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Unintentional and violence-related injury fatalities, including suicide, homicide, overdoses, motor vehicle crashes, and falls, were among the 10 leading causes of death for all age groups in the United States in 2019.* There were 246,041 injury deaths in 2019 (unintentional injury was the most frequent cause of death after heart disease and cancer) with an economic cost of $2.2 trillion (1). Extending a national analysis (1), CDC examined state-level economic costs of fatal injuries based on medical care costs and the value of statistical life assigned to 2019 injury records from the CDC's Web-based Injury Statistics Query and Reporting System (WISQARS).† West Virginia had the highest per capita cost ($11,274) from fatal injury, more than twice that of New York, the state with the lowest cost ($4,538). The five areas with the highest per capita total fatal injury costs were West Virginia, New Mexico, Alaska, District of Columbia (DC), and Louisiana; costs were lowest in New York, California, Minnesota, Nebraska, and Texas. All U.S. states face substantial avoidable costs from injury deaths. Individual persons, families, organizations, communities, and policymakers can use targeted proven strategies to prevent injuries and violence. Resources for best practices for preventing injuries and violence are available online from the CDC's National Center for Injury Prevention and Control.§. [ABSTRACT FROM AUTHOR]

Approximately 47,000 persons in the United States died from an opioid-involved overdose in 2018 (1), and 2.0 million persons met the diagnostic criteria for an opioid use disorder in 2017 (2). The economic cost of the U.S. opioid epidemic in 2017 was estimated at $1,021 billion, including cost of opioid use disorder estimated at $471 billion and cost of fatal opioid overdose estimated at $550 billion (3). CDC used national-level cost estimates to estimate the state-level economic cost of opioid use disorder and fatal opioid overdose during 2017. Cases and costs of state-level opioid use disorder and fatal opioid overdose and per capita costs were calculated for each of the 38 states and the District of Columbia (DC) that met drug specificity requirements for mortality data (4). Combined costs of opioid use disorder and fatal opioid overdose (combined costs) varied substantially, ranging from $985 million in Wyoming to $72,583 million in Ohio. Per capita combined costs also varied considerably, ranging from $1,204 in Hawaii to $7,247 in West Virginia. States with high per capita combined costs were mainly in two regions: the Ohio Valley and New England. Federal and state public health agencies can use these data to help guide decisions regarding research, prevention and response activities, and resource allocation. [ABSTRACT FROM AUTHOR]

Objectives. We examined the associations between 2 measures of sexual orientation and 4 suicide risk outcomes (SROs) from pooled local Youth Risk Behavior Surveys. Methods. We aggregated data from 5 local Youth Risk Behavior Surveys from 2001 to 2009. We defined sexual minority youths (SMYs) by sexual identity (lesbian, gay, bisexual) and sex of sexual contacts (same- or both-sex contacts). Survey logistic regression analyses controlled for a wide range of suicide risk factors and sample design effects. Results. Compared with non-SMYs, all SMYs had increased odds of suicide ideation; bisexual youths, gay males, and both-sex contact females had greater odds of suicide planning; all SMYs, except same-sex contact males, had increased odds of suicide attempts; and lesbians, bisexuals, and both-sex contact youths had increased odds of medically serious attempts. Unsure males had increased odds of suicide ideation compared with heterosexual males. Not having sexual contact was protective of most SROs among females and of medically serious attempts among males. Conclusions. Regardless of sexual orientation measure used, most SMY subgroups had increased odds of all SROs. However, many factors are associated with SROs. [ABSTRACT FROM AUTHOR]

K- ras mutations are found in 40–50% of human colorectal adenomas and carcinomas, but their functional contribution remains incompletely understood. Here, we show that a conditional mutant K- ras mouse model (K- ras Asp12 /Cre), with transient intestinal Cre activation by β-Naphthoflavone (β-NF) treatment, displayed transgene recombination and K- ras Asp12 expression in the murine intestines, but developed few intestinal adenomas over 2 years. However, when crossed with Apc Min/+ mice, the K- ras Asp12/ Cre/Apc Min/+ offspring showed acceleration of intestinal tumourigenesis with significantly changed average lifespan ( P < 0.05) decreased to 18.4 ± 5.4 weeks from 20.9 ± 4.7 weeks (control Apc Min/+ mice). The numbers of adenomas in the small intestine and large intestine were significantly ( P < 0.01) increased by 1.5-fold and 5.7-fold, respectively, in K- ras Asp12 /Cre/Apc Min/+ mice compared with Apc Min/+ mice, with the more marked increase in adenoma prevalence in the large intestine. To explore possible mechanisms for K- ras Asp12 and Apc Min co-operation, the Mitogen-activated protein kinase ( Mapk), Akt and Wnt signalling pathways, including selected target gene expression levels, were evaluated in normal large intestine and large intestinal tumours. K- ras Asp12 increased activation of Mapk and Akt signalling pathway targets phospho-extracellular signal-regulated kinase (pErk) and pAkt, and increased relative expression levels of Wnt pathway targets vascular endothelial growth factor ( VEGF), gastrin, cyclo-oxygenase 2 ( Cox2) and T-cell lymphoma invasion and metastasis 1 ( Tiam1) in K- ras Asp12 /Cre/Apc Min/+ adenomas compared with that of Apc Min/+ adenomas, although other Wnt signalling pathway target genes such as Peroxisome proliferator-activated receptor delta ( PPARd), matrix metalloproteinase 7 ( MMP7), protein phosphatase 1 alpha ( PP1A) and c -myc remained unchanged. In conclusion, intestinal expression of K- ras Asp12 promotes mutant Apc-initiated intestinal adenoma formation in vivo more in the large intestine than the small intestine, with evidence of synergistic co-operation between mutant K- ras and Apc involving increased expression of some Wnt-pathway target genes. [ABSTRACT FROM AUTHOR]

