Source emission contributions to particulate matter and ozone, and their health impacts in Southeast Asia.

Southeast Asia has been experiencing severe air pollution due to its substantial local emissions and transboundary air pollution (TAP), causing significant health impacts. While literature focused on air pollution episodes in Southeast Asia, we have yet to fully understand the contributions of local emission sectors and TAP to air quality in the region annually. Herein we employed air quality modeling with the species tagging method to first assess the contributions of source sectors and locations to fine particulate matter (PM2.5) and ozone (O3) in Southeast Asia and to hence quantify the resultant health impacts. Our results show that air pollutant exposure was associated with âˆ¼ 900 thousand premature mortalities in Southeast Asia every year. Of which, 77 % and 23 % were due to local emissions and TAP in the region, respectively. âˆ¼ 87 % of the premature mortalities due to local emissions were induced by PM2.5 exposure, whereas the remaining were due to O3 exposure. PM2.5-related health impacts were dominated by industrial (45 %) and residential (17 %) emissions, and O3-related impacts were mainly due to biogenic (40 %) and road transport (24 %) emissions. Furthermore, the health impacts of TAP were particularly adverse in Brunei, East Timor, Singapore, Laos, and border regions.

Triggering receptor expressed in myeloid cells 1 (TREM1) as a potential prognostic biomarker and association with immune infiltration in oral squamous cell carcinoma.

OBJECTIVE: The objective of this study is to investigate the significance and impact of Triggering Receptor Expression on Myeloid Cells-1 (TREM-1) in the context of oral squamous cell carcinoma (OSCC). METHODS: This study involved 51 OSCC patients, 21 oral epithelial dysplasia patients (OED), and the TCGA-HNSCC dataset. TREM1 expression was analyzed using quantitative reverse transcription PCR (RT-qPCR), and Western blot. Furthermore, we assessed TREM1 expression for clinicopathological, prognosis, and immune infiltration correlations utilizing publicly available TCGA-HNSCC datasets through UALCAN, Protein Atlas, Kaplan-Meier plot, TIMER2.0, and TISIDB. We also conducted bioinformatic analyses for functional enrichment employing publicly accessible datasets. RESULTS: TREM1 was significantly upregulated in OSCC and OED when compared to normal tissues, confirmed through multiple methods. Analysis of clinicopathological features showed associations with disease stage, grade, nodal metastasis, HPV status, and TP53 mutation. High TREM1 expression correlated with poorer patient survival. TREM1 was linked to immune cell infiltration and immune-related pathways. CONCLUSION: TREM1 is significantly upregulated in OSCC and is associated with poor clinicopathological features and survival. It may hold promise as a therapeutic target and prognostic marker in OSCC. Further research is needed to understand its functional role in OSCC.

Impact of epizootics on mussel farms: Insights into microbiota composition of Mytilus species.

Outbreaks of marine mussel mortality on French farms could have different aetiologies. One of them implies Vibrio splendidus strains. Beyond the involvement of this pathogen, there is considerable evidence that diseases often result from interactions between several microbes and the host. In this study, we explored the bacterial communities associated with mussel species and the surrounding water collected from a mussel farm affected by mortalities. The microbiota of Mytilus edulis, Mytilus galloprovincialis and their hybrids displayed an abnormal abundance of Proteobacteria, in particular the genera Vibrio, Cobetia and Arcobacter. Despite the dysbiosis, the Mediterranean mussel showed a different microbiota profile with a higher richness and presence of the phylum Bacteroidetes. Bipartite network analyses at the level of bacteria families confirmed this finding and showed that the microbiomes of M. edulis and the hybrids tended to cluster together. In addition, injection of mussels with the virulent V. splendidus induced less mortality rate in M. galloprovincialis compared to the other Mytilus sp. suggesting a better resistance of the Mediterranean mussel to infection. Our findings point to a probable aetiology of pathobiome-mediated disease in mussels. To fully understand this phenomenon, more knowledge is needed on the roles of pathobiotic systems and their development during disease establishment.

