| 1. |
- Ademuyiwa, Adesoji O., et al.
(author)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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In: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Journal article (peer-reviewed)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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| 2. |
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| 3. |
- Thomas, HS, et al.
(author)
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- 2019
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swepub:Mat__t
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| 4. |
- Ahmed, Naeem, et al.
(author)
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Effects of Oxygen (O2) Plasma Treatment in Promoting the Germination and Growth of Chili
- 2022
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In: Plasma chemistry and plasma processing. - : Springer. - 0272-4324 .- 1572-8986. ; 42:1, s. 91-108
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Journal article (peer-reviewed)abstract
- In general, seed germination is improved by low-pressure plasma treatment using precursors such as air, nitrogen, O2, and argon, etc. For the first time, low-pressure O2 plasma was used to treat chili seeds in this study. When compared to untreated and vacuum-treated seeds, O2 plasma treatment using the discharge power of 80 W for 60 s significantly improves chili seed germination and growth. The effect of vacuum on the germination and growth of chili seeds was also studied and shown to be negligible. The physical and chemical changes induced by O2 plasma treatment were investigated to understand the plasma treatment to germination improvement. Combinatory etching and chemical modification aided imbibition and increased germination percentage in this O2 plasma treatment on chili seeds. The success of this method has the potential to be scaled up to solve food security issues with seeds that would otherwise struggle to germinate.
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| 5. |
- Ahmed, Naeem, et al.
(author)
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Germination and growth improvement of papaya utilizing oxygen (O2) plasma treatment
- 2022
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In: Journal of Physics D. - : Institute of Physics (IOP). - 0022-3727 .- 1361-6463. ; 55:25
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Journal article (peer-reviewed)abstract
- In general, cold plasma treatment improves crop germination and growth. The purpose of this research is to examine the impact of low-pressure O2 plasma treatment on the germination and growth kinetics of papaya seeds. Seeds were treated for 40 s at a discharge power of 80 W using O2 as a monomer. Physical and chemical changes were studied to understand the mechanism of germination and growth improvement. Furthermore, changes in phytohormones and antioxidant activity that were beneficial to germination were also examined. O2 plasma treatment improved wettability, surface etching, and oxidation, and affected other molecular-level changes leading to a 16% germination improvement in papaya.
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| 6. |
- Bakhiet, Salaheldin Farah Attallah, et al.
(author)
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Understanding the Simber Effect : why is the age-dependent increase in children's cognitive ability smaller in Arab countries than in Britain?
- 2018
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In: Personality and Individual Differences. - : Elsevier. - 0191-8869 .- 1873-3549. ; 122, s. 38-42
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Journal article (peer-reviewed)abstract
- Previous research indicates that the typical increase in IQ during childhood is greater in European countries than in Arab countries. A systematic literature review of age-dependent IQ in Arab countries is conducted, yielding relevant studies for 12 countries that fulfil the inclusion criteria. In almost all of these studies, Arab children exhibit an age-dependent IQ decline relative to Caucasian children, from 5 to about 12 years of age in particular. We term this phenomenon the Simber Effect. We propose two non-exclusive explanations. (1) The Flynn Effect is less intense in Arab countries because of localised differences, including poorer education quality and greater religiosity. (2) Those from Arab countries follow a faster Life History Strategy than Europeans, for environmental and possibly genetic reasons. Either way, the Simber Effect may amount to a Wilson Effect, meaning that the impact of genetic IQ increases with age.
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| 7. |
- Bogo, Renata, et al.
