Research Database Research Articles

Extraction of the essential elements for urban systems modelling – A word-to-vector approach

Due to its ever-evolving nature, urbanisation continues to escalate in complexity, further exacerbating the urban sustainability challenges. This necessitates the need for evidence-based policymaking enabled by modelling approaches, to facilitate informed decisions, and propel and gravitate towards urban sustainability. The major constraint is that of identifying the essential characteristics for consideration when modelling cities as complex systems, in a structured manner that integrates these characteristics, cognisant of their relative importance. The distinctive urban systems, corresponding system characteristics and interdependencies impacting the modelling of cities as complex systems, can be identified from peer-reviewed literature. The limiting constraint is, although there is widely available information on cities in research databases, the ability to use this literature for a quantitative model has not been proven, presenting a research gap. This approach results in significant complexities. In order to resolve these complexities, this study seeks a systems-based approach including a 2-tier structured protocol, leveraging qualitative-to-quantitative techniques to automatically extract the key systems which impact the development of city models. Through a systematic literature review, data on 13 key systems is qualitatively extracted from research databases such as Scopus and ScienceDirect, for the duration 2014 – 2024. Through word2vector analysis, machine learning techniques are utilised to perform the quantitative mapping of each urban system into corresponding system characteristics, and quantitatively illustrate them based on relative importance. The results illustrate that this proposed method is significant to characterize the essential systems that constitute a city as a complex system, based on machine learning and text analytics.

Characteristics of low-temperature plasma for activation of plastic-degrading microorganisms

Plastic pollution is a problem that threatens the future of humanity, and various methods are being researched to solve it. Plastic biodegradation using microorganisms is one of these methods, and a recent study reported that plastic-degrading microorganisms activated by plasma increase the plastic decomposition rate. In contrast to microbial sterilization using low-temperature plasma, microbial activation requires a stable plasma discharge with a low electrode temperature suitable for biological samples and precise control over a narrow operating range. In this study, various plasma characteristics were evaluated using SDBD (Surface Dielectric Barrier Discharge) to establish the optimal conditions of plasma that can activate plastic-degrading microorganisms. The SDBD electrode was manufactured using low-temperature co-fired ceramic (LTCC) technology to ensure chemical resistance, minimize impurities, improve heat conduction, and consider freedom in designing the electrode metal part. Plasma stability, which is important for microbial activation, was investigated by changing the frequency and pulse width of the voltage applied to the electrode, and the degree of activation of plastic-degrading microorganisms was evaluated under each condition. The results of this study are expected to be used as basic data for research on the activation of useful microorganisms using low-temperature plasma.

Investigating the Impacts of Microplastics on the Plants Growth in Agriculture Soil

MP in the environment thrive for a long time and enter the ecosystem in vast amounts every day, microplastics pose a serious threat to the entire planet at the moment. The purpose of this study was to ascertain whether MP contamination affects plant development, the physical and chemical qualities of the soil, and soil metabolism. Several research databases about the identification and consequences of MP pollution of soil are available to evaluate its sources, impacts, mitigation, and global perspective. The effects of artificially spiked Poly Vinyl Acetate (PVA) micro plastics soil at different concentrations (0%, 0.5%, 1 %, 1.5%, 2%) on the growth parameters and nutrient contents of horse gram, green gram and chili grown soil. The germination percentage, seedlings length and vigor index was also reduced due to the presence of PVA particles which may be suspected to hinder the growth of the seeds, also the Boron and the Sulphur concentrations showed drastic reduction at higher concentrations of PVA micro plastics in green gram, horse gram and chili grown soil. Along with he reduced pH and Chlorophyll a due to the presence of PVA particles. Hence this study can help to focus on future need of remediation of micro plastics contaminated soil.

