Prevalence and gender - specific analysis of a systemic sclerosis cohort in Latvia.

BACKGROUND: Systemic sclerosis (SSc) is considered by many to be one of the most severe autoimmune rheumatic diseases with lower prevalence observed in Northern Europe. No previous studies on the prevalence of SSc in Latvia have been conducted and the aim was to study the demographic and clinical data of patients with SSc in northeastern Europe country. METHODS: This study was conducted in two main Latvian hospitals for adults and includes patients with SSc who were consulted between 2016 and 2021. RESULTS: During the study period, 159 patients with SSc were consulted. The point prevalence on 1 January 2021 was 84.0 per million. Female to male ratio was 4.67:1, and highest gender ratio was observed in the age group 70-79-year (6.75:1). Antinuclear antibodies were present in 82.58% of patients, without gender difference. Centromere pattern was more frequently observed in females (40.19% vs. 19.04%), in contrast to speckled pattern (50.98% vs. 57.14%). At disease onset females tended to be younger (46.51 ± 13.52) than males (50.5 ± 16.64). Males had more diffuse cutaneous subtype, interstitial lung disease, pulmonary hypertension and esophageal dysmotility. More than half of patients received treatment with glucocorticoids at any point of the disease (68.31%), without gender difference. CONCLUSIONS: Systemic sclerosis is less common in Latvia than in other countries and regions. Due to its location, the data from Latvia are consistent with a north-south gradient in Europe. Gender ratio differences persisted in older age groups as well. Antinuclear antibodies presence did not differ between genders, but in female's centromere pattern was much more likely to be present. Males had more severe disease course, but in both genders more than half of patients received treatment with GCs at any point of the disease.

Changes in food habits during the transition to retirement: the Whitehall II cohort study.

BACKGROUND: The transition to retirement is a significant turning point in life, which may lead to changes in food habits. OBJECTIVE: To examine changes in red meat, fish, vegetables and fruit consumption during the retirement transition and whether these changes vary between sociodemographic groups. METHODS: The data were from the Whitehall II study, a cohort of 10 308 British civil servants aged 35-55 years at study induction (1985-1988). Data collection has taken place every 2-3 years. Food consumption (n=2484-2491) was assessed with the Food Frequency Questionnaire in the periods before (max. 16 years) and after retirement (max. 16 years). Changes in preretirement and postretirement consumption were compared in the total cohort and subgroups by sex, marital status, preretirement occupation status and financial hardship using linear regression analyses with generalised estimating equations. RESULTS: Weekly red meat consumption was stable before retirement but increased after retirement (p=0.02), especially among women, single and lower occupational status participants. Fish consumption increased during the follow-up and the increase was steeper before retirement than postretirement period (p=0.02). Vegetable and fruit consumption also increased during the entire follow-up, but more strongly during preretirement than postretirement period (p<0.001 for both). CONCLUSION: The transition to retirement is accompanied by favourable (increase in fruit, vegetable and fish) and unfavourable (increase in red meat) dietary changes, varied to some extent by sex, marital status and preretirement occupational status. Our findings suggest that attention should be paid to this transitional phase to promote eating habits in accordance with the recommendations for retirement.

Clinical Profile and Outcomes of Patients With Systemic Lupus Erythematosus.

