial burden, improvements in mitigating risk factors, educational programs, and access to care may be a more cost-effective option. <b>Disclosure:</b> Miss Lorio has nothing to disclose. Miss Malone has nothing to disclose. Dr. Garcia Rodriguez has nothing to disclose. Ali Seifi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Chiesi. Ali Seifi has received intellectual property interests from a discovery or technology relating to health care.

Biological and chemical properties of 2-in-1 calcium-chelating and antibacterial root canal irrigants

ObjectivesTo evaluate the capacity of canal wall smear layer removal, precipitation caused by irrigant interaction, antibacterial activity and cytotoxicity of three 2-in-1 root canal irrigating solutions. MethodsForty single-rooted teeth were mechanically instrumented and irrigated with QMix, SmearOFF, Irritrol or 0.9% saline. Each tooth was evaluated for smear layer removal using scanning electron microscopy. Precipitation after interaction of the irrigating solutions with sodium hypochlorite (NaOCl) was evaluated with 1H nuclear magnetic resonance and mass spectroscopy. Confocal laser scanning microscopy was used to evaluate the antimicrobial activity of the irrigants against Enterococcus faecalis biofilms. Neutral red and clonogenic assays were performed on Chinese hamster V79 cells to evaluate the short-term and long-term cytotoxicity of the irrigants. ResultsThere was no significant difference between QMix and SmearOFF in eliminating smear layers from the coronal-third and middle-third of the canal spaces. In the apical-third, SmearOFF removed smear layers effectively. Irritrol incompletely removed smear layers from all the canal-thirds. When mixed with NaOCl, precipitation was evident only with Irritrol. QMix demonstrated a higher E. faecalis cell death percentage and a smaller biovolume. SmearOFF exhibited a larger decrease in biovolume compared with Irritrol, although Irritrol had a higher death percentage. Irritrol was more cytotoxic than the other irrigants on a short-term interval. In terms of long-term cytotoxicity, both Irritrol and QMix were cytotoxic. ConclusionQMix and SmearOFF performed better in smear layer removal and antimicrobial activity. QMix and Irritrol were cytotoxic when compared to SmearOFF. Irritrol was associated with precipitation after interacting with NaOCl. Clinical significanceEvaluation of the smear layer removal capability, antibacterial activity and cytotoxicity of 2-in-1 root canal irrigants is necessary to ensure that they are safe to use during root canal treatment.

Pentoxifylline Effects on Hospitalized COVID-19 Patients with Cytokine Storm Syndrome: A Randomized Clinical Trial.

COVID-19 is a fatal, fast-spreading pandemic, and numerous attempts are being made around the world to understand and manage the disease. COVID-19 patients may develop a cytokine-release syndrome, which causes serious respiratory diseases and, in many cases, death. The study examined the feasibility of employing legally available anti-inflammatory pentoxifylline (PTX), a low toxicity and cost medication, to mitigate the hyper-inflammation caused by COVID-19. Thirty adult patients who tested positive for SARS-CoV2 were hospitalized owing to the cytokine storm syndrome. They were given 400 mg of pentoxifylline orally TID according to the standard COVID-19 protocol of the Egyptian Ministry of Health. Besides this, a group of thirty-eight hospitalized COVID-19 patients who received the standard COVID-19 protocol was included in the study as a control group. The outcomes included laboratory test parameters, clinical improvements, and number of deaths in both groups. After receiving PTX, all patients showed a significant improvement in C reactive protein (CRP), and interleukin-6 (IL-6) levels at p < 0.01 and p = 0.004, respectively, while there was an increase in total leukocyte count (TLC) and neutrophil-to-leucocyte ratio (NLR) at p < 0.01 compared to their baseline levels. The D-dimer level showed a significant increase in the treatment group at p < 0.01, while showing no statistically significant difference in the control group. The median initial ALT (42 U/L) in the treatment group showed a decrease compared to the control group (51 U/L). No statistical significance was reported regarding clinical improvement, length of stay, and death percentages between the two groups. Our results showed no significant improvement of PTX over controls in clinical outcomes of hospitalized COVID-19 patients. Nevertheless, PTX displayed a positive effect on certain inflammatory biomarkers.