U-shaped correlation of lymphocyte count with all-cause hospital mortality in sepsis and septic shock patients: a MIMIC-IV and eICU-CRD database study

BackgroundIn sepsis, the relationship between lymphocyte counts and patient outcomes is complex. Lymphocytopenia and lymphocytosis significantly influence survival, illustrating the dual functionality of lymphocytes in responding to infections. This study investigates this complex interaction, focusing on how variations in lymphocyte counts correlate with all-cause hospital mortality among sepsis patients.MethodsThis retrospective cohort study analyzed data from two extensive critical care databases: the Medical Information Mart for Intensive Care IV 2.0 (MIMIC-IV 2.0) from Beth Israel Deaconess Medical Center, Boston, Massachusetts, and the eICU Collaborative Research Database (eICU-CRD), which was Multi-center database from over 200 hospitals across the United States conducted by Philips eICU Research Institute. We included adult patients aged 18 years and older who met the Sepsis-3 criteria, characterized by documented or suspected infection and a Sequential Organ Failure Assessment (SOFA) score of 2 or higher. Sepsis patients were categorized into quartiles based on lymphocyte counts. The primary outcome was all-cause mortality in the hospital, with 90 and 60-day all-cause mortality as the secondary outcomes. Univariable and multivariable Cox proportional hazard regressions were utilized to assess lymphocyte counts' impact on hospital mortality. An adjusted restricted cubic spline (RCS) analysis was performed to elucidate this relationship further. Subgroup analyses were also conducted to explore the association across various comorbidity groups among sepsis and septic shock patients.ResultsOur study included 37,054 patients, with an observed in-hospital mortality rate of 16.6%. Univariable and multivariable Cox proportional hazard regression models showed that lymphocyte counts were independently associated with in-hospital mortality (HR = 1.04, P < 0.01; HR = 1.06, P < 0.01). RCS regression analysis revealed a U-shaped relationship between lymphocyte levels and hospital mortality risk in sepsis and septic shock patients (P for overall < 0.001, P for nonliner < 0.01; P for overall = 0.002, P for nonliner = 0.014). Subgroup analyses revealed that elevated lymphocyte counts correlated with increased hospital mortality among sepsis patients with liver disease and requiring renal replacement therapy (P for overall = 0.021, P for nonliner = 0.158; P for overall = 0.025, P for nonliner = 0.759). These findings suggest that lymphocytes may have enhanced prognostic value in specific subsets of critically ill sepsis patients.ConclusionOur findings demonstrate that lymphocyte counts are a significant independent predictor of hospital mortality in sepsis and septic shock patients. We observed a U-shaped association between lymphocyte levels and mortality risk, indicating that high and low counts are linked to increased mortality. This result highlights the complex role of lymphocytes in sepsis outcomes and suggests the need for further investigation into the underlying mechanisms and potential therapeutic approaches. Integrating lymphocyte count assessment into risk stratification algorithms and clinical decision support tools could enhance the early identification of high-risk sepsis patients.

Perinatal outcomes after a prenatal diagnosis of a fetal copy number variant: a retrospective population-based cohort study

BackgroundThere are no established guidelines for the follow up of infants born after a prenatal diagnosis of a genomic copy number variant (CNV), despite their increased risk of developmental issues. The aims of this study were (i) to determine the perinatal outcomes of fetuses diagnosed with and without a CNV, and (ii) to establish a population-based paediatric cohort for long term developmental follow up.MethodsAn Australian state-wide research database was screened for pregnant individuals who had a prenatal chromosomal microarray (CMA) between 2013–2019 inclusive. Following linkage to laboratory records and clinical referrer details, hospital records were manually reviewed for study eligibility. Eligible participants were mother–child pairs where the pregnancy resulted in a livebirth, the mother was able to provide informed consent in English (did not require a translator) and the mother was the primary caregiver for the child at hospital discharge after birth. Research invitations were sent by registered post at an average of six years after the prenatal diagnostic test. Statistical analysis was performed in Stata17.ResultsOf 1832 prenatal records examined, 1364 (74.5%) mother–child pairs were eligible for recruitment into the follow up cohort. Of the 468 ineligible, 282 (60.3%) had ‘no live pregnancy outcome’ (209 terminations of pregnancy (TOP) and 73 miscarriages, stillbirths, and infant deaths), 157 (33.5%) required a translator, and 29 (6.2%) were excluded for other reasons. TOP rates varied by the type of fetal CNV detected: 49.3% (109/221) for pathogenic CNVs, 18.2% (58/319) for variants of uncertain significance and 3.3% (42/1292) where no clinically significant CNV was reported on CMA. Almost 77% of invitation letters were successfully delivered (1047/1364), and the subsequent participation rate in the follow up cohort was 19.2% (201/1047).ConclusionsThis study provides Australia’s first population-based data on perinatal outcomes following prenatal diagnostic testing with CMA. The relatively high rates of pregnancy loss for those with a prenatal diagnosis of a CNV presented a challenge for establishing a paediatric cohort to examine long term outcomes. Recruiting a mother–child cohort via prenatal ascertainment is a complex and resource-intensive process, but an important step in understanding the impact of a CNV diagnosis in pregnancy and beyond.Trial registrationACTRN12620000446965p; Registered on April 6, 2020.

