Systolic blood pressure and 6-year mortality in South Africa: a country-wide, population-based cohort study

Background: Improving hypertension control is an important global health priority, yet, to our knowledge, there is no direct evidence on the relationship between blood pressure and mortality in sub-Saharan Africa. We aimed to investigate the relationship between systolic blood pressure and mortality in South Africa and to assess the comparative effectiveness of different systolic blood pressure targets for clinical care and population-wide hypertension management efforts. Methods: In this country-wide, population-based cohort study, we used longitudinal data on adults aged 30 years and older from five waves (2008, 2010–11, 2012, 2014–15, and 2017) of the South African National Income Dynamics Study. We estimated the relationship between systolic blood pressure and 6-year all-cause mortality and compared the mortality reductions associated with lowering systolic blood pressure to different targets (120 mm Hg, 130 mm Hg, 140 mm Hg, 150 mm Hg). We also estimated the mean blood pressure reduction required to achieve each target, the share of the population in need of management, and the number needed to treat (NNT) to avert one death under different hypothetical population-wide scale-up scenarios. Findings: Of the 8338 age-eligible respondents in the 2010–11 survey, 4993 had all required data and were included in our study. We found a weak, non-linear relationship between systolic blood pressure and 6-year mortality, with larger incremental mortality benefits at higher systolic blood pressure values: reducing systolic blood pressure from 160 mm Hg to 150 mm Hg was associated with a relative risk of mortality of 0·95 (95% CI 0·90 to 0·99; p=0·033), reducing systolic blood pressure from 150 mm Hg to 140 mm Hg had a relative risk of 0·96 (0·91 to 1·01; p=0·12), with no evidence of incremental benefits of reducing systolic blood pressure below 140 mm Hg. At the population level, reducing systolic blood pressure to 150 mm Hg among all those with a starting systolic blood pressure of more than 150 mm Hg was associated with the lowest NNT (n=50), 3·3 deaths averted (95% CI −0·6 to 0·3) per 1000 population, blood pressure management for 16% (95% CI 15·2 to 17·3) of individuals, and a −2·7 mm Hg mean change in systolic blood pressure required to achieve the 150 mm Hg scale-up target (−3·0 to −2·5; p<0·0001). Interpretation: The relationship between systolic blood pressure and mortality is weaker in South Africa than in high-income and many low-income and middle-income countries. As such, we do not find compelling evidence in support of targets below 140 mm Hg and find that scaling up management based on a 150 mm Hg target is more efficient in terms of the NNT compared with strategies to reduce systolic blood pressure to lower values. Funding: Non

Economic Globalization, Nutrition and Health: a review of quantitative evidence

BACKGROUND: Unhealthy dietary patterns have in recent decades contributed to an endemic-level burden from non-communicable disease (NCDs) in high-income countries. In low- and middle-income countries rapid changes in diets are also increasingly linked to malnutrition in all its forms as persistent undernutrition and micronutrient deficiencies continue to coexist with a rising prevalence of obesity and associated NCDs. Economic globalization and trade liberalization have been identified as potentially important factors driving these trends, but the mechanisms, pathways and actual impact are subject to continued debate. METHODS: We use a ‘rigorous review’ to synthesize evidence from empirical quantitative studies analysing the links between economic globalization processes and nutritional outcomes, with a focus on impact as well as improving the understanding of the main underlying mechanisms and their interactions. FINDINGS: While the literature remains mixed regarding the impacts of overall globalization, trade liberalization or economic globalization on nutritional outcomes, it is possible to identify different patterns of association and impact across specific sub-components of globalization processes. Although results depend on the context and methods of analysis, foreign direct investment (FDI) appears to be more clearly associated with increases in overnutrition and NCD prevalence than to changes in undernutrition. Existing evidence does not clearly show associations between trade liberalization and NCD prevalence, but there is some evidence of a broad association with improved dietary quality and reductions in undernutrition. Socio-cultural aspects of globalization appear to play an important yet under-studied role, with potential associations with increased prevalence of overweight and obesity. The limited evidence available also suggests that the association between trade liberalization or globalization and nutritional outcomes might differ substantially across population sub-groups. Overall, our findings suggest that policymakers do not necessarily face a trade-off when considering the implications of trade or economic liberalization for malnutrition in all its forms. On the contrary, a combination of nutrition-sensitive trade policy and adequate regulation of FDI could help reduce all forms of malnutrition. In the context of trade negotiations and agreements it is fundamental, therefore, to protect the policy space for governments to adopt nutrition-sensitive interventions

A generalized counterfactual approach to decomposing differences between populations

One central aim of the population sciences is to understand why one population has different levels of health and well-being compared to another. Various demographic and regression decompositions have been used to decompose population-differences in a wide range of outcomes. We provide a way of implementing an alternative decomposition method that, under certain assumptions, adds a causal interpretation to the decomposition by building upon counterfactual-driven methods. Our approach has the advantage of flexibility to accommodate different types of outcome variables and any summary population measure. By using Monte Carlo methods,&nbsp;our approach does not rely on closed-form approximate solutions and can be applied to any parametric model without having to derive any decomposition equations.&nbsp;We demonstrate our approach through two motivating examples using data from the 1970 British Birth Cohort Study and the Korean Longitudinal Study of Aging. Our first example decomposes socioeconomic status differences in three different summary measures of fertility and our second addresses the classic demographic question of the contribution of smoking to sex differences in life expectancy. Together, our two examples outline how to implement a very generalized decomposition procedure that is theoretically grounded in counterfactual theory but still easy to apply to a wide range of situations. We provide example R-code and an R-function [package in development]

