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Life insurance has classically provided financial security to millions of families to offset the financial loss due to the premature death of a breadwinner. Life insurance for this purpose can be as simple as a 10-year term policy providing for a temporary need, or the more complex indexed universal life (IUL) that has become one of the most popular cash value policies purchased in the last 15 years. However, policy sales have begun to shift away from a focus on death benefits toward providing tax-free retirement income. When premium financing is added to the inherent complexity of IUL, such plans have been failing at an alarming rate. The result can end in time-consuming and costly litigation against agents and their insurance companies. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer (CC) and breast cancer (BC) threaten women's well-being, influenced by health-related stigma and a lack of reliable information, which can cause late diagnosis and early death. ChatGPT is likely to become a key source of health information, although quality concerns could also influence health-seeking behaviours. Methods: This cross-sectional online survey compared ChatGPT's responses to five physicians specializing in mammography and five specializing in gynaecology. Twenty frequently asked questions about CC and BC were asked on 26th and 29th of April, 2023. A panel of seven experts assessed the accuracy, consistency, and relevance of ChatGPT's responses using a 7-point Likert scale. Responses were analyzed for readability, reliability, and efficiency. ChatGPT's responses were synthesized, and findings are presented as a radar chart. Results: ChatGPT had an accuracy score of 7.0 (range: 6.6-7.0) for CC and BC questions, surpassing the highest-scoring physicians (P < 0.05). ChatGPT took an average of 13.6 s (range: 7.6-24.0) to answer each of the 20 questions presented. Readability was comparable to that of experts and physicians involved, but ChatGPT generated more extended responses compared to physicians. The consistency of repeated answers was 5.2 (range: 3.4-6.7). With different contexts combined, the overall ChatGPT relevance score was 6.5 (range: 4.8-7.0). Radar plot analysis indicated comparably good accuracy, efficiency, and to a certain extent, relevance. However, there were apparent inconsistencies, and the reliability and readability be considered inadequate. Conclusions: ChatGPT shows promise as an initial source of information for CC and BC. ChatGPT is also highly functional and appears to be superior to physicians, and aligns with expert consensus, although there is room for improvement in readability, reliability, and consistency. Future efforts should focus on developing advanced ChatGPT models explicitly designed to improve medical practice and for those with concerns about symptoms. [ABSTRACT FROM AUTHOR]

Hyperlipidemia significantly contributes to the risk of developing cardiovascular diseases. However, about half of the patients do not adhere to their antihyperlipidemic medications, leading to healthcare costs and premature mortality. This study's objective was to determine the prevalence and associated factors of non-adherence to antihyperlipidemic medications. The study covered hypertensive patients (21,451) aged 21–75 years, presenting to the primary and secondary healthcare facilities across Pakistan (covering 21 divisions) from January 2022 to April 2023. The outcome intended was non-adherence to antihyperlipidemic medication, which was assessed by SEAMS and pill-counting methods (non-adherence < 80%). The study found overall non-adherence to antihyperlipidemic medication of 60.6% across Pakistan, with the highest non-adherence rates found in Azad Jammu and Kashmir (71.9%) and the lowest in Islamabad (47.7%). Multivariable logistic regression analysis revealed that female, no health card (Sehat Sahulat Program government insurance), < 5 years of illness, < 5 daily medications, and dose frequency of twice daily revealed a positively significant association with non-adherence. While monthly income 51,000–100,000, graduation level of education, Muhajir, and hyperlipidemia with one comorbid condition had a significant negative association with the non-adherence. Antihyperlipidemic non-adherence is a multifaceted, multifactorial, profound problem requiring a multipronged approach. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol remains a significant contributor to mortality and morbidity in Finland and the Baltic countries, particularly among men. This study aimed to assess alcohol policy restrictiveness in this region from 1995 to 2019 using a modified version of the Bridging the Gap (BtG‐M) policy scale and examine its association with alcohol‐related disease burden. Methods: The study utilised national laws to score policy restrictiveness (higher BtG‐M scores mean stricter policies) and age‐standardised rates of disability‐adjusted life years (DALY), years of life lost, years lived with disability and deaths per 100,000 from the 2019 Global Burden of Disease Study (GBD). Spearman correlation tests and panel data regression models were applied to assess the association between policy score and burden of disease. Results: Finland maintained a high BtG‐M score, while the Baltic countries experienced recent increases from initially lower scores. Alcohol‐related disease burden showed an inverse association with policy changes in these countries. Strongest association was seen between the BtG‐M score and DALY rates attributed to injuries. Premature mortality among men constituted the largest proportion of disease burden. Discussion and Conclusions: Despite challenges in accessing and comparing policy data over time, we showed a strong association between alcohol policy and alcohol‐related harm in Finland and the Baltic countries. This study is one of the first to use the BtG‐M scale to monitor changes in alcohol policies over time and their relationship to alcohol‐related harm using GBD methodology. The study highlights the effects of national alcohol policies on levels of alcohol‐related harm. [ABSTRACT FROM AUTHOR]

Bicyclists are recognized as vulnerable road users, with the escalating fatalities posing a safety concern. While fatal crashes involving bicyclists are often assumed to be similar, there is a crucial distinction between instant death and death occurring several days later, with the former being substantially more severe. This study delves into the analysis of bicyclists' time-to-death, spanning from immediate fatalities to deaths within 30 days, using data from the Fatality Analysis Reporting System from 2015 to 2019. Employing the Haddon Matrix approach, the variables are categorized into pre-crash, during-crash, and postcrash phases. This study considers crash notification time as the key postcrash measure. An explainable XGBoost model is developed using the SHAP technique to investigate the associations between variables and bicyclist time-to-death. The results show that substantial delays in crash notification time considerably reduce bicyclists' time-to-death and increase the likelihood of early death. Specifically, hit-and-run crashes, crashes in rural areas, and crashes during late-night hours exhibit notably longer crash notification times compared to non-hit-and-run crashes, urban areas, and other hours, respectively. In such cases, when no witnesses or survivors can notify emergency responders, on-road vehicle technologies like the advanced automatic collision notification system can promptly inform responders, reducing notification delays. [ABSTRACT FROM AUTHOR]

Although canine pituitary masses (PM) are increasingly treated with stereotactic radiotherapy (SRT), historical literature supports superior outcomes with conventional full‐course fractionated radiation therapy (FRT). A multi‐institutional retrospective study was performed, including dogs with PM treated from 2016 to 2022 with SRT (total dose 30 or 35 Gy in 5 daily fractions) or FRT (total dose 50–54 Gy in 19–20 daily fractions). The influence of potential prognostic/predictive factors was assessed, including pituitary: brain height, pituitary: brain volume, sex, age and endocrine status (functional [F] vs. nonfunctional [NF] PM). Forty‐four dogs with PM were included (26 F, 14 NF, 4 unknown). All patients completed protocols as scheduled (SRT = 27, FRT = 17) and two dogs had suspected Grade 1 acute neurotoxicity. During the first 6 months after RT, 5/27 (19%) dogs treated with SRT (4 F, 1 NF) and 3/17 (18%) dogs treated with FRT (all F) died or were euthanised because of progressive neurologic signs. The overall median survival time was 608 days (95% CI, 375–840 days). Young age at the time of treatment was significant for survival (p = 0.0288); the overall median survival time was 753 days for dogs <9 years of age (95% CI, 614–892 days) and 445 days for dogs ≥9 years of age (95% CI, 183–707 days). Survival time was not associated with treatment type or any other factor assessed herein. A prospective study using standardised protocols would further validate the results of the present study and potentially elucidate the predictors of early death. [ABSTRACT FROM AUTHOR]

Dravet syndrome is a developmental and epileptic encephalopathy (DEE) characterized by intractable seizures, comorbidities related to developmental, cognitive, and motor delays, and a high mortality burden due to sudden unexpected death in epilepsy (SUDEP). Most Dravet syndrome cases are attributed to SCN1A haploinsufficiency, with genetic modifiers and environmental factors influencing disease severity. Mouse models with heterozygous deletion of Scn1a recapitulate key features of Dravet syndrome, including seizures and premature mortality; however, severity varies depending on genetic background. Here, we refined two Dravet survival modifier (Dsm) loci, Dsm2 on chromosome 7 and Dsm3 on chromosome 8, using interval-specific congenic (ISC) mapping. Dsm2 was complex and encompassed at least two separate loci, while Dsm3 was refined to a single locus. Candidate modifier genes within these refined loci were prioritized based on brain expression, strain-dependent differences, and biological relevance to seizures or epilepsy. High priority candidate genes for Dsm2 include Nav2, Ptpn5, Ldha, Dbx1, Prmt3 and Slc6a5, while Dsm3 has a single high priority candidate, Psd3. This study underscores the complex genetic architecture underlying Dravet syndrome and provides insights into potential modifier genes that could influence disease severity and serve as novel therapeutic targets. [ABSTRACT FROM AUTHOR]

