[The demographic aging of population: regional trends in Russia]

The article considers evolution of research and views on challenges and menaces of demographic aging process in the works of national and foreign scientists. The characteristics of this process in regions of the Russian Federation consist in special diversity of social economic, climatic, geographical and mental conditions in which demographic processes proceed. This determined availability of various types and stages of demographic aging in regions of the Russian Federation as well as opportunities to temper negative consequences of this process.

[The algorithm of planning the needs in medical care provided in out-patient conditions to elderly age groups of population using mathematical models]

The purpose of the study is to develop algorithm for planning the need in medical care provided in out-patient conditions to elderly groups of population based on mathematical modeling methods. Research materials and methods. As a source of information, data on cases of medical care provided to the population of elderly age groups (60 years and older) were used. The probability of access was studied in each one-year age interval, starting from the age of 60 years. The principle of mathematical modeling was based on functional approach applying algebraic functions by least squares method (regression analysis). The final choice of mathematical model was made in favor of mathematical function having largest value of approximation coefficient. The degree of influence of analyzed variable "age" was evaluated by residual variance calculation.It is established that overall need for out-patient care is higher in women. The maximum consumption in both women and men falls on the age of 76 years. After this age, frequency of visits decreases regardless of gender. Minimal levels of need are observed in the oldest age groups (95-100 and older). The variability of the indicator is higher in men, both at the area of need increasing and at the stage of need decreasing. The existence of common mechanisms and factors underlying the formation of the need for out-patient care confirms the use of the identical functions in modeling process. The character of modeling function has no gender differences. The age dynamics is described optimally by polynomial functions. The proposed models of age dynamics of out-patient visit rates of representatives of elder age groups in more than 90% describe existing fluctuations using non-smoothed data.

[Modern features of fertility in lowand middle-income countries, including in the context of the COVID-19 pandemic]

The main issues in the problem of fertility in countries with low and middle incomes of the population are the high prevalence of complications and maternal deaths during childbirth, as well as the high incidence of such indicators of the birth of an infant with low growth and weight indicators for their gestational age, malnutrition of pregnant women and mothers, frequent abortions, short intervals between births due to the educational status of the mother and the financial wealth of households, high prevalence of teenage motherhood, low availability of cesarean section, high cost of educating children as a factor in fertility. The impact of the COVID-19 pandemic on fertility in low- and middle-income countries has been most pronounced due to disruptions in the health care system, a surge in domestic violence, teenage pregnancy and female genital mutilation.

Decreased Modulation of Population Correlations in Auditory Cortex Is Associated with Decreased Auditory Detection Performance in Old Mice

Age-related hearing loss (presbycusis) affects one-third of the world's population. One hallmark of presbycusis is difficulty hearing in noisy environments. Presbycusis can be separated into two components: the aging ear and the aging brain. To date, the role of the aging brain in presbycusis is not well understood. Activity in the primary auditory cortex (A1) during a behavioral task is because of a combination of responses representing the acoustic stimuli, attentional gain, and behavioral choice. Disruptions in any of these aspects can lead to decreased auditory processing. To investigate how these distinct components are disrupted in aging, we performed in vivo 2-photon Ca²⁺ imaging in both male and female mice (Thy1-GCaMP6s × CBA/CaJ mice) that retain peripheral hearing into old age. We imaged A1 neurons of young adult (2-6 months) and old mice (16-24 months) during a tone detection task in broadband noise. While young mice performed well, old mice performed worse at low signal-to-noise ratios. Calcium imaging showed that old animals have increased prestimulus activity, reduced attentional gain, and increased noise correlations. Increased correlations in old animals exist regardless of cell tuning and behavioral outcome, and these correlated networks exist over a much larger portion of cortical space. Neural decoding techniques suggest that this prestimulus activity is predictive of old animals making early responses. Together, our results suggest a model in which old animals have higher and more correlated prestimulus activity and cannot fully suppress this activity, leading to the decreased representation of targets among distracting stimuli.SIGNIFICANCE STATEMENT Aging inhibits the ability to hear clearly in noisy environments. We show that the aging auditory cortex is unable to fully suppress its responses to background noise. During an auditory behavior, fewer neurons were suppressed in the old relative to young animals, which leads to higher prestimulus activity and more false alarms. We show that this excess activity additionally leads to increased correlations between neurons, reducing the amount of relevant stimulus information in the auditory cortex. Future work identifying the lost circuits that are responsible for proper background suppression could provide new targets for therapeutic strategies to preserve auditory processing ability into old age.