THE CORRELATION OF BETWEEN BREAST CANCER KNOWLEDGE LEVELS AND BREAST SELF-EXAMINATION BEHAVIOR (BSE) IN CLASS X AND X1 TEENAGE GIRLS AT GLOBAL ISLAMIC HIGH SCHOOL TERATAI PUTIH BEKASI IN 2022

Background: According to data from Global Burden Cancer in the International Agency for Research On Cancer (IARC), it is known that breast cancer is a disease with the highest percentage of new cases (after controlling for age), which is 43.3%, and the percentage of deaths (after being controlled by age ) due to breast cancer by 12.9% (Kendal, 2022). Breast cancer (carcinoma mammae) itself is a condition where cells have lost their normal control and mechanism, resulting in abnormal, fast, and uncontrolled growth that occurs in breast tissue (MOH, 2015). However, over time, this disease begins to lead to a younger age, so teenagers (13-20 years) also need to do BSE regularly as an effort to prevent and early detection to reduce the possibility of other diseases caused by these risks factors (WHO, 2007). Objectives: This study aims to determine the correlation of between knowledge levels of breast cancer and breast self-examination behavior (BSE) in class X and XI adolescent girls at Teratai Putih Global Islamic High School Bekasi in 2022. Methods: The research method that will be carried out by researchers is quantitative. The design in this study uses Analytical Observation with a Cross-Sectional research design. The population in this study was 66 young women in classes X and XI at the global white lotus Islamic high school. The sampling technique used in this research is total sampling. Results: it was found that with a significant level of 95% or a value of 5% (0.05) the results of the Fisher's Exact Test obtained a p-value (0.00) &lt; value of (0.05) there was a Correlation between the level of knowledge of breast cancer with examination behavior Breast Self (BSE) for Teenage Girls in Class X and XI at Teratai Putih Global Islamic High School Bekasi in 2022. Conclusion: There is a correlation between the level of knowledge of breast cancer and the behavior of breast self-examination (BSE) in Class X and XI Teenage Girls at Teratai Putih Global Islamic High School Bekasi 2022.

Abstract LB035: The role of nucleophosmin1 mediated caspase2 activation in acute myeloid leukemia cell death and cell survival

Abstract Nucleophosmin 1 (NPM1) mutation is the primary genetic lesion in adult acute myeloid leukemia (AML). Typically, a nucleolar protein, NPM1 mutations cause cytoplasmic delocalization of NPM1(NPM1c+), triggering leukemogenesis. Interestingly, NPM1c+ mutation confers enhanced chemosensitivity. However, the mechanism underlying NPM1c+ mutation-induced oncogenesis or chemosensitivity remains unclear. We previously reported that, in response to genotoxic stimuli, NPM1 forms a platform for caspase-2 activation in the nucleolus. Caspase-2 is a pro-apoptotic protein and a known tumor suppressor. Our results indicate that nucleolar caspase-2 activation is specific to NPM1wt cells. In the NPM1c+ cells, caspase-2 activation is exclusively cytosolic, suggesting that caspase-2 is activated in the same sub-cellular compartment as NPM1 localization. Loss of caspase-2 rescued the increased sensitivity of NPM1c+ cells to apoptotic cell death. This is accompanied by reduced cleavage of the apoptotic substrate, caspase-3. Notably, caspase-2 deficient NPM1wt cells showed no significant difference in the percentage of apoptotic cell death or endogenous substrate cleavage compared to its caspase-2 wild-type counterpart. This suggests that caspase-2 may contribute to the chemosensitivity of NPM1c+ cells. Strikingly, in unstimulated cells, loss of caspase-2 leads to prolonged G1 arrest and progressive loss of cell viability. Immunophenotyping of NPM1c+ cells revealed a remarkable increase in the CD14+population representing monocyte/macrophage-like features, suggesting that loss of caspase-2 results in terminal differentiation. Exogenous expression of NPM1c+ in caspase-2 deficient NPM1wt cells impaired viability, confirming that NPM1c+ cells require caspase-2 for its growth and proliferation. Transcriptomic analysis revealed that loss of caspase-2 significantly downregulates pathways involved in stem cell pluripotency. In particular, FGF2, IGFR, WNT, LIF, and one of the core members of the self-renewal transcription factor, OCT 4, were downregulated in the absence of caspase-2 in NPM1c+ cells. This reveals a novel role for caspase-2 in maintaining NPM1c+ AML stemness. Taken together, our study shows that NPM1c+ mediated caspase-2 activation regulates AML cell death and survival cascades, a key determinant of chemosensitivity and leukemogenesis. Citation Format: Dharaniya Sakthivel, Alexandra Brown-Suedel, Francesca Keane, F. Kenneth McSherry, Chloe I. Charendoff, Kevin Dunne, Dexter Robichaux, Jonathan M. Flanagan, Lisa Bouchier-Hayes. The role of nucleophosmin1 mediated caspase2 activation in acute myeloid leukemia cell death and cell survival [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 2 (Clinical Trials and Late-Breaking Research); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(8_Suppl):Abstract nr LB035.

