Cardiovascular health awareness,risk perception,behavioural intention and INTERHEART risk stratification among middle-aged adults in Malaysia

Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023.Participants completed validated questionnaires assessing cardiovascular health awareness,risk perception of cardiovascular diseases,behavioural intention towards adopting healthy habits,and INTERHEART risk stratification score(IHRS)based on established risk factors.A total of 602 respondents were included in the final analysis.Data were analysed with independent t-test/one-way ANOVA or Mann-Whitney/Kruskal-Wallis to test the differences,Pearson correlation or linear regression test to analyze the association of independent and dependent variables.Results:There was a significant positive correlation between medical knowledge related to cardiovascular disease(CVD)and knowledge related to CVD risk prevention,risk perception,behavioural intention and IHRS(P<0.05,Pearson correlation).Notably,individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention,risk perception,and behavioural intention.Males,laborers,active/former smokers,individuals with lower household income and educational levels,those involved in occupations not related to the healthcare sector,and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge,risk perception,and poorer behavioural intention regarding cardiovascular health(P<0.05,one-way ANOVA).While educational level,smoking status,awareness about CVD poster,self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention,risk perception,behavioral intention and/or IHRS(P<0.05,linear regression).Conclusions:These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk.Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.

Correlation between psychological traits and the use of smart medical services in young and middle-aged adults: An observational study

BACKGROUND Psychological problems affect economic development.However,there is a huge gap between mental health service resources and mental health service needs.Existing mental health service technology and platforms cannot meet all the diverse mental health needs of people.Smart medicine is a new medical system based online that can effectively improve the quality and efficiency of medical services and make mental health services accessible.AIM To explore the level of intelligent medical use among young and middle-aged people and its correlation with psychological factors.METHODS Convenience sampling was used to select 200 young and middle-aged patients with medical experience at the Third People's Hospital of Chengdu between January 2022 and January 2023 as the research subjects.The general condition Questionnaire,Eysenck Personality Questionnaire,Symptom Checklist-90,General Health Questionnaire,and Smart Medical Service Use Intention Questionnaire were used to collect data.Pearson’s correlation was used to analyze the correlation between the participants’willingness to use smart medical services and their personality characteristics,psychological symptoms,and mental health.RESULTS The results revealed that the mental health of young and middle-aged people was poor,and some had psycho-logical problems such as anxiety,depression,and physical discomfort.Familiarity,acceptance,and usage of smart healthcare in this population are at a medium level,and these levels correlate with psychological characteristics.Acceptance was positively correlated with E,and negatively correlated with P,anxiety,fear,anxiety/insomnia,and social dysfunction.The degree of use was negatively correlated with P,obsessive-compulsive symptoms,depression,anxiety,hostility,paranoia,and somatic symptoms.CONCLUSION The familiarity,acceptance,and usage of smart medical services among the middle-aged and young groups are related to various psychological characteristics.

Study on the association of multimorbidity with sleep and diet in young and middle-aged adults in Chongqing region,China

Background:The prevalence of multimorbidity is increasing,with a notable shift towards younger age groups.Methods:Convenience sampling was employed to select 15,988 young and middle-aged adults in Chongqing as the study population.The Apriori algorithm was used to identify the multimorbidity patterns within this population,while an unordered binary logistic regression model was applied to assess the association between sleep,diet and the risk of multimorbidity.Results:The study population had an average age of 39.2±10.1 years.Apriori association rules revealed that the most prevalent binary chronic disease multimorbidity pattern was dyslipidaemia+hypertension(14.78%),while the most common ternary chronic disease multimorbidity pattern was diabetes+dyslipidaemia+hypertension(9.66%).The logistic regression analysis revealed that a lower rating of sleep quality was associated with an elevated risk of multimorbidity(odds ratio(OR)=1.17,95%confidence interval(CI):1.01,1.36).Individuals who adhere to a meat-based diet(OR=1.45,95%CI:1.25,1.68)and those with elevated salt intake(OR=1.22,95%CI:1.01,1.47)were also observed to have an increased risk of multimorbidity.Additionally,a greater likelihood of multimorbidity was observed among those following a spicy diet(OR=1.3,95%CI:1.11,1.52)and consuming more oil(OR=1.16,95%CI:1.01,1.33).Conclusion:A poor sleep quality and a dietary preference for meat-based,salt,spicy and oils were found to be associated with an increased risk of multimorbidity progression among young and middle-aged populations.It is recommended that young and middle-aged adults should pay attention not only to sleep duration but also to sleep quality and improve dietary habits to reduce the likelihood of multimorbidity.

