Estimation of Gestational Age via Image Analysis of Anterior Lens Capsule Vascularity in Preterm Infants: A Pilot Study

Introduction: Anterior lens capsule vascularity (ALCV) is resorbed in the developing fetus from 27 to 35 weeks gestation. In this pilot study, we evaluated the feasibility and validity of combining smartphone ophthalmoscope videos of ALCV and image analysis for gestational age estimation.Methods: ALCV videos were captured longitudinally in preterm neonates from delivery using a PanOptic® Ophthalmoscope with an iExaminer® adapter (Welch-Allyn). ALCV video frames were manually selected and quantified using semi-automatic image analysis. A predictive model based on ALCV features was compared to gold-standard ultrasound gestational age estimates.Results: A total of 64 image-capture sessions were carried out in 24 neonates. Ultrasound-estimated gestational age and ALCV-predicted gestational age estimates indicate that the two methods are similar (r = 0.78, p < 0.0001). ALCV estimates of gestational age were within 0.11 ± 1.3 weeks of ultrasound estimates. In the final model, gestational age was predicted within ± 1 week for 54% and within ± 2 weeks for 86% of the measures.Conclusions: This novel application of smartphone ophthalmoscopy and ALCV image analysis may provide a safe, accurate and non-invasive technology to estimate postnatal gestational age, especially in low income countries where gestational age may not be known at birth

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Plastic–polymer composite electrolytes: novel soft matter electrolytes for rechargeable lithium batteries

We present here a soft matter solid composite electrolyte obtained by inclusion of a polymer in a semi-solid organic plastic lithium salt electrolyte. Compared to lithium bis-trifluoromethanesulfonimide-succinonitrile (LiTFSI-SN), the (100 − x)%-[LiTFSI-SN]: x%-P (P: polyacrylonitrile (PAN), polyethylene oxide (PEO), polyethylene glycol dimethyl ether (PEG)) composites possess higher ambient temperature ionic conductivity, higher mechanical strength and wider electrochemical window. At 25 °C, ionic conductivity of 95%-[0.4 M LiTFSI-SN]: 5%-PAN was 1.3 × 10⁻³ Ω⁻¹ cm⁻¹ which was twice that of LiTFSI-SN. The Young’s modulus (Y) increased from Y → 0 for LiTFSI-SN to a maximum ∼1.0 MPa for (100 − x)%-[0.4 M LiTFSI-SN]: x%-PAN samples. The electrochemical voltage window for composites was approximately 5 V (Li/Li+). Excellent galvanostatic charge/discharge cycling performance was obtained with composite electrolytes in Li|LiFePO₄ cells without any separator

A crosslinked “polymer–gel” rechargeable lithium-ion battery electrolyte from free radical polymerization using nonionic plastic crystalline electrolyte medium

A cross-linked polymer–gel soft matter electrolyte with superior electrochemical, thermal and mechanical properties obtained from free radical polymerization of vinyl monomers in a semi-solid organic nonionic plastic crystalline electrolyte for application in rechargeable lithium-ion batteries is discussed here

A cross-linked soft matter polymer electrolyte for rechargeable lithium-ion batteries

Ion man: A soft matter cross-linked polymer electrolyte with superior mechanical, thermal, and electrochemical properties is synthesized by using a new methodology for application in lithium-ion batteries

A crosslinked ``polymer-gel'' rechargeable lithium-ion battery electrolyte from free radical polymerization using nonionic plastic crystalline electrolyte medium

A cross-linked polymer-gel soft matter electrolyte with superior electrochemical, thermal and mechanical properties obtained from free radical polymerization of vinyl monomers in a semi-solid organic nonionic plastic crystalline electrolyte for application in rechargeable lithium-ion batteries is discussed here

Plastic-polymer composite electrolytes: Novel soft matter electrolytes for rechargeable lithium batteries