(author)
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Prevalence, Incidence Proportion, and Heritability for Tinnitus : A Longitudinal Twin Study
- 2017
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In: Ear and Hearing. - 0196-0202 .- 1538-4667. ; 38:3, s. 292-300
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The purpose of this longitudinal twin study was to explore the effect of tinnitus on hearing thresholds and threshold shifts over two decades and to investigate the genetic contribution to tinnitus in a male twin cohort (n = 1114 at baseline and 583 at follow-up). The hypothesis was that participants with faster hearing deterioration had a higher risk for developing tinnitus and there is an underlying role of genetic influences on tinnitus.DESIGN: Male mono- and dizygotic twin pairs, born between 1914 and 1958 were included. Mixed models were used for comparison of hearing threshold shifts, adjusted for age. A co-twin comparison was made within pairs discordant for tinnitus. The relative influence of genetic and environmental factors was estimated by genetic modeling.RESULTS: The overall prevalence of tinnitus was 13.5% at baseline (x age 50) and 34.4% at follow-up (x age 67). The overall incidence proportion was 27.8%. Participants who reported tinnitus at baseline or at both time points were older. At baseline, the hearing thresholds differed between tinnitus cases and controls at all frequencies. New tinnitus cases at follow-up had the greatest hearing threshold shift at the high-frequency area compared with the control group. Within pairs, the tinnitus twin had poorer hearing than his unaffected co-twin, more so for dizygotic than monozygotic twin pairs. The relative proportion of additive genetic factors was approximately 0.40 at both time points, and the influence of individual-specific environment was 0.56 to 0.61. The influence of genetic factors on tinnitus was largely independent of genetic factors for hearing thresholds.CONCLUSIONS: Our hypotheses were confirmed: The fastest hearing deterioration occurred for new tinnitus cases. A moderate genetic influence for tinnitus was confirmed.
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| 8. |
- Bogo, Renata, et al.
(author)
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The Role of Genetic Factors for Hearing Deterioration Across 20 Years : A Twin Study
- 2015
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In: The journals of gerontology. Series A, Biological sciences and medical sciences. - : Oxford University Press (OUP). - 1079-5006 .- 1758-535X. ; 70:5, s. 647-653
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Journal article (peer-reviewed)abstract
- Background. Hearing deterioration at advanced ages is associated with environmental exposures (eg, to noise and solvents) and genetic influences may also be important. Little is known about the role of genetic influences on hearing when evaluated longitudinally. We sought to investigate longitudinal hearing loss in a cohort of adult male twins to evaluate the importance of genetic and environmental factors for hearing deterioration over time. Methods. Hearing using conventional clinical audiometry was assessed in 583 male twins (128 monozygotic twin pairs and 111 dizygotic twin pairs) aged 34-79 at baseline and again two decades later. The hearing thresholds at two time points were compared at each frequency and in two different frequency regions. Genetic analyses were based on structural equation models. Bivariate Cholesky decomposition was used for longitudinal analysis. Results. The prevalence of hearing loss increased over time in better and worse ear. The hearing threshold shift was more pronounced in the high-frequency region, especially at 8000 Hz. Genetic influences were moderate (heritability: 53%-65%) for pure-tone averages at both lower and higher frequencies, and were of equal magnitude at baseline and follow-up. In contrast, environmental influences were of substantial importance (55%-88%) for rate of change of the hearing threshold over the 18-year period. Conclusions. Genetic factors are of considerable importance for level of hearing acuity, but environmental factors are more important for rate of change over an 18-year period.
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| 9. |
- Dutton, Edward, et al.
(author)
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Sex differences on Raven's Standard Progressive Matrices within Saudi Arabia and across the Arab world : females' advantage decreases from childhood to adolescence
- 2018
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In: Personality and Individual Differences. - : Elsevier. - 0191-8869 .- 1873-3549. ; 134, s. 66-70
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Journal article (peer-reviewed)abstract
- Sex differences in intelligence are of great importance with regard to understanding intelligence's underlying evolutionary forces. Previous research in this area has had a strong focus on Western countries and data across developmental stages are fragmented. Here, we present new data on Raven's Standard Progressive Matrices from three samples in Saudi Arabia, and combine these with nine previously published studies from other Arab countries, which also provide data for each year of age. We specifically consider Lynn's developmental theory of sex differences in intelligence, whereby a female advantage becomes pronounced due to earlier average puberty and then decreases as males enter puberty. The estimates for each age do not differ significantly from zero, and very few from each other, apparently due to large heterogeneity across studies. Nevertheless, the age trend is largely consistent with Lynn's model. Moreover, its specific predictions are seemingly borne out in many individual countries. Plausible explanations for incongruities in Sudan, Libya, Yemen and Saudi Arabia are also examined.
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| 10. |
- Herz, Rachel S., et al.