Healthcare utilization and expenditures in patients with tricuspid regurgitation: A population-based cohort study

BackgroundTricuspid regurgitation (TR) is the most common tricuspid valve (TV) condition. However, little is known about the prevalence, clinical significance, or economic impact of TR, including TR with comorbid heart failure (HF). Materials and MethodsTaiwan’s National Health Insurance Research Database was used to perform a retrospective cohort study about patients with TR. The study included patients over the age of 18 with TR who provided data from January 2017 to December 2019. The cohorts were divided into six groups based on whether significant TR was present (sTR) or not (nsTR), and whether HF was present (HF) or not present (noHF), or inconclusive (incHF). ResultsThis study included 21,051 patients with TR. Patients with nsTR-noHF had an annualized healthcare burden of 0.36 all-cause hospitalizations, 3.26 days length of stay (LOS), and NTD 66,834 in expenses. sTR led to significant increases in healthcare utilization and expenditures. The annualized economic burden for sTR-noHF patients increased to 1.03 all-cause hospitalizations, 10.75 days LOS, and NTD 210,842 in expenses. Patients with sTR and HF had significantly higher healthcare utilization and expenditures; patients with sTR-HF had an annualized economic burden of 2.46 all-cause hospitalizations, 33.18 days LOS, and NTD 480,711 in spending. ConclusionTR patients with HF or sTR are more likely to be hospitalized, use more healthcare resources, and face higher financial burdens.

Public Availability of Data Management and Analysis Scripts of Studies Conducted on Open-Access Intensive Care Databases.

Intensive care units (ICUs) provide care for critical patients at high risk of morbidity and mortality, and require continuous monitoring of clinical, biological and, imaging parameters. Collaborative ventures have enabled the emergence of large open access databases for the secondary use of Electronic Health Records (EHRs). The objective of this work was to evaluate the availability of scripts and datasets in publications based on ICU open-access databases. We included 910 original articles based on four ICU open-access databases (Amsterdam University Medical Centers Database, eICU Collaborative Research Database, High time resolution ICU dataset, and Medical Information Mart for Intensive Care). The majority of the studies did not provide their data management scripts (n=839, 92.9%), neither the analysis script (n=843, 93.4%) in the article. Attempts to contact the 845 corresponding authors in question resulted in 89.11% (n=753) of our e-mail requests going unanswered over a two-month period. We received 51 automated messages (55.43%) indicating that emails have not been delivered, while 6 messages (6.52%) redirected to alternative email addresses. Only 20 corresponding authors (18.18%) answered, finally providing the requested materials. Despite scientific journals recommendations to share materials, our study unveils the absence of crucial components for the replication of studies by other research teams.

Conductive Hearing Loss Associates With Dementia, and Middle Ear Reconstruction Mitigates This Association: A Multinational Database Study.

To test the hypothesis that conductive hearing loss (CHL) is associated with dementia, and that middle ear reconstruction (MER) associates with improved outcomes for these measures in a multinational electronic health records database. Retrospective cohort study with propensity-score matching (PSM). TriNetX is a research database representing about 110 million patients from the United States, Taiwan, Brazil, and India. Subjects older than 50 years with no HL and any CHL (ICD-10: H90.0-2). Subjects of any age with and without any MER (CPT: 1010174). Odds ratios (ORs) and hazard ratios with 95% confidence intervals (95% CIs) for incident dementia (ICD-10: F01, F03, G30). Of 103,609 patients older than 50 years experiencing any CHL, 2.74% developed dementia compared with 1.22% of 38,216,019 patients with no HL (OR, 95% CI: 2.29, 2.20-2.37). Of patients experiencing CHL, there were 39,850 who received MER. The average age was 31.3 years, with 51% female patients. A total of 343,876 control patients with CHL were identified; 39,900 patients remained in each cohort after 1:1 PSM for HL- and dementia-related risk factors. Matched risk for developing dementia among MER recipients was 0.33% compared with 0.58% in controls (OR: 0.58, 0.46-0.72). CHL increases the odds for dementia, and MER improves the odds for incident dementia. This study represents the first population study on the topic of CHL, MER, and dementia.