We present here a soft matter solid composite electrolyte obtained by inclusion of a polymer in a semi-solid organic plastic lithium salt electrolyte. Compared to lithium bis-trifluoromethanesulfonimide-succinonitrile (LiTFSI-SN), the (100 - x)%-[LiTFSI-SN]: x%-P (P: polyacrylonitrile (PAN), polyethylene oxide (PEO), polyethylene glycol dimethyl ether (PEG)) composites possess higher ambient temperature ionic conductivity, higher mechanical strength and wider electrochemical window. At 25 °C, ionic conductivity of 95%-[0.4 M LiTFSI-SN]: 5%-PAN was 1.3 x 10 -3 omega -1 cm1 which was twice that of LiTFSI-SN. The Young's modulus (Y) increased from Y tends to 0 for LiTFSI-SN to a maximum not, vert, similar1.0 MPa for (100 - x)%-[0.4 M LiTFSI-SN]: x%-PAN samples. The electrochemical voltage window for composites was approximately 5 V (Li/Li+). Excellent galvanostatic charge/discharge cycling performance was obtained with composite electrolytes in Li|LiFePO4 cells without any separator

Increasing ionic conductivity and mechanical strength of a plastic electrolyte by inclusion of a polymer

In this contribution we present a soft matter solid electrolyte which was obtained by inclusion of a polymer (polyacrylonitrile, PAN) in LiClO₄/LiTFSI–succinonitrile (SN), a semi-solid organic plastic electrolyte. Addition of the polymer resulted in considerable enhancement in ionic conductivity as well as mechanical strength of LiX–SN (X = ClO₄, TFSI) plastic electrolyte. Ionic conductivity of 92.5%-[1 M LiClO₄–SN]:7.5%-PAN (PAN amount as per SN weight) composite at 25 °C recorded a remarkably high value of 7 × 10⁻³ Ω⁻¹ cm⁻¹, higher by few tens of order in magnitude compared to 1 M LiClO₄–SN. Composite conductivity at sub-ambient temperature is also quite high. At −20 °C, the ionic conductivity of (100 − x)%-[1 M LiClO₄–SN]:x%-PAN composites are in the range 3 × 10⁻⁵–4.5 × 10⁻⁴ Ω⁻¹ cm⁻¹, approximately one to two orders of magnitude higher with respect to 1 M LiClO₄–SN electrolyte conductivity. Addition of PAN resulted in an increase of the Young's modulus (Y) from Y → 0 for LiClO₄–SN to a maximum of 0.4 MPa for the composites. Microstructural studies based on X-ray diffraction, differential scanning calorimetry and Fourier transform infrared spectroscopy suggest that enhancement in composite ionic conductivity is a combined effect of decrease in crystallinity and enhanced trans conformer concentration

Utilizing an ionic liquid for synthesizing a soft matter polymer ``gel'' electrolyte for high rate capability lithium-ion batteries

A cross-linked polymer ``gel'' electrolyte obtained from free radical polymerization of a vinyl monomer (acrylonitrile; AN) in a room temperature ionic liquid electrolyte (N,N-methyl butyl pyrrolidinium-bis (trifluoromethanesulphonyl)imide-lithium bis(trifluoromethanesulphonyl) imide;LiTFSI-[Py(1,4)-TFSI]) for application in high rate capability rechargeable lithium-ion batteries is discussed here. This is a novel alternative compared to the often employed approach of using a molecular liquid as the medium for performing the polymerization reaction. The polymer ``gel'' electrolytes (AN:Py(1,4)-TFSI = 0.16-0.18, w/w) showed remarkable compliable mechanical strength and higher thermal stability compared to LiTFSI-[Py(1,4)-TFSI]. Despite two orders increase in magnitude of viscosity of polymer ``gels'', the room temperature ionic conductivity of the ``gels'' (1.1 x 10(-3)-1.7 x 10(-3) Omega(-1) cm(-1)) were nearly identical to that of the ionic liquid (1.8 x 10(-3) Omega(-1) cm(-1)). The present ``gel'' electrolytes did not exhibit any ageing effects on ionic conductivity similar to the conventional polymer gel electrolytes (e.g. high molecular weight polymer + salt + high dielectric constant molecular solvent). The disorder (ionic liquid) to a relative order (cross-linked polymer electrolyte) transformation does not at all influence the concentration of conducting species. The polymer framework is still able to provide efficient pathways for fast ion transport. Unlike the ionic liquid which is impossible to assemble without a conventional separator in a cell, the polymer ``gel'' electrolyte could be conveniently assembled without a separator in a Li vertical bar lithium iron phosphate (LiFePO(4)) cell. Compared to the ionic liquid, the ``gel'' electrolyte showed exceptional cyclability and rate capability (current density: 35-760 mA g(-1) with LiFePO(4) electronically wired with carbon (amorphous or multiwalled nanotube [MWCNT])