Statisticon (Sweden)

AimTo examine the use of violent suicide methods across life stages, and associations with sociodemographic characteristics, healthcare utilization, and place of death.MethodsData from Swedish national registers encompassing all recorded suicide deaths between 2013 and 2019 were analyzed. Suicide methods were categorized as violent or non-violent. Associations were assessed using univariable and multivariable logistic regression, with age modeled using restricted cubic splines to capture nonlinear effects. Interaction analyses were conducted to examine how associations varied by age.ResultsA total of 8,325 suicides were included, with 77% involving violent methods. The likelihood of violent method use peaked at age 20 and declined until around age 60, after which a modest increase was observed. The use of violent suicide methods was stable across all ages for men but there was a steady decrease in women until age 60. Foreign-born older adults were less likely to use violent methods than their Swedish-born counterparts. Lower educational attainment, living with others, and dying in nursing homes or other institutional settings were also associated with higher odds of violent method use.ConclusionsThis study contributes to the literature by highlighting distinct age- and subgroup-specific trends in the use of violent suicide methods. We noted a consistent decrease among women up to age 60, and lower rates among older migrants. These insights underscore the value of a lifespan approach in understanding suicide risk and method choice, and point to the need for tailored, context-aware prevention strategies.

BackgroundAlthough some meta-analyses show that triple inhaled therapy (TT) reduces all-cause mortality compared with dual inhaled therapy (DT), the effect on cardiovascular events is not yet well defined. We estimated the effect of TT compared with DT (LAMA/LABA or LABA/ICS) on MACE and cardiovascular outcomes in an evidence synthesis.MethodsFollowing prospective registration (https://osf.io/gtfvm), a comprehensive search strategy of PubMed, Scopus, and Embase was performed until 15 January 2025. All randomized clinical trials (RCTs) evaluating TT vs. DT and reporting MACE and cardiovascular outcomes were included. We assessed risk of bias and conducted a random-effects meta-analysis estimating summary relative risk (RR) with 95% confidence intervals, evaluating heterogeneity using I2. A network meta-analysis (NMA) was undertaken.ResultsFrom 781 citations, five RCTs were selected (7,855 patients receiving TT, 7,003 LABA/ICS, 5,059 LAMA/LABA). The risk of bias was moderate in three and low in two RCTs. TT reduced MACE by a non-significant 11% vs. LAMA/LABA (0.89; 0.70–1.12, four RCTs, I2 = 0%) and increased by a non-significant 26% vs. LABA/ICS (1.26; 0.97–1.64, four RCTs, I2 = 0%). TT reduced cardiovascular mortality (CVD) by 50% (0.50; 0.31–0.80, three RCTs, I2 = 0%) and increased non-fatal stroke by 92% (1.92; 1.09–3.39, two RCTs, I2 = 0%) compared with LAMA/LABA. TT shows a favorable trend in myocardial ischemia outcomes. For CVD, NMA showed that TT ranked first and LAMA/LABA last in effectiveness.ConclusionsIn exacerbating patients with moderate to very severe COPD, TT significantly reduces CVD compared with LAMA/LABA dual therapy, without a significant reduction in MACE.Systematic Review Registrationhttps://doi.org/10.17605/OSF.IO/GTFVM.

The study investigates methods of vibration diagnostics for axlebox bearings in rolling stock using spectral analysis and envelope vibration modulation. The critical importance of early fault detection for safe operation has been established. Fast Fourier Transform was employed for accurate identification of fault location and type. Vibration spectrum analysis established a correlation between fault frequencies and bearing geometry. An algorithm for automated monitoring has been proposed, main fault categories have been identified, and directions for further research have been outlined to enhance diagnostic capabilities.