Tailoring Treatment for Patients with Inflammatory Breast Cancer.

Inflammatory breast cancer (IBC) is a rare but aggressive subtype of breast cancer that has a propensity for locoregional recurrence and distant metastasis and is associated with a disproportionately high percentage of breast cancer deaths. IBC is not resectable at initial diagnosis and trimodality therapy is considered the standard treatment for IBC. This includes systemic therapy upfront, followed by modified radical mastectomy and comprehensive chest wall and regional node radiation. Despite this aggressive multi-modal treatment strategy, the prognosis remains worse in IBC when compared with non-inflammatory locally advanced breast cancers. For patients presenting with de novo stage IV IBC, treatment recommendations vary depending on tumor burden, cancer subtype, and presence of comorbidities. Efforts to improve outcomes in IBC are currently underway; however, progress has been affected by the low incidence of disease and limited number of dedicated studies in this population. Improvements in systemic therapies in breast cancer in general are likely to lead to improvements in IBC as well. More dedicated trials are needed to identify additional treatment strategies that may help to improve prognosis for these patients. Additionally, better frameworks for diagnosis, risk stratification based upon factors such as molecular subtype and response to neoadjuvant therapy, will be important to make further progress in IBC.

Antiproliferative and apoptotic effect of tuna blood on human lung cancer A549 cells via p38 MAPKs and Akt pathway

Tuna blood has been reported the anti-inflammatory properties. However, the anticancer effects of tuna blood remain unelucidated. Therefore, this study investigated the anticancer effects of tuna blood against human non-small cell lung cancer (NSCLC) A549 cells and its potential mechanism of action. The amino acid profile presented in tuna whole blood freeze-dried (TWBF) and tuna blood cell freeze-dried (TRBF) were analyzed, and the antiproliferative effect was assessed by MTT assay. The nuclear staining, reactive oxygen species (ROS) generation, and mitochondrial membrane potential (MMP) were examined by Hoechst/PI staining, DCFHDA assay, and JC-1 staining. The expression of apoptosis-related proteins and the involvement of p38 MAPKs and Akt signaling were evaluated by western blotting. TWBF and TRBF inhibited the proliferation of lung cancer A549 cells with IC50 values of 354.97, 141.31 µg/mL, respectively. TRBF revealed more efficacy of cell proliferation inhibition than that of TWBF. The percentage of apoptotic cell death after treatment with 100 µg/mL TRBF was 35.95%. The increase in the ROS production and the disruption of MMP were also detected. At a mechanistic level, the exposure of TRBF to A549 cells showed an increase of the Bax/Bcl2 ratio and subsequently activated the proteolytic activity of caspase-3. TRBF administration induced apoptosis through the downregulation of protein kinase B (Akt) and upregulation of p38 MAPK. These findings indicate TRBF inhibits lung cancer cell proliferation and mediates apoptosis signaling, suggesting a promising chemotherapeutic candidate target NSCLC.

Prevalence, causes, medical interventions, and mortality outcome of acute gastrointestinal bleeding among COVID-19 inpatients

Objective This study aimed to evaluate the prevalence, causes, medical interventions, and mortality outcome of acute gastrointestinal bleeding (AGIB) among COVID-19 patients hospitalized during the delta pandemic in Vietnam. Methods The medical records of COVID-19 patients hospitalized in a tertiary hospital in Vietnam from July to October 2021 were retrospectively collected. Data regarding age, sex, comorbidities, COVID-19 severity, onset time of AGIB, therapeutic interventions for AGIB, and mortality outcome were analyzed. Results Of 1567 COVID-19 inpatients, 56 (3.6%) had AGIB. The independent risk factors for AGIB in COVID-19 inpatients included age (OR = 1.03, 95% CI: 1.01–1.04, p = .003), male sex (OR = 1.86, 95% CI: 1.06–3.26, p = .03), chronic liver disease (OR = 6.21, 95% CI: 2.97–13.00, p < .001), and chronic kidney disease (OR = 2.17, 95% CI: 1.01–4.65, p = .047). Among 34 AGIB patients undergoing endoscopy, upper AGIB was determined in 24 (70.6%) patients. Peptic ulcer disease and hemorrhagic erosive gastritis were the most common causes (64.7%, 22/34). The therapeutic interventions for AGIB included blood transfusion (76.8%, 43/56), endoscopic hemostasis (23.5%, 8/34), and surgery (1.8%, 1/56). The mortality rate in the AGIB group was significantly higher than that in the non-AGIB group (46.4% vs. 27.7%, OR = 2.26, 95% CI: 1.32–3.87, p = .002). However, the majority (76.9%) of deaths in COVID-19 inpatients with AGIB were not bleeding-related. Conclusions Age, male sex, chronic liver disease, and chronic kidney disease are risk factors for AGIB among COVID-19 inpatients. Peptic ulcer disease is the most common cause. COVID-19 inpatients with AGIB have a higher risk of mortality, but a large percentage of deaths are not bleeding-related.