Effect of hyperchloremia on mortality of pediatric trauma patients: a retrospective cohort study

ABSTRACT BACKGROUND: Hyperchloremia is often encountered due to the frequent administration of intravenous fluids in critically ill patients with conditions such as shock or hypotension in the pediatric intensive care unit, and high serum levels of chloride are associated with poor clinical outcomes. OBJECTIVES: This study aimed to determine the association between hyperchloremia and in-hospital mortality in pediatric patients with major trauma. DESIGN AND SETTING: This retrospective cohort study was conducted at a tertiary university hospital in Turkey. METHODS: Data were collected between March 2020 and April 2022. Patients aged 1 month to 18 years with major trauma who received intravenous fluids with a concentration > 0.9% sodium chloride were enrolled. Hyperchloremia was defined as a serum chloride level > 110 mmol/L. Clinical and laboratory data were compared between the survivors and nonsurvivors. RESULTS: The mortality rate was 23% (n = 20). The incidence of hyperchloremia was significantly higher in nonsurvivors than in survivors (P = 0.05). In multivariate logistic analysis, hyperchloremia at 48 h was found to be an independent risk factor for mortality in pediatric patients with major trauma. CONCLUSIONS: In pediatric patients with major trauma, hyperchloremia at 48-h postadmission was associated with 28-day mortality. This parameter might be a beneficial prognostic indicator.

Isolation, Identification, and Pathogenicity of Vibrio gigantis Retrieved from European Seabass (Dicentrarchus labrax) Farmed in Türkiye.

In this study, V. gigantis strain C24 was isolated from cases of winter mortalities of hatchery-reared European seabass (Dicentrarchus labrax) broodstock in Türkiye. The first mortalities were reported in September 2016 and occurred annually in early autumn/late winter until the end of February 2019, when 15% of accumulated mortality was recorded. Diseased moribund fish exhibited general septicemic signs, including dermal ulcerations with hemorrhagic margins, distended abdomens, and hemorrhages below the pectorals, pelvic fins, and at the operculum. Postmortem findings showed congestion in several internal organs, hemorrhagic ascitic fluid, and congested prolapsed anal openings. The representative bacterial isolate V. gigantis strain C24 was characterized as Gram-negative, motile, nitrite-producing, and as vibrio static agent O/129-sensitive. The full-length 16S rRNA sequence (Accession No. ON778781) and gyrB gene sequence (Accession No. ON792326) of the C24 strain showed high similarity to V. gigantis strains. Moreover, the whole-genome average nucleotide identity (ANI) values (ANI > 97.7%) against four V. gigantis strains above the species demarcation limit unambiguously identified the C24 isolate as a member of this species. A preliminary virulence-gene analysis showed that the V. gigantis isolate C24 encoded at least three exotoxins, including two aerolysins and a thermolabile hemolysin. The experimental infection showed that the C24 isolate exhibited low to moderate virulence in experimentally infected European seabass juveniles. Interestingly, antimicrobial susceptibility testing revealed that the C24 isolate was susceptible to nalidixic acid, ciprofloxacin, and several other antibiotics but resistant to tilmicosin, kanamycin, streptomycin, and ampicillin. To our knowledge, this study is the first to report that V. gigantis could be considered an emerging bacterial pathogen in Türkiye, and it may threaten the international European seabass production.

Wildlife roadkill in Southwestern Ethiopia: Hotspots, drivers, and victim species.

Wildlife-vehicle collision (WVC) is one of the major causes of wildlife mortality and a concern for conservationists worldwide. The study of roadkill data that can be used to develop appropriate measures and strategies for both wildlife conservation and traffic safety to mitigate the WVC and animals' mortality. Extensive studies have been conducted in the developed countries on the identification of WVC hotspots and its potential impact; however, less attention is given in developing countries. Because of this, the problem is not well understood in developing countries. This study was intended to identify victim species, hotspot areas for roadkill, and factors that contribute to WVC in Jimma Zone, along three roads leading from Jimma City. Data were collected using a citizen science approach and a skilled man power road survey (March-September 2022) to document the number and type of species killed. Three road segments (135 km in total) were surveyed weekly as a baseline for future research. All statistical analyses were carried out using R-software. In the present study, a total of 84 roadkill specimens were collected from 16 different mammal species, of which 85.7% were medium-sized carnivores. The findings showed that Jackals (Canis mesomalis and Canis adustus) were the most frequently killed species (25%, n is 21), followed by Civettictis civetta (22.62%, n is 19). The study revealed that the major factors causing collisions include habitat type (forest cover) and wildlife behavior (nocturnal or diurnal). Further, the study revealed that the majority of WVC occurred at night (dusk) and at dawn in areas that are covered with dense forests. To minimize the potential risks of WVC and animals' mortality, we suggest putting warning signs in hotspot areas where roadkill usually occur frequently. In addition, we recommend creating awareness among drivers, traffic police, and all communities about the negative impacts and consequences of collisions on the ecological and economic value of wildlife.