Intruder identification using feed forward encasement-based parameters for cybersecurity along with IoT devices

Using IoT and cloud-based resources that have high-speed storage and processors with maximum bandwidth is obligatory. Live interaction between heterogeneous resources is supported physically and virtually through a variety of modes, which allows heterogeneous resources to interact in real time. These connected devices are often mentioned as pervasive connectivity that can be accessed public often. There are several interactions such as sensors, billing operations and much more services that are highlighted for Internet of Things (IoT) based communication. Existing IoT environments are application oriented data that are mostly sensitive which are ubiquitous collective from various IoT devices. Data classifications are implemented in the surrounding area to facilitate various decisions. The Internet is one of the primary needs in everyone's workplace where multiple advanced handheld devices or laptops are mostly accessed along with the internet for all aspects. Machine learning does the data sharing based on the growth of information collected where some of the intrusion and cyber attacks from IoT devices were not comparatively good in error detection or accurate classifications. Using the proposed algorithm Xception based Feedforward Encasement (XBFE) based Parameters for Cybersecurity along with IoT Devices where cyclic communication among hidden layers that can focus on unsupervised monitoring such that the feature mapping and scaling can filter along with maximum or minimum usage. The main research idea is to use the UNSW-NB15 dataset to analyze cyber attacks from 49 features to enhance the result

Diagnostics of molecular plasmas and trace gas analysis using mid infrared lasers

Mid infrared (MIR) absorption spectroscopy between 3 and 20 µm, known as Infrared Laser Absorption Spectroscopy (IRLAS) and based on tuneable semiconductor lasers, namely lead salt diode lasers, often called tuneable diode lasers (TDL), and quantum cascade lasers (QCL) has progressed considerably as a powerful diagnostic technique for in situ studies of the fundamental physics and chemistry of molecular plasmas and for trace gas analysis. The increasing interest in molecular processing plasmas has lead to further applications of IRLAS. IRLAS provides a means of determining the absolute concentrations and temperatures of the ground states of stable and transient molecular species, which is of particular importance for the investigation of reaction kinetics. Since plasmas with molecular feed gases are used in many applications such as thin film deposition and semiconductor processing this has stimulated the adaptation of infrared spectroscopic techniques to industrial requirements. The recent development of QCLs offers an attractive new option for the monitoring and control of industrial plasma processes as well as for highly time-resolved studies on the kinetics of plasma processes and for trace gas analysis. The aim of the present contribution is threefold: (i) to report on selected studies of the spectroscopic properties and kinetic behaviour of the methyl radical, (ii) to review recent achievements in our understanding of molecular phenomena in plasmas and the influence of surfaces, and (iii) to describe the current status of advanced instrumentation for quantum cascade laser absorption spectroscopy (QCLAS)

Demography of Aging

From 2010-2015, the annual growth rate of older adults was 3.3 percent globally (United- Nations 2017). As the proportion of the world’s population continues to age, the increasing number of older adults in the population presents significant challenges for policy makers in nearly all sectors of society. According to the United Nations Population Ageing Report 2017, the global population of adults 60 years and older increased more than two-fold from 382 million in 1980 to 962 million in 2017, and the number is expected to reach nearly 2.1 billion by 2050 (United Nations 2018). While population aging affects nearly every country in the world, the pace of aging has been faster is less developed countries than in developed countries (He, Goodkind, & Kowal 2016). Demographic changes in fertility, mortality, and to a lesser extent migration, have had profound effects on the age-structure of many societies worldwide. These population trends in global aging require improved data and analyses to assist societies with social and economic shifts in social welfare and health care services, labor markets and retirement, technology, housing, transportation, and intergenerational relationships. With an increasingly larger share in the population of aging adults in virtually every country throughout the world, it is imperative that governments design innovative policies specifically aimed at public services to benefit aging individuals and societies. In our chapter we present an overview of important issues related to global trends in population aging. We organized this review according to five key areas: (1) demographic determinants of global aging; (2) measures and methods; (3) trajectories of population aging; (4) theoretical considerations; and (5) future research directions

QD laser on InP substrate for 1.55 µm emission and beyond

International audienceInAs nanostructures formed on InP substrates allow the realization of devices working in telecommunication wavelength range between 1.4 and 1.65 µm. However due to the low lattice mismatch existing between InAs and InP, the self assembling process in InP is more complex than on GaAs substrates. First high density quantum wires obtained on InP(001) have been integrated in laser. Lasers emitting at room temperature have been achieved. For an infinite length cavity, a threshold current density per QD plane as low as 45 A/cm2 is deduced. This result compares favourably with those obtained on quantum wells lasers. However, the stability of the threshold current with temperature, predicted for quantum dots laser is not observed. Thus, growth on non standard substrates such as miscut substrates or high index substrates have been investigated in order to achieve QDs on InP. On (113) B substrates, quantum dots in high density and with size comparable with those achieved on GaAs(001) have been obtained. Lasers with record threshold current have been obtained. However the modulation properties of the laser are not as good as predicted for ideal quantum dots lasers. Finally we present the attempts to extend the QD emission wavelength in the 2-3 µm regio