The incidence of inflammatory bowel disease (IBD) has increased considerably over the past few decades. In the present review, we discuss several disadvantages existing in the treatment of IBD and current understandings of the structures, sources, and natures of various kinds of non-starch polysaccharides (NSPs). Available evidences for the use of different sources of NSPs in IBD treatment both in vitro and in vivo are analyzed, including glucan from oat bran, mushroom, seaweed, pectin, gum, prebiotics, etc. Their potential mechanisms, especially their related molecular mechanism of protective action in the treatment and prevention of IBD, are also summarized, covering the anti-inflammation, immune-stimulating, and gut microbiota-modulating activities, as well as short-chain fatty acids (SCFAs) production, anti-oxidative stress accompanied with inflammation, the promotion of gastric epithelial cell proliferation and tissue healing, and the reduction of the absorption of toxins of NSPs, thus ameliorating the symptoms and reducing the reoccurrence rate of IBD. In summary, NSPs exhibit the potential to be promising agents for an adjuvant therapy and for the prevention of IBD. Further investigating of the crosstalk between immune cells, epithelial cells, and gut microorganisms in addition to evaluating the effects of different kinds and different molecular weights of NSPs will lead to well-designed clinical intervention trials and eventually improve the treatment and prevention of IBD. [ABSTRACT FROM AUTHOR]

Objectives: Policies that increase household income, such as the earned income tax credit (EITC), have shown reductions on risk factors for child maltreatment (ie, poverty, maternal stress, depression), but evidence is lacking on whether the EITC actually reduces child maltreatment. We examined whether states' EITCs are associated with state rates of hospital admissions for abusive head trauma among children aged <2 years. Methods: We conducted difference-in-difference analyses (ie, pre- and postdifferences in intervention vs control groups) of annual rates of states' hospital admissions attributed to abusive head trauma among children aged <2 years (ie, using aggregate data). We conducted analyses in 14 states with, and 13 states without, an EITC from 1995 to 2013, differentiating refundable EITCs (ie, tax filer gets money even if taxes are not owed) from nonrefundable EITCs (ie, tax filer gets credit only for any tax owed), controlling for state rates of child poverty, unemployment, high school graduation, and percentage of non-Latino white people. Results: A refundable EITC was associated with a decrease of 3.1 abusive head trauma admissions per 100 000 population in children aged <2 years after controlling for confounders (P = .08), but a nonrefundable EITC was not associated with a decrease (P = .49). Tax refunds ranged from $108 to $1014 and $165 to $1648 for a single parent working full-time at minimum wage with 1 child or 2 children, respectively. Conclusions: Our findings with others suggest that policies such as the EITC that increase household income may prevent serious abusive head trauma. [ABSTRACT FROM AUTHOR]

The article discusses the results of the U.S. Centers for Disease Control and Prevention's (CDC) analysis of the National Vital Statistics System (NVSS) mortality data from 1999-2010 to determine trends in suicide rates among adults aged 35-64 years. The study showed a 28.4 percent increase in the annual, age-adjusted suicide rate among persons aged 35-64 years. The greatest suicide rate increased were recorded among American Indian/Alaska Natives (AI/AN).

