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Objective To compare avoidable mortality for causes amenable to medical care and suicide in physicians versus other professionals with similar university studies and socioeconomic position in Spain. Methods All people aged 25–64 years who were employed on 1 November 2001 (8,697,387 men and 5,282,611 women) were included. Their vital status was followed for 10 years and the cause of death of deceased was recorded. Using a Poisson regression to estimate the mortality rate ratio (MRR), we compared mortality due to causes of death amenable to medical care, all other causes, and suicide in physicians versus other professionals. Mortality in physicians was used as a reference. Results The lowest MRR for causes amenable to medical care was observed in engineers/architects (men: 0.84, 95% confidence interval [CI] 0.72, 0.97; women: 0.93, 95% CI 0.64, 1.35) and healthcare professions other than physicians/pharmacists/nurses (men: 0.86, 95% CI 0.56, 1.34; women: 0.69, 95% CI 0.32, 1.46). Regarding mortality for all other causes of death, professionals from these and other occupations presented lower mortality than physicians. Other healthcare professions, entrepreneurs, and managers/executives completed suicide at a higher rate than physicians. Conclusion Although the accessibility to the healthcare system and to the pharmacological drugs could suggest that physicians would present low rates for causes amenable to medical care and high rates of suicide, our results show that this is not the case in Spain.

Objectives: The recent publication of additional data retrieval for patients missing week 52 vital status in the original analyses of the ETHOS study provides the urgent need of updating previous network meta-analyses (NMA) to produce stronger evidence on mortality in patients receiving dual and triple FDCs according with the level of ICS dose. Methods: A NMA was performed to compare the effect of ICS/LABA/LAMA, ICS/LABA, and LABA/LAMA FDCs administered via the same inhaler device in COPD patients. The number need to treat (NNT) was also calculated. Results: When considering on-treatment all-cause of death (analyzed patients: 18,864), MD ICS/LABA/LAMA and MD ICS/LABA FDCs significantly reduced the risk of mortality vs. LABA/LAMA FDC (RR 0.59 95%CrI 0.35–0.97 and 0.61 95%CrI 0.38–0.99 respectively, P

Animal experiment findings suggest that high doses of ionizing radiation exposure (>1.0 Gy) may cause genetic and epigenetic effects in offspring. However, epidemiological studies of offspring of radiation-exposed parents did not find increased risks of any health effects. Findings of cellular/experimental investigations and studies of human health effects are contradicting, and further investigations are needed to help resolve ambiguities using updated and/or improved data. This paper provides a detailed description of a database of families of workers of the first Russian nuclear facility, Mayak Production Association, located in the Southern Urals in the Chelyabinsk region close to Ozyorsk city, which started its operation in 1948 and today consists of reactors, radiochemical and plutonium production plants, and auxiliary facilities. The Mayak worker cohort includes 22,377 individuals (25% females) who were hired at one of the main Mayak PA facilities between 1948 and 1982 and were externally or internally exposed to ionizing radiation over prolonged periods. Advantages of the cohort include its large size, extensive follow-up period (70 y), individually measured doses from external and internal exposure and the wide range of these doses, heterogeneity by gender/age/ethnicity/initial health status, complete data on vital status and causes of death, available medical information on morbidity and reproduction, available data on non-radiation factors, and stored biological specimens donated by more than one-third of the cohort members. Based on medical and dosimetry database "Clinics" containing raw data on workers of the study cohort, the Mayak workers' family and offspring database was created. To date, it comprises 12,195 family couples (a husband and a wife) and 16,585 offspring. Biological specimens are available for more than 1,000 family triads (a husband, a wife, and their child). Stages of assembling the database and its descriptive characteristics are presented in this paper. Examples of potential applications of the database for investigations of non-targeted and transgenerational radiation effects in offspring of exposed parents are discussed.

OBJECTIVES To update the U.S. portion of an historical cohort mortality study of workers with potential exposure to chloroprene (CD) and vinyl chloride (VC) with focus on lung and liver cancer. METHODS Subjects were 6864 workers from two sites with vital status determined through 2017 for 99% of subjects and cause of death for 97.2% of deaths. Historical exposures to CD and VC were estimated quantitatively. We performed external and internal mortality comparisons. RESULTS External comparisons revealed mostly deficits in deaths; internal comparisons revealed no consistent evidence of exposure-response relationships with CD or VC. CONCLUSIONS Our update continues to support the conclusion that the risk of death from lung or liver cancer is unrelated to exposure to CD or VC at levels experienced by workers in the two U.S. sites.

