The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Analysis of Rate One Quasi-Orthogonal Space-Time Block Coding over Rayleigh Fading Channel

Full-rate is very important in any data transmission coding. For transmitting data at low bit rate than full-rate code, higher modulation scheme is required. But it is impossible to design full rate orthogonal designs with complex constellation for more than two transmit antennas. Only Alamouti code provides full-rate for two transmit antennas. In this paper, Bit Error Rate (BER) is calculated for Quasi-Orthogonal Space-time Block Coding (QOSTBC). Here we work with Rayleigh fading channel. We consider the codes which decodes pairs of symbols instead of simple separate decoding like Orthogonal Space-Time Block Coding. In Quasi-Orthogonal Space-time Block Code full-rate is achieved but full-diversity is sacrificed. Diversity is the most important techniques for providing reliable communication over fading channels. One of the diversity techniques that uses multiple transmit and/or receive antennas is space diversity. Multiple antenna technique provides a space diversity to struggle with the fading without necessarily sacrificing bandwidth resources, so the excellent solutions of removing the fading of the channel for broadband wireless communications is using space diversity. Then, with the constellation rotation of the symbol, rotated version of Quasi-Orthogonal Space-Time Block Code is generated. It provides full diversity

Proximate analysis, phtochemical screening and antioxidant activity of different strains of ganoderma lucidum (Reishi Mushroom)

In this study, proximate analysis, phytochemical screening and antioxidant activity of two strains of medicinal mushroom Ganoderma lucidum (arbitrarily named strain 5 and 7) and their mix, cultivated in Bangladesh National Mushroom Development Institute, have been determined. The mix was used to determine whether it contains higher nutritive value than strain 5 and 7 alone. Protein content per 100 gm of strain 5, 7 and mix had been found to be 278.85mg, 298.69mg&nbsp; and 286.19mg, respectively. Lipid content estimated were 2.43gm, 1.96 gm and 2.4gm, respectively, while that of ash were 4.42 gm, 6.11gm and 3.93gm, respectively.&nbsp; Ganoderma lucidum strain 7 contained highest amounts of total phenol, total flavonoid, ascorbic acid and reducing sugar than the others. Among the three strains evaluated in the present study, G. lucidum 7 contained highest nutritional and medicinal components. Thus, G. lucidum 7 might be an ideal food supplement to the consumers.&nbsp; &nbsp;</p

Hypertension prevalence and influence of basal metabolic rate on blood pressure among adult students in Bangladesh

Abstract Background Hypertension is a global health issue and is currently increasing at rapid pace in South Asian countries including Bangladesh. Although, some studies on hypertension have been conducted in Bangladesh, there is a lack of scientific evidence in the adult student population that was missing from the previous and recent national cross-sectional studies. Moreover, the specific risk factors of hypertension in the Bangladeshi adults still need to be investigated. This study was conducted to estimate hypertension prevalence among adult students in Bangladesh and to test the hypothesis of Luke et al. (Hypertension 43:555–560, 2004) that basal metabolic rate (BMR) and blood pressure are positively associated independent of body size. Method The data was collected on 184 adult university students (118 female and 66 male) in Dhaka, Bangladesh. Anthropometric, BMR details and an average of at least two blood pressure measurements were obtained. Hypertension was defined by a systolic blood pressure (SBP) ≥ 140 mmHg and/or, diastolic blood pressure (DBP) ≥ 90 mmHg. Results Overall, 6.5% of participants had hypertension with significantly (p < 0.001) higher prevalence in male (12.1%) than in the female (3.4%) students. Age and BMI showed positive and significant correlation with hypertension among the students. When adjusted for body mass index (BMI), as well as other potentially confounding variables such as age, sex, smoking status and degree of urbanization, BMR was positively correlated with SBP and DBP (p < 0.001). Thus, higher BMR is associated with SBP and DBP; this is opposite the well documented inverse relationship between physical activity and blood pressure. If the influence of BMR on blood pressure is confirmed, the systematically elevated BMR might be an important predictor that can explain relatively high blood pressure and hypertension in humans. Conclusion This study reports the prevalence and associated risk factors of hypertension in the Bangladeshi adult students. The study also showed a positive association between BMR and blood pressure among the participants. A large scale longitudinal study across the country is needed to find out the underlying causes of hypertension in the Bangladeshi adults. In addition, comprehensive and integrated intervention programs focusing on modifiable risk factors are recommended to make awareness and prevent hypertension

Seaweed farming for food and nutritional security, climate change mitigation and adaptation, and women empowerment: A review