Treatment Pathways in Patients With Crohn's Disease and Ulcerative Colitis: Understanding the Road to Advanced Therapy.

Patients with Crohn's disease (CD) or ulcerative colitis (UC) often cycle through conventional therapies (CT) with different mechanisms of action (MOA) before initiating advanced therapy (AT). We describe treatment patterns among patients with CD/UC. Using Merative MarketScan Research databases, adult patients with CD/UC were identified from medical/pharmacy claims (2017-2021). Patients had ≥1 hospitalization or ≥2 outpatient visits (≥30 days apart within 1 year) for CD/UC. Two cohorts were established; cohort 1: Newly diagnosed patients (index date is the date of first diagnosis) and cohort 2: Patients initiating AT (index date is the date of first AT). First-line treatment patterns (cohort 1) and CT pathways before AT initiation (cohort 2) by the number of episodes (ie, adding a new therapy, switching to another therapy, or restarting the same therapy after ≥60 days) and MOA are reported. Among newly diagnosed patients in cohort 1 (CD: n = 1739; UC: n = 2740), 14.4% (CD) and 5.9% (UC) of patients had any AT use during the follow-up period (mean: 2.3 years; ≥ 77% initiated corticosteroids). Among patients in cohort 2 (CD: n = 2594; UC: n = 2431), the mean number of CT episodes before AT initiation was 4.0 ± 4.3 (CD) and 5.9 ± 5.0 (UC). Among those with ≥1 corticosteroid episode (CD: 82.2%; UC: 91.5%), the mean number of episodes was 4.6 ± 4.3 (CD) and 6.3 ± 5.0 (UC). Overall, 13.3% (CD) and 23.7% (UC) of patients cycled through 3 MOAs before AT initiation. Despite treatment recommendations, few newly diagnosed CD/UC patients initiated AT as their first treatment. Moreover, patients cycled through multiple CTs before initiating AT.

Associations of family socioeconomic indicators and physical activity of primary school-aged children: a systematic review

BackgroundFamily socioeconomic indicators (education, occupation, and household income) are key determinants influencing children’s physical activity (PA). This study aims to systematically review the current research about the association between family socioeconomic indicators and PA among primary school-aged children and to quantify the distribution of reported associations by childs’ and parents’ sex and according to analysis and assessment methods.MethodsA systematic literature research in multiple scientific databases (MEDLINE via PubMed, Web of Science, ScienceDirect, SPORTDiscus and ERIC) was performed for literature published between 1st January 2010 and 31st March 2022. Only studies reporting statistical associations between an SES indicator of at least one parent (education, occupation, income, or an SES index) and different types and intensities of PA in primary school-aged children (6 to 12 years) were included in the analysis. The distributions of the reported associations were evaluated across and differentiated by sub-group analysis of assessment methods (objectively measured vs. self-reported PA) and analysis methods (univariate vs. multivariate models).ResultsOverall, 93 studies reported in 77 publications were included in this review. Most of the studies were conducted in Europe and used self-reports (questionnaires) to assess PA. Most studies used only a single SES indicator (commonly maternal education), and only two studies calculated an SES index. The majority of the studies focused on moderate-to-vigorous physical activity (MVPA), total physical activity (TPA), and organized physical activity (OPA). Results showed predominantly positive associations between SES indicators and OPA. In contrast, results regarding different intensities of daily PA (TPA, LPA, MPA, MVPA, VPA, LTPA) were heterogeneous, with overwhelmingly no associations.ConclusionOverall, the results expand the knowledge about the association between family socioeconomic indicators and children’s PA and disprove the hypothesis of a clear positive association. However, large multicenter studies are lacking using a real SES index as a predictor and analyzing gender-specific multivariate models.

