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Background: To inform researchers about the methodology and results of epidemic estimation studies performed for COVID-19 epidemic in Iran, we aimed to perform a rapid review. Methods: We searched for and included published articles, preprint manuscripts and reports that estimated numbers of cumulative or daily deaths or cases of COVID-19 in Iran. We found 131 studies and included 29 of them. Results: The included studies provided outputs for a total of 84 study-model/scenario combinations. Sixteen studies used 3–4 compartmental disease models. At the end of month two of the epidemic (2020-04-19), the lowest (and highest) values of predictions were 1,777 (388,951) for cumulative deaths, 20,588 (2,310,161) for cumulative cases, and at the end of month four (2020-06-20), were 3,590 (1,819,392) for cumulative deaths, and 144,305 (4,266,964) for cumulative cases. Highest estimates of cumulative deaths (and cases) for latest date available in 2020 were 418,834 on 2020-12-19 (and 41,475,792 on 2020-12-31). Model estimates predict an ominous course of epidemic progress in Iran. Increase in percent population using masks from the current situation to 95% might prevent 26,790 additional deaths (95% confidence interval 19,925–35,208) by the end of year 2020. Conclusions: Meticulousness and degree of details reported for disease modeling and statistical methods used in the included studies varied widely. Greater heterogeneity was observed regarding the results of predicted outcomes. Consideration of minimum and preferred reporting items in epidemic estimation studies might better inform future revisions of the available models and new models to be developed. Not accounting for under-reporting drives the models' results misleading. [ABSTRACT FROM AUTHOR]

The steadily growing COVID-19 pandemic is challenging health systems worldwide including Sudan. In Sudan, the first COVID-19 case was reported on 13th March 2020, and up to 11 November 2020 there were 14,401 confirmed cases of which 9,535 cases recovered and the rest 3,750 cases were under treatment. Additionally, 1,116 deaths were reported, indicating a relatively high case fatality rate of 7.7%. Several preventive and control measures were implemented by the government of Sudan and health partners, including the partial lockdown of the country, promoting social distancing, and suspending mass gathering such as festivals and performing religious practices in groups. However, new cases still emerging every day and this could be attributed to the noncompliance of the individuals to the advocated preventive measurements. [ABSTRACT FROM AUTHOR]

This study assesses the effect of COVID-19 proxied by the number of confirmed cases of the infection and deaths on Nigeria's stock market over the 23rd March to 11th September 2020 period using the autoregressive distributed lag (ARDL), canonical cointegrating regression (CCR), dynamic ordinary least squares (DOLS) and fully modified ordinary least squares (FMOLS) techniques. The bounds test to cointegration result reveals that a long-run relationship exists between COVID-19 and Nigeria's stock market (along with oil prices and exchange rate). The results of the various estimations demonstrate that COVID-19 (proxied by the number of confirmed cases of infection) has a negative and significant impact on stock market performance, while the number deaths has a positive and significant impact on the market in the long-run. In addition, oil prices and exchange rate have a significant and positive effect on stock market performance in the long-run. Similar results were found for sub-sectors including consumer goods and healthcare sub-sectors of the stock market. The study recommends policies to curb the spread of the virus. [ABSTRACT FROM AUTHOR]

Background: The treatment of critically ill patients with COVID-19 who were hospitalized in Wuhan has been reported. However, the clinical characteristics of patients who died of COVID-19 in regions with relatively scarce healthcare resources remain unknown.Methods: In this retrospective study, a total of 14 patients who were admitted from January 18 to February 11, 2020 and died of COVID-19 were evaluated. The epidemiological, symptomatic, laboratory, radiological and treatment records were reviewed and analyzed.Results: The mean age of the 14 patients was 56.7 (SD 15.3) years, and 8 (57.1%) were older than 50 years. Eight (57.1%) were men, and 11 (78.6%) had one or more high risk factors. The most common chronic diseases among these patients were cardiovascular disease (7, 50.0%), hypertension (6, 42.9%), and chronic kidney disease (5, 35.7%). General symptoms included cough (12, 85.7%), fever (11, 78.6%), and dyspnea (10, 71.4%). The median duration from the onset of symptoms to death was 11 (IQR 6.5-19.5) days, and the median duration from admission to death was 4.5 (1.0-11.8) days. Patients who died within 4.5 days had more severe pulmonary lesions, significantly reduced lymphocytes and elevated C-reactive protein (CRP). Most patients had organ dysfunction, including 13 (92.9%) with acute respiratory distress syndrome (ARDS), 4 (28.6%) with cardiac injury, 3 (21.4%) with acute kidney injury, and 3 (21.4%) with liver dysfunction.Conclusions: Elderly SARS-CoV-2-infected patients with comorbidities, especially those with ARDS and severe chest CT findings on admission, are at increased risk of death and deserve special attention and quality medical treatment. [ABSTRACT FROM AUTHOR]

