An Abbreviated Leap: The Geopolitical and Geoeconomic Significance of the China – Pakistan Economic Corridor to the New Silk Road

The objective of this analysis is to reveal the geopolitical and geoeconomic significance of the China – Pakistan Economic Corridor of the Belt and Road Initiative to its major stakeholders; Pakistan and China. In 2013, Chinese President Xi Jinping unveiled one of the most ambitious international infrastructure plans in modern history. The plan, in its earliest stages, is currently underway with its first portion, the China – Pakistan Economic Corridor (CPEC). Through careful preliminary analysis of the greater Belt and Road Initiative, the China – Pakistan Economic Corridor, and history of Sino-Pak relations, the motivations of the collaborating nations are then manifested. This report examines a variety of geopolitical and geoeconomic subject matter; including domestic security, resource management, economic development, and inter state of both Pakistan and China. In order to capture the myriad of interests and complexity of the CPEC, four expert interviews are included in this report that captures the breadth of perspective surrounding the Belt and Road Initiative

Alzheimer\u27s- the cholinergic hypothesis and gene- targeting stem cell treatment

As the mean age of the world population rises and people\u27s life expectancies increase, the prevalence of Alzheimer\u27s disease will increase and will pose a threat to society in terms of the people affected and the money used. Current therapies are not adequate in that they are unable to extend life beyond a few months. This review will both overview the predominant hypotheses about how to approach the treatment of Alzheimer\u27s as well as discuss some of the treatments available and those in preclinical phases. Finally, we will discuss the ideas and recent research behind gene therapy and stem cell therapy as well as the new ways in which these two methods have been combined and could be combined in the future to create a more effective approach to treating Alzheimer\u27s

A Transdiagnostic Examination of Cognitive Heterogeneity in Children and Adolescents with Neurodevelopmental Disorders

Children and adolescents with neurodevelopmental disorders (NDDs) demonstrate extensive cognitive heterogeneity that is not adequately captured by traditional diagnostic systems. Using a transdiagnostic approach, a retrospective cohort study of cognitive functioning was conducted with a large heterogenous sample (n = 1529) of children and adolescents 7 to 18 years of age with NDDs. Measures of short-term memory, verbal ability, and reasoning were administered to participants with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), comorbid ADHD/ASD, and typically developing (TD) participants using a 12-item web-based neurocognitive testing battery. Unsupervised machine learning techniques were implemented to create a self-organizing map (SOM), an artificial neural network, in conjunction with k-means clustering algorithms to identify data-driven subgroups. Six clusters representing different cognitive profiles were identified, including participants with varying degrees of cognitive impairment. Diagnostic status did not correspond with cluster-membership, providing evidence for the application of transdiagnostic approaches to understanding cognitive heterogeneity in children and adolescents with NDDs. Additionally, the findings suggest that many TD participants may have undiagnosed learning difficulties, emphasizing the need for accessible cognitive assessment tools in school-based settings

Out of School Factors Affecting Indigenous Girls’ Educational Attainment: A Theory of Change for the Opening Opportunities Program in Rural Guatemala

Guatemalans have the lowest education rates in Latin America, and within Guatemala, Indigenous, rural and poor girls have much lower education rates than their peers. The ‘Opening Opportunities’ program attempts to invest in the poorest girls from rural Guatemala to build their personal, social, health and economic assets. Realist evaluation attempts to understand the key mechanisms in complex social interventions, and is under-used in education research. Based on data from life history interviews from graduates, this paper presents a Theory of Change to understand the contexts, mechanisms and outcomes of the ‘Opening Opportunities’ Program relating to educational attainment. The four mechanisms most discussed by program graduates are: leadership and participation create confidence; greater networks (models, mentors, peers); opportunities created to participate in novel paid work; and desire for later marriage and childbearing. This is the first Theory of Change that explains out of school factors affecting educational attainment

Global mortality from dementia : application of a newmethod and results from the Global Burden of Disease Study 2019

Introduction: Dementia is currently one of the leading causes of mortality globally, and mortality due to dementia will likely increase in the future along with corresponding increases in population growth and population aging. However, large inconsistencies in coding practices in vital registration systems over time and between countries complicate the estimation of global dementia mortality. Methods: We meta-analyzed the excess risk of death in those with dementia and multiplied these estimates by the proportion of dementia deaths occurring in those with severe, end-stage disease to calculate the total number of deaths that could be attributed to dementia. Results: We estimated that there were 1.62 million (95% uncertainty interval [UI]: 0.41–4.21) deaths globally due to dementia in 2019. More dementia deaths occurred in women (1.06 million [0.27–2.71]) than men (0.56 million [0.14–1.51]), largely but not entirely due to the higher life expectancy in women (age-standardized female-tomale ratio 1.19 [1.10–1.26]). Due to population aging, there was a large increase in allage mortality rates from dementia between 1990 and 2019 (100.1% [89.1–117.5]). In 2019, deaths due to dementia ranked seventh globally in all ages and fourth among individuals 70 and older compared to deaths from other diseases estimated in the Global Burden of Disease (GBD) study. Discussion: Mortality due to dementia represents a substantial global burden, and is expected to continue to grow into the future as an older, aging population expands globally