Can enhanced CSR quality reduce the cost of debt capital? An empirical analysis of CEO expertise and non-financial reporting practices in China

This study aims to investigate whether stockholders and creditors place a positive value on corporate social responsibility (CSR) information disclosure when making decisions about providing financing to firms, thereby influencing their investment choices. Utilizing data from the China Stock Market &amp;amp;amp; Accounting Research Database (CSMAR) and HEXUN, the study analyzes CSR disclosures and financial data of 7,123 firm-year observations of A-share listed companies on the Shanghai and Shenzhen stock exchanges from 2012 to 2020. A comprehensive methodology involving regression analysis was applied to assess the relationship between CSR quality and the cost of debt capital. Various robustness tests, including different model specifications and alternative variable measurements, were conducted to ensure the reliability and validity of the findings. The results obtained indicate that higher CSR quality significantly correlates with a lower cost of debt capital, supporting the hypothesis that improved CSR disclosure reduces perceived credit risk. However, CEO financial expertise shows a significantly positive relationship with the cost of debt capital. Furthermore, the study reveals that CSR assurance and engagement with Big 4 accounting firms do not noticeably affect the price of debt capital, whereas mandatory CSR reporting does. The findings underscore the importance of CSR quality in financial decision-making, offering valuable insights. AcknowledgmentThis paper is co-funded by the European Union through the European Education and Culture Executive Agency (EACEA) within the project “EU Best Practice of Life Cycle Assessment, Social, Environmental Accounting and Sustainability Reporting” – 101047667-ERASMUS-JMO-2021-MODULE https://jm.snau.edu.ua/en/eu-best-practice-of-life-cycle-assessment-social-environmental-accounting-and-sustainability-reporting/ Oleh Pasko expresses sincere gratitude for the support from the Kirkland Research Program, generously provided by the Leaders of Change Foundation established by the Polish-American Freedom Foundation.

Real-world treatment patterns, resource utilization and costs in biliary tract cancers in the USA.

Aim: To evaluate real-world treatment patterns, survival and healthcare-resource utilization in US patients with advanced biliary tract cancers (BTC) receiving systemic therapy.Patients & methods: This study used claims data from the Healthcare Integrated Research Database (HIRD®) linked to clinical data from the Cancer Care Quality Program (January 1, 2015-September 30, 2020).Results: Of 413 patients, 84.5% received gemcitabine-based first-line (1L) treatment, 46% received second-line treatment, and 16.5% received third-line (3L) treatment. All-cause mortality was 53% and approximately 70% of patients had ≥1 inpatient visit. The total mean per-patient-per-month all-cause costs were $19,589 for 1L and $33,534 for 3L treatment.Conclusion: Results showed poor survival, significant resource use and high costs as treatment line progresses for patients with advanced BTC.

Long-term exposure to air pollution and the risks of venous thromboembolism: a nationwide population-based retrospective cohort study.

To delineate the effects of exposure to air pollution on the risk of venous thromboembolism (VTE). The association between air pollution and arterial occlusive diseases has been well reported in the literature. VTE is the third most common acute cardiovascular syndrome; however, its relationship with exposure to air pollution has been controversial. This study linked data from the Taiwan National Health Insurance Research Database with that from the Taiwan Environmental Protection Administration. Patients who were first admitted for VTE between January 1, 2001, and December 31, 2013, were analyzed. A time-stratified, case-crossover design was employed. Three different exposure periods were defined: exposure for 1month, one quarter, and 1year. Four control periods were designated for each exposure period. The association between exposure to air pollutants and the risk of VTE was tested using logistic regression analysis. Subgroup analyses were also performed, stratified by age, sex, type of VTE, the use of hormone therapy, and level of urbanization at the site of residence. Exposures to particulate matter (PM) smaller than 2.5µm (PM2.5) and those smaller than 10µm (PM10) were associated with higher risks of VTE, with longer exposures associated with higher risk. The concentration of PM2.5 exposure for 1month was linearly associated with a greater risk of VTE up to 28.0µg/m3, beyond which there was no association. PM2.5 exposure for one quarter or 1year remained significantly associated with higher risks of VTE at higher concentrations. The increased risk in VTE associated with exposure to PM2.5 was more prominent in older patients and in patients not under hormone therapy. Similar results were observed for PM10 exposures. Exposure to PM, particularly PM2.5, leads to an increased risk of VTE, with possible accumulative effects. With increased PM production in industrializing countries, the effects of PM on VTE occurrence warrant further attention.

Trends in pancreatic cancer mortality in the United States 1999-2020: a CDC database population-based study.