Indoor environments pose a significant health risk due to exposure to particulate matter (PM), leading to various diseases and premature deaths, and raising public concerns about indoor air quality. Household kitchens are a major contributor to indoor air pollution, emitting particulate matter of varying sizes during cooking, which disperses throughout the house. Understanding the extent of PM exposure and identifying its sources is crucial. This study assesses PM presence in Kuwaiti household kitchens, measuring concentrations of different‐sized particles (PM 0.3, 0.5, 1.0, 2.5, 5.0, and 10 μm) under various conditions. Measurements were taken for 24 h using a particle/mass monitor device, considering different ventilation scenarios, cooking oils, and methods. Spearman's rank correlation and indoor/outdoor (I/O) ratios investigate the correlation between indoor and outdoor PM exposure. Principal component analysis (PCA) models identify specific sources contributing to PM exposure. A questionnaire survey in Kuwaiti households determines primary kitchen sources during cooking. Results show that kitchens with ventilation systems consistently reduce PM concentrations. PM emissions during cooking vary based on factors like cooking method, energy type, cooking oil, food, additives, temperature, and ventilation. The cooking stove is the primary emission source, but other household activities contribute. This study enhances our understanding of influential factors affecting cooking emissions and their concentrations, contributing valuable insights into mitigating indoor air pollution. [ABSTRACT FROM AUTHOR]

Air pollution is arguably the most pressing human health concern today, accounting for approximately 7–9 million premature deaths worldwide. In the United States, more than 40% of early deaths caused by air pollution are assessed to be caused by emissions produced by neighboring states. This article examines one of the governance mechanisms used by the U.S. to address this issue: section 126 of the Clean Air Act. Critical factors including case length, evidence used, and case outcome are compiled for the population of section 126 petitions submitted from 2000–2022. This evidence is assessed using comparative case analysis. The findings reinforce two issues with the petition process already identified in the literature–the use of cost as a proxy for significance and the excessive and unclear burden of proof placed on downwind states–adding texture to the latter issue by examining the modeling techniques used by downwind states. This analysis identifies lengthy response timelines as an additional issue and calls to attention the infrequency with which the EPA has formally accepted petitions. Collectively, these issues increase the cost, complexity, and unpredictability of filing a section 126 petition. [ABSTRACT FROM AUTHOR]

Introduction: Air pollution is a major health risk factor. Ports might be an understudied source of air pollution. Methods: We conducted a spatial health impact assessment (HIA) of port-sourced air pollution for Barcelona for 2017 at the neighbourhood level. Total NO2 and PM10 and port-sourced NO2, PM10 and PM2.5 concentrations were available through the ADMS-Urban model. Population data, mortality and morbidity data, and risk estimates were obtained. We followed standard HIA methodologies and calculated relative risks and impact fractions for 1.35 million adults living in 73 neighbourhoods. Results: The city-wide mean total NO2 and PM10 concentrations were 37.88 μg/m3 (range: 19.61–52.17 μg/m3) and 21.68 μg/m3 (range: 17.33–26.69 μg/m3), respectively, of which 7% (range: 2–36%) and 1% (range: 0–7%) were port-sourced, respectively. The mean port-sourced PM2.5 concentration was 0.19 μg/m3 (range: 0.06–1.38 μg/m3). We estimated that 1,123 (PI: 0–3,060) and 1,230 (95% CI: 0–2,566) premature deaths were attributable to total NO2 and PM10, respectively, of which 8.1% (91; PI: 0–264) and 1.1% (13; 95% CI 0–29) were attributable to port-sourced NO2 and PM10, respectively. 20 (95% CI: 15–26) premature deaths were attributable to port-sourced PM2.5. Additionally, a considerable morbidity burden and losses in life expectancy were attributable to port-sourced air pollution. Neighbourhoods closest to the port in the south-east were most adversely affected, gradually decreasing towards the north-west. Conclusions: The port is an understudied air pollution source in Barcelona with strong health impacts. Cities need local insight into health risk factors, their sources, attributable burdens and distributions for defining targeted policies. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to investigate the clinical characteristics and analysis of related factors associated with early death in newly diagnosed patients with acute promyelocytic leukemia (APL). Methods: This retrospective study included patients who visited our hospital between January 2010 and August 2022 and were diagnosed with APL for the first time. We analyzed their clinical and laboratory characteristics and analysis of related factors associated with early death. Results: A total of 269 patients with a primary diagnosis of APL were collected. The male to female ratio was 6:5, and the median age was 42 years (range 7–80). Among patients with initial APL diagnosis, there were 34 early deaths, resulting in an early mortality rate of 13%. The median time from diagnosis to death was 8.5 days (range 3–24). Comparative analysis of the clinical characteristics between patients who died early and those who did not, using a logistic regression model, revealed that age, white blood cell count (WBC) at initial diagnosis, and prolongation time of prothrombin time (PT) were independent risk factors for early death in patients with primary APL (P < 0.05). Comparing the clinical characteristics during hospitalization between the early death group and the non-early death group, it was observed that the daily mean of WBC during hospitalization was significantly higher in patients who died early than in those who did not (P < 0.001). Conversely, the daily mean of platelet count (PLT) was significantly lower in patients who died early compared to those who did not (P < 0.001). Furthermore, statistically significant differences were found in the mean daily infusion of PLT (P < 0.05), fibrinogen (Fib) (P < 0.05), and fresh frozen plasma (FFP) (P < 0.05) during hospitalization between patients who died early and those who did not. Specifically, the mean daily infusion of PLT and FFP was significantly higher in the early-death group than in the non-early-death group. Cerebral hemorrhage was identified as the immediate cause of death in 25 out of the 34 early-death patients (74%). The remaining causes of death included infection in 5 cases (15%), all of which were severe pulmonary infections, including 2 cases of combined differentiation syndrome, and abandonment of treatment in 4 patients (11%) at initial diagnosis. Conclusion: In patients with primary APL, age, WBC at initial diagnosis, and PT prolongation time were identified as independent risk factors for early death (P < 0.05). Laboratory findings regarding WBC and PLT during hospitalization, as well as the infusion of PLT, Fib, and FFP during hospitalization, were also statistically significant. Cerebral hemorrhage was found to be the main cause of early death in patients with primary APL. [ABSTRACT FROM AUTHOR]

People with severe mental illness engage in considerably less physical activity than those without. They also experience premature mortality of around 10–25 years. A large proportion of these premature deaths are attributed to modifiable behaviours, including physical activity. The inpatient environment provides an opportunity to support people to become more physically active; however, there is limited evidence on which interventions are most successful and what contextual factors affect their delivery. A scoping review was conducted to help understand the extent and type of evidence in this area and identify research gaps. We included studies of physical activity correlates and interventions in adult inpatient mental health services published in peer-reviewed journals. Reviews, meta-analyses, and papers focusing on eating disorder populations were excluded. We searched the MEDLINE, CINAHL, PsycINFO, ASSIA and Web of Science databases for relevant studies published in English. We extracted data on study design, participant characteristics, intervention and control conditions, key findings, and research recommendations. We used a descriptive analytical approach and results are presented in tables and figures. Of 27,286 unique records screened, 210 reports from 182 studies were included. Sixty-one studies reported on correlates of physical activity, and 139 studies reported on physical activity interventions. Most intervention studies used a single-group, pre-post design (40%) and included fewer than 100 participants (86%). Ninety percent of interventions delivered physical activity directly to participants, and 50% included group-based sessions. The duration, type, frequency and intensity of sessions varied. Mental health was the most commonly reported outcome (64%), whereas physical activity was rarely an outcome (13%). Overall, there is a modest but growing body of research on physical activity in adult users of inpatient mental health services. More high-quality trials are needed to advance the field, and future research should target neglected intervention types, outcomes, populations and settings. [ABSTRACT FROM AUTHOR]

Background: This cohort study determines the predictors for cause-specific and timing of deaths in patients with COVID-19 in Taiwan. Methods: Patients with laboratory-confirmed COVID-19 admitted to Taipei City Hospital from January 1 to July 31, 2022, were recruited in this cohort. All patients were followed up until death, discharge from the hospital, or August 31, 2022. Early deaths within the first 2 weeks were recorded, and the cause of death was confirmed by the death certificate database of Taiwan. Predictors of cause-specific and timing of deaths of patients with COVID-19 were determined using multinomial Cox proportional hazards regression analysis. Results: Of the 195 (8.0%) patients who died during hospitalization, 147 (84.0%) had COVID-19-specific deaths. Moreover, 54.9% of the deceased patients had early death. After controlling for other covariates, patients aged ≥ 65 years had a higher risk of COVID-19-specific, non-COVID-19-specific, early, and late deaths [adjusted hazards ratio (AHR): 3.85, 6.45, 3.33, and 6.57; 95% confidence interval (CI): 1.91–7.78, 1.17–35.68, 1.51–7.36, and 2.18–19.76, respectively]. Fully vaccinated patients had a lower risk of COVID-19-specific (AHR: 0.68; 95% CI: 0.47–0.98) and early deaths (AHR: 0.54; 95% CI: 0.35–0.84), whereas comorbid patients with chronic obstructive pulmonary disease had a higher risk of non-COVID-19-specific deaths (AHR: 5.43; 95% CI: 1.73–17.03). Conclusions: This study suggests that prioritizing COVID-19 vaccination and carefully monitoring comorbid patients during hospitalization can reduce the risk of COVID-19-specific and early deaths and non-COVID-19-specific mortalities, respectively. [ABSTRACT FROM AUTHOR]