Background Systemic lupus erythematosus (SLE) is a complex autoimmune disorder characterized by relapsing-remitting immune system activation, affecting multiple organ systems. Despite significant advances in understanding SLE's pathogenesis, there remains a need for comprehensive clinical profiling at the time of diagnosis to improve early detection and management. This study addresses this gap by providing a detailed analysis of the clinical presentation, disease activity, and patient outcomes using the Systemic Lupus International Collaborating Clinics (SLICC) criteria and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) index. Methodology This cross-sectional observational study included 80 patients diagnosed with SLE using the 2012 SLICC criteria. Patients were recruited from the Rheumatology department and other wards of Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospital, Pune, India. All participants provided informed consent and institutional ethical approval was obtained. Data were collected through detailed clinical history, physical examinations, and standard tests such as chest X-rays, CBC, RFT, LFT, urine microscopy, creatine phosphokinase, ANA, AntiDsDNA, complement consumption, and Coombs' tests, with 2D echocardiography performed as needed. Follow-ups every three months over 1.5 years assessed disease activity using SLEDAI criteria. Patients aged 12 and above who met the SLICC criteria were included and those with other connective tissue disorders were excluded. Associations between clinical symptoms and organ involvement were analyzed using the chi-square test with a p-value of <0.05 considered significant. Results The study evaluated 80 patients with SLE, revealing a predominantly female cohort (80%) with a mean age of 29.4 years and a standard deviation of 8.3 years, skewed towards younger age groups. Clinical manifestations were diverse; the most common symptoms were (83.75%), oral ulcers (98.75%), and alopecia (95%). Anemia (66.25%) was the most prevalent abnormality, followed by albuminuria and renal abnormalities. Organ involvement was highest in the renal system (50%) and mucocutaneous features, with lower incidences in cardiac, gastrointestinal, and vascular systems. Gender-specific analyses indicated significant differences in SLE nephritis (p=0.048) and autoimmune hemolytic anemia (p=0.046). Autoantibody profiles showed high positivity for ANA (98.8%) and DsDNA (61.3%). Clinical outcomes demonstrated that 68.8% of patients achieved remission and 16.3% experienced organ damage. The SLEDAI scores significantly improved over time, with substantial reductions from baseline to nine months (p<0.001). Conclusion In conclusion, this study provides a detailed examination of SLE, revealing that it predominantly affects young adults and is characterized by diverse manifestations including mucocutaneous symptoms, significant renal involvement, and notable autoantibody profiles. The high prevalence of anti-nucleosome and anti-dsDNA antibodies underscores their diagnostic and prognostic value. Clinically, the findings highlight the necessity for early detection and targeted management of SLE, particularly in addressing renal and mucocutaneous symptoms. Future research should focus on longitudinal studies to track disease progression, explore genetic and environmental influences, and investigate regional variations to enhance treatment strategies and patient outcomes.

Misinformation and perception of COVID-19 and risk assessment among people in Pakistan: A pilot study.

BACKGROUND: During the coronavirus pandemic, misinformation was circulated through technology and social media on a large scale. Since people rely on media to keep connected and informed, misinformation can prevent them from staying safe. OBJECTIVES: To examine the quality of information reaching Pakistanis, the effect of information/misinformation on people's perception, and its relationship with risky health behaviours in different demographical groups. METHODS: A community sample of N= 103 Pakistanis was assessed using a mixed-method cross-sectional survey research design to investigate their sources of knowledge/information, perceptions of coronavirus-related facts, and risky health behaviours. RESULTS: Content analysis of the material that participants read/watched indicated the possible effect of media on people's perception of COVID-19. Specific demography (e.g., increasing age) and people's tendency to believe misinformation/information may indicate risky health behaviours pertaining to coronavirus infection. DISCUSSION: Findings showed how the models considered (social cognitive theory, biological warfare conspiracy theory, theory of planned behaviour, protection motivation theory, the health belief model, and biopsychosocial model) may be relevant to examination of the effects of misinformation on different demographic groups. CONCLUSION: The findings and models need to be verified on larger, more representative samples of Pakistanis using a large-scale survey based on the insights obtained from this pilot study.

Physical Restraint Use in Hospitalized Patients: A Study of Routinely Collected Health Records Data.

BACKGROUND: The use of restraints in hospitalized patients is associated with physical and psychological adversity for patients and staff. The minimization of restraint use is a key goal in the hospital setting. Reaching this goal requires an accurate assessment of existing patterns of use across clinical settings. OBJECTIVE: This study reports the rate of physical restraints among patients hospitalized within a multi-entity healthcare network along with stratification by care context, diagnostic, and demographic factors, and examines the sensitivity and specificity of ICD-10 code Z78.1 "physical restraint status" for defining physical restraints relative to electronic health record (EHR) documentation. DESIGN: The EHR was used for a retrospective analysis of all adults hospitalized between 2017 and 2022. PARTICIPANTS: Hospitalized adults. MAIN MEASURES: Patient demographics, structured diagnostic information, care area, length of stay, and in-hospital mortality, Z78.1 coding for physical restraints, restraint documentation in orders and flowsheets. KEY RESULTS: Among 742,607 hospitalizations, 6.3% (n=47,041) involved the use of physical restraint based on coding or EHR documentation. Treatment in the intensive care unit (ICU) included restraint in 39% of encounters whereas treatment outside the ICU included restraint use in 1.3% of encounters. Besides critical illness, demographic factors including increasing age (adjusted odds ratio (aOR)=1.21 [1.19-1.23]), male gender (aOR=1.56, [1.52-1.60]), unknown race (aOR=1.27 [1.19-1.35]), and preferred language other than English (aOR=1.24, [1.18-1.29]) were associated with higher odds of restraint utilization. As compared to EHR orders or documentation of restraint, the ICD-10 code for physical restraint had a sensitivity of 1.5% and a specificity of 99.99%. CONCLUSION: Among adults admitted to acute care hospitals, clinical, demographic, and operational factors were associated with increased odds of restraint, with care in the ICU associated with greatly increased odds of restraint. Research into restraint utilization using coded administrative claims data is likely limited by the sensitivity of physical restraint coding.