Cochlear Implant Awareness in the United States: A National Survey of 15,138 Adults

Hearing loss is increasingly recognized as a chronic disease that warrants treatment. Depression, social isolation, loneliness, and poorer cognitive performance have all been linked to untreated and undertreated adult-onset hearing loss. A significant subset of the patient population with hearing loss is inadequately rehabilitated by hearing aids alone and may benefit from cochlear implantation. Yet, it is estimated that less than 10% of those who qualify have received implants to date. A national survey was conducted online in November and December 2021. Subjects were identified using Dynata panelists and river sampling. Enrollment occurred on a rolling basis. Upfront sample management techniques were used to control the distribution, balancing the respondent cohort to the 2018 U.S. Census on age, household income, sex, marital status, household size, race/ethnicity, and education. Among 15,138 adult respondents with a mean (SD) age of 51 (17) years (54% female), only 10% reported being very familiar with cochlear implants, and 31% of those with hearing difficulty reported that they have “never heard” of a cochlear implant. Females were statistically significantly more likely to report some degree of familiarity with cochlear implants than men (34 vs. 26%; p  < 0.01). The greatest familiarity with cochlear implants was observed among those aged 35 to 44 years (18% reporting “very familiar”), whereas only 9% of those aged 65 to 74, 10% aged 75 to 84, and 8% ≥85 reported being very familiar ( p  < 0.01). Those identifying as White/Caucasian were statistically significantly more likely to report familiarity with cochlear implants than those identifying as Black/African American and Hispanic/Latino/Spanish (33 vs. 56 vs. 50% responding that they had “never heard” of cochlear implants; p  < 0.01). Among adults with hearing difficulty, nearly 80% report having never talked with a medical or hearing care professional about cochlear implants. Limited cochlear implant awareness likely influences its widespread underutilization across the United States. Sex, age, and race disparities compound these issues among men, the Medicare-aged population, and those identifying as Black/African American and Hispanic/Latino/Spanish.

The Use of Telemedicine in Older-Adults During the COVID-19 Pandemic: a Weekly Cross-Sectional Analysis in Ontario, Canada

The COVID-19 pandemic led to rapid adoption of telemedicine for health-care service delivery. There are concerns that older adults, the highest users of the health-care system, would be left behind because of this shift. It remains unclear how the pandemic impacted telemedicine and other health-care service use in this group. We conducted a population-based, weekly cross-sectional study using administrative data from Ontario, Canada. Telemedicine use was measured for the overall older-adult population aged 65+ and across sociodemographic groups from January 2018 to March 2021. We also assessed the use of key health-care services between high and low patient users of telemedicine who were diagnosed with dementia. We found that telemedicine visits outnumbered in-person visits in older adults during the pandemic (average of 74 vs. 62 visits per 1000 per week). Of all specialties, psychiatrists delivered the most telemedicine visits, reaching 90% of visits in a week. Higher rates of telemedicine use during COVID-19 were found for patients who resided in urban regions (84 visits per 1000 per week), but no differences were found across income quintiles. Among dementia patients, high telemedicine users had higher health-care utilization than low telemedicine users (i.e., 21,108 vs. 3,276 outpatient visits per week) during the pandemic. Findings suggest that telemedicine was crucial in helping older adults, a group most vulnerable to COVID-19, maintain access to care during the pandemic. Telemedicine presents an important opportunity for older adults; however, future research should focus on barriers to equitable access and quality of care provided through telemedicine.