Non-small cell lung cancer (NSCLC) leads as a primary cause of cancer-related premature mortality in Western populations. This study leverages cutting-edge gene-expression-profiling technologies to perform an in-depth molecular characterization of NSCLC specimens, with the objective of uncovering tumor-specific genomic alterations. By employing DNA microarray analysis, our research aims to refine the classification of NSCLC for early detection, guide molecular-targeted treatment approaches, enhance prognostication, and broaden the scientific understanding of the disease's biology. We identified widespread genomic abnormalities in our samples, including the recurrent loss of chromosomal regions 3p, 5q, 13q, and 21q and the gain of 12p. Furthermore, utilizing Metascape for bioinformatic analysis revealed critical biological pathways disrupted in NSCLC, offering promising leads for novel therapeutic interventions. [ABSTRACT FROM AUTHOR]

Background: Scientific evidence clearly demonstrates that inhaling the smoke from the combustion of cigarettes is responsible for most of the harm caused by smoking, and not the nicotine. However, a majority of U.S. adults who smoke inaccurately believe that nicotine causes cancer which may be a significant barrier, preventing switching to potentially reduced risk, non-combustible products like electronic nicotine delivery systems (ENDS) and smokeless tobacco (ST). We assessed the population health impact associated with nicotine perceptions. Methods: Using a previously validated agent-based model to the U.S. population, we analyzed nationally representative data from the Population Assessment of Tobacco and Health (PATH) study to estimate base case rates of sustained (maintained over four waves) cessation and switching to non-combustible product use, by sex. Nicotine perception scenarios were determined from PATH data. The overall switch rate from smoking in Wave 4 to non-combustible product use in Wave 5 (3.94%) was stratified based on responses to the nicotine perception question "Do you believe nicotine is the chemical that causes most of the cancer caused by smoking cigarettes?", (four-item scale from "Definitely not" to "Definitely yes"). The relative percent change between the overall and stratified rates, corresponding to each item, was used to adjust the base case rates of switching, to determine the impact, if all adults who smoke exhibited switching behaviors based on responses to the nicotine perceptions question. The public health impact of nicotine perceptions was estimated as the difference in all-cause mortality between the base case and the four nicotine perception scenarios. Results: Switch rates associated with those who responded, "Definitely not" (8.39%) resulted in a net benefit of preventing nearly 800,000 premature deaths over an 85-year period. Conversely switch rates reflective of those who responded, "Definitely yes" (2.59%) resulted in a net harm of nearly 300,000 additional premature deaths over the same period. Conclusions: Accurate knowledge regarding the role of nicotine is associated with higher switch rates and prevention of premature deaths. Our findings suggest that promoting public education to correct perceptions of harm from nicotine has the potential to benefit public health. [ABSTRACT FROM AUTHOR]

Background: In the early postoperative stage after heart transplantation, there is a lack of predictive tools to guide postoperative management. Whether the vasoactive-inotropic score (VIS) can aid this prediction is not well illustrated. Methods: In total, 325 adult patients who underwent heart transplantation at our center between January 2015 and December 2018 were included. The maximum VIS (VISmax) within 24 h postoperatively was calculated. The Kaplan-Meier method was used for survival analysis. A logistic regression model was established to determine independent risk factors and to develop a nomogram for a composite severe adverse outcome combining early mortality and morbidity. Results: VISmax was significantly associated with extensive early outcomes such as early death, renal injury, cardiac reoperation and mechanical circulatory support in a gradedependent manner, and also predicted 90-day and 1-year survival (p < 0.05). A VIS-based nomogram for the severe adverse outcome was developed that included VISmax, preoperative advanced heart failure treatment, hemoglobin and serum creatinine. The nomogram was well calibrated (Hosmer-Lemeshow p = 0.424) with moderate to strong discrimination (C-index = 0.745) and good clinical utility. Conclusion: VISmax is a valuable prognostic index in heart transplantation. In the early post-transplant stage, this VIS-based nomogram can easily aid intensive care clinicians in inferring recipient status and guiding postoperative management. [ABSTRACT FROM AUTHOR]

Purpose: To examine associations between ablative therapy (AT) and partial nephrectomy (PN) and the occurrence of local recurrence (LR), distant metastatic recurrence (DMR) and all-cause mortality in a nation-wide real-world population-based cohort of patients with nonmetastatic renal cell carcinoma (nmRCC). Methods: Data on 2751 AT- or PN-treated nmRCC tumours diagnosed during 2005–2018, representing 2701 unique patients, were obtained from the National Swedish Kidney Cancer Register. Time to LR/DMR or death with/without LR/DMR was analysed using Cox regression models. Results: During a mean of 4.8 years follow-up, LR was observed for 111 (4.0%) tumours, DMR for 108 (3.9%) tumours, and death without LR/DMR for 206 (7.5%) tumours. AT-treated tumours had a 4.31 times higher risk of LR (P < 0.001) and a 1.91 times higher risk of DMR (P = 0.018) than PN-treated, with no significant differences in risk of death without LR/DMR. During a mean of 3.2 and 2.5 years of follow-up after LR/DMR, respectively, 24 (21.6%) of the LR cases and 56 (51.9%) of the DMR cases died, compared to 7.5% in patients without LR/DMR. There were no significant differences between AT- and PN-treated regarding risks of early death after occurrence of LR or DMR. Conclusion: AT treatment of patients with nmRCC implied significantly higher risks of LR and DMR compared with PN treatment. To minimize the risks of LR and DMR, these results suggest that PN is preferred over AT as primary treatment, supporting the EAU guidelines to recommended AT mainly to frail and/or comorbid patients. [ABSTRACT FROM AUTHOR]

The light‐assisted strategy is considered as an effective way to reduce the overpotential of lithium‐oxygen (Li─O2) batteries, however, the generated solid discharge products are prone to cover active sites of the solid‐state photocatalyst, causing the premature death of the cell. Herein, for the first time, the feasibility of soluble photocatalysts in Li─O2 battery system using Iron (II) Phthalocyanine (FePc) is verified. A micro reaction channel is constructed between the sp2‐carbon cathode and the soluble photocatalyst‐phthalein iron through π–π interaction, which can effectively increase the three‐phase reaction interface, facilitating the rapid separation and the transportation of photogenerated electrons and holes, thus improving the photocatalytic efficiency and the reaction kinetics of Li─O2 battery. Moreover, the FePc soluble photocatalysts induced the dual growth modes of surface growth and solution‐mediated growth pathways for the discharge products lead to an additional discharge capacity in the Li─O2 battery. Accordingly, the battery exhibits a lower overpotential of 0.33 V between discharge and charge plateaus at a current density of 0.01 mA cm−2, displaying the excellent cyclic stability (remaining a round‐trip efficiency of 81.1% after 130 cycles). The novel strategy provides new approaches for the construction of the light‐assisted Li─O2 batteries with reduced overpotential and boosted energy efficiency. [ABSTRACT FROM AUTHOR]

In order to study the ecological and atmospheric recovery of the Hexi Corridor region, this paper analyzes the migration changes of land use characteristics and utilizes multivariate data and BenMAP-CE software to study the pollution characteristics of ozone and its precursors and the impact on human health in the Hexi Corridor region. The results showed that the increase of cultivated land area in the Hexi Corridor mainly originated from grassland. The MDA8-O3 concentrations met the primary and secondary standards of the Ambient Air Quality Standards on 43% and 99% of the days, respectively. NO2 showed a negative weekend effect with O3, and HCHO was opposite to it. Temperature, barometric pressure, and vegetation were highly correlated with O3-NO2-HCHO. Ozone pollution in the study area caused about 60% of all-cause premature deaths due to cardiovascular diseases. The study suggests that controlling exogenous transport in Wuwei City during the high ozone period (except August) is mainly dominated by the west and northwest, and that synergistic management of VOCs and NOx emissions can reduce O3 pollution and, consequently, reduce the risk to human health. [ABSTRACT FROM AUTHOR]