Population histories of variable reproductive success and low winter precipitation correlate with risk-averse seed germination in a mediterranean-climate winter annual.

PREMISE: Seed germination involves risk; post-germination conditions might not allow survival and reproduction. Variable, stressful environments favor seeds with germination that avoids risk (e.g., germination in conditions predicting success), spreads risk (e.g., dormancy), or escapes risk (e.g., rapid germination). Germination studies often investigate trait correlations with climate features linked to variation in post-germination reproductive success. Rarely are long-term records of population reproductive success available. METHODS: Supported by demographic and climate monitoring, we analyzed germination in the California winter-annual Clarkia xantiana subsp. xantiana. Sowing seeds of 10 populations across controlled levels of water potential and temperature, we estimated temperature-specific base water potential for 20% germination, germination time weighted by water potential above base (hydrotime), and a dormancy index (frequency of viable, ungerminated seeds). Mixed-effects models analyzed responses to (1) temperature, (2) discrete variation in reproductive success (presence or absence of years with zero seed production by a population), and (3) climate covariates, mean winter precipitation and coefficient of variation (CV) of spring precipitation. For six populations, records enabled analysis with a continuous metric of variable reproduction, the CV of per-capita reproductive success. RESULTS: Populations with more variable reproductive success had higher base water potential and dormancy. Higher base water potential and faster germination occurred at warmer experimental temperatures and in seeds of populations with wetter winters. CONCLUSIONS: Geographic variation in seed germination in this species suggests local adaptation to demographic risk and rainfall. High base water potential and dormancy may concentrate germination in years likely to allow reproduction, while spreading risk among years.

Combining demographic data and transvaginal ultrasonography: a predictive model for endometrial carcinoma in postmenopausal patients.

BACKGROUND: Although clinical guidelines exist for diagnosing abnormal uterine bleeding, there is a significant lack of agreement on the best management strategies for women presenting with symptom, particularly in diagnosing endometrial cancer. This study aimed to develop a preoperative risk model that utilizes demographic factors and transvaginal ultrasonography of the endometrium to assess and predict the risk of malignancy in females with endometrial cancer. METHODS: In this retrospective study, a logistic regression model was developed to predict endometrial carcinoma using data from 356 postmenopausal women with endometrial lesions and an endometrial thickness (ET) of 5 mm or more. These patients had undergone transvaginal ultrasonography prior to surgery, with findings including 247 benign and 109 malignant cases. The model's predictive performance was evaluated using receiver operating characteristic (ROC) curve analysis and compared with post-surgical pathological diagnoses. RESULTS: Our model incorporates several predictors for endometrial carcinoma, including age, history of hypertension, history of diabetes, body mass index (BMI), duration of vaginal bleeding, endometrial thickness, completeness of the endometrial line, and endometrial vascularization. It demonstrated a strong prediction with an area under the curve (AUC) of 0.905 (95% CI, 0.865-0.945). At the optimal risk threshold of 0.33, the model achieved a sensitivity of 82.18% and a specificity of 92.80%. CONCLUSIONS: The established model, which integrates ultrasound evaluations with demographic data, provides a specific and sensitive method for assessing and predicting endometrial carcinoma.

Demographic Data, Risk Factors, and Disease Burden of HS Patients in Lithuania at a Reference Center.