(author)
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A three-factor benefits framework for understanding consumer preference for scented household products : psychological interactions and implications for future development
- 2022
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In: Cognitive Research Principles and Implications. - : Springer Science and Business Media LLC. - 2365-7464. ; 7:1
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Journal article (peer-reviewed)abstract
- Humans have deliberately scented their environment for purpose or pleasure for millennia. In the contemporary marketplace most consumers prefer and purchase scented versions of common household products. However, the drivers of this consumer preference have not been elucidated. To explain the attraction to scent in household products we propose a novel three-factor framework, comprising functional benefits (malodor mitigation, base odor coverage, freshening), in-use experience benefits (cleanliness, efficacy, pleasure), and emotional benefits (increasing in confidence, mood and nostalgia). To support this framework, we present new data from a market research survey on US consumer purchasing habits and attitudes towards home cleaning, laundry, and air freshening products. Further substantiating our framework, a focused review of olfactory psychological science illustrating the central role of scent in cognition, wellbeing, motivated behavior, and social behavior, as well as sensory marketing research highlights the benefits and implications of scent in consumer household products. Based on our three-factor framework we go on to discuss the potential for scent to influence health and raise issues to consider (such as potential negative responding to fragranced products). We conclude by showcasing new opportunities for future research in olfactory science and on scented household products that can advance the positive impacts of scent.
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| 11. |
- Johnson, Ann-Christin, et al.
(author)
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Influence of well-known risk factors for hearing loss in a longitudinal twin study
- 2017
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In: International Journal of Audiology. - : Informa UK Limited. - 1499-2027 .- 1708-8186. ; 56, s. 63-73
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim was to investigate the influence of environmental exposures on hearing loss in a twin cohort.STUDY SAMPLE: Male twins born 1914-1958, representing an unscreened population, were tested for hearing loss at two occasions, 18 years apart.DESIGN: Clinical audiometry and a questionnaire were performed at both time points in this longitudinal study. Noise and solvent exposure were assessed using occupational work codes and a job exposure matrix. Hearing impairment was investigated using two different pure tone averages: PTA4 (0.5, 1, 2, and 4 kHz) and HPTA4 (3, 4, 6, and 8 kHz).RESULTS: Age affected all outcome measures. Noise exposure between time point one and two affected the threshold shifts of PTA4 and HPTA4 more in participants with a pre-existing hearing loss at time point one. Lifetime occupational noise exposure was a risk factor especially for the low-frequency hearing threshold PTA4. Firearm use was a statistically significant risk factor for all outcome measures.CONCLUSIONS: Pre-existing hearing loss can increase the risk of hearing impairment due to occupational noise exposure. An increased risk for NIHL was also seen in the group with exposures below 85 dB(A), a result that indicates awareness of NIHL should be raised even for those working in environments where sound levels are below 85 dB(A).
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| 12. |
- Khalil, Ibrahim, et al.
(author)
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Burden of Diarrhea in the Eastern Mediterranean Region, 1990-2013 : Findings from the Global Burden of Disease Study 2013
- 2016
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In: American Journal of Tropical Medicine and Hygiene. - : American Society of Tropical Medicine and Hygiene. - 1476-1645 .- 0002-9637. ; 95:6, s. 1319-1329
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Journal article (peer-reviewed)abstract
- Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low- and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0-1) in Bahrain and Oman to 471 (95% UI = 245-763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520-989) in Syria to 40,869 (95% UI = 21,540-65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden.
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| 13. |
- Malm, Mari-Cristin, et al.