A software system for modeling evolution in a population of organisms with vision, interacting with each other in 3D simulator

Development of computer models imitating the work of the nervous systems of living organisms, taking into account their morphology and electrophysiology, is one of the important and promising branches of computational neurobiology. It is often sought to model not only the nervous system, but also the body, muscles, sensory systems, and a virtual three-dimensional physical environment in which the behavior of an organism can be observed and which provides its sensory systems with adequate data streams that change in response to the movement of the organism. For a system of hundreds or thousands of neurons, one can still hope to determine the necessary parameters and get the functioning of the nervous system more or less similar to that of a living organism - as, for example, in a recent work on the modeling of the Xenopus tadpole. However, of greatest interest, both practical and fundamental, are organisms that have vision, a more complex nervous system, and, accordingly, significantly more advanced cognitive abilities. Determining the structure and parameters of the nervous systems of such organisms is an extremely difficult task. Moreover, at the cellular level they change over time, these including changes under the influence of the streams of sensory signals they perceive and the life experience gained, including the consequences of their own actions under certain circumstances. Knowing the structure of the nervous system and the number of nerve cells forming it, at least approximately, one can try to optimize the initial parameters of the model through artificial evolution, during which virtual organisms will interact and survive, each under the control of its own version of the nervous system. In addition, in principle, the rules by which the brain changes during the life of the organism can also evolve. This work is devoted to the development of a neuroevolutionary simulator capable of performing simultaneous functioning of virtual organisms that have a visual system and are able to interact with each other. The amount of computational resources required for the operation of models of the physical body of an organism, the nervous system and the virtual environment was estimated, and the performance of the simulator on a modern desktop computing system was determined depending on the number of simultaneously simulated organisms.

Managing the effects of multiple stressors on wildlife populations in their ecosystems: developing a cumulative risk approach

Assessing cumulative effects of human activities on ecosystems is required by many jurisdictions, but current science cannot meet regulatory demands. Regulations define them as effect(s) of one human action combined with other actions. Here we argue for an approach that evaluates the cumulative risk of multiple stressors for protected wildlife populations within their ecosystems. Monitoring effects of each stressor is necessary but not sufficient to estimate how multiple stressors interact to affect wildlife populations. Examining the mechanistic pathways, from cellular to ecological, by which stressors affect individuals can help prioritize stressors and interpret how they interact. Our approach uses health indicators to accumulate the effects of stressors on individuals and to estimate changes in vital rates, driving population status. We advocate using methods well-established in human health and integrating them into ecosystem-based management to protect the health of commercially and culturally important wildlife populations and to protect against risk of extinction for threatened species. Our approach will improve abilities to conserve and manage ecosystems but will also demand significant increases in research and monitoring effort. We advocate for increased investment proportional to the economic scale of human activities in the Anthropocene and their pervasive effects on ecology and biodiversity.

Phylogenetic and Phylodynamic Analyses of Soybean Mosaic Virus Using 305 Coat Protein Gene Sequences

Soybean mosaic virus (SMV) of the family Potyviridae is the most devastating virus that infects soybean plants. In this study, we obtained 83 SMV coat protein (CP) sequences from seven provinces in Korea using RT-PCR and Sanger sequencing. Phylogenetic and haplotype analyses revealed eight groups of 83 SMV isolates and a network of 50 SMV haplotypes in Korea. The phylogenetic tree using 305 SMV CP sequences available worldwide revealed 12 clades that were further divided into two groups according to the plant hosts. Recombination rarely occurred in the CP sequences, while negative selection was dominant in the SMV CP sequences. Genetic diversity analyses revealed that plant species had a greater impact on the genetic diversity of SMV CP sequences than geographical origin or location. SMV isolates identified from Pinellia species in China showed the highest genetic diversity. Phylodynamic analysis showed that the SMV isolates between the two Pinellia species diverged in the year 1248. Since the divergence of the first SMV isolate from Glycine max in 1486, major clades for SMV isolates infecting Glycine species seem to have diverged from 1791 to 1886. Taken together, we provide a comprehensive overview of the genetic diversity and divergence of SMV CP sequences.