Objective To study the adherence of an Early Inpatient Exercise Program in patients with acute hip fracture, identify variables associated with its performance, and its association to one-year survival. Methods Observational longitudinal study of a cohort of 509 patients, admitted consecutively with a hip fracture in La Paz University Hospital (Madrid, Spain). Data included sociodemographic variables, pre-fracture physical functioning, cognitive impairment, comorbidities, measure of exercise adherence (pre-surgery exercise, post-surgery exercise, and rehabilitation sessions) and vital status at follow-up. One year after the fracture, either patients or relatives were contacted by telephone to ascertain their vital status. Data were analyzed using logistic regressions and multivariate Cox proportional hazards regression. Results Three quarters of patients (76.0%) were able to comply with the Early Inpatient Exercise Program. Factors associated with adherence were: living at home (Odds Ratio (OR) = 3.39; 95% Confidence Interval (CI): 2.03, 5.64), absence of pre-fracture disability (OR = 3.78; 95% CI: 2.21, 6.47), absence of pre-fracture cognitive impairment (OR = 2.36; 95% CI: 1.36, 4.07) and comorbidities (OR = 1.66; 95% CI: 1.03, 2.67). Early Inpatient Exercise Program adherence was associated with one-year survival (HR = 1.62; 95% CI: 1.06, 2.49). Conclusions The adherence with an Early Inpatient Exercise Program is high and is associated with 1-year survival. It is important to make a stronger effort to encourage participation in Early Inpatient Exercise Program in the 24% currently non-compliant, and in those with cognitive and physical impairments.

Corona virus disease 2019 (COVID-19) was declared as global pandemic and caused devastating crisis in society. Despite of the growing pandemic, high quality medical services toward gynaecologic oncology patients must continue without overlooking the safety of medical staffs. Reducing risk is crucial and achieved by limiting high risk situations. The decision to perform or postpone surgery should be made based on the type and stage of the disease, medical condition of the patient, area census of COVID-19 cases, COVID-associated risks, and available logistic support including adjuvant treatment services. There are several recommendation for gynaecology cancer treatment published by several countries. However, those guidelines cannot be applied to every country across the globe because of the different situations of COVID-19 therefore we proposed guidelines for Indonesia. Surgical management for confiermed COVID-19 case should be postponed for at least 15 days for nonemergency cases. Surgery must be performed immediately for emergency cases such as Haemorrhage with unstable vital status refractory to transfusion, viscus perforation, signs of bowel obstruction refractory to conservative treatment, closed loop bowel or large bowel obstruction, hydatiform mole for live saving procedure. Keywords: COVID-19, gynaecology cancer, surgical management

Защитные лесные насаждения играют важную роль в стабилизации экологических систем. Хозяйственная деятельность человека по мере своего развития привела к усилению антропогенного воздействия на природную среду, в том числе на лесные экосистемы. Целью работы являлась оценка состояния культур сосны на территории Бугульминско-Белебеевской возвышенности, Белорецкого района и Южного промышленного узла в пределах Республики Башкортостан. В задачи работы входили: выбор пробных площадей, лесотаксационная характеристика культур сосны на исследуемой территории, оценка жизненного состояния сосняков. Оценку состояния лесных культур на пробных площадях производили расчетным путем, используя общепринятую методику В.А. Алексеева (1990). Исходя из проведенных исследований, получили следующие выводы: наиболее благоприятные условия развития сосняков наблюдаются на Бугульмино-Белебеевской возвышенности и в Белорецком районе, где минимизировано антропогенное влияние. Соответственно, в пределах Южного промышленного узла сосновые насаждения подвержены негативному антропогенному воздействию. Окружающая среда, которая изменяется благодаря деятельности человека, оказывает сильное влияние на состояние лесных экосистем., The protective forest stands play an important role in stabilizing ecological systems. Human economic activities, as they develop, have led to an increased anthropogenic impact on the nature, including forest ecosystems. The purpose of the work was to assess the state of pine crops in the territory of Bugulma-Belebey Upland, the Beloretsky District and the Southern Industrial Hub. The tasks of the work included: selection of trial areas, forest-taxing characteristics of pine crops in the study area, assessment of the living condition of pine trees. The assessment of the state of forest crops on trial areas was performed by calculation using the generally accepted method by V.A. Alekseev (1990). Due to the conducted research, the following conclusions were obtained: the most favorable conditions are observed on Bugulma-Belebey Upland and in the Beloretsky District, where the anthropogenic impact is minimized. Accordingly, the pine stands in the Southern Industrial Hub are subject to negative human impact. The environment, which is changing due to human activities, strongly affects the state of forests.