Risk factors for dementia include cardiovascular disease, smoking, and diabetes, which also are linked to compromised oral health and periodontal disease. Tooth loss, the hallmark of compromised oral health, is of interest for its systemic effects, including potential impacts on cognitive function. To evaluate tooth loss as a prognostic indicator in dementia, we conducted a register-based cohort study to assess associations of compromised oral health, defined by tooth loss, with mortality risk and progression of cognitive decline. The study population, obtained from linked Swedish nationwide health and quality assurance registries, comprised 3,361 individuals diagnosed with dementia from 2010 to 2013, with follow-up until 2018. Participants were categorized by tooth count: severe tooth loss (<10 remaining teeth), moderate tooth loss (10 to 19 remaining teeth), and a reference group with ≥20 remaining teeth. Mortality rate was analysed by Cox and Poisson regression models, and cognitive decline was assessed by longitudinal analyses of Mini Mental State Examination scores. Analyses were adjusted for demographic and health variables. Tooth loss at the time of dementia diagnosis was not independently associated with increased mortality after covariate adjustment (hazard ratio, 1.12 [95% CI, 0.97 to 1.28] for severe tooth loss vs reference). Annual Mini Mental State Examination scores declined across all groups, with no statistically significant differences among groups. After robust covariate control, no association was observed between tooth loss and increased mortality or cognitive decline in individuals newly diagnosed with dementia. Further studies are needed to determine whether tooth loss is an independent risk factor or a contributing marker in dementia prognosis.

Does the addition of three antioxidants to culture media during gamete collection, insemination, and embryo culture increase the clinical pregnancy rate from fresh blastocyst transfers? The clinical pregnancy rate from fresh blastocyst transfers was not increased by the addition of antioxidants to IVF and embryo culture media. Addition of antioxidants to media is beneficial in mouse IVF, embryo culture, and cryopreservation. Prospective clinical trials of sibling human oocytes found an improvement in embryo quality and increased pregnancy rates from frozen blastocyst transfers in older patients. Single-centre, prospective randomized controlled trial, superiority study comparing media with or without the addition of antioxidants from January 2019 to November 2021. A total of 1482 patients were randomized before egg collection. Patients and their doctors were blinded to the treatment group. Patients undergoing IVF/ICSI cycles and intending to undergo a fresh transfer of a single blastocyst were recruited. Exclusion criteria were previous participation in the study, use of cryopreserved oocytes/embryos, artificial oocyte activation, freeze-all cycle, or extraction of sperm from testicular biopsy. Seven hundred thirty-nine patients were randomized to control media and 743 patients to media containing the 'A3' antioxidant combination of acetyl-L-carnitine, α-lipoic acid, and N-acetyl-L-cysteine (treatment group). The clinical pregnancy rate per randomized patient per cycle from fresh embryo transfer was not different between the control and antioxidant media (26.1% vs 22.9%; P > 0.05; RR 0.88 (95% CI 0.73-1.05)). In the Per Protocol population, which excludes patients with protocol violations or without a fresh transfer due to freeze-all or no embryo available, there was also no difference in between the control and antioxidant media in clinical pregnancy rate (36.7% vs 33.2%; P > 0.05; RR 0.90 (95% CI 0.76-1.07)) and live birth rate (32.4% vs 29.5%, P > 0.05). In the Intention-to-Treat population, antioxidant media produced a significant increase in the fertilization rate from 59.2 ± 26.3% to 64.5 ± 25.4% (P < 0.001) compared to control media. Blastocyst development rate per fertilized oocyte was not affected by antioxidant media, but the higher fertilization rate resulted in more fertilized oocytes per patient and therefore more blastocysts utilized per patient in the antioxidant group compared to the control (2.70 ± 2.59 vs 3.09 ± 2.96, P < 0.01). The increase in fertilization rate was observed in a subgroup analysis of ICSI cycles (57.9 ± 27.2% vs 68.3 ± 24.7%, P < 0.0001), and a decrease in the number of cycles with failed fertilization from 8.0 to 3.7% with antioxidant media (P < 0.01). In contrast, there was no effect of antioxidant media on fertilization rate in cycles with IVF insemination. This was a single-centre study, so the effects of antioxidant media in clinics with different protocols are unknown. Patient oxidative stress, which may be influenced by inflammation, diet, smoking status, antioxidant supplement consumption, and other lifestyle factors, was not accounted for. Any potential effect of renewing the antioxidants in the media during culture was not examined. Addition of antioxidants to culture media did not affect pregnancy rates from fresh single embryo transfers. An increase in fertilization rate was observed, which resulted in more blastocysts available for transfer and cryopreservation. There was no effect of antioxidants on blastocyst development rate or grade. Further studies are needed to validate the observed effect of antioxidants on fertilization rate following ICSI. Culture media and an independent statistician were funded by Vitrolife AB. R.L.K has received travel funding and a speaker's honorarium from Vitrolife. D.K.G. has received research grants from Vitrolife at the University of Melbourne. N.-G.P. has received consulting fees from Vitrolife for work related to the study. All other authors have nothing to declare. ACTRN12618001479291. 4 September 2018. 28 January 2019.