Genetic Relationships and Signatures of Adaptation to the Climatic Conditions in Populations of Apis cerana Based on the Polymorphism of the Gene Vitellogenin

Apis cerana and Apis mellifera are important honey bee species in Asia. A. cerana populations are distributed from a cold, sharply continental climate in the north to a hot, subtropical climate in the south. Due to the Sacbrood virus, almost all A. cerana populations in Asia have declined significantly in recent decades and have recovered over the past five years. This could lead to a shift in the gene pool of local A. cerana populations that could affect their sustainability and adaptation. It was assumed that adaptation of honey bees could be observed by comparative analysis of the sequences of genes involved in development, labor division, and caste differentiation, such as the gene Vitellogenin VG. The VG gene nucleotide sequences were used to assess the genetic structure and signatures of adaptation of local populations of A. cerana from Korea, Russia, Japan, Nepal, and China. A. mellifera samples from India and Poland were used as the outgroup. The signatures of adaptive selection were found in the local population of A. cerana using VG gene sequence analysis based on Jukes−Cantor genetic distances, cluster analysis, dN/dS ratio evaluation, and Tajima’s D neutrality test. Based on analysis of the VG gene sequences, Apis cerana koreana subspecies in the Korean Peninsula were subdivided into three groups in accordance with their geographic localization from north to south. The VG gene sequences are acceptable tools to study the sustainability and adaptation of A. cerana populations.

Pharmacogenetic Study of the Impact of ABCB1 Single Nucleotide Polymorphisms on the Response to Cyclosporine in Psoriasis Patients

Psoriasis is a chronic, T cell-mediated skin disease affecting 2-3% of the Caucasian population. Cyclosporine A is a calcineurin inhibitor that acts selectively on T cells. The cyclosporine A treatment response has been suggested to be modulated by single-nucleotide polymorphisms (SNPs) in the ABCB1 gene. The aim of this research was to evaluate the effect of ABCB1 genetic variants that could affect the response to a cyclosporine treatment in Russian psoriasis patients with the ABCB1 genotype status. The ABCB1 T-129C, G1199A, C1236T, G2677T/A and C3435T SNPs in the 168 patients with psoriasis were genotyped by PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) and TaqMan SNP genotyping assays. The ABCB1 C1236T, G2677T/A and C3435T SNPs were significantly associated with a negative response to cyclosporine therapy. A very strong association was evident for the C3435T SNP in the ABCB1 gene in the allele, dominant and recessive models (OR = 2.58, OR = 4.01, OR = 2.50, respectively). ABCB1 C1236T and G2677T/A polymorphisms were significantly associated with a negative response to the cyclosporine therapy in the codominant, dominant and recessive models (p ˂ 0.05). Additionally, the haplotype analysis identified that the TGC haplotype is significantly associated with a negative response to cyclosporine therapy in psoriasis patients (p ˂ 0.05). The current study to the best of our knowledge is the first of its kind to be performed in the Russian population. In conclusion, the present results suggest an association between the ABCB1 genetic variants and unresponsiveness to cyclosporine in the Russian population. Further, larger studies are necessary to confirm our findings and replicate them in various ethnic populations before its implementation in the clinical practice.

Coordinated Evolution and Influencing Factors of Population and Economy in the Yangtze River Economic Belt

The degree of population-economy coupling and coordination is an important indicator of a region's balanced development. This study examines the evolution of the population-economy coupling coordination pattern in the Yangtze River Economic Belt spanning from 2000 to 2019. It draws from the economic growth stage and related theories, and employs methods such as geographic concentration, center of gravity analysis, and the coupling coordination model. Accordingly, the population and economy of the Yangtze River Economic Belt form a core-periphery, with a decreasing center toward the periphery, and the east higher than the west. The spatial coupling situation of the population-economic center of gravity yields an inverted U-shaped curve, where their center of gravity separates and then converges, and the difference in regional development expands and then shrinks. Moreover, the population center of gravity lags behind that of the economy. The population-economy coupling and coordination degree shows a decreasing trend after rising fluctuations. Further, the study finds that regional economic development, government role, and market-led capital agglomeration are significant drivers of the population-economy coupling and coordination, with the industrial structural influence being spatially heterogeneous.