Seaweed is a promising marine macroalgae of the millennium, providing various ecological, social, and economic benefits. At present, seaweed production reached 35.8 million t from farming, accounting for 97% of global seaweed output, with a world market of US$ 11.8 billion. Seaweeds are an excellent source of nutritious human food because of their low lipid content, high minerals, fibers, polyunsaturated fatty acids, polysaccharides, vitamins, and bioactive compounds. Many seaweed sub-products offer unique properties to develop various functional foods for the food processing industries. In the perspective of climate change mitigation, seaweed farms absorb carbon, serve as a CO2 sink and reduce agricultural emissions by providing raw materials for biofuel production and livestock feed. Seaweed farming system also helps in climate change adaptation by absorbing wave energy, safeguarding shorelines, raising the pH of the surrounding water, and oxygenating the waters to minimize the impacts of ocean acidification and hypoxia on a localized scale. Moreover, it contributes substantially to the sustainable development of the economic condition of coastal women by providing livelihood opportunities and ensuring financial solvency. This review paper highlights the significance of seaweed farming in global food and nutritional security, mitigation and adaptation to global climate change, and women empowerment within a single frame. This review paper also outlined the major issues and challenges of seaweed farming for obtaining maximum benefits in these aspects. The main challenges of making seaweed as a staple diet to millions of people include producing suitable species of seaweeds, making seaweed products accessible, affordable, nutritionally balanced, and attractive to the consumers. Various food products must be developed from seaweeds that may be considered equivalent to the foods consumed by humans today. Lack of effective marine spatial planning to avoid user conflicts is vital for expanding the seaweed farming systems to provide aquatic foods and contribute globally for mitigation and adaptation of climate change impacts. Hence, women's empowerment through seaweed farming is primarily constrained by the lack of technical knowledge and financial resources to establish the coastal farming system. All the information discussed in this paper will help to understand the critical needs for large-scale seaweed farming for climate resilience mariculture, potentials for global food security, and future research on various aspects of seaweed farming and their diverse utilization

Transdermal delivery of mitochondrial-targeted hydrogen sulphide donor, AP39 protects against 6-hydroxydopamine-induced mitochondrial dysfunction

Hydrogen sulphide (H 2S) is an important gaseous signalling molecule with emerging roles as a neuroprotectant. The objective of this study was to investigate the feasibility of transdermal delivery of mitochondrial-targeted H 2S donor, AP39 whilst investigating the ability of permeated AP39 on abrogating 6-hydroxydopamine (6-OH-dop)-induced mitochondrial dysfunction, as a model of Parkinson's disease, established in human neuroblastoma cells, SHSY-5Y. Aqueous hypromellose gels (5% w/v) were prepared with up to 10% v/v propylene glycol (PG) with 0.002% w/w AP39. AP39 permeation from formulations across excised murine skin into PBS was quantified over 24 h using HPLC-UV detection. Media was collected and applied to a microvasculature blood–brain-barrier (BBB) model to evidence AP39 permeability. Following, the permeate was applied to neuroblastoma cells SHSY-5Y to evidence its therapeutic potential in modulating the mitochondrial bioenergetics and antioxidant in response to 6-OH-dop-induced mitochondrial dysfunction. The presence of PG in gel formulations significantly increased the cumulative amount of AP39 permeated across murine skin over 24 h from 24.40 ± 2.39 % to 48.59 ± 2.93 %. Conditioned media applied to a microvasculature BBB model observed AP39 permeation across the barrier and H 2S release. Finally, permeated AP39 enhanced parameters of mitochondrial bioenergetics in SHSY-5Y exposed to 6-OH-dop. Moreover, permeated AP39 abrogated mitochondrial-specific reactive oxygen species generation induced by 6-OH-dop. These findings demonstrate transdermal delivery of AP39 may provide a promising alternative to deliver this mitochondrial-targeted H 2S donor and this approach allows the potential to cross the BBB reaching CNS organs in the treatment of neurodegenerative conditions such as Parkinson's disease. Moreover, our observations show that gels prepared with 10% v/v PG have the potential for use in conditions requiring rapid H 2S delivery whereas gels without PG have potential for therapy requiring sustained H 2S delivery

Calibration, validation and uncertainty analysis of a SWAT water quality model

Sediment and nutrient pollution in water bodies is threatening human health and the ecosystem, due to rapid land use changes and improper agricultural practices. The impact of the nonpoint source pollution needs to be evaluated for the sustainable use of water resources. An ideal tool like the soil and water assessment tool (SWAT) can assess the impact of pollutant loads on the drainage area, which could be beneficial for developing a water quality management model. This study aims to evaluate the SWAT model’s multi-objective and multivariable calibration, validation, and uncertainty analysis at three different sites of the Yarra River drainage area in Victoria, Australia. The drainage area is split into 51 subdrainage areas in the SWAT model. The model is calibrated and validated for streamflow from 1990 to 2008 and sediment and nutrients from 1998 to 2008. The results show that most of the monthly and annual calibration and validation for streamflow, nutrients, and sediment at the three selected sites are found with Nash–Sutcliffe efficiency values greater than 0.50. Furthermore, the uncertainty analysis of the model shows satisfactory results where the p-factor value is reliable by considering 95% prediction uncertainty and the d-factor value is close to zero. The model's results indicate that the model performs well in the river's watershed, which helps construct a water quality management model. Finally, the model application in the cost-effective management of water quality might reduce pollution in water bodies due to land use and agricultural activities, which would be beneficial to water management managers. Validerad;2024;Nivå 2;2024-04-02 (joosat);Full text: CC BY License</p