Coping review of dementia fear studies among middle-aged and elderly people in the community

This study used Arksey and O’Malley’s scoping review methodology as a framework and searched the following databases:PubMed,Embase,EBSCO,CINAHL,Web of Science,Cochrane Library,Scopus,CNKI,Wanfang,VIP,and the Chinese Biomedical Literature Database.The database is open to December 20,2023,and documents related to the fear of dementia among the elderly in the community are described and analyzed to provide a reference for future research in this field.At the same time,we screened,extracted,and summarized relevant information from 21 included documents(16 in English and 5 in Chinese),which consisted of 16 cross-sectional studies,2 quasi-experimental studies,2 randomized controlled studies,and 1 longitudinal study.Sixteen of the included documents mentioned the incidence or level of dementia fear among the elderly in the community,2 addressed the adverse effects of dementia fear,and 4 reported prevention and intervention measures for dementia fear.In total,there are 8 assessment tools,and the influencing factors are categorized into sociodemographic characteristics,psychological and behavioral characteristics,sociocultural background factors,and health and dementia-related factors.The final conclusion is that the fear of dementia is common among the elderly in the community.In the future,the application of research tools should be expanded among middle-aged individuals,with considerations for other types of dementia in mind.It is recommended to conduct large-scale,multi-center randomized controlled trials while confirming the intervention’s effect on different types of middle-aged and elderly individuals,focusing on the long-term impact of these intervention measures to promote healthy aging.

The Association Between Daily Physical Activity and Risk of Hypertension in Middle-Aged and Older Adults:A Nationwide Cohort Study in China

Physical activity (PA) plays a key role in the treatment of hypertension, and moderate to vigorous PA has been documented to lower the risk of developing hypertension. However, dose-response relationships between PA and hypertension are not consistent, and little is known about this relationship within the Chinese middle-aged and older people. We investigated the relationship between PA and hypertension within this population using China Health and Nutrition Survey 1991-2015 data. Physical activity was expressed in terms of the metabolic equivalent task (MET) and participants were divided into groups according to quartiles, namely, Q1 (< 32.97 METs-h/w), Q2 (32.97-60.38 METs-h/ w), Q3 (60.38-98.95 METs-h/w), and Q4 (> 98.95 METs-h/w). Compared with the Q1 group, the odds ratio of risk with hypertension (95% CIs) after adjusting for confounding factors were 0.63 (0.35, 1.12), 0.49 (0.28, 0.86), and 0.62 (0.35, 1.09) for those in Q2, Q3, and Q4, respectively. Restricted cubic spline functions were used and a U-shaped relationship between physical activity and hypertension risk was found, indicative of an optimal level of physical activity, which was found to be 112 METs-h/w. Our data suggest maintenance of optimal levels of total daily physical activity may be important for preventing hypertension in Chinese adults over the age of 40.

The Relationship between Mental Health Literacy and Subjective Well-Being of Young and Middle-Aged Residents: Perceived the Mediating Role of Social Support and Its Urban-Rural Differences

This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.

Effect of Age and Sex on Stroke Mortality of Young and Middle-aged Adults in China,2002–2019,and Predictions to 2030

Objective This study aimed to examine the trends in stroke mortality among young and middle-aged adults in China.Methods Data were obtained from the China national vital registration system.Significant changes in mortality were assessed by Joinpoint regression.Age-period-cohort analysis was used to explain the reasons for the changes.Future mortality and counts were predicted by the Bayesian age-period-cohort model.Results Between 2002 and 2019,a total of 6,253,951 stroke mortality in young and middle-aged adults were recorded.The age-adjusted mortality rates(AAMRs)of women showed a downward trend.The annual percent changes(APC)were-3.5%(-5.2%,-1.7%)for urban women and-2.8%(-3.7%,-1.9%)for rural women.By contrast,the AAMRs per 100,000 for rural men aged 25–44 years continued to rise from 9.40 to 15.46.The AAMRS for urban men aged 25–44 years and urban and rural men aged 45–64years did not change significantly.Between 2020 and 2030,the projected stroke deaths are 1,423,584 in men and 401,712 in women.Conclusion Significant sex and age disparities in the trends of stroke mortality among young and middle-aged adults were identified in China.Targeted health policy measures are needed to address the burden of stroke in the young generation,especially for rural men,with a focus on the prevention and management of high risk factors.