Objective: To describe COVID-19 deaths among children and adolescents in Sergipe, Brazil.Methods: Ecological study of all COVID-19 reported cases and deaths occurring in children and adolescents < 19 years of age in Sergipe reported by the health surveillance and mortality information systems of Sergipe's Health Secretary and hospital records.Results: Of 37 deaths of children < 19 years old were reported up to 30 September 2020, corresponding to 4.87 deaths for 100 000 population < 19 years old. Most deaths occurred among infants (44.1/100 000), and this age group had the highest case fatality rate (15.3 %). Most children had comorbidities such as chronic neurological diseases (n = 7; 19%) and prematurity (n = 4; 11%). Most children who died (n = 18; 49%) were not admitted to intensive care units (ICUs).Conclusion: COVID-19 mortality in children and adolescents in Sergipe was higher than in other Brazilian states and in high-income countries. A large proportion of the deaths occurred among children with comorbidities and a minority of children were admitted to ICU, reflecting the limited provision of such beds in the State. Newborns and infants are a high-risk group that must have priority in health public policy. [ABSTRACT FROM AUTHOR]

Background: Excessive alcohol use is a risk factor for injury-related deaths. Postmortem blood samples are commonly used to approximate antemortem blood alcohol concentration (BAC) levels. Objectives: To assess differences between antemortem and postmortem BACs among fatally injured adults admitted to one shock trauma center (STC). Method: Fifty-two adult decedents (45 male, 7 female) admitted to a STC in Baltimore, Maryland during 2006–2016 were included. STC records were matched with records from Maryland's Office of the Chief Medical Examiner (OCME). The antemortem and postmortem BAC distributions were compared. After stratifying by antemortem BACs <0.10 versus ≥0.10 g/dL, differences in postmortem and antemortem BACs were plotted as a function of length of hospital stay. Results: Among the 52 decedents, 22 died from transportation-related injuries, 20 died by homicide or intentional assault, and 10 died from other injuries. The median BAC antemortem was 0.10 g/dL and postmortem was 0.06 g/dL. Thirty-one (59.6%) decedents had antemortem BACs ≥0.08 g/dL versus 22 (42.3%) decedents using postmortem BACs. Postmortem BACs were lower than the antemortem BACs for 42 decedents, by an average of 0.07 g/dL. Postmortem BACs were higher than the antemortem BACs for 10 decedents, by an average of 0.06 g/dL. Conclusion: Postmortem BACs were generally lower than antemortem BACs for the fatally injured decedents in this study, though not consistently. More routine antemortem BAC testing, when possible, would improve the surveillance of alcohol involvement in injuries. The findings emphasize the usefulness of routine testing and recording of BACs in acute care facilities. [ABSTRACT FROM AUTHOR]

Deaths in traffic represent a global and multicausal problem. We verified, through a linear regression model, that cognitive abilities (CA) and population indebtedness (PI) predict, together, 56% of the variation of death rates in the traffic (DT) of the twenty-seven states of Brazil. CA's are related to a greater control of the attention and, possibly, to a greater compliance with norms for preventing traffic accidents, has a greater impact than PI on DT, since PI associates to only one deficit of people's attention resources. The decrease of PI and the improvement of CA can decrease DT. [ABSTRACT FROM AUTHOR]

The emergence of coronavirus disease 2019 (COVID-19) has become a worldwide pandemic after its first outbreak in Wuhan, China. However, it remains unclear whether COVID-19 death is linked to ambient air pollutants or meteorological conditions. We collected the daily COVID-19 death number, air quality index (AQI), ambient air pollutant concentrations, and meteorological variables data of Wuhan between Jan 25 and April 7, 2020. The Pearson and Poisson regression models were used accordingly to understand the association between COVID-19 deaths and each risk factor. The daily COVID-19 deaths were positively correlated with AQI (slope = 0.4 ± 0.09, R2 = 0.24, p < 0.01). Detailedly, PM2.5 was the only pollutant exhibiting a positive association (relative risk (RR) = 1.079, 95%CI 1.071–1.086, p < 0.01) with COVID-19 deaths. The PM10, SO2, and CO were all also significantly associated with COVID-19 deaths, but in negative pattern (p < 0.01). Among them, PM10 and CO had the highest and lowest RR, which equaled to 0.952 (95%CI 0.945–0.959) and 0.177 (95%CI 0.131–0.24), respectively. Additionally, temperature was inversely associated with COVID-19 deaths (RR = 0.861, 95%CI 0.851–0.872, p < 0.01). Contrarily, diurnal temperature range was positively associated with COVID-19 deaths (RR = 1.014, 95%CI 1.003–1.025, p < 0.05). The data suggested that PM2.5 and diurnal temperature range are tightly associated with increased COVID-19 deaths. [ABSTRACT FROM AUTHOR]

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A Pandemic is an epidemic at a global scale. The word 'epidemic' has the potential to lead to chaotic, unreasoned responses to health problems, especially when used by journalists. Nigeria like other poor resource countries is equally affected by the current coronavirus disease 2019 (COVID-19) pandemic. Standardization and proper documentation of the mortality of the COVID-19 in the poor-resource countries will help in managing other disease outbreaks in future. This paper calls for improvement in capturing of these data for better planning in the future. Quality data is very essential for policy makers to appreciate any disease condition. In order to present a comprehensive picture of COVID-19 mortality, the deaths were broadly grouped into two as follows: direct and indirect COVID-19 deaths. Most of the current reported deaths seem to be direct deaths. We propose that for better estimation and standardization, verbal autopsy could be used to differentiate direct/indirect COVID deaths. At full development, this model could be applied to other diseases, outbreaks, or pandemics. The disease surveillance officers, and other health workers can be trained in this regard as well as scaling up the e-surveillance of the DSNOs. [ABSTRACT FROM AUTHOR]

