Mortality incidence estimation using federal death certificate and natality data with an application to Tay–Sachs disease

For confidentiality reasons, US federal death certificate data are incomplete with regards to the dates of birth and death for the decedents, making calculation of total lifetime of a decedent impossible and thus estimation of mortality incidence difficult. This paper proposes the use of natality data and an imputation‐based method to estimate age‐specific mortality incidence rates in the face of this missing information. By utilizing previously determined probabilities of birth, a birth date and death date are imputed for every decedent in the dataset. Thus, the birth cohort of each individual is imputed, and the total on‐study time can be calculated. This idea is implemented in two approaches for estimation of mortality incidence rates. The first is an extension of a person‐time approach, while the second is an extension of a life table approach. Monte Carlo simulations showed that both approaches perform well in comparison to the ideal complete data methods, but that the person‐time method is preferred. An application to Tay–Sachs disease is demonstrated. It is concluded that the imputation methods proposed provide valid estimates of the incidence of death from death certificate data without the need for additional assumptions under which usual mortality rates provide valid estimates.     

Drought and the consequences of El Niño in Borneo: a case study of figs

Borneo has a perhumid climate but occasional severe droughts have an important impact. Droughts may affect the composition and size structure of plant communities through differential mortality or, via their impact on the availability of plant resources, affect plant–animal interactions. From January to April 1998, northern Borneo suffered a very severe drought linked to the El Niño Southern Oscillation event of 1997–1998. In this article, the impacts of this drought on the rain forest at Lambir Hills National Park, Sarawak, are considered with special reference to a keystone plant group, the figs. Small fires entered the edge of the forest from the roadside, killing saplings, climbers, and understory trees. Community-wide mortality for adult trees was 0–7 times higher than in nondrought years, with larger trees showing a greater proportional increase. In figs, mortality was significantly higher in pioneers, but hemiepiphytes and roadside species were unaffected. Phenology was substantially affected. Leaf and flower/fruit production decreased or ceased during the drought and increased suddenly following renewed rain. Pollinators of dioecious figs became locally extinct during the drought, and other plant–animal interactions may also have been disrupted. The frequency and severity of droughts has increased substantially in the past three decades, and climate models suggest this may be the result of global warming. The impacts of the 1998 drought at Lambir Hills National Park suggest that, should this trend continue, a substantial alteration of habitats and overall loss of biodiversity can be expected in Borneo.     

Impact of Pulsed Nd:YAG Laser Irradiation on the Growth and Mortality of the Biofilm Forming Marine Bacterium Pseudoalteromonas carrageenovora

The impact of pulsed laser irradiation on the marine biofilm forming bacterium Pseudoalteromonas carrageenovora was investigated in the laboratory by monitoring mortality and the post-irradiation growth pattern. The impact of laser irradiation on bacterial mortality increased with the duration of irradiation. Laser irradiation at 532 nm (0.1 J cm m 2 ) for 15 min resulted in a 53% cell mortality immediately after irradiation. However, the impact after a period of 5 h (delayed impact) was more severe. The growth pattern of irradiated samples showed a prolonged lag phase compared to the reference, due to a reduction in total viable counts (TVC) in the irradiated samples. Nucleic acid staining is suggested to be a promising technique for monitoring laser inflicted bacterial mortality. Thus, the results suggest that laser irradiation could be considered as an alternative technique to reduce the number of biofilm forming bacteria and thereby biofilm formation on hard surfaces.     

Mortality and birth weight in Philadelphia Blacks: an example of stabilizing selection

It has been suggested that as a result of the action of natural selection the mean value of any biological measurement would be the most normal value and associated with the most favorable survival rate. Selection is said to be stabilizing (or normalizing or balancing) if individuals with intermediate values for a given quantitative trait have the highest fitness. Birth weight is perhaps the most clear-cut example of a human character subject to stabilizing selection. This paper presents the distribution of birth weights among 8382 Philadelphia Black infants and the rate of perinatal mortality for the birth weight classes. Using these data, several analyses of stabilizing selection are made. The data were taken from the Collaborative Study on Cerebral Palsy, Mental Retardation, and other Neurological and Sensory Disorders of Infancy and Childhood.     

Growth and mortality of trembling aspen (Populus tremuloides) in response to artificial defoliation

To simulate the effects of forest tent caterpillar (FTC) defoliation on trembling aspen growth and mortality, an artificial defoliation experiment was performed over three years in young aspen stands of northwestern Quebec. Defoliation plots of 15 × 15 m were established on three sites, together with associated control stands of pure trembling aspen. In 2007, root collar diameters were measured and positions of all trees were mapped prior defoliation. Severe FTC defoliation was simulated for three successive years (2007–2009) by manually removing all leaves from all but 7–10% of the trees present in the defoliation plots. Yearly surveys of growth and mortality were conducted until 2010 to evaluate defoliation effects on defoliated as well as surrounding undefoliated trees. In absence of other factors, growth and mortality of trembling aspen decreased and increased, respectively, after defoliation. Our study further revealed that small diameter trees died after one year of artificial defoliation, while larger-diameter trees died after repeated defoliations. Distributions of tree mortality tended to be aggregated at small scales (<5 m), corroborating gap patterns observed in mature stands following FTC outbreaks. This experiment revealed that trembling aspen mortality can be directly attributed solely to defoliation. Repeated defoliations during FTC outbreaks have the potential to profoundly modify stand productivity and structure by reducing tree growth and increasing tree mortality in the absence of predisposing factors.     