Relationship between Waist Circumference, Waist-Height Ratio, Body Fat Percentage, Visceral Fat and Bone Mineral Density in Middle-Aged and Elderly Zhuang of China

Objective: To understand the correlation between different degrees of obesity and bone mineral density (BMD). Methods: 772 cases (300 men and 472 females) of Zhuang over 40 years old were randomly selected. The BMD and T score were calculated by measuring the right heel bone using a quantitative-ultrasound densitometer. Body composition index of body weight, waist circumference (WC), waist height ratio (WtHR), body fat percentage (BFP) and visceral fat (VF) were measured using a bioelectrical impedance method. Results: The BMI, WC, and WtHR of the male osteoporosis group were lower than those of the normal bone mass (NBM) group (P Conclusion: BMI is positively correlated with BMD in Zhuang. BFP has a greater correlation with female BMD, and a small reduction in BFP can result in a significant decrease in BMD. BMD of male was positively correlated with abdominal obesity indicators (WC, WtHR, VF). However, abdominal obesity has no obvious effect on the promotion of BMD in women, and increased WtHR can lead to a decrease in BMD. Zhuang can appropriately increase the amount of fat within the normal weight range. At the same time, reasonable exercise and balanced nutrition to avoid excessive obesity or low body weight can reduce the incidence of osteoporosis and osteoporosis fractures.

Association of fatigue with short-term prognosis in young and middle-aged patients with coronary heart disease

Background:To investigate the effect of fatigue on the short-term prognosis of young and middle-aged patients with coronary heart disease(CHD).Methods:A cross-sectional,observational survey was distributed at a tertiary hospital in Suzhou,China.Patients were assessed for fatigue and their prognosis was assessed at 3 and 6 months after discharge.General Information Questionnaire,Fatigue Scale and Seattle Angina Questionnaire(SAQ)were used for the survey.The Cox proportional hazard model was used to analyze the impact of fatigue on the occurrence of major adverse cardiac events(MACEs)at 3 and 6 months after discharge.Multiple linear regression models were used to analyze the effect of fatigue on health-related quality of life(HRQoL)at 3 and 6 months after discharge.Results:199 patients were followed up with in the end.43 patients(21.6%)with MACE three months after discharge had a total SAQ score of(399.76±39.61).The overall SAQ score was(425.14±22.66)and 52 patients(26.1%)experienced MACE six months after discharge.Fatigue was identified as a risk factor for MACE 6 months after discharge by the Cox proportional hazard model(HR=2.939,95%CI:0.177~0.655,P=0.001)and as an independent risk factor for quality of life 3 and 6 months after discharge by multiple linear regression(P<0.001).Conclusions:In individuals who are young or middle-aged and have coronary heart disease,fatigue is a risk factor for the short-term prognosis.It is advised that clinical professionals prioritize patient fatigue assessment and improve management of fatigue symptoms.

Influencing factors of fatigue in young and middle-aged patients with coronary heart disease:a cross-sectional study

Objective:To examine the present state of fatigue in young and middle-aged patients with coronary heart disease(CHD)and to identify the elements that may be affecting it.Methods:From December 2020 to June 2021,240 young and middle-aged patients with CHD who were being treated in the cardiology department of a tertiary care hospital in Suzhou were chosen using a convenience sampling method in order to gather data on the patients’sociodemographic status,fatigue,social support,and stress.Results:Of the 240 disseminated questionnaires,220 valid responses were returned,resulting in an effective recovery rate of 91.67%.The frequency of exhaustion was 51.8%,and the fatigue score was(5.27±2.77).The stress score was(11.15±3.36),while the overall social support score was(39.13±4.72).Binary logistic regression analysis indicated that age,exercise,staying up late,stress,social support,high-sensitivity troponin T,high-density lipoprotein,and ejection fraction were independent risk factors for fatigue in young and middle-aged patients with CHD(P<0.05).Conclusions:Fatigue is more prevalent in young and middle-aged patients with CHD.Clinical nurses can create a unique management plan for patients based on their lifestyle and behavioral patterns,stress levels,social support,and clinical signs to reduce fatigue.