There are very few reports on mortality of young southern hairy-nosed wombats. We describe the appearance of six young wombats that died when rainfall was well below average in 2017-19. Some of the wombats appeared malnourished, and most died around the age of weaning, which we conclude is a vulnerable time for them. A crude and lower estimate of the mortality of wombats born in 2016 was 31%. There are very few reports on mortality of young southern hairy-nosed wombats. We describe the appearance of six young wombats that died when rainfall was well below average in late 2017-19. Most of the wombats appeared malnourished and died around the age of weaning, which we conclude is a vulnerable time for them, especially during droughts. A crude and lower estimate of mortality of wombats born in 2016 was 31%. [ABSTRACT FROM AUTHOR]

Background: The objective of this study is to conduct a temporal analysis of rheumatic heart disease (RHD) disease burden trends over a 30-year period (1991 to 2021), focusing on prevalence, deaths, and disability-adjusted life years (DALYs) in the South Asia (SA)., Methods: In this ecological study, we analyzed data regarding burden of RHD from the Global Burden of Diseases (GBD) study spanning the years 1991 to 2021 for the SA Region. Estimates of the number RHD-related prevalence, deaths, and DALYs along with age-standardized rates (ASR) per 100,000 population and 95% uncertainty intervals (UI) were evaluated., Results: The overall prevalent cases of RHD in the 2021 were 54785.1 × 10 3 (43328.4 × 10 3 to 67605.5 × 10 3 ), out of which 14378.8 × 10 3 (11206.9 × 10 3 to 18056.9 × 10 3 ) were from SA. The ASR of point prevalence showed upward trend between 1991 and 2021, at global level and for SA with an average annual percentage change (AAPC) of 0.40 (0.39 to 0.40) and 0.12 (0.11 to 0.13), respectively. The overall number of RHD-related deaths in the 2021 were 373.3 × 10 3 (324.1 × 10 3 to 444.8 × 10 3 ), out of which 215 × 10 3 (176.9 × 10 3 to 287.8 × 10 3 ) were from SA, representing 57.6% of the global deaths. The ASR of deaths also showed downward trend between 1991 and 2021, at global level and for SA with an AAPC of -2.66 (-2.70 to -2.63) and -2.07 (-2.14 to -2.00), respectively. The ASR of DALYs showed downward trend between 1990 and 2019, at global level and for South Asian region with an AAPC of -2.47 (-2.49 to -2.44) and -2.22 (-2.27 to -2.17), respectively., Conclusion: The rising age-standardized prevalence of RHD remains a global concern, especially in South Asia which contribute to over 50% of global RHD-related deaths. Encouragingly, declining trends in RHD-related deaths and DALYs hint at progress in RHD management and treatment on both a global and regional scale., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)

Background: After strict COVID-19-related restrictions were lifted, health systems globally were overwhelmed. Much has been discussed about how health systems could better prepare for future pandemics; however, primary health care (PHC) has been largely ignored., Objective: We aimed to investigate what combined policies PHC could apply to strengthen the health care system via a bottom-up approach, so as to better respond to a public health emergency., Methods: We developed a system dynamics model to replicate Shanghai's response when COVID-19-related restrictions were lifted. We then simulated an alternative PHC-based integrated health system and tested the following three interventions: first contact in PHC with telemedicine services, recommendation to secondary care, and return to PHC for recovery., Results: The simulation results showed that each selected intervention could alleviate hospital overwhelm. Increasing the rate of first contact in PHC with telemedicine increased hospital bed availability by 6% to 12% and reduced the cumulative number of deaths by 35%. More precise recommendations had a limited impact on hospital overwhelm (<1%), but the simulation results showed that underrecommendation (rate: 80%) would result in a 19% increase in cumulative deaths. Increasing the rate of return to PHC from 5% to 20% improved hospital bed availability by 6% to 16% and reduced the cumulative number of deaths by 46%. Moreover, combining all 3 interventions had a multiplier effect; bed availability increased by 683%, and the cumulative number of deaths dropped by 75%., Conclusions: Rather than focusing on the allocation of medical resources in secondary care, we determined that an optimal PHC-based integrated strategy would be to have a 60% rate of first contact in PHC, a 110% recommendation rate, and a 20% rate of return to PHC. This could increase health system resilience during public health emergencies., (© Jiaoling Huang, Ying Qian,Yuge Yan, Hong Liang, Laijun Zhao. Originally published in JMIR Medical Informatics (https://medinform.jmir.org).)

Objectives: To quantify and analyze mortality in patients who die within 30 days of discharge home from a hospital emergency department (ED)., Material and Methods: All patients older than 14 years of age who were discharged home from the ED of a tertiary care hospital over a 5-year period were included. We collected age, sex, and other demographic variables, as well as the Charlson Comorbidity Index (CCI). The outcome variables of interest were 7-day and 30-day mortality and cause of death. Deaths were classified as expected and directly related to the emergency, expected but not directly related, unexpected and directly related, and unexpected and not directly related. A death was classified as an adverse event if it was directly related to a problem of diagnosis or management in the ED, underestimation of severity, or complications of a procedure., Results: Of 519312 patients attended in the ED, 453 599 were discharged home. Of those discharged, 148 died at home within 7 days (32.63 deaths/100 000 discharges) and 355 died within 30 days (78.48 deaths/100 000 discharges). One hundred thirteen deaths (31.8%) were expected and related to the emergency 24.91/100 000), 169 (47.6%) were expected but unrelated 37.26/100 000), 4 (1.1%) were unexpected and related 1.10/100000), and 69 (19.4%) were unexpected and unrelated 15.21/100000). Deaths were considered adverse events related to ED care in 24.2% of the cases. Underestimation of severity was responsible for the highest proportion (10.7%) of such deaths. The median age of patients who died was 83 years, and the median Charlson comorbidity index (CCI) was 6. The most common cause of death was a malignant tumor (23.0%), followed by congestive heart failure (20.2%) and atherosclerotic cardiovascular disease (13.2%). Unexpected deaths related to ED care were significantly related to a higher proportion of adverse events related to diagnosis (P = .001), management (P = .004), and underestimation of severity (P .001)., Conclusion: Early deaths after discharge home from a hospital ED occured in patients of advanced age with concomitant conditions. The main clinical settings were neoplastic and cardiovascular disease. Seven-day and 30-day mortality rates directly related to the emergency visit were low. Adverse events related to ED care played a role in about a quarter of the deaths after discharge.