Severe airborne particulate matter (PM, including PM 2.5 and PM 10) pollution in India has caused widespread concern. Accurate PM concentrations are fundamental for scientific policymaking and health impact assessment, while surface observations in India are limited due to scarce sites and uneven distribution. In this work, a simple structured, efficient, and robust model based on the Light Gradient-Boosting Machine (LightGBM) was developed to fuse multisource data and estimate long-term (1980–2022) historical daily ground PM concentrations in India (LongPMInd). The LightGBM model shows good accuracy with out-of-sample, out-of-site, and out-of-year cross-validation (CV) test R2 values of 0.77, 0.70, and 0.66, respectively. Small performance gaps between PM 2.5 training and testing (delta RMSE of 1.06, 3.83, and 7.74 µgm-3) indicate low overfitting risks. With great generalization ability, the openly accessible, long-term, and high-quality daily PM 2.5 and PM 10 products were then reconstructed (10 km, 1980–2022). This showed that India has experienced severe PM pollution in the Indo-Gangetic Plain (IGP), especially in winter. PM concentrations have significantly increased (p<0.05) in most regions since 2000 (0.34 µgm-3yr-1). The turning point occurred in 2018 when the Indian government launched the National Clean Air Programme, and PM 2.5 concentrations declined in most regions (-0.78 µgm-3yr-1) during 2018–2022. Severe PM 2.5 pollution caused continuous increased attributable premature mortalities, from 0.73 (95 % confidence interval (CI) [0.65, 0.80]) million in 2000 to 1.22 (95 % CI [1.03, 1.41]) million in 2019, particularly in the IGP, where attributable mortality increased from 0.36 million to 0.60 million. LongPMInd has the potential to support multiple applications of air quality management, public health initiatives, and efforts to address climate change. The daily and monthly PM 2.5 and PM 10 concentrations are publicly accessible at 10.5281/zenodo.10073944 (Wang et al., 2023a). [ABSTRACT FROM AUTHOR]

Schizophrenia (SCZ) is a severe psychotic disorder associated with premature mortality and aging. Moreover, the symptoms and progression of psychiatric disorders in general are associated with decreased lifespan, biological aging, and poorer medical outcomes. In this study, we investigated the relationship between several epigenetic clocks and scanned the entire genome for association in a cohort of SCZ individuals (n = 107). Biological age was computed from blood DNA methylation (DNAm) and tested for association against common variants across the genome using general linear models. Genes affecting epigenetic age acceleration in our cohort were found mainly when using the telomeric length clock rather than the other biological clocks. These findings pair with existing evidence that there are some genes associated with longevity and suggest further investigations of putative biological mechanisms for morbidity and premature mortality, not only in patients with SCZ but also in the general population. [ABSTRACT FROM AUTHOR]

Aim: To review the epidemiology and outcomes of African children with cerebral palsy (CP) over a 21‐year period. Method: The PubMed, Scopus, and Web of Science online databases were searched for original research on African children with CP aged 18 years and younger published from 2000 to 2021. Results: A total of 1811 articles underwent review against explicit criteria; 93 articles were selected for inclusion in the scoping review. The reported prevalence of CP ranged from 0.8 to 10 per 1000 children. Almost half had perinatal risk factors, but up to 26% had no identifiable risk factor. At least one‐third of children with CP had one or more comorbidities, most commonly epilepsy, intellectual disability, and malnutrition. African children with CP demonstrated excess premature mortality approximately 25 times that of the general population, predominantly from infections. Hospital‐based and younger populations had larger proportions of children with severe impairments. African children with CP had inadequate access to care and education, yet showed functional improvements compared to controls for all evaluated interventions. Interpretation: The prevalence of CP in Africa remains uncertain. African children with CP have different risk profiles, greater premature mortality, and more severe functional impairments and comorbidities compared to the Global North. Several barriers prevent access to optimal care. Larger African studies on validated and effective interventions are needed. [ABSTRACT FROM AUTHOR]

Developmental and epileptic encephalopathies (DEEs) are characterized by pharmacoresistant seizures and developmental delay. Patients with DEEs experience multiple seizure types, including tonic–clonic seizures (TCS) that can be generalized tonic–clonic (GTCS) or focal evolving to bilateral tonic–clonic (FBTCS). Fenfluramine (FFA) has demonstrated efficacy in reduction of TCS in patients with Dravet syndrome (DS), Lennox–Gastaut syndrome (LGS), and other DEEs. Using the PRISMA‐ScR (Preferred Reporting Items for Systematic Review and Meta‐Analyses extension for Scoping Review) guidelines, we performed a scoping review to describe changes in TCS in patients treated with FFA. A comprehensive search of five literature databases was conducted up to February 14, 2023. Studies were included if they reported change in GTCS or TCS (but not FBTCS) after treatment with FFA in patients with DEEs. Duplicate patients and studies with unclear efficacy data were excluded. Fourteen of 422 studies met the eligibility criteria. Data extracted and evaluated by expert clinicians identified 421 unique patients with DS (in nine studies), CDKL5 deficiency disorder, SCN8A‐related disorder, LGS, SCN1B‐related disorder, and other DEEs. The median percent reduction in GTCS or TCS from baseline was available in 10 studies (n = 328) and ranged from 47.2% to 100%. Following FFA treatment, 10 studies (n = 144) reported ≥50% reduction in GTCS or TCS from baseline in 72% of patients; in nine of those (n = 112), 54% and 29% of patients achieved ≥75% and 100% reduction in GTCS or TCS from baseline, respectively. Overall, this analysis highlighted improvements in GTCS or TCS frequency when patients were treated with FFA regardless of the DEE evaluated. Future studies may confirm the impact of FFA on TCS reduction and on decreased premature mortality risk (including sudden unexpected death in epilepsy), improvement in comorbidities and everyday executive function, decreased health care costs, and improvement in quality of life. [ABSTRACT FROM AUTHOR]

Cancer is a leading cause of mortality worldwide. By 2040, over 30 million new cancers are predicted, with the greatest cancer burden in low-income countries. In 2015, the UN passed the Sustainable Development Goal 3.4 (SDG 3.4) to tackle the rising burden of non-communicable diseases, which calls for a reduction by a third in premature mortality from non-communicable diseases, including cancer, by 2030. However, there is a paucity of data on premature mortality rates by cancer type. In this study, we examine annual rates of change for cancer-specific premature mortality and classify whether countries are on track to reach SDG 3.4 targets. This is a retrospective, cross-sectional, population-based study investigating premature mortality trends from 2000–19 using the WHO Global Health Estimates data. All cancers combined and thirteen individual cancers in 183 countries were examined by WHO region, World Bank income level, and sex. The risk of premature mortality was calculated for ages 30–69 years, independent of other competing causes of death, using standard life table methods. The primary objective was to compute average annual rate of change in premature mortality from 2000 to 2019. Secondary objectives assessed whether this annual rate of change would be sufficient to reach SDG 3.4. targets for premature mortality by 2030. This study was conducted using data retrieved for the years 2000–19. Premature mortality rates decreased in 138 (75%) of 183 countries across all World Bank income levels and WHO regions, however only eight (4%) countries are likely to meet the SDG 3.4 targets for all cancers combined. Cancers where early detection strategies exist, such as breast and colorectal cancer, have higher declining premature mortality rates in high-income countries (breast cancer 48 [89%] of 54 and colorectal cancer 45 [83%]) than in low-income countries (seven [24%] of 29 and four [14%]). Cancers with primary prevention programmes, such as cervical cancer, have more countries with declining premature mortality rates (high-income countries 50 [93%] of 54 and low-income countries 26 [90%] of 29). Sex-related disparities in premature mortality rates vary across WHO regions, World Bank income groups, and by cancer type. There is a greater reduction in premature mortality for all cancers combined and for individual cancer types in high-income countries compared with lower-middle-income and low-income countries. However, most countries will not reach the SDG 3.4 target. Cancers with early detection strategies in place, such as breast and colorectal cancers, are performing poorly in premature mortality compared with cancers with primary prevention measures, such as cervical cancer. Investments toward prevention, early detection, and treatment can potentially accelerate declines in premature mortality. WHO. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the leading cause of non‐cancer death in cancer survivors, but the risk of CVD varies between cancers. Objectives: To synthesise available evidence on patterns and magnitude of CVD mortality risk. Methods: A systematic search of Medline (OVID), CINAHL and Scopus databases from 01‐January‐2000 to 16‐July‐2023 of studies of people with cancer, reporting CVD mortality in cancer population compared with a reference population (e.g. general population) as standardised mortality ratios (SMR). Meta‐analysis of SMRs across cancer and CVD types were pooled using a random‐effects model to allow for heterogeneity of the true effect size across studies. Results: We identified 136 studies from 16 countries. Sample sizes ranged from 157 to 7,529,481. The majority (n = 98; 72%) were conducted in the United States, followed by Europe (n = 22; 16%). The most common cancers studied were gastrointestinal (n = 34 studies), haematological (n = 31) and breast (n = 29). A total of 876 CVD SMRs were extracted across diverse CVD conditions. Of those, the majority (535; 61%) indicated an increased risk of CVD death (SMR >1), 109 (12%) a lower risk of CVD death (SMR <1) and 232 (27%) an equivalent risk (95% CI of SMR included 1) compared to the general population. The meta‐analysis of all reported SMRs showed an increased risk of CVD death (SMR = 1.55, 95% CI = 1.40–1.72) in cancer survivors compared with the general population. The SMR varied between CVD conditions and ranged from 1.36 (95% CI = 1.29–1.44) for heart diseases to 1.56 (95% CI = 1.39–1.76) for cerebrovascular diseases. SMR varied across cancer types, ranging from 1.14 (95% CI = 1.04–1.25) for testicular/germ cell tumours to 2.82 (95% CI = 2.20–3.63) for brain/central nervous system tumours. Conclusions: Cancer survivors are at increased risk of premature CVD mortality compared to the general population, but the risk varies by cancer type and CVD. Future research should focus on understanding mechanisms behind the increased CVD risk to develop appropriate interventions. [ABSTRACT FROM AUTHOR]