Effects of Fertilization on Growth and Soil of Middle-aged Slash Pine Forest

In order to promote the growth of mid-aged Pinus elliottii plantation, the effects of different fertilizing amounts of formula fertilizer were studied on the growth, the soil and cost-benefit of 9 year-old Pinus el/iottii plantations in the north- ern part of Hunan, China. Three years after fertilization, the results showed that the increments of DBH, height, individual volume and stock volume of stand, and the fertilizer benefit of the different fertilization treatments were higher than the control to varying degrees, and among them, 700 g/tree was the best for promoting the growth of Pinus elliottii. Two years fertilization, the soil nutrients were improved compared with before, pH values of different layers decreased, organic matter and rapid available K contents increased, and rapid available N content increased dra- matically with the upper layer having an increase higher than the lower one; rapid available P decreased at different levels with the upper layer having a decrease lower than the lower one; and proper application of fertilizer could promote the growth of Pisolithus tinctofius, and 7 months after fertilization, the number of Pisolithus fruiting body generally increased with the increase of the fertilizer within 100-800 g/tree. The yield and benefit per unit area could be increased by fertiliza- tion for 1 time in middle-aged Pinus elliottii plantations, and the best fertilizing amount was N-P-K fertilizer 700 g/tree.

Characteristics of the HIV/AIDS Epidemic among People Aged≥50 Years in China during 2018–2021

Objective This study aimed to determine the current epidemiological status of PLWHA aged≥50 years in China from 2018 to 2021.It also aimed to recommend targeted interventions for the prevention and treatment of HIV/AIDS in elderly patients.Methods Data on newly reported cases of PLWHA,aged≥50 years in China from 2018 to 2021,were collected using the CRIMS.Trend tests and spatial analyses were also conducted.Results Between 2018 and 2021,237,724 HIV/AIDS cases were reported among patients aged≥50 years in China.The main transmission route was heterosexual transmission(91.24%).Commercial heterosexual transmission(CHC)was the primary mode of transmission among males,while non-marital non-CHC([NMNCHC];60.59%)was the prevalent route in women.The proportion of patients with CHC decreased over time(Z=67.716,P<0.01),while that of patients with NMNCHC increased(Z=153.05,P<0.01).The sex ratio varied among the different modes of infection,and it peaked at 17.65 for CHC.The spatial analysis indicated spatial clustering,and the high-high clustering areas were mainly distributed in the southwestern and central-southern provinces.Conclusion In China,PLWHA,aged≥50 years,were predominantly infected through heterosexual transmission.The primary modes of infection were CHC and NMNCHC.There were variations in the sex ratio among different age groups,infected through various sexual behaviors.HIV/AIDS cases exhibited spatial clustering.Based on these results,the expansion of HIV testing,treatment,and integrated behavioral interventions in high-risk populations is recommended to enhance disease detection in key regions.

Evaluation of Compatibilizers for Improving Compatibility between Waste Vegetable Oil and Aged Asphalt

Modifying agents 2,2-Bis(4-glycidyloxyphenyl)propane(2BPE)and dibutyl phthalate(DBP)were selected to enhance the compatibility.By using molecular simulation software(Materials Studio,MS),nine systems were constructed,including molecular models of aged asphalt and WVO monomers with 2BPE and/or DBP.The solubility parameters,Flory-Huggins parameters,and interaction energies of these systems were calculated to determine the impact of 2BPE and DBP on the compatibility of WVO and aged asphalt.Results showed that the addition of 2BPE and DBP reduced the difference in the solubility parameters between WVO and aged asphalt,thus improving the compatibility between WVO and aged asphalt.Additionally,using a combination of 2BPE and DBP in both aged asphalt and rejuvenator was found to be more effective than using either 2BPE or DBP alone.Finally,it was determined that evaluating the compatibility of WVO and aged asphalt using Van der Waals potential and non-bonding energy as evaluation indicators was more accurate than using electrostatic potential energy.

Laboratory Evaluation of Performance Recovery of Aged SBS-modified Asphalt Using Regenerants with Different Base Oil Components

In this study,the regenerative effects of different regenerants on aged SBS-modified asphalt from different perspectives were investigated,including their conventional properties,viscoelastic behavior,creep-related properties,and micromorphology.Base oils composed of different proportions of aromatic and saturated hydrocarbons as well as the styrene-butadiene-styrene(SBS)restorer were used to prepare the regenerants.The results showed that the components of the base oil of the regenerant played a crucial role in determining the characteristics and performance of the recycled SBSmodified asphalt.Regenerants containing a high proportion of aromatics dissolved the hard segment in the SBS restorer,thereby delaying the effect of a reduction in the regenerants on the performance of the aged asphalts at a high temperature.Regenerants containing a high proportion of saturates dissolved the soft segment in the SBS restorer to enhance the lowtemperature performance of the recycled asphalts.In addition,the stress sensitivity of the recycled asphalts increased with the fraction of aromatics in the regenerant.As the aromatic content of the base oil components of the regenerants increased and their saturate content decreased,the state of dispersion of the SBS phase in the recycled SBS-modified asphalts improved.The optimal content of aromatics in the base oil of the regenerants should be set in the range of 33%to 47%to ensure the adequate performance of the recycled asphalts and a high efficiency of the SBS restorer.