(author)
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Somaliland women’s perception of stillbirth : a descriptive survey study
- 2021
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In: Somali Health Action Journal. - Umeå : Umeå University Library. - 2004-1985. ; 1:1
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Journal article (peer-reviewed)abstract
- Background: Somali women, not only those living in Somaliland but also those living abroad as asylum seekers and refugees, are highly vulnerable in terms of perinatal health outcomes. Respectful and supportive care is critical for all women when stillbirth occurs and improving bereavement care and reducing the stigma that surrounds stillbirth are global priorities. Culturally- and context-specific approaches that build on an understanding of the needs of women giving birth to a stillborn baby, no matter where or why, are required.Objective: This study aims to investigate and analyze Somali women’s experiences of stillbirth, including their perceived reasons for losing their unborn baby, the premonitions they had before giving birth and their experiences of psychosocial support from healthcare professionals and relatives.Methods: A descriptive retrospective study was conducted at the Borama regional hospital in Somaliland. A study-specific questionnaire was developed that gathered personal information and data on topics related to women’s experiences of stillbirth. Women who had either experienced a stillbirth at the hospital or had been referred there after a stillbirth 2015 were approached and 75 women agreed to participate in the study.Results: Most of the women were multiparas and had experienced a previous stillbirth. Before having it confirmed that their baby was no longer alive most of the woman reported that they had felt no fetal movements and had a premonition that something was wrong. The most common perceived cause of stillbirth that the women reported was prolonged labour followed by a ‘big baby’. Thirty-three women (44%) felt it was important to know the cause of the stillbirth and eight reported feeling angry or disappointed (11 %) with the health care providers who assisted them during labour, birth, or post-partum, although 41 women (55%) were satisfied with their treatment. A third of the women blamed themselves for their stillbirth and a majority spoke to others about it.Conclusions: Our results show that women in Somaliland share similar perceptions of stillbirth as women in high income countries. This raises important implications for antenatal care and preventive interventions and stressed the need to respond to women’s concerns regardless of background, context or setting. A maternal healthcare approach that is equal in its global application must be established to enable health care providers to give relevant information and care both in the cultural setting of Somaliland and elsewhere in the world where Somali-born women live and give birth.
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| 14. |
- Mgongo, Melina Bernard, et al.
(author)
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A Qualitative Study on Barriers to COVID-19 Vaccine Uptake among Community Members in Tanzania
- 2023
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In: Vaccines. - 2076-393X. ; 11:8, s. 1-13
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Journal article (peer-reviewed)abstract
- The use of vaccines is one of the key tools in reversing the COVID-19 pandemic; however, various reports reported the low uptake of the vaccines. This study explored the barriers to the COVID-19 vaccine uptake among community members in Tanzania. A qualitative explorative study was conducted in December 2021 and April 2022 in eight regions of Tanzania. Focus group discussions (FGDs) and in-depth interviews (IDIs) were the methods of data collection. A total of 48 FGDs and 32 IDIs were conducted. Participants were aware of the COVID-19 disease and vaccines. The barriers to the COVID-19 vaccine non-uptake included receiving contradicting statements from top government leaders, vaccine preceded the education, myths towards vaccines, the presence of different types of vaccines, the process of getting the vaccine, the influence of social media and random people from the community, and vaccine conflicting religious beliefs. Despite being aware of the vaccine, the uptake of the COVID-19 vaccine is still low. Interventions that focus on increasing community knowledge about COVID-19 vaccines and addressing myths about the vaccines are needed.
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| 15. |
- Mokdad, Ali H., et al.
(author)
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Diabetes mellitus and chronic kidney disease in the Eastern Mediterranean Region : findings from the Global Burden of Disease 2015 study
- 2018
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In: International Journal of Public Health. - : SPRINGER BASEL AG. - 1661-8556 .- 1661-8564. ; 63, s. 177-186
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Journal article (peer-reviewed)abstract
- We used findings from the Global Burden of Disease 2015 study to update our previous publication on the burden of diabetes and chronic kidney disease due to diabetes (CKD-DM) during 1990-2015. We extracted GBD 2015 estimates for prevalence, mortality, and disability-adjusted life years (DALYs) of diabetes (including burden of low vision due to diabetes, neuropathy, and amputations and CKD-DM for 22 countries of the EMR from the GBD visualization tools. In 2015, 135,230 (95% UI 123,034-148,184) individuals died from diabetes and 16,470 (95% UI 13,977-18,961) from CKD-DM, 216 and 179% increases, respectively, compared to 1990. The total number of people with diabetes was 42.3 million (95% UI 38.6-46.4 million) in 2015. DALY rates of diabetes in 2015 were significantly higher than the expected rates based on Socio-demographic Index (SDI). Our study showed a large and increasing burden of diabetes in the region. There is an urgency in dealing with diabetes and its consequences, and these efforts should be at the forefront of health prevention and promotion.
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| 16. |
- Mtei, Monica, et al.