Assessment of the Prevalence of the Use of Nasal Decongestants Among the General Population in Saudi Arabia

Background A topical nasal decongestant (NDC) is widely prescribed in ENT practice and used as self-medication because it is available over the counter, which makes it an easily accessible medication. Due to its common and long-term use, it is associated with serious nasal complications. It is commonly self-administrated in many otolaryngology diseases like the common cold, sinusitis, and acute or chronic rhinitis. The long-term usage of nasal decongestants is associated with significantly increased side effects. Aim To assess the prevalence of the usage of nasal decongestants among the general population in Saudi Arabia ad the pattern of its use. Methodology A questionnaire-based, cross-sectional survey was applied to level all available populations in Saudi Arabia. Participants with ages aged 10 to 60 years old in Saudi Arabia were invited to participate in the survey. Data were collected from participants using a predesigned online questionnaire. The questionnaire included the participant's demographic data, NDC use, and pattern of use. The questionnaire was uploaded online by researchers and their friends using social media platforms. Results A total of 1456 participants completed the study questionnaire. Participants ages ranged from 10 to 60 years with a mean age of 26.9 ± 12.4 years old. Exact 585 (40.2%) participants were males and 1270 (87.2%) were from urban regions. A total of 657 (45.1%) respondents reported using nasal decongestants while 799 (54.9%) did not use NDC. As for the duration of use, 70.8% used NDC for less than five days and 13.5% used it for 5-15 days. The most reported causes of using NDC were nasal obstruction (62.7%) and common cold (25.7%). Conclusions In conclusion, the study revealed that the frequency of using nasal decongestants was common (45.1%) in the study. More efforts should be paid to improve public awareness regarding indications, duration of use, and method of using nasal decongestants to avoid rebound reactions that may affect patients' daily life activities.

Trends in 1-Year Recurrent Ischemic Stroke in the US Medicare Fee-for-Service Population

BACKGROUND

There have been important advances in secondary stroke prevention and a focus on healthcare delivery over the past decades. Yet, data on US trends in recurrent stroke are limited. We examined national and regional patterns in 1-year recurrence among Medicare beneficiaries hospitalized for ischemic stroke from 2001 to 2017.

METHODS

This cohort study included all fee-for-service Medicare beneficiaries aged ≥65 years who were discharged alive with a principal diagnosis of ischemic stroke from 2001 to 2017. Follow-up was up to 1 year through 2018. Cox models were used to assess temporal trends in 1-year recurrent ischemic stroke, adjusting for demographic and clinical characteristics. We mapped recurrence rates and identified persistently high-recurrence counties as those with rates in the highest sextile for stroke recurrence in ≥5 of the following periods: 2001-2003, 2004-2006, 2007-2009, 2010-2012, 2013-2015, and 2016-2017.

RESULTS

There were 3 638 346 unique beneficiaries discharged with stroke (mean age 79.0±8.1 years, 55.2% women, 85.3% White). The national 1-year recurrent stroke rate decreased from 11.3% in 2001-2003 to 7.6% in 2016-2017 (relative reduction, 33.5% [95% CI, 32.5%-34.5%]). There was a 2.3% (95% CI, 2.2%-2.4%) adjusted annual decrease in recurrence from 2001 to 2017 that included reductions in all age, sex, and race subgroups. County-level recurrence rates ranged from 5.5% to 14.0% in 2001-2003 and from 0.2% to 8.9% in 2016-2017. There were 76 counties, concentrated in the South-Central United States, that had the highest recurrence throughout the study. These counties had populations with a higher proportion of Black residents and uninsured adults, greater wealth inequity, poorer general health, and reduced preventive testing rates as compared with other counties.