For more than two decades there has been a continuous rise in opioid overdose related deaths. The majority of the deaths include the age range when, traditionally, individuals are likely to attend college or university. As a result, Vassar College has taken the important initiative and created and implemented a new opioid overdose intervention strategy and action plan called AED+. AED+ expands on the Model of Greater Awareness, Training and Increased Availability of and Accessibility to Life Saving Intervention Devices; a model that was created based on AED devices improving outcomes of out-of-hospital cardiac arrest emergencies. Similar to AED's improving out-of-hospital cardiac arrest outcomes, the + component of the AED+ initiative increases awareness and provides basic, targeted education about naloxone and its use. Furthermore, the education includes information about naloxone's greater availability and its more immediate access across the campus by students, staff, faculty, administrators, and visitors in the event of a suspected opioid overdose. Starting in May 2023, members of the school's Health Service and senior administrative leaders identified it necessary to be proactive and not reactive to managing an opioid overdose in the campus community. Although Vassar College has not recently experienced an opioid overdose, it is confidently projected that these targeted actions will proactively and positively reduce the likelihood of opioid-related fatalities on campus. Furthermore, it is the purpose of this article to share the AED+ model so other colleges and universities can modify it to best fit their unique setting in order to improve opioid overdose outcomes., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Coroners' Prevention of Future Death (PFDs) reports are an under-utilized resource to learn about preventable deaths in England and Wales. We aimed to identify sepsis-related PFDs and explore the causes and concerns in this subset of preventable sepsis deaths., Methods: Four thousand three hundred five reports were acquired from the Courts and Tribunals Judiciary website between July 2013 and November 2022, which were screened for sepsis. Demographic information, coroners concerns and responses to these reports were extracted and analyzed, including a detailed paediatric subgroup analysis., Results: Two hundred sixty-five reports (6% of total PFDs) involved sepsis-related deaths. The most common cause of death in these reports was "sepsis without septic shock" (42%) and the most common site of infection was the respiratory system (18%) followed by gastrointestinal (16%) and skin (13%) infections. Specific pathogens were named in few reports (27%). Many deaths involved multimorbid patients (49%) or those with recent surgery (26%). Coroners named 773 individual concerns, the most frequent were: a failure to keep accurate records or notes (28%), failure in communication or handover (27%) or failure to recognize risk factors or comorbidities (20%). Paediatric cases frequently reported issues with sepsis screening tools (26%). Sepsis PFDs resulted in 421 individual reports being sent, of which 45% received no response. Most organisations who did respond acknowledged concerns and initiated a new change (74%)., Conclusion: Sepsis-related PFDs provide valuable insights into preventable causes of sepsis and identify important sources of improvement in sepsis care. Wider dissemination of findings is vital to learn from these reports., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Background: The purpose of this study is to assess the burden of thyroid cancer over the course of 30 years in 204 countries and territories., Methods: Data from the Global Burden of Disease (GBD) 2019 database was analyzed to extract information on prevalence, deaths, DALYs(disability-adjusted life-years), YLL(years of life los), YLD(years lived with disability), and their corresponding age-standardized rates at global, regional, and national levels. The primary focus of the study was to examine trends in thyroid cancer from 1990 to 2019, specifically looking at the Estimated Annual Percentage Change (EAPC) for ASPR, ASDR, and ASDR. Additionally, the study investigated the relationship between cancer burden and the Socio-Demographic Index (SDI)., Results: Globally, there will be approximately 18.3 million thyroid cancer (TC) cases in 2019; China and the USA are projected to be the most significant with 310,327 and 220,711 cases (16.17 and 14.82 cases per 100,000 people, respectively).Over the period from 1990 to 2019, age-standardized prevalence rates exhibited a global rise, whereas deaths and DALYs saw a decrease(EAPC:1.63, -0.15- -0.14, respectively). Significantly, the age-standardized prevalence rate increased in 21 GBD regions, affecting 195 out of 204 countries or territories. Over the studied period, thyroid cancer cases, deaths, and DALYs were consistently higher among females than males. Furthermore, a higher Socio-demographic Index was associated with increased age-standardized prevalence rates., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Dou, Shi and Jia.)