Services play a crucial role in responding to homelessness, facilitating stable housing, and improving health outcomes. Yet people in need do not always access services and little is known about such individuals and groups. Using mortality data from the New Mexico Office of the Medical Investigator (OMI) that was cross-referenced with services records from Homelessness Management Information Systems (HMIS), this study identified and compared people affected by homelessness (N = 1196) who died between 2014 and 2019 based on whether they had engaged with homelessness services (n = 841) or who were unhoused without a record services engagement (n = 355). Groups were compared by age, race, gender, region of the state, and leading causes of death. Approximately 30 percent of individuals found to be homeless were not engaged in homelessness services. There were statistically greater numbers of Native Americans among those who were unhoused without a record of homelessness services. There were also inequities across regions of the state. This supports the need for increased outreach in rural areas and removing barriers to service engagement. The leading causes of death were drug overdose, alcohol, and heart disease, thus reinforcing the need for harm reduction education and practices both within and outside of services. [ABSTRACT FROM AUTHOR]

So far, a large number of studies have quantified the effect of COVID-19 lockdown measures on air quality in different countries worldwide. However, few studies have compared the influence of different approaches on the estimation results. The present study aimed to utilize a random forest machine learning approach as well as a difference-to-difference approach to explore the effect of lockdown policy on nitrogen dioxide (NO2) concentration during COVID-19 outbreak period in mainland China. Datasets from 2017 to 2019 were adopted to establish the random forest models, which were then applied to predict the NO2 concentrations in 2020, representing a scenario without the lockdown effect. The results showed that random forest models achieved remarkable predictive accuracy for predicting NO2 concentrations, with index of agreement values ranging between 0.34 and 0.76. Compared with the modelled NO2 concentrations, on average, the observed NO2 concentrations decreased by approximately 16 µg/m3 in the lockdown period in 2020. The difference-to-difference approach tended to underestimate the influence of COVID-19 lockdown measures. Due to the improvement of NO2 pollution, around 3722 non-accidental premature deaths were avoided in the studied population. The presented machine learning modelling framework has a great potential to be transferred to other short-term events with abrupt pollutant emission changes. [ABSTRACT FROM AUTHOR]

Aims: Hyperactivity of Ca2+/calmodulin‐dependent protein kinase II (CaMKII) has emerged as a central cause of pathologic remodelling in heart failure. It has been suggested that CaMKII‐induced hyperphosphorylation of the ryanodine receptor 2 (RyR2) and consequently increased diastolic Ca2+ leak from the sarcoplasmic reticulum (SR) is a crucial mechanism by which increased CaMKII activity leads to contractile dysfunction. We aim to evaluate the relevance of CaMKII‐dependent RyR2 phosphorylation for CaMKII‐induced heart failure development in vivo. Methods and results: We crossbred CaMKIIδC overexpressing [transgenic (TG)] mice with RyR2‐S2814A knock‐in mice that are resistant to CaMKII‐dependent RyR2 phosphorylation. Ca2+‐spark measurements on isolated ventricular myocytes confirmed the severe diastolic SR Ca2+ leak previously reported in CaMKIIδC TG [4.65 ± 0.73 mF/F0 vs. 1.88 ± 0.30 mF/F0 in wild type (WT)]. Crossing in the S2814A mutation completely prevented SR Ca2+‐leak induction in the CaMKIIδC TG, both regarding Ca2+‐spark size and frequency, demonstrating that the CaMKIIδC‐induced SR Ca2+ leak entirely depends on the CaMKII‐specific RyR2‐S2814 phosphorylation. Yet, the RyR2‐S2814A mutation did not affect the massive contractile dysfunction (ejection fraction = 12.17 ± 2.05% vs. 45.15 ± 3.46% in WT), cardiac hypertrophy (heart weight/tibia length = 24.84 ± 3.00 vs. 9.81 ± 0.50 mg/mm in WT), or severe premature mortality (median survival of 12 weeks) associated with cardiac CaMKIIδC overexpression. In the face of a prevented SR Ca2+ leak, the phosphorylation status of other critical CaMKII downstream targets that can drive heart failure, including transcriptional regulator histone deacetylase 4, as well as markers of pathological gene expression including Xirp2, Il6, and Col1a1, was equally increased in hearts from CaMKIIδC TG on a RyR WT and S2814A background. Conclusions: S2814 phosphoresistance of RyR2 prevents the CaMKII‐dependent SR Ca2+ leak induction but does not prevent the cardiomyopathic phenotype caused by enhanced CaMKIIδC activity. Our data indicate that additional mechanisms—independent of SR Ca2+ leak—are critical for the maladaptive effects of chronically increased CaMKIIδC activity with respect to heart failure. [ABSTRACT FROM AUTHOR]

Hypertension and cardiovascular disease are prominent features of chronic kidney disease, and they are associated with premature mortality and progression toward end-stage kidney disease. Renalase, an enzyme secreted predominantly by the kidney and identified in 2005, seems to be one of the missing pieces in the puzzle of heart and kidney interaction in chronic kidney disease by lowering blood pressure and reducing the overactivity of sympathetic tone. This review aims to summarize evidence from clinical studies performed on subjects with CKD in order to explore the value of renalase as a marker and/or a therapeutic target in this disease. [ABSTRACT FROM AUTHOR]

We quantify anthropogenic sources of health burdens associated with ambient air pollution exposure in South Korea and forecast future health burdens using domestic emission control scenarios by 2050 provided by the United Nations Environment Programme (UNEP). Our health burden estimation framework uses GEOS‐Chem simulations, satellite‐derived NO2, and ground‐based observations of PM2.5, O3, and NO2. We estimate 19,000, 3,300, and 8,500 premature deaths owing to long‐term exposure to PM2.5, O3, and NO2, respectively, and 23,000 NO2‐associated childhood asthma incidences in 2016. Next, we calculate anthropogenic emission contributions to these four health burdens from each species and grid cell using adjoint sensitivity analysis. Domestic sources account for 56%, 38%, 87%, and 88% of marginal emission contributions to the PM2.5‐, O3‐, and NO2‐associated premature deaths and the NO2‐associated childhood asthma incidences, respectively. We project health burdens to 2050 using UNEP domestic emission scenarios (Baseline and Mitigation) and population forecasts from Statistics Korea. Because of population aging alone, there are 41,000, 10,000, and 20,000 more premature deaths associated with PM2.5, O3, and NO2 exposure, respectively, and 9,000 fewer childhood asthma incidences associated with NO2. The Mitigation scenario doubles the NO2‐associated health benefits over the Baseline scenario, preventing 24,000 premature deaths and 13,000 childhood asthma incidences by 2050. It also slightly reduces PM2.5‐ and O3‐associated premature deaths by 9.9% and 7.0%, unlike the Baseline scenario where these pollutants increase. Furthermore, we examine foreign emission impacts from nine SSP/RCP‐based scenarios, highlighting the need for international cooperation to reduce PM2.5 and O3 pollution. Plain Language Summary: This study examines the impact of anthropogenic air pollution on human health in South Korea. For the year 2016, air pollution is associated with various health burdens, including premature deaths and childhood asthma incidences. Using advanced air quality model simulations and data analysis, we assess the contribution of local emissions to these problems, finding a significant portion attributable to domestic sources. Looking to the year 2050, we apply United Nations Environment Programme emission scenarios to forecast future health impacts. Without further emission reductions, premature deaths associated with major air pollutants are expected to increase. However, adopting additional emission reduction measures could significantly lower both premature deaths and childhood asthma incidences by 2050. The study underscores the importance of international cooperation for reducing air pollution, highlighting the extent to which South Korea's air quality is affected by foreign emissions, and emphasizing the necessity of both local and international actions to enhance air quality and safeguard public health. Key Points: We estimate premature deaths and childhood asthma incidences associated with air pollution exposure in South KoreaWe quantify responses of each health burden to anthropogenic emission changes using adjoint sensitivity analysisWe project health burdens to 2050 with assessment of domestic emission control scenarios provided by the United Nations Environment Programme [ABSTRACT FROM AUTHOR]