CONCLUSIONS

Recurrent ischemic strokes decreased over time overall and across demographic subgroups; however, there were geographic areas with persistently higher recurrence rates. These findings can inform secondary prevention intervention opportunities for high-risk populations and communities.

DNA polymorphism underlying allozyme variation at a malic enzyme locus (mMEP-2*) in Atlantic salmon (Salmo salar L.)

A non-synonymous single nucleotide polymorphism (SNP) underlies a diallelic allozyme polymorphism at the mitochondrial NADP-dependent mMEP-2* locus in Atlantic salmon (Salmo salar L.). The resultant amino acid substitution, which alters the charge of the allelic products, matches the differential mobility of the two allozyme alleles, whereas allozyme and SNP assays revealed genotyping concordance in 257 of 258 individuals. A single mismatch, homozygous allozyme vs. heterozygote SNP, suggests the presence of a second, less common null allele.

Morphological, Phaneroptic, Habitat and Population Description of Three Muntjac Species in a Tibetan Nature Reserve

Researchers have proposed a variety of classification schemes for the species in the genus Muntiacus (Artiodactyla: Cervidae) based on morphological, molecular, and other evidence, but disputes remain. The Tibetan Yarlung Zangbo Grand Canyon National Nature Reserve in the Eastern Himalayas is an area with a rich diversity of muntjac species. The habitats of many species overlap in this area, but systematic research in this area is lacking. To clarify the species, population and habitat size of muntjac species in the study area, we used camera-traps to monitor muntjacs in the nature reserve from 2013 to 2021 and described and compared morphological characteristics of the muntjac species. Subsequently, we used the MaxEnt model to simulate the habitats of the muntjac species and the Random Encounter Model to estimate the population density and numbers of muntjacs. Three muntjac species were found in the area, namely Muntiacus vaginalis (n = 7788 ± 3866), Muntiacus gongshanensis (n = 6673 ± 2121), and Muntiacus feae (n = 3142 ± 942). The red muntjac has the largest habitat area, the highest population density, and largest size, followed by Gongshan muntjac and Fea's muntjac. This study provides basic data for improving the background knowledge of the animal diversity in the Eastern Himalayan biodiversity hotspot, as well as detailed information and references required by wildlife workers for species identification.

Performance Verification of CYP2C19 Enzyme Abundance Polymorphism Settings within the Simcyp Simulator v21

Physiologically based pharmacokinetic (PBPK) modeling has a number of applications, including assessing drug−drug interactions (DDIs) in polymorphic populations, and should be iteratively refined as science progresses. The Simcyp Simulator is annually updated and version 21 included updates to hepatic and intestinal CYP2C19 enzyme abundance, including addition of intermediate and rapid metabolizer phenotypes and changes to the ultra-rapid metabolizer enzyme abundance, with implications for population clearance and DDI predictions. This work details verification of the updates with sensitive CYP2C19 substrates, omeprazole and lansoprazole, using available clinical data from literature. Multiple assessments were performed, including recovery of areas under the concentration-time curve (AUC) and Cmax from compiled datasets for each drug, recovery of victim DDI ratios with CYP2C19 and/or CYP3A4 inhibition and recovery of relative exposure between phenotypes. Simulated data were within respective acceptance criteria for >80% of omeprazole AUC values, >70% of lansoprazole AUC and Cmax, >60% of AUC and Cmax DDI ratios and >80% of exposure ratios between different phenotypes. Recovery of omeprazole Cmax was lower (>50−70% within 2-fold) and possibly attributed to the variety of formulations used in the clinical dataset. Overall, the results demonstrated that the updated data used to parameterize CYP2C19 phenotypes reasonably described the pharmacokinetics of omeprazole and lansoprazole in genotyped or phenotyped individuals.