Background: In Mexico, homicides are the leading cause of death among men aged 15 to 44 years; however, despite their increase in recent decades, the study of this issue is insufficient, given its magnitude and impact. Therefore, this study aimed to characterize the spatial and temporal patterns and associated factors of homicides in Mexico from 2015 to 2022., Methods: An analytical cross-sectional study was conducted, analyzing death records from the National Institute of Statistics and Geography's general mortality databases. Simple frequencies and incidence rates per 100,000 inhabitants by sex, year, and state of the Mexican Republic were calculated. Mortality was evaluated by age groups and geographic areas, and bivariate logistic regression models with sociodemographic variables were performed., Results: Records of 229,182 homicides in Mexico were analyzed, with a median age of 33 years, interquartile range 18. A total of 203,898 (88.96%) were men and 25,284 (11.04%) were women. The majority of deaths occurred in public places and were caused by firearms; women had a higher percentage of homicides at home. States with high incidence rates for both sexes were Chihuahua, Zacatecas, Michoacán, Colima, and Estado de México. The total years of life lost were 9.19 million years. The national incidence of homicides in men showed an upward trend from 2015 to 2019; however, in the case of women, this incidence increased in various age groups during the study period. Occupation, education, marital status, and place of occurrence had significant associations in the logistic regression models., Conclusions: This study provides a spatial-temporal characterization of homicides in Mexico between 2015 and 2022, highlighting the high incidence in men and the upward trend in certain age groups among women. These findings underscore the need for preventive measures and public policies to address this issue in a multisectoral manner.

Background: In response to the harm caused by tobacco use worldwide, the World Health Organization (WHO) World Health Assembly actioned the WHO Framework Convention on Tobacco Control (FCTC) in 2005. To help countries meet their FCTC obligations, the WHO introduced in 2008 the MPOWER policy package and by 2020 the FCTC had been ratified by 182 parties. The package consists of six evidence-based demand reduction smoking cessation policies to assist countries to achieve best practice. We used published evaluation results and replicated the published model to estimate current policy achievement and demonstrate the impact and equity of the MPOWER policy package in reducing the global number of smokers and smoking-attributable deaths (SADs) between 2007 and 2020., Methods: We replicated an evaluation model (the Abridged SimSmoke model) used previously for country impact assessments and validated our replicated reduction in SADs for policies between 2014 and 2016 against the published results. The replicated model was then applied to report on the country level SADs averted from achieving the highest level of implementation, that is best practice in MPOWER policies, between 2016 and 2020. The latest results were then combined with past published results to estimate the reduction in SADs since the commencement of the MPOWER policy package. Country level income status was used to investigate the equity in the uptake of MPOWER policies worldwide., Results: Identical estimates for SADs in 41 out of 56 MPOWER policies implemented in 43 countries suggested good agreement in the model replication. The replicated model overestimated the reduction in SADs by 159,800 (1.5%) out of a total of 10.5 million SADs with three countries contributing to the majority of this replication discrepancy. Updated analysis estimated a reduction of 8.57 million smokers and 3.37 million SADs between 2016 and 2020. Between 2007 and 2020, 136 countries had adopted and maintained at least one MPOWER policy at the highest level which was associated with a reduction in 81.0 million smokers and 28.3 million SADs. Seventy five percent of this reduction was in middle income countries, 20% in high income and less than 5% in low income countries., Conclusions: Considerable progress has been made by MPOWER policies to reduce the prevalence of smokers globally. However, there is inequality in the implementation and maintenance, reach and influence, and the number of SADs averted. Future research to modify the model could provide a more comprehensive evaluation of past and future progress in tobacco control policies, worldwide., (© 2024. The Author(s).)

The epidemiological dynamics of paracoccidioidomycosis (PCM) has been changing over the years. We analyzed secondary public data from the Hospital Information System of the Brazilian Unified Health System (SIH/SUS), focusing on PCM-related hospitalizations and in-hospital deaths. In the period between 2010 and 2019, 396 hospitalizations and 30 deaths were related to PCM among 7 073 334 hospitalizations registered in Rio de Janeiro. We highlight the rising rates, reflecting the increase in the number of acute forms previously reported. Urgent public health policies are essential to prevent poor outcomes related to this neglected mycosis., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.)