Objective: In epilepsy, early diagnosis, accurate determination of epilepsy type, proper selection of antiseizure medication, and monitoring are all essential. However, despite recent therapeutic advances and conceptual reconsiderations in the classification and management of epilepsy, serious gaps are still encountered in day‐to‐day practice in Egypt as well as several other resource‐limited countries. Premature mortality, poor quality of life, socio‐economic burden, cognitive problems, poor treatment outcomes, and comorbidities are major challenges that require urgent actions to be implemented at all levels. In recognition of this, a group of Egyptian epilepsy experts met through a series of consecutive meetings to specify the main concepts concerning the diagnosis and management of epilepsy, with the ultimate goal of establishing a nationwide Egyptian consensus. Methods: The consensus was developed through a modified Delphi methodology. A thorough review of the most recent relevant literature and international guidelines was performed to evaluate their applicability to the Egyptian situation. Afterward, several remote and live rounds were scheduled to reach a final agreement for all listed statements. Results: Of 278 statements reviewed in the first round, 256 achieved ≥80% agreement. Live discussion and refinement of the 22 statements that did not reach consensus during the first round took place, followed by final live voting then consensus was achieved for all remaining statements. Significance: With the implementation of these unified recommendations, we believe this will bring about substantial improvements in both the quality of care and treatment outcomes for persons with epilepsy in Egypt. Plain Language Summary: This work represents the efforts of a group of medical experts to reach an agreement on the best medical practice related to people with epilepsy based on previously published recommendations while taking into consideration applicable options in resource‐limited countries. The publication of this document is expected to minimize many malpractice issues and pave the way for better healthcare services on both individual and governmental levels. [ABSTRACT FROM AUTHOR]

Air pollution causes premature death and disease and disproportionately harms non-white and lower-income groups in the United States. Government policies are responsible for the racial disparity in air pollution exposure and related health outcomes. Investigating complex relationships between policies, air pollution, and health requires (i) harmonized data connecting policies, environmental exposures, socioeconomic characteristics, and health at the individual and area level; (ii) interpretable estimands accounting for the complex interplay between policies and disparities in exposures and health outcomes; and (iii) data science approaches that can elucidate direct and indirect policy effects on disparities to identify effective interventions. We review statistical considerations and new data science approaches needed to scrutinize the policy impacts on disparities in air pollution exposure and health outcomes. [ABSTRACT FROM AUTHOR]

Background: Niemann-Pick disease type C1 (NPC1, MIM 257220) is a heritable lysosomal storage disease characterized by a progressive neurological degeneration that causes disability and premature death. A murine model of Npc1-/- displays a rapidly progressing form of Npc1 disease, which is characterized by weight loss, ataxia, and increased cholesterol storage. Npc1-/- mice receiving a combined therapy (COMBI) of miglustat (MIGLU), the neurosteroid allopregnanolone (ALLO) and the cyclic oligosaccharide 2-hydroxypropyl-ß-cyclodextrin (HPßCD) showed prevention of Purkinje cell loss, improved motor function and reduced intracellular lipid storage. Although therapy of Npc1-/- mice with COMBI, MIGLU or HPßCD resulted in the prevention of body weight loss, reduced total brain weight was not positively influenced. Methods: In order to evaluate alterations of different brain areas caused by pharmacotherapy, fresh volumes (volumes calculated from the volumes determined from paraffin embedded brain slices) of various brain structures in sham- and drug-treated wild type and mutant mice were measured using stereological methods. Results: In the wild type mice, the volumes of investigated brain areas were not significantly altered by either therapy. Compared with the respective wild types, fresh volumes of specific brain areas, which were significantly reduced in sham-treated Npc1-/- mice, partly increased after the pharmacotherapies in all treatment strategies; most pronounced differences were found in the CA1 area of the hippocampus and in olfactory structures. Discussion: Volumes of brain areas of Npc1-/- mice were not specifically changed in terms of functionality after administering COMBI, MIGLU, or HPßCD. Measurements of fresh volumes of brain areas in Npc1-/- mice could monitor region-specific changes and response to drug treatment that correlated, in part, with behavioral improvements in this mouse model. [ABSTRACT FROM AUTHOR]

Introduction: HIV late presenters were defined as individuals presenting with a CD4 count below 350 cells/μL or with an AIDS-defining event, according to the European Late Presenter Consensus working group. Early diagnosis and treatment of HIV have proven beneficial for people living with HIV (PLHIV), reducing the burden on healthcare systems, and contributing to ending the HIV/AIDS epidemic. However, in Malaysia, over 50% of newly diagnosed HIV patients present late, leading to increased morbidity and premature mortality. This study aims to determine the prevalence of late HIV presenters and its association with HIV-related stigma and HIV knowledge among PLHIV attending public primary care clinics in Selangor. Methods: A cross-sectional study was conducted at selected public health clinics in Selangor, involving PLHIV aged 18 years and older, who were diagnosed since 2019. HIV-related stigma was measured using the Malay version of Berger's HIV Stigma Scale, and HIV knowledge was assessed using the Malay version of Brief HIV-KQ-18. Univariate and multivariate logistic regression analyses were performed to identify factors associated with late HIV presentation. Results: A total of 400 participants were included in the study, with 60.0% (n = 240, 95% CI: 55.0–65.0) classified as late presenters. The participants had a mean age of 30.29 (±7.77) years. The risk factors for late presenters were high levels of HIV-related stigma (aOR = 1.049, 95% CI: 1.034–1.063, p-value <0.001), low levels of HIV knowledge (aOR = 0.709, 95% CI: 0.646–0.778, p-value <0.001), tertiary education background (aOR = 15.962, 95% CI: 1.898–134.235, p-value = 0.011), and being single (aOR = 3.582, 95% CI: 1.393–9.208, p-value = 0.008). Conclusion: This study highlights the association between high levels of HIV-related stigma, low levels of HIV knowledge, and late HIV presentation. Interventions targeting stigma reduction and HIV education can promote early testing and prompt access to care, improving health outcomes for PLHIV. [ABSTRACT FROM AUTHOR]

In 1106, Constance, the daughter of King Philip I of France, married Bohemond of Antioch, a hero of the First Crusade. After their wedding, the couple returned to Bohemond’s territories in Apulia. However, their marriage proved short-lived. Bohemond’s untimely death in 1111 left Constance with the task of securing the inheritance of their only surviving son, Bohemond II, still a minor at the time. Throughout the course of the next fifteen years, Constance was relentless in her determination to preserve Bohemond II’s patrimony, enduring repeated captivities and working tirelessly to secure the military and diplomatic support necessary to establish permanent control of his inheritance. This article argues that these actions on behalf of her son and the experiences that informed them reflect her expectations about motherhood and her understanding of her role in that capacity. It integrates a range of sources, most notable among them her unique seal, to demonstrate how her conception of motherhood was informed by her own experiences as a child and her observations of other powerful women acting on behalf of their own sons. Her tenacity was a direct reflection of her emotional investment in and maternal commitment to Bohemond II, providing insight into the medieval mother-son bond. Her determination to physically protect her son in the present as well as ensure his future safety by establishing control of the lands he inherited from his father were impulses she would have shared with noble mothers across medieval Europe. [ABSTRACT FROM AUTHOR]

Background: Smoking is a leading cause of premature mortality and morbidity globally. The pollutants generated from smoke are not only harmful to smokers, but also to those exposed to secondhand smoke. As a result of increasingly restrictive indoor smoke-free policies in many countries, there is a tendency for tobacco smoking to move outdoors into partially enclosed settings in hospitality venues. The aim of this systematic review was to evaluate the impact of secondhand smoke on air quality in outdoor hospitality venues. Methods: Two electronic databases PubMed and Scopus were searched from 1 January 2010 to 30 June 2022 for studies of air quality impacts from tobacco smoking in outdoor hospitality venues. A total of 625 studies were screened and 13 studies were included in this review. Results: The majority (9 studies) of reviewed studies monitored PM2.5 concentration as an indicator of secondhand smoke. PM2.5 was reported from 10.9 µg/m3 to 91.0 µg/m3 in outdoor smoking areas, compared to 4.0 µg/m3 to 20.4 µg/m3 in outdoor control sites unaffected by smoking. Secondhand smoke can also drift into adjacent outdoor areas or infiltrate into indoor environments thus affecting air quality in spaces where smoking is not permitted. Conclusions: The reviewed studies indicated that air quality within outdoor hospitality venues where smoking is permitted is unlikely to meet current World Health Organization (WHO) ambient air quality guidelines for PM2.5. Customers and staff in outdoor hospitality venues with active smoking, and in adjacent outdoor and indoor non-smoking areas, are potentially exposed to secondhand smoke at levels exceeding WHO guidelines. Stronger smoking control policies are recommended for outdoor hospitality venues to protect the health of customers and staff from harmful secondhand smoke exposure. Prospero registration: CRD42022342417. [ABSTRACT FROM AUTHOR]