Microbiomics and metabolomics insights into the microbial regulation on the formation of flavor components in the traditional fermentation process of Chinese Hongqu aged vinegar

This study aimed to investigate microbial succession and metabolic dynamics during the traditional fermentation of Hongqu aged vinegar,and explore the core functional microbes closely related to the formation of flavor components.Microbiome analysis demonstrated that Lactobacillus,Acetobacter,Bacillus,Enterobacter,Lactococcus,Leuconostoc and Weissella were the predominant bacterial genera,while Aspergillus piperis,Aspergillus oryzae,Monascus purpureus,Candida athensensis,C.xylopsoci,Penicillium ochrosalmoneum and Simplicillium aogashimaense were the predominant fungal species.Correlation analysis revealed that Acetobacter was positively correlated with the production of tetramethylpyrazine,acetoin and acetic acid,Lactococcus showed positive correlation with the production of 2-nonanone,2-heptanone,ethyl caprylate,ethyl caprate,1-hexanol,1-octanol and 1-octen-3-ol,C.xylopsoci and C.rugosa were positively associated with the production of diethyl malonate,2,3-butanediyl diacetate,acetoin,benzaldehyde and tetramethylpyrazine.Correspondingly,non-volatile metabolites were also detected through ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry.A variety of amino acids and functional dipeptides were identified during the traditional brewing of Hongqu aged vinegar.Correlation analysis revealed that Lactobacillus was significantly associated with DL-lactate,indolelactic acid,D-(+)-3-phenyllactic acid,pimelic acid,pregabalin and 3-aminobutanoic acid.This study is useful for understanding flavor formation mechanism and developing effective strategies for the suitable strains selection to improve the flavor quality of Hongqu aged vinegar.

Weldability of steel used in an aged bridge

A series of experiments was performed to investigate the weldability of steel used in an aged bridge.A steel material used in an aged railway bridge constructed in 1912 was extracted for this investigation.The chemical compositions of this steel were suitable for welding.However,the aged steel contained much sulfur.Cruciform welded joints were fabricated with this aged steel.Welding defects or cracks were not observed in the joints.The Vickers hardness test on the welded part did not confirm extreme hardening or softening.After yielding by the static tensile test,the cruciform joints were fractured at the welded parts.One of the specimens was fractured in the middle of the thickness of the aged steel.The Sulfur contained in the aged steel might cause this type of fracture.The results show that there may be a risk of brittle fracture not only from the welded part but also from the base metal.The chemical compositions of aged steel must be analyzed when repair welding is applied to the steel.

Risk Factors for Geo-Helminthiasis in Children Aged 6 - 36 Months in a Rural Health District in Cameroon

Introduction and Objectives: Soil-Transmitted-Helminthiasis (STH) is a public health problem in Cameroon. The control strategies currently in place, particularly chemoprevention, has shortcomings linked to the target population, which are school-age children. The objective was to determine the prevalence and the risk factors associated with geo-helminthiasis in children aged 0 to 3 years in a rural health district. Method: From December 2020 to May 2021, a descriptive and analytical cross-sectional study of 376 children between 6 and 36 months was carried out in the Akonolinga health district. This was a cluster sampling in 4 health areas. Stool samples were collected and analysed using the mini-FLOTAC method. The results expressed as the number of eggs per gram of stool. A questionnaire on socio-demographic and lifestyle data was administered to the parents. The Chi-squared test was used to measure the association between geo-helminth infection and the data collected. A multivariate analysis using logistic regression was performed (p 0.05). Results: The prevalence of STH was 19.4% (Ascaris lumbricoides: 16% and Trichuris trichiura: 8%). Risk factors were: consumption of contaminated water (AOR = 1.93 [1.03 - 3.6];p = 0.040), early contact of the child with the ground (before age of 4 months) (AOR = 4.9 [2.1 - 11.37];p .001), habit of walking barefoot (AOR = 2.91 [1.1 - 7.97];p = 0.038), and living in a habitat with unpaved ground (AOR = 7.4 [1.55 - 35.7];p = 0.012). Conclusion: The prevalence of STHs in infants was high. Preventive chemotherapy should be extended to this age-group, and other measures intensified.