Objectives: The objective of this experiment was to evaluate the spatial pattern and temporal trend of colorectal cancer (CRC) burden attributed to dietary risk factors in China from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019., Methods: Numbers and age-standardised rates of deaths, disability-adjusted life years (DALYs) and corresponding average annual percentage change (AAPC) were determined. The joinpoint regression analysis was used to assess the temporal trends of CRC deaths and DALYs from 1990 to 2019., Results: In China, the number of diet-attributable CRC deaths and DALYs in 2019 were 90.41 (95% uncertainty interval: 65.69, 114.67) and 2234.06 (1609.96, 2831.24) per-1000 population, marking 2.05% and 1.68% annual increases since 1990, respectively. The region with the highest increase in age-standardised rates (ASRs) of diet-related CRC deaths and DALYs was in Taiwan with an AAPC of 2.00% (1.51, 2.48), whereas the highest decline in ASRs of CRC deaths and DALYs was observed in Hong Kong with an AAPC of -0.63% (-0.90, -0.35) (all P < 0.05). Nationally, men suffered higher CRC deaths and DALY burdens attributable to dietary risks than did women. Regarding the specific diet group, diets low in calcium, milk, and whole grains contributed to CRC deaths and DALYs the most., Conclusions: Diet is an important contributor to increasing CRC burden in China. Necessary measures should be taken to kerb the growing burden attributed to dietary factors, particularly in males and in regions with middle Socio-demographic Index or lower., (Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Objective: This study was undertaken to characterize changes in health care utilization and mortality for people with epilepsy (PWE) during the COVID-19 pandemic., Methods: We performed a retrospective study using linked, individual-level, population-scale anonymized health data from the Secure Anonymised Information Linkage databank. We identified PWE living in Wales during the study "pandemic period" (January 1, 2020-June 30, 2021) and during a "prepandemic" period (January 1, 2016-December 31, 2019). We compared prepandemic health care utilization, status epilepticus, and mortality rates with corresponding pandemic rates for PWE and people without epilepsy (PWOE). We performed subgroup analyses on children (<18 years old), older people (>65 years old), those with intellectual disability, and those living in the most deprived areas. We used Poisson models to calculate adjusted rate ratios (RRs)., Results: We identified 27 279 PWE who had significantly higher rates of hospital (50.3 visits/1000 patient months), emergency department (55.7), and outpatient attendance (172.4) when compared to PWOE (corresponding figures: 25.7, 25.2, and 87.0) in the prepandemic period. Hospital and epilepsy-related hospital admissions, and emergency department and outpatient attendances all reduced significantly for PWE (and all subgroups) during the pandemic period. RRs [95% confidence intervals (CIs)] for pandemic versus prepandemic periods were .70 [.69-.72], .77 [.73-.81], .78 [.77-.79], and .80 [.79-.81]. The corresponding rates also reduced for PWOE. New epilepsy diagnosis rates decreased during the pandemic compared with the prepandemic period (2.3/100 000/month cf. 3.1/100 000/month, RR = .73, 95% CI = .68-.78). Both all-cause deaths and deaths with epilepsy recorded on the death certificate increased for PWE during the pandemic (RR = 1.07, 95% CI = .997-1.145 and RR = 2.44, 95% CI = 2.12-2.81). When removing COVID deaths, RRs were .88 (95% CI = .81-.95) and 1.29 (95% CI = 1.08-1.53). Status epilepticus rates did not change significantly during the pandemic (RR = .95, 95% CI = .78-1.15)., Significance: All-cause non-COVID deaths did not increase but non-COVID deaths associated with epilepsy did increase for PWE during the COVID-19 pandemic. The longer term effects of the decrease in new epilepsy diagnoses and health care utilization and increase in deaths associated with epilepsy need further research., (© 2024 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)

This paper discusses the impact of a series of psychological phenomena on the U.S. response to COVID-19, focusing on forecasts of cases and deaths. The specific phenomena comprise unrealistic optimism bias, overconfidence, anchoring and adjustment, representativeness, motivated reasoning, and groupthink.

The burden of end of life in Internal Medicine wards is not neglegible. However, literature evidence about end of life care in Internal Medicine wards lacks. Therefore, the aim of this study was to report on end of life management in a Internal Medicine ward. We performed a retrospective study focusing on characteristics and management of patients consecutively died in an italian Internal Medicine ward between 2018, July-1 and 2019, June-30. Demographic, co-morbidity, pharmacological treatment at hospital admission and in the last 48- hours of life and procedures during hospital stay were collected. Study population was composed by 354 patients (190 females), corresponding to about ten percent of patients admitted in the ward, with mean age ± DS 83.5 ± 10.6 years. Eighty-four percent of deaths was exepected in the last 48 hours before exitus. The main co-morbidities were blood hypertension (66.3 %), solid or haematological malignancies (40.3%), arhythmias (34.7%), pressure ulcers (31.3%) and diabetes (27.4%). The main causes of hospitalization were infectious diseases (23.1%) and cardiac or respiratory failure (20.9%). In seven percent of patients palliative cares had been already activated before the hospital admission. No patient had written living wills or advance directives. In the last 48 hours of life, the main phramacological classes prescribed were opioids (63.2%), antibiotics (46.9%) and corticosteroids (46.3%). Compared with pharmacological classes prescribed at hospital admission, in the last 48 hours of life the prescription of antibiotics, corticosteroids, opioids and benzodiazepines was significantly increased, whereas the prescription of antihypertensive agents, proton pump inhibitors and antithrombotic drugs resulted significantly reduced. Written order to withdrawal of vital parameters relevation or active treatment were found in 30.7% and 31.9%, respectively. In the last 48 hours of life, 61% of patients underwent to at least one blood assay, 34% arterial blood gas analysis and about 35% at least one of radiography, computer tomography, magnetic resonance or endoscopy. During hospital stay 9% of patients underwent to blood transfusion. Of them 28.1% of patients received blood transfusion in the last 48 hours of life. Appropriate management of end of life represents a challenge in Internal Medicine wards.

On 9 March 2020, Italy passed the Prime Minister's Decree n. 648, establishing urgent measures to contain the transmission of COVID-19 and prevent biological hazards, including very restrictive interventions on public Holy Masses and funerals. Italy banned burial procedures based (i) on the recent acknowledgment about the virus environmental stability as well as (ii) its national civil contingency plan. Hence, only the cremation process is admitted for COVID-19 deaths. Viewing of the body is permitted only for mourners, which are allowed to perform the prayer at the closing of the coffin and the prayer at the tomb (cf. Rite of Succession, first part n. 3 and n. 5). The dead cannot be buried in their personal clothes; however, priests have been authorized to put the family clothes on top of the corpse, as if they were dressed. Burying personal items is also illegal. The dignity of the dead, their cultural and religious traditions, and their families should be always respected and protected. Among all the threats, COVID-19 epidemic in Italy revealed the fragility of human beings under enforced isolation and, for the first time, the painful deprivation of families to accompany their loved ones to the last farewell. Ethics poses new challenges in times of epidemics.