State prescription drug monitoring programs are promising tools to rein in the epidemic of prescription opioid overdose. We used data from a national survey to assess the effects of these programs on the prescribing of opioid analgesics and other pain medications in ambulatory care settings at the point of care in twenty-four states from 2001 to 2010.We found that the implementation of a prescription drug monitoring program was associated with more than a 30 percent reduction in the rate of prescribing of Schedule II opioids. This reduction was seen immediately following the launch of the program and was maintained in the second and third years afterward. Effects on overall opioid prescribing and prescribing of non-opioid analgesics were limited. Increased use of these programs and the adoption of new policies and practices governing their use may have contributed to sustained effectiveness. Future studies are needed to evaluate the policies' comparative effectiveness. [ABSTRACT FROM AUTHOR]

The article discusses the findings of a study which investigated the lifetime work-loss and medical costs of fatal injuries in the U.S. in 2013. Topics covered include the estimated 214 billion dollar cost of fatal injuries, economic costs attributed to males, estimated costs attributed to drug poisoning, unintentional injuries and suicide and injury prevention programs and strategies.

A large number of nonfatal injuries are treated in U.S. emergency departments (EDs) every year. CDC's National Center for Health Statistics estimates that approximately 29% of all ED visits in 2010 were for injuries. To assess the economic impact of ED-treated injuries, CDC examined injury data from the National Electronic Injury Surveillance System--All Injury Program (NEISS-AIP) for 2013, as well as injury-related lifetime medical and work-loss costs from the Web-Based Injury Statistics Query and Reporting System (WISQARS). NEISS-AIP collects data from a nationally representative sample of EDs, using specific guidelines for recording the primary diagnosis and mechanism of injury. Number of injuries, crude- and age-specific injury rates, and total lifetime work-loss costs and medical costs were calculated for ED-treated injuries, stratified by sex, age groups, and intent and mechanism of injury. ED-treated injuries were further classified as those that were subsequently hospitalized or treated and released. The rate of hospitalized injuries was 950.8 per 100,000, and the rate of treated and released injuries was 8,549.8 per 100,000. Combined medical and work-loss costs for all ED-treated injuries (both hospitalized and treated and released) were $456.9 billion, or approximately 68% of the total costs of $671 billion associated with all fatal and ED-treated injuries. The substantial economic burden associated with nonfatal injuries underscores the need for effective prevention strategies. [ABSTRACT FROM AUTHOR]

The article presents an update on suicide trends among persons aged ten-24 years in the U.S. from 1994-2012. Topics discussed include the three most common mechanisms of suicide in the country and an analysis of National Vital Statistics System mortality data by the Centers for Disease Control and Prevention (CDC). Significant findings by the CDC are also discussed which include an increase in overall age-adjusted suicide rates by sex during the period.

Background: Alterations in gene splicing occur in human sporadic colorectal cancer (CRC) and may contribute to tumour progression. The K-ras proto-oncogene encodes two splice variants, Kras 4A and 4B, and K-ras activating mutations which jointly affect both isoforms are prevalent in CRC. Past studies have established that splicing of both the K-ras oncogene and proto-oncogene is altered in CRC in favour of K-ras 4B. The present study addressed whether the K-Ras 4A protooncoprotein can suppress tumour development in the absence of its oncogenic allele, utilising the ApcMin/+ (Min) mouse that spontaneously develops intestinal tumours that do not harbour K-ras activating mutations, and the K-rastmΔ4A/tmΔ4A mouse that can express the K-ras 4B splice variant only. By this means tumorigenesis in the small intestine was compared between ApcMin/+, K-ras+/+ and ApcMin/+, K-rastmΔ4A/tmΔ4A mice that can, and cannot, express the K-ras 4A proto-oncoprotein respectively. Methods: The relative levels of expression of the K-ras splice variants in normal small intestine and small intestinal tumours were quantified by real-time RT-qPCR analysis. Inbred (C57BL/6) ApcMin/+, K-ras+/+ and ApcMin/+, K-rastmΔ4A/tmΔ4A mice were generated and the genotypes confirmed by PCR analysis. Survival of stocks was compared by the Mantel-Haenszel test, and tumour number and area compared by Student's t-test in outwardly healthy mice at approximately 106 and 152 days of age. DNA sequencing of codons 12, 13 and 61 was performed to confirm the intestinal tumours did not harbour a K-ras activating mutation. Results: The K-ras 4A transcript accounted for about 50% of K-ras expressed in the small intestine of both wild-type and Min mice. Tumours in the small intestine of Min mice showed increased levels of K-ras 4B transcript expression, but no appreciable change in K-ras 4A transcript levels. No Kras activating mutations were detected in 27 intestinal tumours derived from Min and compound mutant Min mice. K-Ras 4A deficiency did not affect mouse survival, or tumour number, size or histopathology. Conclusion: The K-Ras 4A proto-oncoprotein does not exhibit tumour suppressor activity in the small intestine, even though the K-ras 4A/4B ratio is reduced in adenomas lacking K-ras activating mutations. [ABSTRACT FROM AUTHOR]