Clustering Trend Changes of Lung Cancer Incidence in Europe via the Growth Mixture Model during 1990-2016

Clustering of the causes of death in Northeast Iran: a mixed growth modeling

BACKGROUND

Processing and analyzing data related to the causes of mortality can help to clarify and monitor the health status, determine priorities, needs, deficiencies, and developments in the health sector in research and implementation areas. In some cases, the statistical population consists of invisible sub-communities, each with a pattern of different trends over time. In such cases, Latent Growth Mixture Models (LGMM) can be used. This article clusters the causes of individual deaths between 2015 and 2019 in Northeast Iran based on LGMM.

METHOD

This ecological longitudinal study examined all five-year mortality in Northeast Iran from 2015 to 2019. Causes of mortality were extracted from the national death registration system based on the ICD-10 classification. Individuals' causes of death were categorized based on LGMM, and similar patterns were placed in one category.

RESULTS

Out of the total 146,100 deaths, ischemic heart disease (21,328), malignant neoplasms (17,613), cerebrovascular diseases (11,924), and hypertension (10,671) were the four leading causes of death. According to statistical indicators, the model with three classes was the best-fit model, which also had an appropriate interpretation. In the first class, which was also the largest class, the pattern of changes in mortality due to diseases was constant (n = 98, 87.50%). Second-class diseases had a slightly upward trend (n = 10, 8.92%), and third-class diseases had a completely upward trend (n = 4, 3.57%).

CONCLUSIONS

Identifying the rising trends of diseases leading to death using LGMM can be a suitable tool for the prevention and management of diseases by managers and health policy. Some chronic diseases are increasing up to 2019, which can serve as a warning for health policymakers in society.

Clinical application of intubation-free anesthesia in radical resection of lung cancer

Background

In recent years, video-assisted thoracic surgery (VATS) has become increasingly widespread. However, the implementation of VATS requires the assistance with lung isolation techniques. Spontaneous breathing with laryngeal masks is also increasingly used in VATS. However, evidence on the characteristics of intubated anesthesia is insufficient.

Objective

This study aimed to explore whether intubation-free anesthesia has more advantages than other intubation methods in the clinical setting.

Methods

Patients with lung tumors who underwent VATS in our hospital between June 2022 and October 2022 were included in the study. Perioperative data of patients, including basic information, intraoperative hemodynamic changes, postoperative inflammatory indicators, and adverse reactions were obtained through the electronic medical record system. According to the protocol of airway management during anesthesia, participants were divided into the following groups: laryngeal mask with spontaneous breathing group (LMSB group), laryngeal mask combined with bronchial blocker group (LM + BB group), double-lumen tube group (DLT group), and tracheal tube combined with bronchial blocker group (TT + BB group). All data were analyzed using SPSS 25.0 software.

Results

At baseline, patients in the LMSB and LM + BB groups had a lower body weight (P = 0.024). Systolic blood pressure (SBP), diastolic BP (DBP), and heart rate (HR) were significantly higher in the DLT group than in the non-intubated group during surgery (SBP: T1 P = 0.048, T4 P = 0.021, T5 P ≤ 0.001, T6 P ≤ 0.001, T7 P = 0.004; DBP: T5 P ≤ 0.001, T6 P ≤ 0.001, T7 P ≤ 0.001; HR: T1 P = 0.021, T6 P ≤ 0.001, T7 P = 0.007, T8 P ≤ 0.001). The input fluid (P = 0.009), urine output (P = 0.010), surgery duration (P = 0.035), and procalcitonin levels (P = 0.024) of the DLT group were also significantly higher than those of the other groups. The recovery duration of the LMSB group was significantly longer (P = 0.003) and the incidence of postoperative adverse reactions, mainly atelectasis, was higher (P = 0.012) than those of the other groups.

Conclusion

Although the intubation-free anesthesia has less stimulation during operation and less postoperative inflammatory response, it has obvious adverse reactions after operation, which may be not the best anesthesia scheme for radical resection of lung cancer in VATS.

Clinical trial registration

https://www.chictr.org.cn/showproj.html?proj=182767, identifier ChiCTR2200066180.