Investigating the impact of CO2 emissions on the COVID-19 pandemic by generalized linear mixed model approach with inverse Gaussian and gamma distributions

Abstract Carbon dioxide (CO2) rate within the atmosphere has been rising for decades due to human activities especially due to usage of fuel types such as coal, cement, flaring, gas, oil, etc. Especially in 2020, COVID-19 pandemic caused major economic, production, and energy crises all around the world. As a result of this situation, there was a sharp decrease in the global CO2 emissions depending on the fuel types used during this pandemic. The aim of this study was to explore the effects of “CO2 emissions due to the fuel types” on “percentage of deaths in total cases” attributed to the COVID-19 pandemic using generalized linear model and generalized linear mixed model (GLMM) approaches with inverse Gaussian and gamma distributions, and also to obtain global statistical inferences about 169 World Health Organization member countries that will disclose the impact of the CO2 emissions due to the fuel types during this pandemic. The response variable is taken as “percentage of deaths in total cases attributed to the COVID-19 pandemic” calculated as “(total deaths/total confirmed cases attributed to the COVID-19 pandemic until December 31, 2020)*100.” The explanatory variables are taken as “production-based emissions of CO2 from different fuel types,” measured in tonnes per person, which are “coal, cement, flaring, gas, and oil.” As a result of this study, according to the goodness-of-fit test statistics, “GLMM approach with gamma distribution” called “gamma mixed regression model” is determined as the most appropriate statistical model for investigating the impact of CO2 emissions on the COVID-19 pandemic. As the main findings of this study, 1 t CO2 emissions belonging to the fuel types “cement, coal, flaring, gas, and oil” per person cause increase in deaths in total cases attributed to the COVID-19 pandemic by 2.8919, 2.6151, 2.5116, 2.5774, and 2.5640%, respectively.

In-hospital complications after trauma due to road traffic accidents.

The study aimed to verify the association between in-hospital complications and characterization and clinical variables including hospital care and trauma severity. This analysis with the prospective cohort data was conducted at a municipal hospital in São Paulo, Brazil, and included participants aged 14years or older, with traumatic injuries from traffic accidents. Data was collected from January 2015 to July 2016 and included demographics variables, type of traumatic event, clinical parameters, length of stay in the Emergency department and in the Intensive Care Unit, length of hospital stay, survival probability, trauma severity and mortality. Of the 327 patients, 25.1% had in-hospital complications and their occurrence was statistically associated with higher mean age, run-overs and higher trauma severity. The length of stay in the emergency room, hospital stay, ICU stay, percentage of deaths, and hospital readmission were higher in patients with complications. The number of complications was correlated with trauma severity, ICU stay, and mortality. Complications were associated with older age, run-overs, greater trauma severity, length of stay and readmission after hospital discharge.

A new data driven method for summarising multiple cause of death data

BackgroundNational mortality statistics are based on a single underlying cause of death. This practice does not adequately represent the impact of the range of conditions experienced in an ageing population in which multimorbidity is common.MethodsWe propose a new method for weighting the percentages of deaths attributed to different causes that takes account of the patterns of associations among underlying and contributing causes of death. It is driven by the data and unlike previously proposed methods does not rely on arbitrary choices of weights which can over-emphasise the contribution of some causes of death. The method is illustrated using Australian mortality data for people aged 60 years or more.ResultsCompared to the usual method based only on the underlying cause of death the new method attributes higher percentages of deaths to conditions like diabetes and dementia that are frequently mentioned as contributing causes of death, rather than underlying causes, and lower percentages to conditions to which they are closely related such as ischaemic heart disease and cerebrovascular disease. For some causes, notably cancers, which are usually recorded as underlying causes with few if any contributing causes the new method produces similar percentages to the usual method. These different patterns among groups of related conditions are not apparent if arbitrary weights are used.ConclusionThe new method could be used by national statistical agencies to produce additional mortality tables to complement the current tables based only on underlying causes of death.