Race influences outcomes in patients with cardiovascular diseases. However, the impact of race on cardiogenic shock outcomes is unclear. This retrospective cohort study included adult patients admitted to a cardiac intensive care unit for cardiogenic shock from June 2019 through June 2023. For analysis, patients were divided into 3 racial groups: White, Black, and other. Baseline demographics, comorbidities, admission source, and Sequential Organ Failure Assessment scores were collected. Primary outcomes were hospital and cardiac intensive care unit mortality. Secondary outcomes were hospital and cardiac intensive care unit lengths of stay and temporary mechanical circulatory support use. Propensity score weighting was used; pairwise comparisons between each group were performed. The analysis included 2458 patients (1959 White, 327 Black, 172 other). Black patients were younger, were less likely to be admitted from the emergency department (and more likely to be admitted from inpatient wards), and had higher Sequential Organ Failure Assessment scores than patients in the other 2 groups. Propensity-weighted pairwise comparisons demonstrated no significant differences in hospital and cardiac intensive care unit mortality. However, Black patients had significantly longer hospital (incidence rate ratio, 1.31; P < .001) and cardiac intensive care unit (incidence rate ratio, 1.33; P = .03) stays than did White patients but not patients in the "other" group. Temporary mechanical circulatory support use did not differ among groups. The results highlight disparities in clinical management of cardiogenic shock and the need for further research to address these inequities.

ABSTRACTIntroductionCardiac surgery in infants often triggers a severe inflammatory response. The role of biomarkers in predicting clinical outcomes in this group of patients has been debated in the literature. This study aimed to investigate the predictive value of 20 inflammatory biomarkers, in combination with clinical data, for acute kidney injury, ventilator support duration, and inotropic score following infant cardiac surgery by developing and comparing three models: Clinical‐Data‐Only, Biomarker‐Only, and Combined.MethodsThis secondary analysis of the MiLe‐1 study included infants undergoing surgery with cardiopulmonary bypass. Biomarkers were measured before and after CPB. Using BIC‐guided logistic regression, we developed and compared three multivariable models—Clinical‐Data‐Only, Biomarker‐Only, and Combined—for each outcome. Model performance was assessed using c‐statistics and p‐contrast tests.ResultsRegarding AKI risk prediction, the c‐statistics for Biomarker‐Only, Clinical‐Data‐Only, and Combined Model were 0.79, 0.60, and 0.78 respectively. The difference in performance between the Combined and Clinical‐Data‐Only Models was statistically significant (p < 0.001). Concerning ventilator support time prediction, the c‐statistics were 0.80, 0.72, and 0.77 for the models respectively (p‐contrast = 0.10). As for inotropic score prediction, the c‐statistics were 0.83, 0.77, and 0.85 for the models (p‐contrast = 0.007).ConclusionInflammatory biomarkers may enhance risk stratification for postoperative outcomes in infant cardiac surgery. However, given the exploratory nature of this study, further validation in larger and more diverse cohorts is needed.