Adding predictive and diagnostic values of pulmonary ground-glass nodules on lung cancer via novel non-invasive tests

Pulmonary ground-glass nodules (GGNs) are highly associated with lung cancer. Extensive studies using thin-section high-resolution CT images have been conducted to analyze characteristics of different types of GGNs in order to evaluate and determine the predictive and diagnostic values of GGNs on lung cancer. Accurate prediction of their malignancy and invasiveness is critical for developing individualized therapies and follow-up strategies for a better clinical outcome. Through reviewing the recent 5-year research on the association between pulmonary GGNs and lung cancer, we focused on the radiologic and pathological characteristics of different types of GGNs, pointed out the risk factors associated with malignancy, discussed recent genetic analysis and biomarker studies (including autoantibodies, cell-free miRNAs, cell-free DNA, and DNA methylation) for developing novel diagnostic tools. Based on current progress in this research area, we summarized a process from screening, diagnosis to follow-up of GGNs.

Modeling trend changes in percent of under five-year-old children with malnutrition amongst 39 Asian countries from 1987 to 2016 via growth mixture model

Purpose

Malnutrition is an important public health issue and the main cause of child morbidity and mortality, especially in developing countries. The present study aimed to model trend changes in percentage of the malnourished children under 5 among 39 Asian countries during 1987 to 2016.

Methods

Information about percentage of the malnourished under 5 years children based on under-weight (weight for age) malnutrition for 39 Asian countries were extracted from Gapminder web site during 1987 to 2016. To cluster Asian countries based on trend changes, Growth Mixture Model (GMM) was implemented. All the statistical analyses were performed in Mplus 7.4 software and P < 0.10 in likelihood ratio test (LRT) was considered as statistically significant.

Results

Based on P-value of LRT, the model with 3 clusters was selected. Although, cluster 3 with 9 countries had higher intercept in 1987 and the worst situation in malnutrition, they gained a sharp decrease (− 0.93) in percentage of malnourished children under five annually. The slope of − 0.64 for cluster 1 countries indicate a moderate decrease annually in percent of children with malnutrition. The other 20 countries with slope of − 0.29 in their linear trend belonged to cluster 2 which shows slow decrease in the percentage of children with malnutrition.

Conclusion

The investments in public health and education programs, as well as political commitment and government proper response in line with needs and demands are crucial to promote food security, nourishing diets and improving child nutrition. Certainly, most of them are still a long way from eradicating malnutrition.

The Main Patterns in the Trend Change of Stomach Cancer Incidence amongst Selected African Countries

Aim. The current study aimed to investigate the trend changes of stomach cancer incidence amongst African countries and identify the main patterns. Methods. The annual reports of stomach cancer incidence rate (per 100,000 people) for males and females in 53 African countries from 1990 to 2016 were maintained from the World Health Organization archive. The growth mixture model was used for fitting the models in Mplus 7.4. The estimated linear trend in each pattern was characterized by intercept (the rate at 1990) and slope (the observed biennial trend changes), and finally, each country was grouped into a cluster with the most similar pattern. Results. Three main patterns for males and two main patterns for females were determined. For males, the first cluster, containing Cape Verde, Central African Republic, and Mauritius, showed a sharp fall, while countries in the second pattern including Algeria, Côte d’Ivoire, Egypt, Gambia, Libya, Malawi, Morocco, Namibia, Nigeria, and Tunisia were categorized in a pattern with a slight decrease, and other 43 countries were in the third pattern with a moderate falling trend. For females, 19 countries including Angola, Botswana, Burundi, Cape Verde, Central African Republic, Congo Republic, Equatorial Guinea, Ethiopia, Gabon, Kenya, Mali, Mauritius, Rwanda, Sao Tome and Principe, Sudan, Swaziland, Uganda, Zambia, and Zimbabwe were categorized in the moderate-to-high falling pattern, but the other 34 countries had a gentle downward pattern. Conclusion. Although most of the observed trends of stomach cancer were falling, only a few countries had experienced a favorable decreasing trend (three countries in male incidence and nineteen countries in female incidence). Therefore, taking effective actions to accelerate the observed falling trends seems necessary.