BACKGROUND: Hidradenitis suppurativa (HS) diagnosis often faces a global delay of 7.2 years due to factors like lack of recognition, stigma, and socioeconomic barriers. Limited effective therapies and frequent exacerbations impact patients' quality of life, posing a significant burden on healthcare systems. METHODS: HS patients were assessed according to European Hidradenitis Suppurativa Foundation (EHSF) Registry questionnaire guidelines at various stages of the disease and treatment. RESULTS: The study included 49 patients; 57.14% (n = 28) of them were male. The average age of the subjects was 39.91 ± 13.665 years; the average BMI was 27.84 ± 7.362. A total of 59.18% (n = 29) were active or previous smokers. There were statistically more male smokers than female (p < 0.01). Average disease onset was 25.71 ± 13.743 years; the mean time to diagnosis was 5.2 ± 7.607 years. A total of 70.2% (n = 33) were previously misdiagnosed. Subjects had 6.17 ± 6.98 painful days over the preceding 4 weeks. The average intensity of pain according to the visual analogue scale (VAS) was 5.60 ± 3.36 points. The mean dermatology life quality index (DLQI) at baseline was 8.9 ± 7.436. CONCLUSIONS: The research revealed delayed diagnoses, especially for females. Smoking was linked to higher Hurley stages, with a prevalence among male smokers, and HS had a substantial impact on patients' quality of life.

Mortality risk predicts global, local, and individual patterns of human reproduction.

BACKGROUND: Human reproductive dynamics in the post-industrial world are typically explained by economic, technological, and social factors including the prevalence of contraception and increasing numbers of women in higher education and the workforce. These factors have been targeted by multiple world governments as part of family policies, yet those policies have had limited success. The current work adopts a life history perspective from evolutionary biology: like most species, human populations may respond to safer environments marked by lower morbidity and mortality by slowing their reproduction and reducing their number of offspring. We test this association on three levels of analysis using global, local, and individual data from publicly available databases. RESULTS: Data from over 200 world nations, 3,000 U.S. counties and 2,800 individuals confirm an association between human reproductive outcomes and local mortality risk. Lower local mortality risk predicts "slower" reproduction in humans (lower adolescent fertility, lower total fertility rates, later age of childbearing) on all levels of analyses, even while controlling for socioeconomic variables (female employment, education, contraception). CONCLUSIONS: The association between extrinsic mortality risk and reproductive outcomes, suggested by life history theory and previously supported by both animal and human data, is now supported by novel evidence in humans. Social and health policies governing human reproduction, whether they seek to boost or constrain fertility, may benefit from incorporating a focus on mortality risk.

Small population size and possible extirpation of the threatened Malagasy poison frog Mantella cowanii.

Amphibians are experiencing severe population declines, requiring targeted conservation action for the most threatened species and habitats. Unfortunately, we do not know the basic demographic traits of most species, which hinders population recovery efforts. We studied one of Madagascar's most threatened frog species, the harlequin mantella (Mantella cowanii), to confirm it is still present at historic localities and estimate annual survival and population sizes. We surveyed eleven of all thirteen known localities and were able to detect the species at eight. Using a naïve estimate of detection probability from sites with confirmed presence, we estimated 1.54 surveys (95% CI [1.10-2.37]) are needed to infer absence with 95% confidence, suggesting the three populations where we did not detect M. cowanii are now extirpated. However, we also report two new populations for the first time. Repeated annual surveys at three sites showed population sizes ranged from 13-137 adults over 3-8 years, with the most intensively surveyed site experiencing a >80% reduction in population size during 2015-2023. Annual adult survival was moderately high (0.529-0.618) and we recaptured five individuals in 2022 and one in 2023 first captured as adults in 2015, revealing the maximum lifespan of the species in nature can reach 9 years and beyond. Our results confirm M. cowanii is characterized by a slower life history pace than other Mantella species, putting it at greater extinction risk. Illegal collection for the international pet trade and continued habitat degradation are the main threats to the species. We recommend conservation efforts continue monitoring M. cowanii populations and reassess the International Union for Conservation of Nature (IUCN) Red List status because the species may be Critically Endangered rather than Endangered based on population size and trends.

'They will be like a person with a disease': a qualitative investigation of variation in contraceptive side-effect experiences in Central Oromia, Ethiopia.