Supervising anesthesiologists oversee junior anesthesiologists in several operating rooms to instruct and provide advice, and hence ensure high patient safety. Supervisors benefit from good situation awareness but accessing information about multiple patients can be challenging. In a user-centered design process, we have developed an interface concept for a head-worn display (HWD) to support multi-patient monitoring. The design includes data about the patients’ physiology, vital status, vital trends, and medications. We conducted an exploratory evaluation of a prototype in a high-fidelity medical simulation with six supervising anesthesiologists. Our results show that the supervisors’ situation awareness of all simulated operations improved because participants noticed and responded to multiple events over the course of the scenario. However, the supervisors reported increased mental workload due to the constant availability of patient data. We discuss insights about the HWD display, the design process, and the experience and views of staff on using the HWD.

The workforce is aging in most developed countries. Simultaneously, the parents of workers nearing retirement age are more likely to still be alive and in need of care. This study investigated the association between retirement transition and parental vital status in Sweden. The data were derived from Swedish population registers of women and men born between 1940 and 1945. A discrete-time survival analysis using complementary log-log functions was employed. The outcome was individuals’ retirement transition, and the main dependent variable was parental vital status, e.g., whether the mother, father or both parents were alive in the year that the individual retired. We also controlled for whether either one or both parents recently died prior to the retirement transition. This study’s findings indicate that the parental vital status has an independent, but relatively small, influence on individuals’ retirement transition and that the association is somewhat stronger and more consistent among women than men, particularly women with only a living mother or father (approximately 8 and 6% higher risk of retirement, respectively). Additionally, women had a higher risk of retirement during the immediate period after parental death, especially when the father was widowed (9% higher risk). In contrast, men had a 9% higher risk of retiring when either the mother or father had been widowed for some years. Moreover, siblings seem to moderate the effect of retirement, and the pattern was most noticeable among women. Overall, the risk of retirement was greater among individuals without siblings with both living parents or only a living mother or father. These findings indicate that individuals with parents who are vulnerable due to widowhood are able to work longer if they have larger families, which is consistent with the caregiving explanation. This relationship was more evident among women, providing support for the conclusion that care provision for parents may motivate labor force disengagement in the form of retirement.

Aim The objective of the present study was to evaluate the effect of dynapenia, central obesity and the presence of chronic diseases in 8-year mortality of community-dwelling older adults. Methods Participants comprised 610 older adults, aged ≥65 years at baseline, who participated in the "Frailty in Brazilian Older People" study carried out in 2008. Baseline data, such as weight, height, waist circumference, muscle strength, sex, self-reported diseases and physical activity, were assessed. Vital status in 2016 was assessed by Mortality Information System database of Campinas. The χ2 -test and Mann-Whitney U-test were used to compare categorical and continuous variables, respectively. Path analysis was carried out to study the factors associated with mortality. Results There was a statistical difference between alive and deceased groups for the variables sex, age group, physical activity, waist circumference and dynapenia. Path analysis explored the relationship among the studied variables. Direct paths showed a positive association to mortality for those who presented the combination of more diseases (β = 0.105), male sex (β = 0.108), low physical activity (β = 0.121), low handgrip strength (β = 0.090) and no central obesity (β = -0.143). When indirect paths were concerned, variables "central obesity", the presence of "more diseases" and dynapenia had a mediator role. Conclusions Central obesity was not positively associated with higher mortality, unless it was associated with the presence of chronic diseases. Dynapenia showed a direct effect on mortality, but not combined with central obesity. The findings of this study shed light on complex relationships between nutritional status and elderly mortality through the use of simple measurements. Geriatr Gerontol Int 2019; 19: 108-112.

Background HIV programs are often assessed by the proportion of patients who are alive and retained in care; however some patients are categorized as lost to follow-up (LTF) and have unknown vital status. LTF is not an outcome but a mixed category of patients who have undocumented death, transfer and disengagement from care. Estimating vital status (dead versus alive) among this category is critical for survival analyses and program evaluation. Methods We used three methods to estimate survival in the cohort and to ascertain factors associated with death among the first cohort of HIV positive patients to receive antiretroviral therapy in Haiti: complete case (CC) (drops missing), Inverse Probability Weights (IPW) (uses tracking data) and Multiple Imputation with Chained Equations (MICE) (imputes missing data). Logistic regression was used to calculate odds ratios and 95% confidence intervals for adjusted models for death at 10 years. The logistic regression models controlled for sex, age, severe poverty (living on

