The role of alcohol and patterns of alcohol-related deaths in Republic of North Macedonia within the period 2007-2020.

Excessive alcohol consumption is one of the most important factors in a substantial number of violent deaths. The aim of our study was to investigate alcohol-related deaths in the Republic of North Macedonia in the period from 2007 to 2020, in order to study the influence of elevated blood alcohol levels in violent deaths. Five hundred sixty-four post-mortem blood samples from alcohol-related death cases-natural deaths and violent deaths (suicides, accidents, and homicides)-were analyzed, and the results were evaluated according to sex, age, and cause of death. Among 564 cases, traffic accidents were the leading cause of violent death (54.3% of the cases) followed by suicides (19.9% of the cases). In the examined post-mortem samples, BAC values ranged from 0.15-6.20 g/L. The average age was 45 ± 16 years for the male and 49 ± 19 years for the female group. The biggest proportion of high BAC values was found in the group of accidents specifically road traffic accidents and accidental intoxication as well as in the group of bolus deaths. The analysis of BAC in the cases of violent deaths in the Republic of North Macedonia confirmed that consumption of alcohol is strongly related to violent deaths. The data obtained from this study could raise caution and give aid in a national strategy for the prevention of alcohol-related violent deaths.

Measurement-oriented deep-learning workflow for improved segmentation of myelin and axons in high-resolution images of human cerebral white matter.

BACKGROUND: Standard segmentation of high-contrast electron micrographs (EM) identifies myelin accurately but does not translate easily into measurements of individual axons and their myelin, even in cross-sections of parallel fibers. We describe automated segmentation and measurement of each myelinated axon and its sheath in EMs of arbitrarily oriented human white matter from autopsies. NEW METHODS: Preliminary segmentation of myelin, axons and background by machine learning, using selected filters, precedes automated correction of systematic errors. Final segmentation is done by a deep neural network (DNN). Automated measurement of each putative fiber rejects measures encountering pre-defined artifacts and excludes fibers failing to satisfy pre-defined conditions. RESULTS: Improved segmentation of three sets of 30 annotated images each (two sets from human prefrontal white matter and one from human optic nerve) is achieved with a DNN trained only with a subset of the first set from prefrontal white matter. Total number of myelinated axons identified by the DNN differed from expert segmentation by 0.2%, 2.9%, and -5.1%, respectively. G-ratios differed by 2.96%, 0.74% and 2.83%. Intraclass correlation coefficients between DNN and annotated segmentation were mostly >0.9, indicating nearly interchangeable performance. COMPARISON WITH EXISTING METHOD(S): Measurement-oriented studies of arbitrarily oriented fibers from central white matter are rare. Published methods are typically applied to cross-sections of fascicles and measure aggregated areas of myelin sheaths and axons, allowing estimation only of average g-ratio. CONCLUSIONS: Automated segmentation and measurement of axons and myelin is complex. We report a feasible approach that has so far proven comparable to manual segmentation.

Human Hippocampal Neurogenesis Persists throughout Aging.

Adult hippocampal neurogenesis declines in aging rodents and primates. Aging humans are thought to exhibit waning neurogenesis and exercise-induced angiogenesis, with a resulting volumetric decrease in the neurogenic hippocampal dentate gyrus (DG) region, although concurrent changes in these parameters are not well studied. Here we assessed whole autopsy hippocampi from healthy human individuals ranging from 14 to 79 years of age. We found similar numbers of intermediate neural progenitors and thousands of immature neurons in the DG, comparable numbers of glia and mature granule neurons, and equivalent DG volume across ages. Nevertheless, older individuals have less angiogenesis and neuroplasticity and a smaller quiescent progenitor pool in anterior-mid DG, with no changes in posterior DG. Thus, healthy older subjects without cognitive impairment, neuropsychiatric disease, or treatment display preserved neurogenesis. It is possible that ongoing hippocampal neurogenesis sustains human-specific cognitive function throughout life and that declines may be linked to compromised cognitive-emotional resilience.

Drug-related deaths between 2002 and 2013 with accent to methadone and benzodiazepines.

AIM: The aim of the study is to assess the trends of overdose and drug related fatalities in the Republic of Macedonia during the 11 years. MATERIAL AND METHODS: Cross-sectional retrospective survey and reviewed of postmortem toxicological analyses which examined fatal poisonings with illegal drugs in years 2002-2013. Information about gender, age, drug consumption, reported years were analyzed. Narcotics were confirmed with toxicological semi quantitative fluorescence polarization immunoassay (FPIA) in urine (range 250-4000 ng/ml). RESULTS: Total of 165 deaths were observed. Out of them 145 (87.9%) were male. There is statistical significant differences between male and female DRD due to age (Mann-Whitney U Test = 925, Z = -2626, p = 0.0087). For p < 0.05 there is significant differences between genders due to cause of overdose (Pearson Chi-square = 9743, df = 4, p = 0.0449). DRD among male were mainly because of overdose due to heroin in 80 (51.17%) cases followed by DRD due to combination of methadone and BZD in 25 (11.72%) cases. Out of all DRD cases 50 (30.3%) are related to polydrug use. For p < 0.01 there is a significant differences between analyzed age groups due to cause of overdose (Pearson Chi-square = 33,886, df = 12, p = 0.0007). CONCLUSIONS: Death cause analysis reveals the difficulties in determining the role of substitution drugs, as many other factors may be involved. The findings also highlight the importance of further enhancing treatment interventions for benzodiazepine misuse among patients on methadone substitution treatment.