Disparities in Neonatal Mortalities in the United States.

OBJECTIVE: We aimed to look for the mortality of Black and White Neonates and compare the Black and White neonates' mortalities after stratifying the population by many significant epidemiologic and hospital factors. DESIGN/METHOD: We utilized the National Inpatient Sample (NIS) dataset over seven years from 2012 through 2018 for all neonates ≤ 28 days of age in all hospitals in the USA. Neonatal characteristics used in the analysis included ethnicity, sex, household income, and type of healthcare insurance. Hospital characteristics were urban teaching, urban non-teaching, and rural. Hospital location was classified according to the nine U.S. Census Division regions. RESULTS: Neonatal mortality continues to be higher in Black populations: 21,975 (0.63%) than in White populations: 35,495 (0.28%). Government-supported health insurance was significantly more among Black populations when compared to White (68.8% vs. 35.3% p < 0.001). Household income differed significantly; almost half (49.8%) of the Black population has income ≤ 25th percentile vs. 22.1% in White. There was a significant variation in mortality in different U.S. LOCATIONS: In the Black population, the highest mortality was in the West North Central division (0.72%), and the lower mortality was in the New England division (0.51%), whereas in the White population, the highest mortality was in the East South-Central division (0.36%), and the lowest mortality was in the New England division (0.21%). Trend analysis showed a significant decrease in mortality in Black and White populations over the years, but when stratifying the population by sex, type of insurance, household income, and type of hospital, the mortality was consistently higher in Black groups throughout the study years. CONCLUSIONS: Disparities in neonatal mortality continue to be higher in Black populations; there was a significant variation in mortality in different U.S. LOCATIONS: In the Black population, the highest mortality was in the West North Central division, and the lower mortality was in the New England division, whereas in the White population, the highest mortality was in the East South Central division, and the lowest mortality was in the New England division. There has been a significant decrease in mortality in Black and White populations over the years, but when stratifying the population by many significant epidemiologic and hospital factors, the mortality was consistently higher in Black groups throughout the study years.

In-hospital mortality rate in subaxial cervical spinal cord injury patients: a systematic review and meta-analysis.

PURPOSE: To determine existing trends concerning in-hospital mortality in patients with traumatic subaxial cervical spinal cord injury (SCI) over the last four decades. METHODS: We searched MEDLINE and EMBASE to assess the role of the following factors on in-hospital mortality over the last four decades: neurological deficit, age, surgical decompression, use of computed tomography (CT) and magnetic resonance imaging (MRI), use of methylprednisolone in the acute post-injury period, and study location (developing versus developed countries). RESULTS: Among 3333 papers after deduplication, 21 studies met the eligibility criteria. The mortality rate was 17.88% [95% confidence interval (CI): 12.9-22.87%]. No significant trend in mortality rate was observed over the 42-year period (meta-regression coefficient = 0.317; p = 0.372). Subgroup analysis revealed no significant association between acute subaxial cervical SCI-related mortality when stratified by use of surgery, administration of methylprednisolone, use of MRI and CT imaging, study design (prospective versus retrospective study), and study location. The mortality rate was significantly higher in complete SCI (20.66%, p = 0.002) and American Spinal Injury Association impairment scale (AIS) A (20.57%) and B (9.28%) (p = 0.028). CONCLUSION: A very low level of evidence showed that in-hospital mortality in patients with traumatic subaxial cervical SCI did not decrease over the last four decades despite diagnostic and therapeutic advancements. The overall acute mortality rate following subaxial cervical SCI is 17.88%. We recommend reporting a stratified mortality rate according to key factors such as treatment paradigms, age, and severity of injury in future studies.

Effect of storage periods and conditions on embryonic mortalities and hatchability of artificially incubated ostrich eggs.