In 2018, there were more than 371 million cigarette smokers and 12. 6 million electronic cigarette users, with 340.2 million non-smokers exposed to secondhand smoke (SHS) in China, which resulted in heavy tobacco-attributable disease burden. According to the definition by the Global Burden of Disease Study 2017 (GBD 2017), tobacco is a level 2 risk factor that consists of three sublevel risk factors, namely, smoking, SHS, and chewing tobacco. In this study, we aimed to evaluate the trends in deaths and disability-adjusted life years (DALYs) attributable to tobacco, smoking, SHS, and chewing tobacco by sex in China from 1990 to 2017 and to explore the leading causes of tobacco-attributable deaths and DALYs using data from the GBD 2017. From 1990 to 2017, the tobacco-attributable death rates per 100,000 people decreased from 75.65 [95% uncertainty interval (95% UI) = 56.23–97.74] to 70.90 (95% UI = 59.67–83.72) in females and increased from 198.83 (95% UI = 181.39–217.47) to 292.39 (95% UI = 271.28–313.76) in males. From 1990 to 2017, the tobacco-attributable DALY rates decreased from 2209.11 (95% UI = 1678.63–2791.91) to 1489.05 (95% UI = 1237.65–1752.57) in females and increased from 5650.42 (95% UI = 5070.06–6264.39) to 6994.02 (95% UI = 6489.84–7558.41) in males. In 2017, the tobacco-attributable deaths in China were concentrated on chronic obstructive pulmonary disease, ischemic heart disease, lung cancer, and stroke. The focus of tobacco control for females was SHS in 1990, whereas smoking and SHS were equally important for tobacco control in females in 2017. Increasing tobacco taxes and prices may be the most effective and feasible measure to reduce tobacco-attributable disease burdens.

Introduction: In December 2019, cases of pneumonia of unknown cause arose in Wuhan, China. The causative agent was subsequently identified as 2019-nCoV and later called SARS-CoV-2. In Mexico, since January 2020 when the first cases were reported, the spread of the infection has occurred throughout the country. The state of Guanajuato, which is located in the center of the country, has taken isolation measures and closed public places in March 2020. The objective of this study was to analyze the evolution, symptoms, co-morbidities and deaths due to confirmed cases of COVID-19. Methods: An ecological study was designed from the database of confirmed cases of COVID-19 in the state of Guanajuato. Odds ratios and 95% confidence intervals were calculated for symptoms and co-morbidities in deaths of confirmed cases. Logistic regression models were generated adjusting for age group and gender. Results: Among the 838 confirmed cases in the state, cases with dyspnea and cyanosis showed more significant effect on death. Age group and gender had little involvement as confounders. For practically all comorbidities (including diabetes, hypertension, cardiovascular disease, chronic kidney disease, and immunosuppression), there was a significant effect (odds ratio greater than 2) on mortality from COVID-19. Age group showed a confounding effect on comorbidities and death, but not gender. Conclusion: The confirmed cases had more than twice the possibility of having comorbidities, compared with those who did not die.

ABSTRACT Age, sex and presence of comorbidities are risk factors associated with COVID-19. Hypertension, diabetes and heart disease are the most common comorbidities in patients with COVID-19. The objective of this study was to estimate the prevalence of patients with comorbidities who died of COVID-19 in Brazil. Searches of data were carried out on the official pages of the 26 State health departments and the federal district. The random-effect method was used to calculate the prevalence of patients with comorbidities who died. From the beginning of the pandemic in Brazil until May 20, 2020, 276,703 cases of COVID-19 were notified in Brazil, 6.4% died, 58.6% of whom were male. The prevalence of comorbidities among deaths was 83% (95% CI: 79 - 87), with heart disease and diabetes being the most prevalent. To our knowledge, this study represents the first large analysis of cases of patients with confirmed COVID-19 in Brazil. There is a high prevalence of comorbidities (83%) among patients who died from COVID-19 in Brazil, with heart disease being the most prevalent. This is important considering the possible secondary effects produced by drugs such as hydroxychloroquine.

The article presents infant mortality in Polish historical research and points towards more important works focusing on the above issue. The author analyses approximately seventy academic works in order to answer the fundamental question as to what extent they deal with the issue of deaths in children under the age of one. The research shows that, in particular groups of research papers, infant mortality is most often presented in a general and formulaic manner. A dozen or so papers present this problem as a side issue in their research and only a few Polish studies have infant mortality as their main issue and discuss it in a multi-faceted and broader context.

Abstract Background Chikungunya virus infection in neonates is relatively rare and can lead to death. Case presentation We report the occurrence of the first death of a mother and child after probable vertical transmission of chikungunya virus in Brazil. A 28-year-old pregnant woman with hypertension presented with symptoms compatible with an arboviral disease at 34 weeks’ gestation. She developed preeclampsia with severe respiratory failure which resulted in the emergency cesarean section, and the patient died 12 days after the onset of symptoms. The pre-term newborn weighed 2535 g, with an Apgar score of 4/8. He was referred to the neonatal ICU with neutrophilia and thrombocytopenia, several seizure episodes, and hemorrhagic disorders, which resulted in death. Chikungunya IgM antibody was detected in the cerebrospinal fluid. Conclusions We present the first documented maternal and neonatal death in Brazil after probable chikungunya infection during pregnancy.