Contraceptive side effects are consistently given as the main reason why women are dissatisfied with contraception or choose not to use it. However, why some women suffer more from side effects remains unknown. Through inductive analysis of in-depth interviews and focus group discussions with 40 contraceptive users and 3 key informants in Central Oromia, Ethiopia, we explored women's rationales for variation in side-effect experiences. The data first reveal the wide diversity in type and severity of side-effect experiences reported by users of contraception. Second, we found that women's rationales for why some individuals suffer more side effects from contraception invoke economic and physical hardship (food insecurity and heavy workloads), as well as interindividual differences in biology (one's blood must 'fit' with contraception). Finally, the analysis revealed the tension many women face in trying to negotiate the trade-off between the consequences of these side effects and those of an unwanted pregnancy. The results show the value of using a biosocial approach, which centres women's voices and experiences, for informing the measurement of contraceptive side effects within population health surveys and clinical trials. Additionally, the findings help gain an understanding of how an individual's social, biological, and cultural contexts drive variation in when and why different side effects manifest.

Accurately estimating correlations between demographic parameters: A comment on Deane et al. (2023).

Estimating correlations among demographic parameters is an important method in population ecology. A recent paper by Deane et al. (Ecology and Evolution 13:e9847, 2023) attempted to explore the effects of different priors for covariance matrices on inference when using mark-recovery data. Unfortunately, Deane et al. (2023) made a mistake when parameterizing some of their models. Rather than exploring the effects of different priors, they examined the effects of the use of incorrect equations on inference. In this manuscript, we clearly describe the mistake in Deane et al. (2023). We then demonstrate the use of an alternative and appropriate method and reach different conclusions regarding the effects of priors on inference. Consistent with other recent literature, informative inverse Wishart priors can lead to flawed inference, while vague priors on covariance matrix components have little impact when sample sizes are adequate.

Inpatient Hospitalizations for COVID-19 Among Patients with Prader-Willi Syndrome: a National Inpatient Sample Analysis.

Background: Prader-Willi syndrome (PWS) is a genetic disorder associated with baseline respiratory impairment caused by multiple contributing etiologies. While this may be expected to increase the risk of severe COVID-19 infections in PWS patients, survey studies have suggested paradoxically low disease severity. To better characterize the course of COVID-19 infection in patients with PWS, this study analyzes the outcomes of hospitalizations for COVID-19 among patients with and without PWS. Methods: The National Inpatient Sample, an all-payors administrative claims database of hospitalizations in the United States, was queried for patients with a coded diagnosis COVID-19 in 2020 and 2021. Hospitalizations for patients with PWS compared to those for patients without PWS using Augmented Inverse Propensity Weighting (AIPW). Results: There were 295 (95% CI: 228 to 362) COVID-19 hospitalizations for individuals with PWS and 4,112,400 (95% CI: 4,051,497 to 4,173,303) for individuals without PWS. PWS patients had a median age of 33 years compared to 63 for those without PWS. Individuals with PWS had higher baseline rates of obesity (47.5% vs. 28.4%). AIPW models show that PWS diagnosis is associated with increased hospital length of stay by 7.43 days, hospital charges by $80,126, and the odds of mechanical ventilation and in-hospital death (odds ratios of 1.79 and 1.67, respectively). Conclusions: PWS patients hospitalized with COVID-19 experienced longer hospital stays, higher charges, and increased risk of mechanical ventilation and death. PWS should be considered a risk factor for severe COVID-19, warranting continued protective measures and vaccination efforts. Further research is needed to validate coding for PWS and assess the impact of evolving COVID-19 variants and population immunity on this vulnerable population.

Training a rural oral health workforce: Effects of rural background on dentist practice choice.

PURPOSE: The Regional Initiatives in Dental Education (RIDE) program is an educational track of the University of Washington School of Dentistry that aims to produce leaders who practice in rural areas of the Pacific Northwest. This study assesses outcomes of the first 10 years of the RIDE program. The hypothesis tested is that rural background is the most important predictor of long-term rural dental practice. METHODS: This descriptive study assessed existing data including graduates' location of practice, demographics, rurality of origin, parental occupation, and practice type over time. Subjects are all graduates of the RIDE program from 2012 to 2021 (N = 80), and range in age from 25 to 50 years. Statistical analyses were utilized to explore associations. RESULTS: Within the study sample 78% of graduates practiced in a rural and/or underserved area, 32.5% of graduates pursued post-graduate dental training, 40% participated in Medicaid, and 78% practiced in the Pacific Northwest at the time of analysis (March 2023). Statistical analysis demonstrated a strong association and medium to large effect sizes between both rural upbringing and training sites and established dental practice in a rural region. CONCLUSIONS: Graduates of the RIDE program practice in rural areas in greater proportion compared to the general population of practicing dentists. RIDE graduates from the study period tended to be male, and white, and practice in a health professional shortage area or rural site. The rurality of origin analysis was confounded by the substantial number of graduates from Spokane, Washington, an urban area surrounded by extensive rural territory.