There were 1.7 million HIV/AIDS-related deaths worldwide. The low retention of patients in care was a hindrance to their treatment. The objective of this study was to establish the epidemiological profile of patients, to implement “tracking” and to evaluate its effectiveness. This is a descriptive and analytical retrospective study of all patients living with HIV/AIDS enrolled from 2004 to 2012 by the non-governmental organization ACONDA-VSCI. It consisted of a series of phone calls and home visits. Results showed that 71% of the 51.703 patients enrolled were female with a sex-ratio (F/M) of 2.5. The average age of patients was 33±13 years. 47% of the patients enrolled had an unknown vital status in 2011 and only 42% of them had a telephone number. In addition, 11% of patients with unknown vital status were contacted and reintegrated into the care system. Multivariate regression analysis showed that the lack of awareness of status in patients was related to elevated CD4s, and having spent more than three years in a health center. On the other hand, being in a relationship and living in a rural area was a protective factor against the lack of knowledge of status. At the end of this study, it appears that the tracking method is an excellent method of combating the loss of sight of patients. However, it must be carried out routinely as a method of health vigilance and not a health emergency.

Monitoring the structure parameters and damage to trees plays an important role in forest management. Remote-sensing data collected by an unmanned aerial vehicle (UAV) provides valuable resources to improve the efficiency of decision making. In this work, we propose an approach to enhance algorithms for species classification and assessment of the vital status of forest stands by using automated individual tree crowns delineation (ITCD). The approach can be potentially used for inventory and identifying the health status of trees in regional-scale forest areas. The proposed ITCD algorithm goes through three stages: preprocessing (contrast enhancement), crown segmentation based on wavelet transformation and morphological operations, and boundaries detection. The performance of the ITCD algorithm was demonstrated for different test plots containing homogeneous and complex structured forest stands. For typical scenes, the crown contouring accuracy is about 95%. The pixel-by-pixel classification is based on the ensemble supervised classification method error correcting output codes with the Gaussian kernel support vector machine chosen as a binary learner. We demonstrated that pixel-by-pixel species classification of multi-spectral images can be performed with a total error of about 1%, which is significantly less than by processing RGB images. The advantage of the proposed approach lies in the combined processing of multispectral and RGB photo images., National Science Program “Environmental Protection and Reduction of Risks of Adverse Events and Natural Disasters”, approved by the Resolution of the Council of Ministers № 577/17.08.2018 and supported by the Ministry of Education and Science (MES) of Bulgaria (Agreement № D01-363/17.12.2020), Russian Foundation for Basic Research (RFBR) with projects no. 19-01-00215 and no. 20-07-00370, Moscow Center for Fundamental and Applied Mathematics (Agreement 075-15-2019-1624 with the Ministry of Education and Science of the Russian Federation; MESRF)

В Тарногском районе Вологодской области проведено исследование по оценке влияния изменений среды после лесозаготовок на количество и интенсивность роста хвойного подроста в высоту. Приводятся данные лесоводственно-таксационной характеристики объектов исследования до лесозаготовок разных видов. Сделано заключение об энергии роста хвойного подроста на объектах лесозаготовок с применением разных технологий удаления древостоев., In the Tarnogsky district of the Vologda region, a study was carried out to assess the impact of environmental changes after logging on the number and intensity of growth of coniferous undergrowth in height. The data of silvicultural-taxation characteristics of the research objects prior to logging of different types are presented. A conclusion was made about the growth energy of coniferous undergrowth at logging sites using different technologies for removing stands.

IntroductionStudies of select groups (e.g. pre-industrial or subsistence farming populations) suggest that children had improved survival if their grandparents were alive, particularly maternal grandmothers (MGMs). This question is unanswered for Aboriginal Australian communities, where care of children is commonly shared by extended family members, and it is not known if this association holds for physical health in addition to mortality. Objectives and ApproachWe examined relationships between the health of Aboriginal children born in Western Australia from 2000 to 2013 and the health and vital status of their grandparents. Birth, death, inpatient hospital and emergency department records of all Aboriginal children and their grandparents were linked. Grandparents were categorised as ‘healthy’ (alive with Charlson comorbidity index score of 0 or 1), ‘unhealthy’ (alive with a score of 2 or more), or dead when the child was born. Results27,425 Aboriginal children linked to their MGM (at a minimum). Mortality up to age 2 was lower with healthy grandparents than unhealthy or dead grandparents (e.g. 11 deaths per 1000 live births with healthy MGM; 22 with unhealthy MGMs and 16 with dead MGMs). Children also had fewer acute healthcare contacts (e.g. 13% with healthy MGMs spent at least 7 days in hospital in their first 2 years compared with 19% with unhealthy or dead MGMs). However, healthcare contacts was largely unrelated to grandfathers. Outcomes were also associated with the number of living grandmothers. (e.g. 1.5% of children with 2 grandmothers were discharged against medical advice in their first 2 years, compared to 2.7% with one healthy grandmother and 3.7% with no grandmothers). Conclusion / ImplicationsChildren with healthy grandmothers have lower mortality and morbidity, possibly because of their care giving. These associations are unlikely to be due to genetic or environmental factors, as they are weaker or missing for grandfathers.