Object tracking application is one of the important as well as challenging application of energy constrained Wireless Sensor Network (WSN).Timely and accurate action is required whenever the presence of object is sensed in the area of interest (AOI).This requires a lot of data collection from surrounding environment, routing of these data to base station (BS) and data processing. Large volume of data processing challenges the long survival of the WSN. In other way, expecting accurate tracking result with less data is quite impossible. Early exhaustion of node energy leads to early node death which affects the tracking quality. Therefore, it is required to maintain the accuracy in tracking result while not affecting the longevity of the network. Use of heterogeneous sensor nodes and cluster architecture of the network are two of the many factors that can enhance the lifetime of the network to some extent. Lifetime of the network can be further enhanced using optimum data routing procedure. This paper proposes a novel swarm intelligence based routing algorithm called HGWO-Firefly algorithm for routing of information to BS in a WSN with cluster architecture. Proposed algorithm consists of two broad steps. In first step, potential cluster head (CH) selection is done using hybrid K-means and Grey Wolf Optimization (GWO) algorithm. In second step, selection of energy efficient route in between BS and sensor node is done using Firefly algorithm. When the performance of the proposed algorithm is compared with existing PSO-based routing algorithm and FIGWO algorithm, it is found that the performance of the proposed algorithm is better. [ABSTRACT FROM AUTHOR]

AbstractTupac Shakur is remembered for many things. Rapper. Actor. Poet. Thug. Scholar. Moreover, while Shakur was “one of hip-hop’s most successful and influential artists, with more than 75 million records sold worldwide (Hess, 2007), he was also remembered as a contradiction. Known for his anthem to black womanhood, Dear Momma, Shakur was found guilty of sexual assault. As the son of Black Panther, the late Afeni Shakur, Tupac spoke out against gun violence, and yet songs such as Death Around the Corner promoted the use of violence. Beyond his enigmatic persona, his body of work, 25 years after his untimely death, still leaves questions for exploration. [ABSTRACT FROM AUTHOR]

School dropout is associated with numerous detrimental consequences including prolonged unemployment, poverty, a wide range of psychological and physical health problems, and premature mortality. As such, designing and implementing interventions to prevent school dropout and ensure successful school completion is crucial. The purpose of the current study was to conduct a longitudinal realist evaluation to understand how, and under which circumstances, a multi-component intervention delivered through the charitable foundation of a professional sports team may impact the developmental outcomes of disengaged students. The intervention comprised one-to-one mentoring, classroom-based learning, sport and physical activity. Participant observations and fifty-two interviews were conducted with teachers and students over a ten-month period to form context-mechanism-outcome configurations (CMOCs) and to refine initial programme theories. The CMOCs developed highlighted the importance of students developing healthy conflict resolution skills and emotional regulation strategies, the potential of sporting content to re-ignite interest in academic learning, the powerful effects of deviant peer contagion, the synergistic impact of a multi-component intervention, and the role of pre-existing and ongoing contextual factors in determining whether interventions can create sustainable and lasting desirable outcomes among students. The findings provide practical recommendations for future sport-framed intervention design, implementation, and evaluation. [ABSTRACT FROM AUTHOR]

Objective: This study analyzed the mortality trends from avoidable causes in Korea from 1997 to 2021, to estimate its contribution to the overall mortality in different subgroups, including. Gender, age, and cause of disease. Methods: The all-cause and avoidable mortality were presented as a time series plot and average annual percent change. Trend of avoidable mortality was also analyzed by subgroups, disease causes and the percentage attributed to each causes. Results: The decline in avoidable mortality accounted for 82.6% of all-cause mortality reduction. Preventable mortality showed a more pronounced decline than treatable mortality, explaining 72.3% of the avoidable mortality reduction. In 1997-2001, avoidable death occurred in 72.2% (537,024 cases) of all-cause deaths, which declined to 60.0% (342,979 cases) in 2017-2021. The contribution of avoidable mortality in the decline of all-cause morality was greater in males (83.6%) than in females (79.3%). Conclusion: The decline in avoidable mortality and its contribution to the all-cause mortality reduction implies general improvement of the population health in Korea. Nevertheless, the heterogenous trend within different subgroups warrants more equitable design and implementation of health services and policies. [ABSTRACT FROM AUTHOR]

Aim: To investigate the association of gestational diabetes mellitus (GDM) with premature mortality and cardiovascular (CVD) outcomes and risk factors. Materials and Methods: Parous women recruited to the UK Biobank cohort during 2006‐2010 were followed up from their first delivery until 31 October 2021. The data were linked to Hospital Episode Statistics and mortality registries. Multivariate Cox proportional hazard models investigated associations of GDM with all‐cause mortality, CVD, diabetes, hypertension and dyslipidaemia. Results: The maximum total analysis time at risk and under observation was 9 694 090 person‐years. Among 220 726 women, 1225 self‐reported or had a recorded diagnosis of GDM. After adjusting for confounders and behavioural factors, GDM was associated with increased risk for premature mortality [hazard ratio (HR): 1.44, 95% confidence interval (CI): 1.12‐1.86], particularly CVD‐related death (HR: 2.38, 95% CI: 1.63‐3.48), as well as incident total CVD (HR: 1.50, 95% CI: 1.30‐1.74), non‐fatal CVD (HR: 1.41, 95% CI: 1.20‐1.65), diabetes (HR: 14.37, 95% CI: 13.51‐15.27), hypertension (HR: 1.49, 95% CI: 1.38‐1.60), and dyslipidaemia (HR: 1.30, 95% CI: 1.22‐1.39). The total CVD risk was greater in women with GDM who did not later develop diabetes than in those with GDM and diabetes. Conclusions: Women with GDM are at increased risk of premature death and have increased CV risk, emphasizing the importance of interventions to prevent GDM. If GDM develops, the diagnosis represents an opportunity for future surveillance and intervention to reduce CVD risk factors, prevent CVD and improve long‐term health. [ABSTRACT FROM AUTHOR]

Introduction Early appropriate allocation of resources for critically injured combat casualties is essential. This is especially important when inundated with an overwhelming number of casualties where limited resources must be efficiently allocated, such as during mass casualty events. There are multiple scoring systems utilized in the prehospital combat setting, including the shock index (SI), modified shock index (MSI), simple triage and rapid treatment (START), revised trauma score (RTS), new trauma score (NTS), Glasgow Coma Scale + age + pressure (GAP), and the mechanism + GAP (MGAP) score. The optimal score for application to the combat trauma population remains unclear. Materials and Methods This is a secondary analysis of a previously described dataset from the Department of Defense Trauma Registry from January 1, 2007 through March 17, 2020. We constructed univariable analyses to determine the area under the receiving operator characteristic (AUROC) for the scoring systems of interest. Our primary outcomes were early death (within 24 hours) or early massive transfusion, as defined by ≥3 units. Results There were 12,268 casualties that met inclusion criteria. There were 168 (1%) who died within the first 24 hours and 2082 (17%) that underwent significant transfusion within the first 24 hours. When assessing the predictive capabilities for death within 24 hours, the AUROCs were 0.72 (SI), 0.69 (MSI), 0.89 (START), 0.90 (RTS), 0.83 (NTS), 0.90 (GAP), and 0.91 (MGAP). The AUROCs for massive transfusion were 0.89 (SI), 0.89 (MSI), 0.82 (START), 0.81 (RTS), 0.83 (NTS), 0.85 (MGAP), and 0.86 (GAP). Conclusions This study retrospectively applied seven triage tools to a database of 12,268 cases from the Department of Defense Trauma Registry to evaluate their performance in predicting early death or massive transfusion in combat. All scoring systems performed well with an AUROC >0.8 for both outcomes. Although the SI and MSI performed best for predicting massive transfusion (both had an AUROC of 0.89), they ranked last for assessment of mortality within 24 hours, with the other tools performing well. START, RTS, NTS, MGAP and GAP reliably identified early death and need for massive transfusion, with MGAP and GAP performing the best overall. These findings highlight the importance of assessing triage tools to best manage resources and ultimately preserve lives of traumatically wounded warfighters. Further studies are needed to explain the surprising performance discrepancy of the SI and MSI in predicting early death and massive transfusion. [ABSTRACT FROM AUTHOR]

Purpose: External ventricular drain (EVD) is one of the most frequent procedures in neurosurgery and around 15 to 30% of these patients require a permanent cerebrospinal fluid (CSF) diversion. The optimal EVD weaning strategy is still unclear. Whether gradual weaning compared to rapid closure, reduces the rate of permanent CSF diversion remains controversial. The aim of this trial is to compare the rates of permanent CSF diversion between gradual weaning and rapid closure of an EVD. Methods: This was a single-center, retrospective cohort study including patients between 2010 to 2020. Patients were divided into a weaning (WG) and non-weaning (NWG) group. The primary outcome was permanent CSF diversion rates, secondary outcomes included hospitalization time, EVD-related morbidity, and clinical outcome. Results: Out of 412 patients, 123 (29.9%) patients were excluded due to early death or palliative treatment. We registered 178 (61.6%) patients in the WG and 111 (38.4%) in the NWG. Baseline characteristics were comparable between groups. The VPS rate was comparable in both groups (NWG 37.8%; WG 39.9%, p = 0.728). EVD related infection (13.5% vs 1.8%, p < 0.001), as well as non-EVD related infection rates (2.8% vs 0%, p < 0.001), were significantly higher in the WG. Hospitalization time was significantly shorter in the NWG (WG 24.93 ± 9.50 days; NWG 23.66 ± 14.51 days, p = 0.039). Conclusion: Gradual EVD weaning does not seem to reduce the need for permanent CSF diversion, while infection rates and hospitalization time were significantly higher/longer. Therefore, direct closure should be considered in the clinical setting. [ABSTRACT FROM AUTHOR]