Severe fire regimes decrease resilience of ectothermic populations.

Understanding populations' responses to environmental change is crucial for mitigating human-induced disturbances. Here, we test hypotheses regarding how three essential components of demographic resilience (resistance, compensation and recovery) co-vary along the distinct life histories of three lizard species exposed to variable, prescribed fire regimes. Using a Bayesian hierarchical framework, we estimate vital rates (survival, growth and reproduction) with 14 years of monthly individual-level data and mark-recapture models to parameterize stochastic integral projection models from five sites in Brazilian savannas, each historically subjected to different fire regimes. With these models, we investigate how weather, microclimate and ecophysiological traits of each species influence their vital rates, emergent life history traits and demographic resilience components in varying fire regimes. Overall, weather and microclimate are better predictors of the species' vital rates, rather than their ecophysiological traits. Our findings reveal that severe fire regimes increase populations' resistance but decrease compensation or recovery abilities. Instead, populations have higher compensatory and recovery abilities at intermediate degrees of fire severity. Additionally, we identify generation time and reproductive output as predictors of resilience trends across fire regimes and climate. Our analyses demonstrate that the probability and quantity of monthly reproduction are the proximal drivers of demographic resilience across the three species. Our findings suggest that populations surpass a tipping point in severe fire regimes and achieve an alternative stable state to persist. Thus, higher heterogeneity in fire regimes can increase the reproductive aspects and resilience of different populations and avoid high-severity regimes that homogenize the environment. Despite being more resistant, species with long generation times and low reproductive output take longer to recover and cannot compensate as much as species with faster paces of life. We emphasize how reproductive constraints, such as viviparity and fixed clutch sizes, impact the ability of ectothermic populations to benefit and recover from disturbances, underscoring their relevance in conservation assessments.

The effects of climatic and non-climatic factors on malaria mortality at different spatial scales in western Kenya, 2008-2019.

BACKGROUND: Malaria mortality is influenced by several factors including climatic and environmental factors, interventions, socioeconomic status (SES) and access to health systems. Here, we investigated the joint effects of climatic and non-climatic factors on under-five malaria mortality at different spatial scales using data from a Health and Demographic Surveillance System (HDSS) in western Kenya. METHODS: We fitted Bayesian spatiotemporal (zero-inflated) negative binomial models to monthly mortality data aggregated at the village scale and over the catchment areas of the health facilities within the HDSS, between 2008 and 2019. First order autoregressive temporal and conditional autoregressive spatial processes were included as random effects to account for temporal and spatial variation. Remotely sensed climatic and environmental variables, bed net use, SES, travel time to health facilities, proximity from water bodies/streams and altitude were included in the models to assess their association with malaria mortality. RESULTS: Increase in rainfall (mortality rate ratio (MRR)=1.12, 95% Bayesian credible interval (BCI): 1.04-1.20), Normalized Difference Vegetation Index (MRR=1.16, 95% BCI: 1.06-1.28), crop cover (MRR=1.17, 95% BCI: 1.11-1.24) and travel time to the hospital (MRR=1.09, 95% BCI: 1.04-1.13) were associated with increased mortality, whereas increase in bed net use (MRR=0.84, 95% BCI: 0.70-1.00), distance to the nearest streams (MRR=0.89, 95% BCI: 0.83-0.96), SES (MRR=0.95, 95% BCI: 0.91-1.00) and altitude (MRR=0.86, 95% BCI: 0.81-0.90) were associated with lower mortality. The effects of travel time and SES were no longer significant when data was aggregated at the health facility catchment level. CONCLUSION: Despite the relatively small size of the HDSS, there was spatial variation in malaria mortality that peaked every May-June. The rapid decline in malaria mortality was associated with bed nets, and finer spatial scale analysis identified additional important variables. Time and spatially targeted control interventions may be helpful, and fine spatial scales should be considered when data are available.

The "angioletti" of Palermo: the health and development of mummified non-adults in late modern Palermo, Sicily (1787-1880 CE).