Background: A low vitamin D and K status has been associated with increased cardiovascular disease (CVD) risk but the evidence of their combined effect on cardiovascular health is limited.Objectives: Our study aimed to investigate the prospective association of vitamin D and K status with subclinical measures of cardiovascular health and all-cause mortality among a population of Dutch Caucasians.Methods: We performed an observational prospective study on 601 participants of the Hoorn Study (mean +/- SD age: 70 +/- 6 y, 50.4% women, BMI: 27.2 +/- 4.0 kg/m(2)), of whom 321 underwent an echocardiogram in 2000-2001 and 2007-2009. Vitamin D and K status was assessed at baseline by serum 25-hydroxyvitamin D [25(OH)D] and plasma desphospho-uncarboxylated matrix-gla protein (dp-ucMGP)-high concentrations indicate low vitamin K status. Vital status was assessed from baseline until 2018. We studied the association of categories of 25(OH)D (stratified by the clinical cutoff of 50 mmol/L) and dp-ucMGP (stratified by the median value of 568 pmol/L) with echocardiographic measures using linear regression and with all-cause mortality using Cox regression, adjusted for confounders.Results: Compared with markers of normal vitamin D and K status, markers of low vitamin D and K status were prospectively associated with increased left ventricular mass index (5.9 g/m(2.7); 95% CI: 1.8, 10.0 g/m(2.7)). Participants with low vitamin D and K status were also at increased risk of all-cause mortality with an HR of 1.64 (95% CI: 1.12, 2.39) compared with normal vitamin D and K status.Conclusions: A combination of low vitamin D and K status is associated with adverse cardiac remodeling and increased risk of all-cause mortality in men and women. Future studies should investigate whether vitamin D and K supplementation could help to improve cardiovascular health and to decrease CVD risk.

Monitoring the vital status of an aging population especially those with chronic diseases can potentially reduce the multiple emergency room visits and hospitalizations if patients and care providers are provided with information that might help them make informed decisions on appropriate cause of actions. This process can be enabled by utilizing temporal abstraction and deriving temporal patterns in order to understand the underlying temporal relationships on vital status in data collected from patients participating in telehealth programs in combination with other data sets in order to get a complete patient flow. Such discovery can highlight when an elderly patient is at risk of an adverse event and this is information that can be utilized for provision of appropriate care for the patient. This paper demonstrates application of a method for deriving temporal patterns from patient's physiological data thereby quantifying the many states a patient can transition to before, during and after an adverse event. With this approach, it is possible to quantify patients with vital scores based on their physiology.

Objectives Coronavirus Disease 2019 (COVID-19) has become a pandemic outbreak. Risk stratification at hospital admission is of vital importance for medical decision making and resource allocation. There is no sophisticated tool for this purpose. This study aimed to develop neural network models with predictors selected by genetic algorithms (GA). Methods This study was conducted in Wuhan Third Hospital from January 2020 to March 2020. Predictors were collected on day 1 of hospital admission. The primary outcome was the vital status at hospital discharge. Predictors were selected by using GA, and neural network models were built with the cross-validation method. The final neural network models were compared with conventional logistic regression models. Results A total of 246 patients with COVID-19 were included for analysis. The mortality rate was 17.1% (42/246). Non-survivors were significantly older (median (IQR): 69 (57, 77) vs. 55 (41, 63) years; p < 0.001), had higher high-sensitive troponin I (0.03 (0, 0.06) vs. 0 (0, 0.01) ng/L; p < 0.001), C-reactive protein (85.75 (57.39, 164.65) vs. 23.49 (10.1, 53.59) mg/L; p < 0.001), D-dimer (0.99 (0.44, 2.96) vs. 0.52 (0.26, 0.96) mg/L; p < 0.001), and α-hydroxybutyrate dehydrogenase (306.5 (268.75, 377.25) vs. 194.5 (160.75, 247.5); p < 0.001) and a lower level of lymphocyte count (0.74 (0.41, 0.96) vs. 0.98 (0.77, 1.26) × 109/L; p < 0.001) than survivors. The GA identified a 9-variable (NNet1) and a 32-variable model (NNet2). The NNet1 model was parsimonious with a cost on accuracy; the NNet2 model had the maximum accuracy. NNet1 (AUC: 0.806; 95% CI [0.693–0.919]) and NNet2 (AUC: 0.922; 95% CI [0.859–0.985]) outperformed the linear regression models. Conclusions Our study included a cohort of COVID-19 patients. Several risk factors were identified considering both clinical and statistical significance. We further developed two neural network models, with the variables selected by using GA. The model performs much better than the conventional generalized linear models.