Factors Associated with Acute Respiratory Infections in Children Aged 0 - 5 Years in the Yénawa District of Cotonou (Benin) in 2023

Introduction: Acute respiratory infections remain one of the main causes of mortality in children aged 0 to 5. This work aimed to study the associated factors with the occurrence of acute respiratory infections in children 0 to 5 years old in Yénawa, Cotonou in 2023. Subjects and Method: It was an analytical cross-sectional study of children aged 0 - 5 years and their mothers in Yénawa, selected by four-degree random sampling. The sampling size, calculated using the Schwartz formula, was 126 children and 126 mothers. The dependent variable was the occurrence of acute respiratory infections. The independent variables were classified into four groups: socio-demographic and economic characteristics, behavioral factors, child-related factors, and environmental factors. Data collected by observation and questionnaire survey were analyzed using STATA version 15 software. Associated factors were investigated by bivariate analysis and multiple logistic regression, at the 5% significance level. Results: A total of 126 children aged 0 - 5 years and 126 mothers were surveyed, aged 23.5 (11 - 36) months and 30 (18 - 48) years respectively. The prevalence of acute respiratory infections was 74.60% (CI95% = 66.89 to 82.30). The associated factors were the mother’s age between 18 and 28 (OR = 10.77;CI95% = 1.89 to 61.27;p = 0.007), the use of charcoal/wood for cooking (OR = 7.36;IC = 1.99 to 27.10;p = 0.003)), children's poor personal hygiene (OR = 8.87;IC = 2.92 to 26.97;p 0.001)), and cohabitation with domestic animals (OR = 7.27;IC = 1.67 to 31.71;p = 0.015). Conclusion: Communicating with mothers about the factors identified will help reduce the prevalence of acute respiratory infections in children aged 0 to 5.

Factors Associated with Mortality in Children Aged 1 Month to 15 Years Hospitalized in the Pediatric Ward of the Kalaban-Coro Reference Health Center: Cross-Sectional Study

Introduction: Infant and child mortality is a worldwide concern, but developing countries such as Mali are more affected. The aim of this study was to investigate morbidity and factors associated with mortality in children aged 1 month to 15 years. Methodology: This was a cross-sectional study which took place from January 1 to December 31, 2020 covering children aged 1 month to 15 years hospitalized at the Kalaban-Coro CSRéf. Data were entered into Excel and analyzed using SPSS version 20 software. Results: Five hundred children aged 1 months to 15 years were included. The age range 1 to 5 years (53.6%) and male sex (58.2%) were the most represented. Malaria (72.2%), acute respiratory infections (6.2%) and diarrhea/dehydration (3%) were the main morbidities. Mortality was estimated at 10.6%, and the two main causes of death were malaria (56.6%) and acute respiratory infections (7.54%). Univariate analysis revealed a statistically significant association between the dependent variable (death) and age (p Conclusion: This study confirms the high rate of infant and child morbidity and mortality in our health facilities. Strengthening human resources and intensifying behavior-change communication can help reverse the trend.

Case of clear-cell hepatocellular carcinoma that developed in the normal liver of a middle-aged woman

A 36-year-old woman was admitted to our department for close examination of a liver tumor that was found during a medical checkup. Abdominal US, CT and MRI showed a tumor in segment 7 (S7) of the liver. Although imaging suggested hepatocellular carcinoma, laboratory tests showed no abnormality in liver function, hepatitis virus markers were negative, and tumor markers including protein induced by vitamin K absence or antagonist Ⅱ (PIVKA-Ⅱ), α-fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA) were all within normal ranges. Upon aspiration biopsy of the liver, the histopathological diagnosis was moderately differentiated hepatocellular carcinoma. Therefore, right hepatectomy was performed. Although a part of the tumor was necrotic, about 60% of the viable part showed a clear-cell variant. Consequently, it was diagnosed as clear-cell hepatocellular carcinoma. It was noted that the background liver tissue was normal. This case is worthy of reporting because development of clear-cell hepatocellular carcinoma in the normal liver of a middle-aged woman is rarely seen.