1. Despite substantial research, the hatching failure of ostrich eggs remains a key concern for many commercial breeding farms.2. This source of reproductive failure needs to be addressed for ostrich farming to become more profitable.3. Information from 2212 eggs were obtained from the ostrich resource flock at the Oudtshoorn Research Farm (2013-2014). Egg data were divided on a daily basis into two groups: Group 1 included eggs stored from 1 to 13 d in cold storage (CS) at a controlled temperature of 17°C and a relative humidity (RH) of 90%. Group 2 was stored for the same time interval as Group 1, but in a cool room (CR) at ambient temperature to simulate the uncontrolled storage conditions prevalent on most breeding farms.4. Overall embryonic mortalities (OEM) were significantly higher for eggs stored for 1 d (0.38 ± 0.04) and for 8 d or more (between 0.31 ± 0.04 and 0.43 ± 0.04) compared to eggs stored for between 2 and 7 d (between 0.20 ± 0.03 and 0.26 ± 0.04).5. The moisture loss during storage (ML) for eggs stored for 13 d in CS during spring was on average slightly higher (1.28%) than that during summer (0.95%). In contrast, the ML of eggs stored in the CR for 13 d was significantly higher, at 1.59% in spring and 2.08% in summer.6. A general reduction in chick weight occurred for all the seasons (winter, spring and summer) as the number of storage days increased. Ostrich eggs should be stored for between 2 and 8 d under controlled storage conditions for improved hatchability.

Impact of COVID-19 Pandemic on Non-COVID-19 Maternal Mortalities in a Tertiary Health Care Center of North India.

Introduction: While dealing with the COVID-19-related morbidities and mortalities in general, its adverse impact on non-COVID-19 maternal mortalities was completely forgotten so our aim is to study the adverse consequences of the COVID-19 pandemic on non-COVID-19 hospital births and non-COVID-19 maternal mortalities. Methodology: Retrospective observational study was done in the Department of Obstetrics and Gynecology, Swaroop Rani Hospital, Prayagraj, to compare the non-COVID-19 hospital births, referrals, and non-COVID-19 maternal mortalities during 15 months of pre-pandemic period (March 2018 to May 2019) and 15 months of pandemic period (March 2020 to May 2021 period) and to assess their relation to GRSI using chi-square test, paired T test and Pearson's Correlation Coefficient. Result: The total non-COVID-19 hospital births decreased by 4.32% in pandemic period as compared to pre-pandemic period. Monthly hospital births decreased drastically, to 32.7% during the end of the first pandemic wave and to 60.17% during the second wave. 67% increase in the total referral and a significant decrease in the quality of referral leading to significantly higher non-COVID-19 maternal mortality figures (p value 0.00003) during the pandemic period. Leading causes of mortalities were uterine rupture (p value 0.00001), septic abortion (p value 0.0001), primary postpartum hemorrhage (p value 0.002) and preeclampsia (p value 0.003). Conclusion: While the world is talking only about COVID deaths, increased non-COVID-19 maternal mortalities during the COVID pandemic need equal attention and call for more stringent government guidelines for the care of non-COVID-19 pregnant women as well during the pandemic period.

Seasonality in Synergism with Multi-Pathogen Presence Leads to Mass Mortalities of the Highly Endangered Pinna nobilis in Greek Coastlines: A Pathophysiological Approach.

Mortalities of Pinna nobilis populations set at risk the survival of the species from many Mediterranean coastline habitats. In many cases, both Haplosporidium pinnae and Mycobacterium spp. are implicated in mass mortalities of P. nobilis populations, leading the species into extinction. In the context of the importance of these pathogens' role in P. nobilis mortalities, the present study investigated two Greek populations of the species hosting different microbial loads (one only H. pinnae and the second both pathogens) by the means of pathophysiological markers. More specifically, the populations from Kalloni Gulf (Lesvos Island) and from Maliakos Gulf (Fthiotis), seasonally sampled, were chosen based on the host pathogens in order to investigate physiological and immunological biomarkers to assess those pathogens' roles. In order to determine if the haplosporidian parasite possesses a major role in the mortalities or if both pathogens are involved in these phenomena, a variety of biomarkers, including apoptosis, autophagy, inflammation and heat shock response were applied. The results indicated a decreased physiological performance of individuals hosting both pathogens in comparison with those hosting only H. pinnae. Our findings provide evidence for the synergistic role of those pathogens in the mortality events, which is also enhanced by the influence of seasonality.

Analysis and forecasting of road traffic mortalities in Azad Jammu and Kashmir.