This case series characterizes the demographics, health services use, and vital status and discharge dispositions of patients with polymerase chain reaction–confirmed coronavirus disease 2019 (COVID-19) hospitalized in the Kaiser Permanente Northern California health system in March 2020.

Dengue is an important tropical infection caused by an arbovirus. As a mosquito borne infection, this disease is widely spread in several tropical endemic countries and this implies the global importance of this infection. In this specific case report, the author discussed the case management of dengue hemorrhagic fever (DHF). A 42-year-old patient came to a secondary level hospital with complaints of diffuse abdominal pain (more in central region) continually for 3 days. Based on his clinical investigations the patient was diagnosed by DHF and managed with intravenously administered fluid resuscitation as he had a history of vomiting, close monitoring of vital status, and gave conservative treatment. Although, the plasma leakage had concerned the doctors about developing DSS. But after seeing his blood report, when the doctors found that the patients platelet count was raised gradually and no other associated signs then they decided to give him discharge from the hospital. Prevention and control of dengue and DHF has become more urgent and the available vaccine is still limited. Hence, effective disease prevention programs, education of the medical community to ensure effective case management, community-based integrated mosquito control are necessary. (C) 2020 Published by Elsevier Ltd.

A follow-up study of a cohort of workers from a coke plant compared with a control group from the same industrial area was conducted in 2019. The recruitment and environmental and biomarker measurements were performed during 1993/1994. The environmental concentrations of polycyclic aromatic hydrocarbons (PAH), B(a)P, pyrene and nitro-PAH were measured. Personal data were collected via an individual semi-structured questionnaire by a trained physician. All biomarkers were measured after a specific blood drawing for every test. Significant risks (ORs) were observed for nitro-PAH (&ge, 0.12 &micro, g/m3) [OR = 7.96 (1.01&ndash, 62.82)], urinary 1-hydroxypyrene (1-OHpy) (&ge, 0.99 &micro, moles/moles of creatinine) [OR = 11.71 (1.47&ndash, 92.90)], PAH DNA adducts (P32) (&ge, 2.69 adducts/108 nucleotides) [OR = 5.46 (1.17&ndash, 25.58)], total nitro-PAH hemoglobin adducts (&ge, 161.68 fg/&micro, g of Hb) [OR = 5.92 (1.26&ndash, 27.86)], sister chromatid exchange (SCE) with TCR (&ge, 377.84 SCE/cell chromosomes) [OR = 13.06 (3.95&ndash, 93.10)], sister chromatid exchange with T (&ge, 394.72 total SCE) [OR = 13.06 (3.95&ndash, 93.10)], and sister chromatid exchange with X (&ge, 8.19 mean SCE) [OR = 13.06 (3.95&ndash, 93.10)]. Significant risk of death for all causes and chromosomal aberrations (48 h) (OR = 7.19 [1.19&ndash, 43.44]) or micronuclei in culture at 48 h (OR = 3.86 [1.04&ndash, 14.38]) were also found.

Background Studies linking large pregnancy cohorts with mortality data can address critical questions about long-term implications of gravid health, yet relevant US data are scant. We examined the feasibility of linking the Collaborative Perinatal Project, a large multiracial U.S. cohort study of pregnant women (n = 48,197; 1959-1966), to death records. Methods We abstracted essential National Death Index (NDI) (1979-2016) (n = 46,428). We performed a linkage to the Social Security Administration Death Master File through 2016 (n = 46,450). Genealogists manually searched vital status in 2016 for a random sample of women (n = 1,249). We conducted agreement analyses for women with abstracted data among the three sources. As proof of concept, we calculated adjusted associations between mortality and smoking and other sociodemographic factors using Cox proportional hazards regression. Results We successfully abstracted identifying information for most of the cohort (97%). National Death Index identified the greatest proportion of participants deceased (35%), followed by genealogists (31%) and Death Master File (23%). Estimates of agreement (κ [95% confidence interval]) between National Death Index and Death Master File were lower (0.52 [0.51, 0.53]) than for National Death Index and genealogist (0.66 [0.61, 0.70]). As expected, compared with nonsmokers, smoking ≥1 pack per day was associated with elevated mortality for all vital sources and was strongest for National Death Index. Conclusions Linking this historic cohort with mortality records was feasible and agreed reasonably on vital status when compared with other data sources. Such linkage enables future examination of pregnancy conditions in relation to mortality in a diverse U.S. cohort.