Primary gaseous air pollutants have been associated with death from multiple causes, however, it remains unknown if they play a role in premature mortality among individuals living with HIV/AIDS. Data on HIV/AIDS patients were collected from the Hubei Provincial Center for Disease Control and Prevention, with a total of 1,467 AIDS-related deaths (ARD) between 2013 and 2020. Daily mean sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) were generated by artificial intelligence algorithms combined with big data. We employed a time-stratified case-crossover approach and conditional logistical regression models to investigate the acute effects of primary gaseous air pollutants on ARD. Per interquartile range increase in the concentrations of SO2 was significantly linked with ARD, with a corresponding odds ratio (OR) of 1.17 [95% confidence intervals (CIs): 1.01, 1.35] at lag 4 day. Furthermore, our findings indicated that males exhibited a heightened vulnerability to the adverse effects of SO2 and NO2, for example, the ORs were 1.24 (95% CIs: 1.05, 1.47) and 1.16 (95% CIs: 1.01, 1.34), respectively. Moreover, individuals aged over 65 years were more susceptible to SO2 and CO. Additionally, we identified the warm season as a sensitive period for mortality associated with SO2 and NO2. Our study furnished fresh evidence regarding the detrimental effects of primary gaseous air pollutants on ARD. [ABSTRACT FROM AUTHOR]

It has been estimated that in 2010, over two million patients with end-stage kidney disease may have faced premature death due to a lack of access to affordable renal replacement therapy, mostly dialysis. To address this shortfall in dialytic kidney replacement therapy, we propose a novel, cost-effective, and low-complexity hemodialysis method called allo-hemodialysis (alloHD). With alloHD, instead of conventional hemodialysis, the blood of a patient with kidney failure flows through the dialyzer's dialysate compartment counter-currently to the blood of a healthy subject (referred to as a "buddy") flowing through the blood compartment. Along the concentration and hydrostatic pressure gradients, uremic solutes and excess fluid are transferred from the patient to the buddy and subsequently excreted by the healthy kidneys of the buddy. We developed a mathematical model of alloHD to systematically explore dialysis adequacy in terms of weekly standard urea Kt/V. We showed that in the case of an anuric child (20 kg), four 4 h alloHD sessions are sufficient to attain a weekly standard Kt/V of >2.0. In the case of an anuric adult patient (70 kg), six 4 h alloHD sessions are necessary. As a next step, we designed and built an alloHD machine prototype that comprises off-the-shelf components. We then used this prototype to perform ex vivo experiments to investigate the transport of solutes, including urea, creatinine, and protein-bound uremic retention products, and to quantitate the accuracy and precision of the machine's ultrafiltration control. These experiments showed that alloHD performed as expected, encouraging future in vivo studies in animals with and without kidney failure. [ABSTRACT FROM AUTHOR]

The critical platform studies literature is increasingly considering the role of social difference as a structuring logic in the platform economy, complementing understandings of worker precarity facilitated by worker misclassification and algorithmic management. Contributing to this literature, this paper demonstrates how platforms and police produce carceral geographies that manage and exploit immigrant delivery workers as surplus populations. The carceral geographies of the platform economy account for both how carceral space produces and manages the surplus populations from which platform capital draws its workers, facilitating the disposability and exploitation of workers. Focusing on South Asian delivery workers in New York City, the paper uses the example of bike registrations to show how police and platforms expand carceral spaces in immigrant communities, increasing their vulnerability to premature death and violence. Finally, it suggests how delivery worker organising offers instances of situated resistance that challenge platform capital and carceral logics. [ABSTRACT FROM AUTHOR]

Background: Duchenne muscular dystrophy (DMD) is a neuromuscular disorder with progressive decline of pulmonary function increasing the risk of early mortality. The aim of this study was to explore the respiratory-related comorbidities, and the effect of these comorbidities and treatments on life expectancy and causes of death. Methods: All male patients living in Sweden with DMD, born and deceased 1970–2019, were included. Data regarding causes of death were collected from the Cause of Death Registry and cross-checked with the medical records along with diagnostics and relevant clinical features. Results: Hundred and twenty nine patients were included with a median lifespan of 24.3 years. Acute respiratory failure accounted for 63.3% of respiratory-related causes of death. 70.1% suffered at least one pneumonia, with first episode at a median age of 17.8 years. Hypoventilation was found in 73.0% with onset at 18.1 years. 60.5% had their first pneumonia before established hypoventilation. Age at onset of hypoventilation showed a strong correlation with age at first pneumonia. First pneumonia and scoliosis non-treated with scoliosis surgery increased the risk of dying of respiratory-related causes. In 10% of the patients, first pneumonia resulted in acute tracheostomy or early death. Patients treated with assisted ventilation had higher life expectancy compared to untreated patients. Conclusions: Our results highlight the importance of identifying subclinical hypoventilation in a timely manner and the importance of an active treatment regime upon clinical signs of pneumonia. [ABSTRACT FROM AUTHOR]

This article discusses the insights into cancer-associated thrombosis gained from the case of John Menteith, a Scottish slater who died from leukemia in the 19th century. Dr. John Hughes Bennett, who first described leukemia, hypothesized that an excess of white blood cells in the absence of infection or inflammation was due to a primary systemic blood disorder. The autopsy of Menteith revealed extensive multivessel thrombosis, which is a rare finding in existing medical literature. The article also explores the possible subtype of Menteith's leukemia and the risk factors for thrombosis in cancer patients. The historical perspectives provided by Dr. Bennett's case and the pioneering discoveries of Dr. Rudolf Virchow continue to inspire clinicians and researchers in the field. [Extracted from the article]

Lung transplantation (LT) constitutes the last therapeutic option for selected patients with end-stage respiratory disease. Primary graft dysfunction (PGD) is a form of severe lung injury, occurring in the first 72 h following LT and constitutes the most common cause of early death after LT. The presence of pulmonary hypertension (PH) has been reported to favor PGD development, with a negative impact on patients' outcomes while complicating medical management. Although several studies have suggested a potential association between pre-LT left ventricular diastolic dysfunction (LVDD) and PGD occurrence, the underlying mechanisms of such an association remain elusive. Importantly, the heterogeneity of the study protocols and the various inclusion criteria used to define the diastolic dysfunction in those patients prevents solid conclusions from being drawn. In this review, we aim at summarizing PGD mechanisms, risk factors, and diagnostic criteria, with a further focus on the interplay between LVDD and PGD development. Finally, we explore the predictive value of several diastolic dysfunction diagnostic parameters to predict PGD occurrence and severity. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) is a common sleep disorder among chronic kidney disease (CKD) patients, associated with considerable morbidity. Various studies from around the globe have reported different prevalence rates. This systematic review and meta-analysis aimed to determine the prevalence of OSA and quantify the relationship between OSA and mortality risk in patients with CKD. Four databases were systematically searched, and additional references to relevant articles were manually searched. The prevalence of OSA and the mortality risk based on random-effects models were assessed using percentages and hazard ratio (HR) with a 95 % confidence interval (95 % CI). In addition, the heterogeneity between studies was assessed using I 2 statistics. A total of 44 literature (47 studies with 223,967 participants) met the eligibility criteria for the meta-analysis. The results showed that the prevalence of OSA in CKD patients was reported to be 39.3 % (95 % CI, 32.3–46.7). Among study participants in different age groups, the highest prevalence of OSA was found in CKD respondents aged 60 years or older, at 47.1 % (95 % CI 34.4–60.3). Of the eight literature (10 cohorts) that provided survival data, the pooled estimates indicated a 26.5 % (HR: 1.265; 95 % CI 1.021–1.568) higher mortality risk in subjects with OSA than CKD patients without OSA. This systematic review and meta-analysis found that more than 1/3 of CKD patients have comorbid OSA, which increases the risk of early death in CKD patients. These results should help policymakers to provide adequate healthcare for this population. CRD42023465497. [Display omitted] • This is the first meta-analysis to summarize the prevalence of OSA in CKD patients and its quantitative association with all-cause mortality risk. • The global prevalence of obstructive sleep apnea in CKD patients is approximately 39.3 % (95 % CI, 32.3–46.7). • OSA was significantly associated with a 26.5 % higher risk of all-cause mortality in CKD patients. [ABSTRACT FROM AUTHOR]