Peritoneal mesothelioma mortality in Italy: Spatial analysis and search for asbestos exposure sources

BackgroundThis study is part of a national plan of epidemiological surveillance of malignant mesothelioma (MM) mortality in Italy. The paper shows the results of malignant peritoneal mesothelioma (MPeM) mortality study in Italian Regions and municipalities.MethodsNational Bureau of Statistics data for MPeM municipal mortality (ICD-10, Code C45.1) were analyzed in the time-window 2003–2014: mortality standardized rates (reference Italian population, census 2011), temporal trends of the annual national rates, Standardized Mortality Ratios and a municipal clustering analysis were performed.Results747 deaths for MPeM were recorded (0.10/100,000): 464 in men (0.14/100,000) and in 283 women (0.07/100,000). No significant MPeM mortality temporal trend was found.Seventeen municipalities showed excesses of mortality for MPeM in at least one gender and/or overall population.Four clusters in male population, and one in women were identified.ConclusionsThe study identifies some areas where remediation activities and/or health care actions may be warranted.     

Increasing incidence and survival of corpus uteri cancer in Estonia over the past two decades

BackgroundCorpus uteri cancer has become the fourth most common female cancer in Europe. In Estonia, the prevalence of obesity is increasing, and corpus uteri cancer survival has been relatively low. The aim of the study was to evaluate incidence, mortality and survival trends of corpus uteri cancer in Estonia by age, stage and histological subtypes with an emphasis on surgical treatment.MethodsEstonian Cancer Registry data on incident cases of corpus uteri cancer were used to examine incidence trends (1995–2016) and calculate relative survival ratios (RSR) (1996–2016). Cases were classified by morphology and FIGO stage. Causes of Death Registry data were used to analyse corrected mortality (1995–2017).ResultsA total of 4281 cases were diagnosed in 1996–2016. A significant increase was seen in age-standardized incidence from 2009, while mortality remained stable throughout the study period. Significant increases were observed for type I cancers and age groups ≥65 years. Overall age-standardized 5-year RSR improved from 70% in 1996–2002 to 78% in 2010–2016. Survival increased for type I cancers, all age groups and all stages (significantly for stage IV). The proportion of surgically treated cases increased significantly from 85% to 89%, with the largest increases seen in older age groups and later stages.DiscussionThe rising corpus uteri cancer incidence in Estonia is driven by the type I cancer trend. Survival gain for later stages and older age groups likely reflected more frequent surgical treatment. To reduce mortality, further efforts are necessary to ensure appropriate care for all patients.     

Rational targeting of population groups and residential areas for colorectal cancer screening

BackgroundSociodemographic and spatial disparities in incidence and mortality burden of colorectal cancer (CRC) are important to consider in the implementation of population screening, in order to achieve expected benefit and not increase health inequities. Analytic methods should be adapted to provide rational support for targeted interventions.MethodsCRC incidence rates by tumor stage (I-IV) and location (colon vs. rectum) were analyzed for the time period 2008–2016 within a screening-relevant age interval of 55–74 years for the population of South and West Sweden, where screening is planned for. The study population was stratified by sex, country of birth, educational level (for Swedish-born citizens) and residential area. We also estimated disparities in excess mortality from CRC across groups of patients accordant to relevant population groups.ResultsThe analyses were based on 8961 patients with a first CRC diagnosis. There were marked socioeconomic gradients in the stage II-IV CRC incidence rates among Swedish-born men and women. Compared to men with high educational level, the incidence rate ratios (IRRs) of stage II, III, and IV CRC in men with low educational level were 1.38 (95% confidence interval 1.18, 1.62), 1.09 (0.95, 1.26), and 1.18 (1.02, 1.37), respectively. In women, the corresponding figures were 1.26 (1.06, 1.51), 1.19 (1.01, 1.39), and 1.45 (1.20, 1.80). The groups of patients with low educational level showed relatively high excess mortality burdens from CRC.ConclusionsOur analytic approach provided rational support for targeted intervention when implementing CRC screening, aiming at optimizing participation in groups with low educational level.     

Cardiac resynchronization therapy pacemakers versus defibrillators in older non-ischemic cardiomyopathy patients

Introduction

With the recent publication of the negative DANISH trial, the mortality benefit of the implantable cardioverter-defibrillator (ICD) has been put in question in patients with non-ischemic cardiomyopathy (NICM). Because a majority of patients in DANISH receive cardiac resynchronization therapy (CRT) devices, we investigated in the present study the survival of recipients of CRT pacemakers (CRT-P) versus CRT ICDs (CRT-D) in a cohort of older (≥75 years) NICM patients at our institution.