This study computes educational inequalities in life expectancy (LE), healthy life expectancy (HLE), and unhealthy life expectancy (ULE) by gender and education level in Spain in 2012. Death registrations and vital status by level of education were obtained from Spain&rsquo, s National Institute of Statistics. Health prevalences were estimated from the National Health Survey for Spain. We used Sullivan&rsquo, s method to compute HLE, ULE, and the proportion of time lived with health problems. Our results reveal that Spanish women live longer than men in all education groups, but a higher proportion of women report poor health. We detect substantial differences in unhealthy life by gender and education, with higher effect for women and for those with low levels of education. Poor self-perceived health shows the largest educational gradient, chronic diseases present the lowest. This is the first work that provides evidence on health inequalities by education level in Spain. Our findings seem to be in line with reports of the smaller social inequalities experienced in Southern Europe and highlight the importance of education level on extending the proportion of years spent in good health in a Mediterranean country.

English Abstract: Longitudinal surveys aim to correctly represent the population of interest over time. In this respect, panel attrition, i.e. the systematic drop-out of sample members, is a major challenge for maintaining long-running panel surveys. A second problem might arise when some sample members die during the life of the panel. This holds in particular for panel surveys that consider (mainly) older people, because here the overall mortality rate is higher than in studies including all age groups. Distinguishing between mortality and other forms of attrition hence is crucial as the death of respondents in a longitudinal survey is a natural process that needs to be considered in order to maintain representativeness of the panel sample. If mortality is not taken into account properly, attrition analyses might overestimate the effect of systematic drop-outs for variables that are highly correlated with mortality, such as age or health of the respondents. Therefore, lacking information on the reason why a former respondent cannot be contacted anymore and thus on the vital status is a huge problem in many longitudinal studies that further increases from wave to wave. Using the Survey of Health, Ageing and Retirement in Europe (SHARE), three methods are implemented in this paper to examine the extent of missing death reports. The first method randomly assigns people with unknown vital status to death. The second method uses mortality rates form life-expectancy tables to extrapolate the expected number of deaths among the panel members with unknown vital status. The third method models deaths from data internal to the survey. The correction methods are compared to the original, uncorrected sample and the implications for analyses of died sample members as well as attrition analyses are explored. German Abstract: Ein zentrales Ziel von langsschnittlichen Umfragen ist die reprasentative Abbildung der Zielpopulation uber die gesamte Untersuchungsperiode. In dieser Hinsicht ist Panel Attrition, also der systematische Ausfall von Befragten, ein Kernproblem fur jede Panelstudie, da hierdurch nicht nur die zu analysierende Fallzahl abnimmt, sondern es auch zu substanziellen Verzerrungen kommen kann. Hiermit eng verbunden ist eine weitere Schwierigkeit bei Panelstudien, namlich das naturliche Ausscheiden von Befragten durch Mortalitat. Dies gilt in besonderer Weise fur Panelstudien, die (mehrheitlich) altere Menschen befragen, da hier die naturliche Mortalitat hoher ist als in Umfragen, die alle Altersgruppen umfassen. Die prazise Unterscheidung zwischen unterschiedlichen Arten eines systematischen Ausscheidens aus dem Panel auf der einen und naturlicher Mortalitat bzw. deren Berucksichtigung auf der anderen Seite ist demnach zentral fur eine Aufrechterhaltung der Reprasentativitat des Panelsamples. Sofern Mortalitat nicht angemessen berucksichtigt wird, besteht die Gefahr einer Unterschatzung ihrer Konsequenzen sowie gleichzeitig einer Uberschatzung des Ausmases systematischer Ausfalle – insbesondere fur Variablen wie etwa Alter und Gesundheit der Befragten, die eine hohe Korrelation mit Mortalitat aufweisen. Fehlende Informationen uber die konkrete Ursache, weshalb ehemalige Befragte nicht mehr kontaktiert und interviewt werden konnten, ist daher ein groses und sich uber die Zeit verscharfendes Problem zahlreicher Panelstudien. Auf der Grundlage des Survey of Health, Ageing and Retirement in Europe (SHARE) werden in diesem Papier drei Korrekturmethoden vorgestellt, die das Ausmas und die Folgen einer Unterschatzung des Ausmases naturlicher Mortalitat der Befragten untersuchen. Die erste Methode erhoht dabei die absolute Zahl tatsachlich Verstorbener, indem zufallig bestimmte Panelbefragte als verstorben markiert werden, die nicht mehr kontaktiert werden konnten und deren vitaler Status demnach unbekannt ist. Die zweite Methode verwendet Mortalitatsraten auf der Basis von offiziellen Sterbetafeln, um die zu erwartende Anzahl an Toten unter den Panelbefragten mit unbekanntem Status zu extrapolieren. Die dritte Methode modelliert schlieslich den vitalen Status der Befragten anhand verfugbarer Informationen direkt aus den Paneldaten. Die Korrekturmethoden werden mit dem ursprunglichen, nicht korrigierten Panelsample verglichen, deren Validitat uberpruft und Implikationen fur Mortalitats- und Attrition-Analysen untersucht.