(author)
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Confidence in COVID-19 vaccine effectiveness and safety and its effect on vaccine uptake in Tanzania : A community-based cross-sectional study
- 2023
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In: Human Vaccines & Immunotherapeutics. - 2164-5515. ; 19:1, s. 1-8
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Journal article (peer-reviewed)abstract
- COVID-19 is a major public health threat associated with increased disease burden, mortality, and economic loss to countries and communities. Safe and efficacious COVID-19 vaccines are key in halting and reversing the pandemic. Low confidence in vaccines has been one of the factors leading to hesitancy. We aimed to assess the COVID-19 vaccine confidence (safety and effectiveness), associated factors, and its effects on vaccine uptake among general community members in Tanzania. This was a community-based cross-sectional survey conducted from December 2021 to April 2022 in six regions of Tanzania mainland and two regions in Zanzibar. Participants were interviewed using an electronic questionnaire. Multiple logistic regression models estimated odds ratios (ORs) and 95% confidence interval (CI) for factors associated with vaccine confidence. All analyses were performed using SPSS version 25.0. The study enrolled 3470 general Tanzanian community members; their mean age was 40.3 (standard deviation ±14.9) years, and 34% were males. The proportion of COVID-19 vaccine confidence was 54.6%. Geographical region, residence area, COVID-19 disease risk perception, and good knowledge of COVID-19 vaccines were significantly associated with COVID-19 vaccine confidence. Confidence in COVID-19 vaccines was associated with over three times higher odds of vaccine uptake. Confidence in COVID-19 vaccines was low in Tanzania. Innovative community engagement strategies and region-specific interventions are needed to improve comprehensive knowledge and address community perceptions and attitudes toward COVID-19 vaccines.
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| 17. |
- Nisar, Muhammad Imran, et al.
(author)
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Early to mid-pregnancy HbA1c levels and its association with adverse pregnancy outcomes in three low middle-income countries in Asia and Sub-Saharan Africa
- 2024
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In: BMC Pregnancy and Childbirth. - : BioMed Central (BMC). - 1471-2393. ; 24:1
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Journal article (peer-reviewed)abstract
- Background: Hyperglycemia during pregnancy leads to adverse maternal and fetal outcomes. Thus, strict monitoring of blood glucose levels is warranted. This study aims to determine the association of early to mid-pregnancy HbA1c levels with the development of pregnancy complications in women from three countries in South Asia and Sub-Saharan Africa.Methods: We performed a secondary analysis of the AMANHI (Alliance for Maternal and Newborn Health Improvement) cohort, which enrolled 10,001 pregnant women between May 2014 and June 2018 across Sylhet-Bangladesh, Karachi-Pakistan, and Pemba Island-Tanzania. HbA1c assays were performed at enrollment (8 to < 20 gestational weeks), and epidemiological data were collected during 2-3 monthly household visits. The women were followed-up till the postpartum period to determine the pregnancy outcomes. Multivariable logistic regression models assessed the association between elevated HbA1c levels and adverse events while controlling for potential confounders.Results: A total of 9,510 pregnant women were included in the analysis. The mean HbA1c level at enrollment was found to be the highest in Bangladesh (5.31 +/- 0.37), followed by Tanzania (5.22 +/- 0.49) and then Pakistan (5.07 +/- 0.58). We report 339 stillbirths and 9,039 live births. Among the live births were 892 preterm births, 892 deliveries via cesarean section, and 532 LGA babies. In the multivariate pooled analysis, maternal HbA1c levels of >= 6.5 were associated with increased risks of stillbirths (aRR = 6.3, 95% CI = 3.4,11.6); preterm births (aRR = 3.5, 95% CI = 1.8-6.7); and Large for Gestational Age (aRR = 5.5, 95% CI = 2.9-10.6).Conclusion: Maternal HbA1c level is an independent risk factor for predicting adverse pregnancy outcomes such as stillbirth, preterm birth, and LGA among women in South Asia and Sub-Saharan Africa. These groups may benefit from early interventional strategies.
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| 18. |
- Ruilope, LM, et al.
(author)
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Design and Baseline Characteristics of the Finerenone in Reducing Cardiovascular Mortality and Morbidity in Diabetic Kidney Disease Trial
- 2019
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In: American journal of nephrology. - : S. Karger AG. - 1421-9670 .- 0250-8095. ; 50:5, s. 345-356
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Journal article (peer-reviewed)abstract
- <b><i>Background:</i></b> Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. <b><i>Patients and</i></b> <b><i>Methods:</i></b> The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate ≥25 mL/min/1.73 m<sup>2</sup> and albuminuria (urinary albumin-to-creatinine ratio ≥30 to ≤5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level α = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. <b><i>Conclusions:</i></b> FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049.