OBJECTIVE: To analyse road traffic accident mortalities in a geographical region. Method: The retrospective study was conducted in Azad Jammu and Kashmir based on secondary data from 2004 to 2017 collected from the police department. Duncan's multiple range test was used to assess the trends in road traffic accident fatalities with respect to districts and divisions. Different goodness-of-fit criteria were used to compare the performance of different regression models to analyse road traffic accident mortalities with respect to vehicle ownership. The parsimonious time series model was used to forecast the future trends of road traffic accident mortalities. R 3.6.0 software was used for data analysis. RESULTS: There were 5263 major road traffic accidents during the period studied, causing 2317 deaths and 12963 injuries. The number of mortalities in Mirpur division was 923(39.8%), in Muzaffarabad 794(34.3%), and inss Poonch 600(25.9%). The rates of road traffic accident mortalities per 100,000 population increased up to year 2010 and dropped slowly afterwards (Figure 1C). Some disparities were noted among different districts and divisions with respect to road traffic accident mortalities. Based on different goodness-of-fit criteria, the Smeed's model was found to be the most efficient model to analyse the trends of road traffic accident mortalities with respect to vehicle ownership (Table 1). The forecast for road traffic accident mortalities exhibited some fluctuations in the start and a uniform trend afterwards (Figure 6). CONCLUSIONS: Disparities in road traffic accident fatalities across different districts and divisions of Azad Jammu and Kashmir were observed. Though the rate of road traffic accident mortality was seen to be decreasing since 2010, the situation is for behind compared to the global Sustainable Development Goals.

Road Infrastructure and Primate Conservation: Introducing the Global Primate Roadkill Database.

As road infrastructure networks rapidly expand globally, especially in the tropics, previously continuous habitats are being fragmented, resulting in more frequent wildlife-vehicle collisions (WVC). Primates are widespread throughout many sub-/tropical countries, and as their habitats are fragmented, they are increasingly at risk of WVC. We created the Global Primate Roadkill Database (GPRD), the largest available standardized database of primate roadkill incidents. We obtained data from published papers, un-published and citizen science databases, anecdotal reports, news reports, and social media posts. Here, we describe the collection methods for the GPRD and present the most up-to-date version of the database in full. For each primate roadkill incident, we recorded the species killed, the exact location, and the year and month the roadkill was observed. At the time of publication, the GPRD includes 2862 individual primate roadkill records from 41 countries. As primates range in more than twice as many countries, the absence of data from these countries is not necessarily indicative of a lack of primate vehicular collisions. Given the value of these data for addressing both local and global research questions, we encourage conservationists and citizen scientists to contribute to the GPRD so that, together, we can better understand the impact road infrastructure has on primates and evaluate measures which may help mitigate risk-prone areas or species.

Streamlining Global and Local Data on HIV: Underscoring Role of Institutions and Ethics in Improving Quality of HIV Research.

OBJECTIVES: There are inconsistencies in the South Africa HIV mortality data reported by Institute of Health Metrics and Evaluation (IHME), Joint United Nations Programme on HIV/AIDS (UNAIDS), and Statistics South Africa (StatsSA) platforms. Between 2006 and 2016, these global data sets (IHME and UNAIDS) show that HIV-related mortalities were improving in South Africa, whereas StatsSA argues the opposite. We explain the causes of this differing stands and highlight areas that may be improved to address such inconsistencies. METHODS: This observational analysis uses data from IHME, UNAIDS, and StatsSA platforms. RESULTS: We demonstrate that IHME and UNAIDS data sets are based on a mathematical compartmental model, which is not dynamic to all HIV epidemiological aspects. Such limitation may cause inflated improvement in HIV mortality outcomes that are not in line with HIV mortality evidence recorded at the household level as demonstrated by StatsSA. CONCLUSION: There is a need to streamline the IHME, UNAIDS, and StatsSA data on HIV to improve the quality of HIV research and programming in South Africa.

Analyzing the impact of vaccinations and weather factors on the COVID-19 pandemic.