The Capuchin Catacombs in Palermo, Sicily, have been home to non-adult mummified remains since the seventeenth century CE. Despite the increasing numbers of scientific studies conducted at this site, very little research has focused specifically on the youngest members of late modern (1787-1880 CE) society. This research aims to redress the balance by examining 43 individuals to gain insight into the demographic profile of mummified non-adults, to characterize their health status and possible cause of death, and to better understand the funerary treatment offered to the youngest members of society. A portable X-ray unit was used to capture anteroposterior and lateral images of each mummy; this facilitated age estimation, the identification of pathological and/traumatic lesions, and evidence of conservation and the mummification process more generally. This study revealed that regardless of age and health status at the time of death, the mortuary rite performed was primarily influenced by the wealth and social standing of the deceased's kin. No demographic trends were observed in the data and the lack of evidence of metabolic, neoplastic, and traumatic bone lesions suggest these non-adults died from short-term, acute illnesses. Even when individuals did display evidence of chronic health conditions that would have impacted their day-to-day lives (e.g., B035), they were not excluded from this mortuary tradition on the basis of their long-term health and care requirements in life. Artifacts were found with all individuals examined and were associated with the mummification process, conservation of mummies, and/or their display. This research has ultimately demonstrated that non-invasive imaging can be used to gain a more comprehensive understanding of the lives and deaths of non-adults inhabiting late modern Palermo.

Synergistic effects of microplastics and cyanotoxins on the demography of the rotifer Brachionus calyciflorus Pallas.

Plastic contamination in aquatic ecosystems all around the world is on the rise. Microplastics (MPs) interfere with the ecological functions of different aquatic animals, including zooplankton. Other contaminants can also be transported by microplastics, resulting in higher toxicity. Here, we evaluated the effect of microplastics alone and in combination with cyanotoxins (CT) on the demographic and feeding responses of the freshwater rotifer Brachionus calyciflorus. The microplastics used were polystyrene spheres of 30 µm diameter. The cyanobacteria were obtained from a sample collected from the Valle de Bravo reservoir in Central Mexico, and the secondary metabolites were obtained after 5 cycles of freezing, thawing and sonication. We conducted acute (LC50, 24h bioassay) and chronic toxicity tests involving population growth, life table experiments, and feeding experiments. The LC50 value using microplastics was 21.91 mg/L, and for the cyanobacterial crude extract it was 2.56 µg/L, but the combination of both resulted in a higher adverse effect (16.64 mg/L) due to the microplastics. Rotifer survival, reproduction, and feeding decreased in the presence of either MPs or CT but the adverse effect was more in the presence of both contaminants. We found that the adverse effects of MPs and CT on the test rotifer species were enhanced when exposed to both contaminants simultaneously.

Contemporary Statistics of Acute Ischemic Stroke and Transient Ischemic Attack in 2021: Insights From the CRCS-K-NIH Registry.

This report presents the latest statistics on the stroke population in South Korea, sourced from the Clinical Research Collaborations for Stroke in Korea-National Institute for Health (CRCS-K-NIH), a comprehensive, nationwide, multicenter stroke registry. The Korean cohort, unlike western populations, shows a male-to-female ratio of 1.5, attributed to lower risk factors in Korean women. The average ages for men and women are 67 and 73 years, respectively. Hypertension is the most common risk factor (67%), consistent with global trends, but there is a higher prevalence of diabetes (35%) and smoking (21%). The prevalence of atrial fibrillation (19%) is lower than in western populations, suggesting effective prevention strategies in the general population. A high incidence of large artery atherosclerosis (38%) is observed, likely due to prevalent intracranial arterial disease in East Asians and advanced imaging techniques. There has been a decrease in intravenous thrombolysis rates, from 12% in 2017-2019 to 10% in 2021, with no improvements in door-to-needle and door-to-puncture times, worsened by the coronavirus disease 2019 pandemic. While the use of aspirin plus clopidogrel for non-cardioembolic stroke and direct oral anticoagulants for atrial fibrillation is well-established, the application of direct oral anticoagulants for non-atrial fibrillation cardioembolic strokes in the acute phase requires further research. The incidence of early neurological deterioration (13%) and the cumulative incidence of recurrent stroke at 3 months (3%) align with global figures. Favorable outcomes at 3 months (63%) are comparable internationally, yet the lack of improvement in dependency at 3 months highlights the need for advancements in acute stroke care.