Full-term pregnancies reduce a woman’s long-term breast cancer risk, while abortions have been shown to have no effect. The precise minimal duration of pregnancy necessary to lower a woman’s breast cancer risk is, however, unknown. Here we provide evidence which point to the protective effect of pregnancy on breast cancer risk arising precisely at the 34th pregnancy week. Using a cohort of 2.3 million Danish women, we found the reduction in breast cancer risk was not observed for pregnancies lasting 33 weeks or less, but restricted to those pregnancies lasting 34 weeks or longer. We further found that parity, socioeconomic status, and vital status of the child at birth did not explain the association, and also replicated our finding in data from 1.6 million women in Norway. We suggest that a distinct biological effect introduced around week 34 of pregnancy holds the key to understand pregnancy-associated breast cancer protection., It is known that full-term pregnancies can reduce a woman’s breast cancer risk. Here, the authors interrogate data from 2.3 million Danish women, showing that this protective effect arises at precisely the 34th week of the pregnancy, and replicated this finding in 1.6 million women from Norway.

Background and objective While cross-referencing information from people living with HIV/AIDS (PLWHA) to the official mortality database is a critical step in monitoring the HIV/AIDS epidemic in Brazil, the accuracy of the linkage routine may compromise the validity of the final database, yielding to biased epidemiological estimates. We compared the accuracy and the total runtime of two linkage algorithms applied to retrieve vital status information from PLWHA in Brazilian public databases. Methods Nominally identified records from PLWHA were obtained from three distinct government databases. Linkage routines included an algorithm in Python language (PLA) and Reclink software (RlS), a probabilistic software largely utilized in Brazil. Records from PLWHA 1 known to be alive were added to those from patients reported as deceased. Data were then searched into the mortality system. Scenarios where 5% and 50% of patients actually dead were simulated, considering both complete cases and 20% missing maternal names. Results When complete information was available both algorithms had comparable accuracies. In the scenario of 20% missing maternal names, PLA 2 and RlS 3 had sensitivities of 94.5% and 94.6% (p > 0.5), respectively; after manual reviewing, PLA sensitivity increased to 98.4% (96.6–100.0) exceeding that for RlS (p Conclusion Both linkage algorithms presented interchangeable accuracies in retrieving vital status data from PLWHA. RlS had a considerably lesser runtime but intrinsically required manually reviewing a fastidious proportion of the matched registries. On the other hand, PLA spent quite more runtime but spared manual reviewing at no expense of accuracy.

Background Time spent in hospital (length of stay) is an important component of patient experience and the financial cost of cancer care. This study documents the length of stay across English cancer diagnoses at a national level and reports on variation by patient demographics and tumour characteristics. Methods Data on all diagnoses of malignant neoplasms from the English National Cancer Registration and Analysis Service for 252,202 patients first diagnosed in 2015 was linked with NHS Digital’s Admitted Patient Care and Outpatient Hospital Episode Statistics datasets to quantify length of stay within one year following diagnosis. Length of stay was modelled using linear regression adjusted for sex, age, tumour type, stage, time spent alive during the study period, vital status at end of study period, region, deprivation and ethnicity. Results Patients spend a mean of 25 days (median = 17 days; IQR = 8–34 days) in hospital in their first year. Tumour type, stage, age and vital status corrections had the strongest effects in the model adjusting for other independent variables. Younger patients tended towards longer stays. Conclusion Length of stay varies among patients by tumour type, age and stage. Estimating future health service demands should account for changes in incident tumour characteristics.