Abstract Background The abortion law in Cameroon is highly restrictive. The law permits induced abortions only when the woman’s life is at risk, to preserve her physical and mental health, and on grounds of rape or incest. Unsafe abortions remain rampant with however rare reported cases of persecution, even when these abortions are proven to have been carried out illegally. Discussion Available public health interventions are cheap and feasible (Misoprostol and Manual Vacuum Aspiration in post abortion care, modern contraception, post-abortion counseling), and must be implemented to reduce unacceptably high maternal mortality rates in the country which still stand at as high as 596/100.000. Changes in the legal status of abortions might take a long time to come by. Albeit, advocacy efforts must be reinforced to render the law more liberal to permit women to seek safe abortion services. The frequency of abortions, generally clandestine, in this restrictive legal atmosphere has adverse economic, health and social justice implications. Conclusion We argue that a non-optimal or restrictive legal atmosphere is not an acceptable excuse to justify these high maternal deaths resulting from unsafe abortions, especially in Cameroon where unsafe abortions remain rampant. Implementing currently available, cheap and effective evidence based practice guidelines are possible in the country. Expansion and use of Manual Vacuum Aspiration kits in health care facilities, post-abortion misoprostol and carefully considering the content of post abortion counseling packages deserve keen attention. More large scale qualitative and quantitative studies nationwide to identify and act on context specific barriers to contraception use and abortion related stigma are urgently needed.

Abstract Background Snakebites are a major cause of mortality and morbidity worldwide with the highest mortality burden in poor rural areas of sub-Saharan Africa. Inadequate surveillance systems result in loss of morbidity and mortality data in these settings. Although rarely reported in these resource-constraint environments, community-based audits are recognised pivotal tools which could help update existing data and indicate key public health interventions to curb snakebite-related mortality. Herein, we present two cases of snakebite-related deaths in a rural Cameroonian community. Case presentations The first case was a 3-year-old female who presented at a primary care health centre and was later referred due to absence of antivenom serum (AVS). However, she had an early fatal outcome before getting to the referral hospital. The second case was an 80-year-old traditional healer who got bitten while attempting to kill a snake. He died before hospital presentation. Conclusion Community-based audits help identify key intervention points to curb snakebite mortality in high-risk rural areas like ours. From our audits, we note a remarkable absence of affordable AVS in rural health facilities in Cameroon. We recommend frequent community health education sessions on preventing snakebites; continuous training modules for health personnel from high-risk areas; training traditional healers on the importance of AVS in managing cases of snakebite envenoming, and the need for timely hospital presentation; and setting up context-specific approaches to rapidly transport snakebite victims to hospitals.

Of patients with multidrug-resistant tuberculosis (MDR TB),

We used national statistics from 1983–2015 to evaluate trends in mortality caused by infectious diseases in South Korea. Age-standardized mortality from infectious disease decreased from 43.5/100,000 population in 1983 to 16.5/100,000 in 1996, and then increased to 44.6/100,000 in 2015. Tuberculosis was the most common cause of death in 1983 and respiratory tract infections in 2015. We observed a significant decline in infant deaths caused by infectious diseases, but mortality in persons age >65 years increased from 135 deaths/100,000 population in 1996 to 307/100,000 in 2015. The relative inequality indices for respiratory tract infections, sepsis, and tuberculosis tended to increase over time. Although substantial progress has been achieved in terms of infant mortality, death rates from infectious disease has not decreased overall. Elderly populations with lower education levels and subgroups susceptible to respiratory infections and sepsis should be the focus of preventive policies.

Introduction: Deaths from traffic accidents (RTIs) are a major public health problem in all societies, especially in the low and middle-income countries; the present study was conducted to investigate the epidemiology of fatal road traffic accidents in Ahvaz city. Methods: This is a cross-sectional study which included all deaths from RTIs in Ahvaz province (Southwest Iran) admitted to forensic medicine during 2015-2016. ICD-10 was used as diagnostic criteria. Demographic variables as well as injury circumstance) name, surname, phone number, age, sex, season, month, day, accident location, vehicle type, status of the injured person (were recorded by trained research team in forensic medicine. Descriptive data are reported. SPSS 20 software was used for analysis of data. Results: During years 2015-2016, a total of 50 deaths occurred due to road accidents in Ahvaz province. The mean age was 34.99 ± 19.98 years. The mortality rate was higher in men (79.4%), married subjects (57.4%), illiterate ones (26.2%), self-employed subjects (34.6%) and residents of urban areas (78.8%). There were statistically significant relationships between the accident location and the place of death, and between the trauma spot and the cause of death (P Conclusion: The results of this study showed that most of the deceased were male, married and young, so preventive measures such as precise traffic surveillance and enforcement of the regulations for safe driving are considered essential.

The interpretation of post-mortem human tissue toxicology levels may be affected by the sampling site chosen. It is important to bear this in mind when looking at the psychoactive constituents of khat (Catha edulis Forsk) that have been consumed and have contributed to or caused death.The post-mortem levels of cathine, cathinone and norephedrine/ norpseudoephedrine are very rarely reported, thereby making it impossible for toxicologists, pathologists and others investigating khat-related fatalities to decide if a level is toxic or fatal. This paper presents all the published data that exists to help start documenting this neglected area. Such information should be collected and reported on a systematic basis to facilitate correct interpretations in the future.