Pancreatic cancer is a significant public health concern and a leading cause of cancer-related deaths worldwide. This study aimed to investigate pancreatic cancer mortality trends and disparities in the United States (US) from 1999 to 2020. Data were obtained from the Centers for Disease Control (CDC) Wide-Ranging Online Data for Epidemiologic Research database. Mortality rates were age-adjusted and standardized to the year 2000 US population. Joinpoint regression was used to analyze temporal trends in age-adjusted mortality rates (AAMRs) by sociodemographic and geographic variables. Between 1999 and 2020, pancreatic cancer led to a total of 810,628 deaths in the US, an average mortality of nearly 39,000 deaths per year. The AAMR slightly increased from 10.6 in 1999 to 11.1 in 2020, with an associated annual percent change (APC) of 0.2. Mortality rates were highest among individuals aged 65 and older. Black individuals experienced the highest overall pancreatic cancer-related AAMR at 13.8. Despite this, Black individuals experienced a decreasing mortality trend over time (APC -0.2) while White individuals experienced an increasing trend in mortality (APC 0.4). Additionally, individuals residing in rural areas experienced steeper rates of mortality increase than those living in urban areas (APC 0.6 for rural vs -0.2 for urban). White individuals in urban and rural populations experienced an increase in mortality, while Black individuals in urban environments experienced a decrease in mortality, and Black individuals in rural environments experienced stable mortality trends. Mortality from pancreatic cancer continues to increase in the US, with racial and regional disparities identified in minorities and rural-dwelling individuals. These disparate findings highlight the importance of ongoing efforts to understand and address pancreatic cancer treatment and outcomes disparities in the US, and future studies should further investigate the underlying etiologies of these disparities and potential for novel therapies to reduce the mortality.

Statin use associated with a reduced risk of hip fracture in patients with gout

Studies show that statins users are at reduced risk of fracture and improved bone mineral density. However, the clinical effectiveness of statin use in patients with gout has not been investigated. This retrospective cohort study used data from Taiwan's National Health Insurance Research Database, consisting of 3443 patients with gout using statins aged 50 years and above and 6886 gout patients of non-statin users matched by sex, age and propensity score. The Cox proportional hazards regression analysis showed that statin use was associated with a reduced risk of hip fracture (adjusted hazard ratio [aHR] = 0.78, 95 % confidence interval [CI] = 0.64–0.94) after controlling for potential confounding factors. The association was significant in both genders aged 50–64 years, with aHRs of near 0.35, but not in the elderly. In addition, women aged 50–64 years who used statins also exhibited a lower risk of vertebral fracture (aHR = 0.70, 95 % CI = 0.50–0.99), but not men. In conclusion, the stating use in gout patients could reduce fracture risk for younger patients. Further research is warranted to confirm these findings.

Estimating expected years of life lost of psychiatric disorders in Taiwan: A Nationwide cohort study

ObjectivesThis study employed a national longitudinal cohort to assess expected years of life lost (EYLL) in newly diagnosed psychiatric patients. MethodsData from Taiwan's National Death Registry and Health Insurance Research Database were scrutinized to identify patients with various psychiatric disorders. Disorders were ranked hierarchically, and age groups were categorized as young, middle-aged, and older adults. We utilized the semiparametric survival extrapolation method to estimate life expectancy (LE) and EYLL. Modifying effect of comorbid conditions and socioeconomic characteristics were also explored. ResultsAmong the 5,757,431 cases, young adults with dementia, alcohol use disorder, schizophrenia, and bipolar disorder experienced an excess of 15 years of EYLL. Middle-aged adults faced approximately 9 years or more of EYLL, while older adults had lower EYLL values. Comorbid conditions, low income levels, and living in rural areas were associated with higher EYLL. ConclusionsThis study underscores the substantial EYLL among young adults with psychiatric disorders and the significant impact of specific disorders on EYLL. Early intervention, tailored support, and healthcare system readiness are imperative for improved outcomes. Resource allocation and targeted interventions focusing on early detection and comprehensive treatment can alleviate the economic burden.