Making physics outreach more gender inclusive

“Diversity in the Cultures of Physics” was an Erasmus+ funded Strategic Partnership launching several key actions aimed at improving the gender balance in physics and its subfields. The Strategic Partnership consisted of six universities in four countries: Freie Universität Berlin in Germany, Universitat Autònoma de Barcelona and Universitat de Barcelona in Spain, the University of Manchester and the University of Sheffield in the United Kingdom and Uppsala Universitet in Sweden. This flyer provides recommendations and a checklist to make outreach activities in physics more gender inclusive. It is aimed at people already active in outreach activities for young people. The flyer indicates relevant examples of outreach projects, highlights diversity-relevant questions and topics for planning outreach activities and provides a checklist for how outreach events in physics can be made more gender inclusive

Global, regional, and national burden of neurological disorders, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders. Methods We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach. Findings Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247-308]) and second leading cause of deaths (9.0 million [8.8-9.4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34-44] and DALYs by 15% [9-21]) whereas their age-standardised rates decreased (deaths by 28% [26-30] and DALYs by 27% [24-31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42.2% [38.6-46.1]), migraine (16.3% [11.7-20.8]), Alzheimer's and other dementias (10.4% [9.0-124]), and meningitis (7.9% [6.6-10.4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1.12 [1.05-1.20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0.7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88.8% (86.5-90.9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22.3% [11.8-35.1] of DALYs are risk attributable) and idiopathic epilepsy (14.1% [10.8-17.5] of DALYs are risk attributable). Interpretation Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies. Copyright (C) The Author(s). Published by Elsevier Ltd.Peer reviewe

Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050 : an analysis for the Global Burden of Disease 2019

Background Given the projected trends in population ageing and population growth, the number of people with dementia is expected to increase. In addition, strong evidence has emerged supporting the importance of potentially modifiable risk factors for dementia. Characterising the distribution and magnitude of anticipated growth is crucial for public health planning and resource prioritisation. This study aimed to improve on previous forecasts of dementia prevalence by producing country-level estimates and incorporating information on selected risk factors. Methods We forecasted the prevalence of dementia attributable to the three dementia risk factors included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 (high body-mass index, high fasting plasma glucose, and smoking) from 2019 to 2050, using relative risks and forecasted risk factor prevalence to predict GBD risk-attributable prevalence in 2050 globally and by world region and country. Using linear regression models with education included as an additional predictor, we then forecasted the prevalence of dementia not attributable to GBD risks. To assess the relative contribution of future trends in GBD risk factors, education, population growth, and population ageing, we did a decomposition analysis. Findings We estimated that the number of people with dementia would increase from 57middot4 (95% uncertainty interval 50middot4-65middot1) million cases globally in 2019 to 152middot8 (130middot8-175middot9) million cases in 2050. Despite large increases in the projected number of people living with dementia, age-standardised both-sex prevalence remained stable between 2019 and 2050 (global percentage change of 0middot1% [-7middot5 to 10middot8]). We estimated that there were more women with dementia than men with dementia globally in 2019 (female-to-male ratio of 1middot69 [1middot64-1middot73]), and we expect this pattern to continue to 2050 (female-to-male ratio of 1middot67 [1middot52-1middot85]). There was geographical heterogeneity in the projected increases across countries and regions, with the smallest percentage changes in the number of projected dementia cases in high-income Asia Pacific (53% [41-67]) and western Europe (74% [58-90]), and the largest in north Africa and the Middle East (367% [329-403]) and eastern sub-Saharan Africa (357% [323-395]). Projected increases in cases could largely be attributed to population growth and population ageing, although their relative importance varied by world region, with population growth contributing most to the increases in sub-Saharan Africa and population ageing contributing most to the increases in east Asia. Interpretation Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform national planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia. Funding Bill & Melinda Gates Foundation and Gates Ventures. Copyright (c) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Prenatal and postpartum maternal mental health and neonatal motor outcomes during the COVID-19 pandemic

Background: Rates of prenatal and postpartum stress and depression in pregnant individuals have increased during the COVID-19 pandemic. Perinatal maternal mental health has been linked to worse motor development in offspring, with motor deficits appearing in infancy and early childhood. We aimed to evaluate the relationship between prenatal and postpartum stress and depression and motor outcome in infants born during the COVID-19 pandemic. Methods: One hundred and seventeen participants completed an online prospective survey study at two timepoints: during pregnancy and within 2 months postpartum. Depression was self-reported using the Edinburgh Perinatal/Postpartum Depression Scale (EPDS), and stress via the Perceived Stress Scale (PSS). Mothers reported total infant motor ability (fine and gross) using the interRAI 0–3 Developmental Domains questionnaire. Results: Prenatal (EPDS median=10.0, interquartile range[IQR]=6.0 – 14.0, B=-0.035, 95%CI=-0.062 to -0.007, p = 0.014) and postpartum maternal depression outcomes (median=7, IQR=4–12, B=-0.037, 95%CI= -0.066 to -0.008, p = 0.012) were significantlynegatively associated with total infant motor ability. Neither pregnancy nor postpartum perceived stress was associated with infant motor function. A cluster analysis revealed that preterm and low-birth weight infants whose mothers reported elevated depressive symptoms during pregnancy and in the postpartum period had the poorest motor outcomes. Conclusions: Prenatal and postpartum depression, but not stress, was associated with early infant motor abilities. Preterm and low-birth weight infants whose mothers reported elevated depressive symptoms maybe at-risk of experiencing poor motor outcomes. These results highlight the importance of identifying pre- and postnatal maternal mental health issues, especially during the ongoing COVID-19 pandemic