OBJECTIVES: A world-wide immunization project was launched at the peak of COVID-19 pandemic to contain and minimize the adverse effects of SARS-CoV-2 virus. We carried out a series of statistical analyses in this paper to determine, confirm and quantify the impact of the vaccinations on COVID-19 cases and mortalities, amidst critical confounding factors-temperature and solar irradiance. METHODS: The experiments in this paper were carried out on the world data, data from 21 countries, and the five major continents. The significance of the 2020-2022 vaccinations on the COVID-19 cases and mortalities response data were evaluated via Hypotheses' tests. Correlation coefficient analyses were carried out to determine the extent of the relationship between vaccination coverage and corresponding COVID-19 mortalities data. The impact of vaccination was quantified. The effects of the weather factors-temperature and solar irradiance, on COVID-19 cases and mortalities data were analyzed. RESULTS: The series of hypotheses tests carried out reveal that vaccinations did not affect cases; however, vaccinations significantly impacted the mean daily mortalities in all five major continents and globally. The correlation coefficient analysis results show vaccination coverage to be highly and negatively correlated with daily mortalities in the world-the five major continents and most of the countries studied in this work. The percentage reduction in mortalities as a result of wider vaccination coverage was indeed significant. Temperature and solar irradiance impacted daily COVID-19 cases and mortalities data during the vaccination and post-vaccination periods. CONCLUSION: Results show that the world-wide vaccination against COVID-19 project had a significant impact in reducing mortalities and minimizing the adverse effects due to COVID-19 globally, in all five (5) major continents of the world and the countries studied in this work, however, temperature and solar irradiance still had effects on COVID-19 response in the vaccination eras.

Investigation of the highly endangered Pinna nobilis' mass mortalities: Seasonal and temperature patterns of health status, antioxidant and heat stress responses.

Recently, P. nobilis populations have suffered a tremendous reduction, with pathogens potentially playing a crucial role. Considering its highly endangered status, mechanisms leading to mass mortalities were examined in one or multiple pathogens infected populations. Thus, seasonal antioxidant enzymatic activities, hsp70 and catalase mRNA levels, were investigated in two different Greek populations, during mass mortality events in summer of 2020. Samples were collected from Fthiotis and Lesvos during February (ToC 14 ± 1.2 and 15 ± 1 respectively), April (ToC 18 ± 1.2 and 17 ± 1.3 respectively), and June (ToC 24.5 ± 1.5 and 21.5 ± 1.5 respectively) 2020. In July of the same year (ToC 26.5 ± 1.7 in Fthiotis and 24.5 ± 1.7 in Lesvos), no live specimens were found. All biochemical parameters and phylogenetic analysis suggest that pathogen infection increases P. nobilis sensitivity to water temperature, subsequently leading to mass mortality. The latter was obvious in Fthiotis individuals, in which Haplosporidium pinnae was also observed with Mycobacterium spp., compared to Lesvos individuals.

Anatoxins from benthic cyanobacteria responsible for dog mortalities in New Brunswick, Canada.

In July 2018 three dogs died after visiting the Wolastoq (Saint John River) near Fredericton, New Brunswick, in Atlantic Canada. All showed signs of toxicosis, and necropsies revealed non-specific pulmonary edema and multiple microscopic brain hemorrhages. Liquid chromatography-high-resolution mass spectrometry (LC-HRMS) analysis of vomitus and stomach contents as well as water and biota from the mortality sites confirmed the presence of anatoxins (ATXs), a class of potent neurotoxic alkaloids. The highest levels were measured in a dried benthic cyanobacterial mat that two of the dogs had been eating before falling ill and in a vomitus sample collected from one of the dogs. Concentrations of 357 and 785 mg/kg for anatoxin-a and dihydroanatoxin-a, respectively, were measured in the vomitus. Known anatoxin-producing species of Microcoleus were tentatively identified using microscopy and confirmed by 16S rRNA gene sequencing. The ATX synthetase gene, anaC, was detected in the samples and isolates. The pathology and experimental results confirmed the role of ATXs in these dog mortalities. Further research is required to understand drivers for toxic cyanobacteria in the Wolastoq and to develop methodology for assessing occurrence.

Trends of Cancer Screenings, Diagnoses, and Mortalities During the COVID-19 Pandemic: Implications and Future Recommendations.