Temporal Trends in Race and Sex Differences in Cardiac Arrest Mortality in the USA, 1999–2020

BackgroundCardiac arrest (CA) affects over 600,000 patients in the USA annually. Despite large-scale public health and educational initiatives, survival rates are lower in certain racial and socioeconomic groups. MethodsA county-level cross-sectional longitudinal study using death data of patients aged 15 years or more from the US Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (WONDER) database from 1999 to 2020. CAs were identified using the International Classification of Diseases, tenth revision, clinical modification codes. ResultsThe CA-related deaths between 1999 and 2020 were 7,710,211 in the entire USA. The annual CA related age-adjusted mortality rates (CA-MR) declined through 2019 (132.9 to 89.7 per 100,000 residents), followed by an increase in 2020 (104.5 per 100,000). White patients constituted 82 % of all deaths and 51 % were female. The overall CA-MR during the study period was 104.48 per 100,000 persons. The CA-MR was higher for men as compared with women (123.5 vs. 89.7 per 100,000) and higher for Black as compared with White adults (154.4 vs. 99.1 per 100,000). ConclusionsCA-MR in the overall population has declined, followed by an increase in 2020, which is likely the impact of the COVID-19 pandemic. There were also significant racial and sex differences in mortality rates.

Analysis of chloroplast genome structure and phylogeny of the traditional medicinal of Ardisia crispa (Myrsinaceae)

Ardisia crispa(Myrsinaceae) is an ethnomedicine with horticultural and important medicinal values. Its morphology is complex, and its identification is difficult. We analyse the chloroplast genome characteristics and phylogenetic position of A. crispa to provide basic research data for the identification of A. crispa species and resource conservation. This study assemble and annotate the chloroplast genome of A. crispa and to compare it with the chloroplast genome within Ardisia. The A. crispa chloroplast genome is 156,785 bp in length, with a typical quadripartite structure containing 131 genes, including 86 protein-coding genes, 37 tRNA genes, and 8 rRNA genes; a total of 59 SSRs sites were identified, and the codon preference of this chloroplast genome is greater in A/U than in G/C, and leucine is the amino acid with the highest frequency of use. The chloroplast genomes of the nine Ardisia species are conserved in gene content and number, with more stable boundaries and less variation. In the phylogenetic tree, A. crispa is clustered on a branch with A. crispa var dielsii, and is closely related to A. mamillata and A. pedalis. In this study, we constructed and analyzed the chloroplast genome structure of A. crispa, and conducted phylogenetic analysis using the whole chloroplast genome sequence data of Ardisia plants, which is of great significance in understanding the genetic basis of A. crispa and adaptive evolution in Ardisia plants, and this will lay the foundation for the future research on A. crispa resource conservation and species identification.

Place of birth and postnatal transfers in infants with congenital diaphragmatic hernia in England and Wales: a descriptive observational cohort study

ObjectiveTo describe clinical pathways for infants with congenital diaphragmatic hernia (CDH) and short-term outcomes.DesignRetrospective observational cohort study using the UK National Neonatal Research Database (NNRD).PatientsBabies with a diagnosis of CDH...

Interpretable machine learning model for early prediction of acute kidney injury in patients with rhabdomyolysis

Abstract Background Rhabdomyolysis (RM) is a complex set of clinical syndromes. RM-induced acute kidney injury (AKI) is a common illness in war and military operations. This study aimed to develop an interpretable and generalizable model for early AKI prediction in patients with RM. Methods Retrospective analyses were performed on 2 electronic medical record databases: the eICU Collaborative Research Database and the Medical Information Mart for Intensive Care III database. Data were extracted from the first 24 hours after patient admission. Data from the two datasets were merged for further analysis. The extreme gradient boosting (XGBoost) model with the Shapley additive explanation method (SHAP) was used to conduct early and interpretable predictions of AKI. Results The analysis included 938 eligible patients with RM. The XGBoost model exhibited superior performance (area under the receiver operating characteristic curve [AUC] = 0.767) compared to the other models (logistic regression, AUC = 0.711; support vector machine, AUC = 0.693; random forest, AUC = 0.728; and naive Bayesian, AUC = 0.700). Conclusion Although the XGBoost model performance could be improved from an absolute perspective, it provides better predictive performance than other models for estimating the AKI in patients with RM based on patient characteristics in the first 24 hours after admission to an intensive care unit. Furthermore, including SHAP to elucidate AKI-related factors enables individualized patient treatment, potentially leading to improved prognoses for patients with RM.