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| 19. |
- Sabri, Muhammad Haziq Mohammad, et al.
(author)
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A study of cloud-to-ground lightning flashes initiated by fast positive breakdown
- 2022
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In: Atmospheric research. - : Elsevier. - 0169-8095 .- 1873-2895. ; 276
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Journal article (peer-reviewed)abstract
- In this paper, we examine the initiation event of two tropical negative cloud to ground (CG) lightning flashes within reversal distance (<8 km) detected on 12 (CG1) and 24 (CG2) November 2019, respectively. The CG flashes were recorded using a fast antenna (FA), slow antenna (SA), magnetic field (B-field), and very high frequency (VHF) sensors located at two observation stations (ST1 and ST2) 13.26 km apart. The key finding is that CG1 flash was initiated by a short VHF pulse followed by a VHF burst (fast positive breakdown) while CG2 flash was initiated by a VHF burst (fast positive breakdown) not preceded by a short VHF pulse. The VHF burst was a precursor for initiation of a narrow bipolar event (NBE)-like pulse and initial electric field changes (IECs). Based on the VHF interferometer map, the VHF sources of NBE-like pulses have been propagated upward predominantly vertical. The initiation altitude, total length of the VHF sources propagation, estimated velocity of NBE-like pulse for CG1 flash were 4.5 +/- 0.5 km, 1.9-3.8 km, and 2.4 x 108 to 4.8 x 108 ms-1, respectively, and for CG2 flash were 5.1 +/- 0.8 km, 0.2-3.0 km, and 2.7 x 107 to 4.1 x 108 ms-1, respectively. It is evident that IECs process has been initiated during fast positive streamers propagation. It can be suggested that the IECs process resulted from charge transfer during a fast positive breakdown. The durations and magnitudes of IECs for CG1 flash were 248.5 mu s and 27.97 V/m, respectively, and for CG2 flash were 265.8 mu s and 2.31 V/m, respectively.
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| 20. |
- Wang, Haidong, et al.
(author)
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Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015
- 2016
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In: The Lancet. - 0140-6736 .- 1474-547X. ; 388:10053, s. 1459-1544
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Journal article (peer-reviewed)abstract
- BACKGROUND: Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures.METHODS: We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).FINDINGS: Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4-61·9) in 1980 to 71·8 years (71·5-72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7-17·4), to 62·6 years (56·5-70·2). Total deaths increased by 4·1% (2·6-5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8-18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6-16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9-14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1-44·6), malaria (43·1%, 34·7-51·8), neonatal preterm birth complications (29·8%, 24·8-34·9), and maternal disorders (29·1%, 19·3-37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death.INTERPRETATION: At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems.
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- Young, William J., et al.
(author)
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Genetic analyses of the electrocardiographic QT interval and its components identify additional loci and pathways
- 2022
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In: Nature Communications. - : Springer Nature. - 2041-1723. ; 13
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Journal article (peer-reviewed)abstract
- The QT interval is a heritable electrocardiographic measure associated with arrhythmia risk when prolonged. Here, the authors used a series of genetic analyses to identify genetic loci, pathways, therapeutic targets, and relationships with cardiovascular disease. The QT interval is an electrocardiographic measure representing the sum of ventricular depolarization and repolarization, estimated by QRS duration and JT interval, respectively. QT interval abnormalities are associated with potentially fatal ventricular arrhythmia. Using genome-wide multi-ancestry analyses (>250,000 individuals) we identify 177, 156 and 121 independent loci for QT, JT and QRS, respectively, including a male-specific X-chromosome locus. Using gene-based rare-variant methods, we identify associations with Mendelian disease genes. Enrichments are observed in established pathways for QT and JT, and previously unreported genes indicated in insulin-receptor signalling and cardiac energy metabolism. In contrast for QRS, connective tissue components and processes for cell growth and extracellular matrix interactions are significantly enriched. We demonstrate polygenic risk score associations with atrial fibrillation, conduction disease and sudden cardiac death. Prioritization of druggable genes highlight potential therapeutic targets for arrhythmia. Together, these results substantially advance our understanding of the genetic architecture of ventricular depolarization and repolarization.
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