INTRODUCTION: The impact of the COVID-19 pandemic on cancer screenings and care has yet to be determined. This study aims to investigate the screening, diagnosis, and mortality rates of the top five leading causes of cancer mortality in the United States from 2019 to 2021 to determine the potential impact of the COVID-19 pandemic on cancer care. METHODS: A retrospective cohort study investigating the impact of the COVID-19 pandemic on screening, diagnoses, and mortality rates of the top five leading causes of cancer death (lung/bronchus, colon/rectum, pancreas, breast, and prostate), as determined by the National Institute of Health (NIH) utilizing The United States Healthcare Cost Institute and American Cancer Society databases from 2019 to 2021. RESULTS: Screenings decreased by 24.98% for colorectal cancer and 16.01% for breast cancer from 2019 to 2020. Compared to 2019, there was a .29% increase in lung/bronchus, 19.72% increase in colorectal, 1.46% increase in pancreatic, 2.89% increase in breast, and 144.50% increase in prostate cancer diagnoses in 2020 (all P < .01). There was an increase in the total number of deaths from colorectal, pancreatic, breast, and prostate cancers from 2019 to 2021. CONCLUSION: There was a decrease in the screening rates for breast and colorectal cancer, along with an increase in the estimated incidence and mortality rate among the five leading causes of cancer deaths from 2019 to 2021. The findings suggest that the COVID-19 pandemic is associated with impaired cancer screening, diagnosis, and care, and further emphasizes the need for proactive screening and follow-up to prevent subsequent cancer morbidity and mortality.

Association of Urinary Nitrate With Diabetes Complication and Disease-Specific Mortality Among Adults With Hyperglycemia.

CONTEXT: The hyperglycemia condition disrupts metabolism of nitrate/nitrite and nitric oxide, and dietary nitrate intake can restore nitric oxide homeostasis. OBJECTIVE: This study aims to examine whether urinary nitrate is associated with diabetes complications and long-term survival among people with hyperglycemia. METHODS: A total of 6208 people with hyperglycemia who participated in the National Health and Nutrition Examination Survey from 2005 to 2014 were enrolled. Diabetes complications included congestive heart failure, coronary heart disease, angina, stroke, myocardial infarction, diabetic retinopathy, and nephropathy. Mortality was obtained from the National Death Index until 2015. Urinary nitrate was measured by ion chromatography coupled with electrospray tandem mass spectrometry, which was log-transformed and categorized into tertiles. Logistic regression models and Cox proportional hazards models were respectively performed to assess the association of urinary nitrate with the risk of diabetes complications and disease-specific mortalities. RESULTS: After adjustment for potential confounders, including urinary perchlorate and thiocyanate, compared with the participants in the lowest tertile of nitrate, the participants in the highest tertile had lower risks of congestive heart failure (odds ratio [OR] 0.41; 95% CI, 0.27-0.60) and diabetic nephropathy (OR 0.50; 95% CI, 0.41-0.62). Meanwhile, during a total follow-up period of 41 463 person-years, the participants in the highest tertile had lower mortality risk of all-cause (hazard ratio [HR] 0.78; 95% CI, 0.62-0.97), cardiovascular disease (CVD) (HR 0.56; 95% CI, 0.37-0.84), and diabetes (HR 0.47; 95% CI, 0.24-0.90), which showed dose-dependent linear relationships (P for nonlinearity > 0.05). Moreover, no association between nitrate and cancer mortality was observed (HR 1.13; 95% CI, 0.71-1.80). CONCLUSION: Higher urinary nitrate is associated with lower risk of congestive heart failure and diabetic nephropathy, and lower risk of all-cause, CVD, and diabetes mortalities. These findings indicate that inorganic nitrate supplementation can be considered as a supplementary treatment for people with hyperglycemia.

Glove Balloon in Postpartum Hemorrhage: A Case Report.

Postpartum hemorrhage is a long-running and frequent cause of maternal death in most developing countries and is associated with uterine atony. Nowadays, balloon tamponade has gained popularity due to its advantages. It is a technically simple, safely applied, time saver, and easily removed in a low-risk method and also needs less expertise and no special equipment. Despite all advantages, the Bakri balloon is very expensive in less developed countries and not available everywhere, especially in limited resource settings. Such disadvantages prompted us to perform an innovative, cost-effective, and practical method relying on low-resource equipment and named it "Glove Balloon." A 26-year-old woman presented in her third pregnancy underwent an elective cesarean section. Following the surgeon's mention of low segment atony, the patient returned to the operating room quickly. The bleeding continued despite the administration of uterotonic drugs, and because of active bleeding, the decision was made to apply a glove balloon. After gently inserting the glove balloon into the uterus, 500 ccs of saline was inflated into the balloon, and the bleeding stopped shortly afterward. The patient was discharged on the third postoperative day and remained well after. We believe that junior obstetricians and midwives should consider all options, even new strategies, to stop hemorrhages before considering invasive surgical procedures. The "Glove Balloon" is an innovative, practical uterine tamponade balloon that can make the difference between life and death in treating postpartum hemorrhage cases and should be considered a life-saver tool in all settings.