Effects of Three Cultural Practices on Drosophila suzukii (Diptera: Drosophilidae) in Open Blueberry Fields in Florida

The spotted-wing Drosophila (SWD), Drosophila suzukii, is native species in Southeast Asia. For over a decade, this invasive pest has been globally expanding. The economic losses to soft fruits and stoned fruits in the United States are increasing every year. Presently, the only viable tool to reduce the SWD population is the continued use of broad-spectrum insecticides. Pesticide resistance is appearing in the populations for the SWD. Organic farmers have limited options to control this pest in open fields. The major goal of this study was to develop cost-effective pest management strategies to manage the SWD using three types of mulches (two plant-based and one fabric-based) to reduce fly population and damage in open blueberry fields in north Florida. The study was conducted in two fruiting seasons (2017 and 2018). The study results demonstrated that the fly trap catches in 2017 shortleaf pine needle mulch had much higher populations (about 2.5-fold) of the SWD than all other treatments. In 2018, the numbers were about 1.7-fold more on shortleaf pine needle mulch than on other treatments. The fine texture of the mulch (pine needles) can easily facilitate the emergence of the SWD if the mulch is not thick enough. Although the pine needles covered the soil surface, it may have been too thin and thus allowed the SWD adults to emerge from the soil without much hindrance. In 2018, a higher population of the SWD was recorded from all the mulching practices. However, there were no significant differences in trap catches between all treatments. In general, the fly population is reduced with the use of pine bark and black weed fabric mulches. This is the first study that reports the effects of three mulches in controlling the SWD populations, which could benefit conventional and organic blueberry growers.

Predation strongly limits demography of a keystone migratory herbivore in a recovering transfrontier ecosystem

Large herbivore migrations are imperiled globally; however the factors limiting a population across its migratory range are typically poorly understood. Zambia's Greater Liuwa Ecosystem (GLE) contains one of the largest remaining blue wildebeest (Connochaetes taurinus taurinus) migrations, yet the population structure, vital rates, and limiting factors are virtually unknown. We conducted a long‐term demographic study of GLE wildebeest from 2012 to 2019 of 107 collared adult females and their calves, 7352 herd observations, 12 aerial population surveys, and concurrent carnivore studies. We applied methods of vital rate estimation and survival analysis within a Bayesian estimation framework. From herd composition observations, we estimated rates of fecundity, first‐year survival, and recruitment as 68%, 56%, and 38% respectively, with pronounced interannual variation. Similar rates were estimated from calf‐detections with collared cows. Adult survival rates declined steadily from 91% at age 2 years to 61% at age 10 years thereafter dropping more sharply to 2% at age 16 years. Predation, particularly by spotted hyena, was the predominant cause of death for all wildebeest ages and focused on older animals. Starvation only accounted for 0.8% of all unbiased known natural causes of death. Mortality risk differed substantially between wet and dry season ranges, reflecting strong spatio‐temporal differences in habitat and predator densities. There was substantial evidence that mortality risk to adults was 27% higher in the wet season, and strong evidence that it was 45% higher in the migratory range where predator density was highest. The estimated vital rates were internally consistent, predicting a stable population trajectory consistent with aerial estimates. From essentially zero knowledge of GLE wildebeest dynamics, this work provides vital rates, age structure, limiting factors, and a plausible mechanism for the migratory tendency, and a robust model‐based foundation to evaluate the effects of potential restrictions in migratory range, climate change, predator–prey dynamics, and poaching.

A scoping review on population-centered indicators for cancer care continuum

Purpose

The purpose of this study was to develop prioritized cancer indicators and measure the population-based monitoring of the entire life cycle of cancer care, guiding the improvement of care delivery systems.

Methods

Scoping review was performed based on the Joanna Briggs Institute's methodology. Electronic databases were searched in PubMed, Cochrane Library, EMBASE, Ovid Medline, RISS, KISS, and KoreaMed. The searches were limited to articles published in English between 2010 and 2020. No restrictions were applied regarding the publication status or country of origin, and all study designs were included. Gray literature was used to broaden the search's scope, identify new recommendations, need to be in connect with subject experts, and explore pertinent websites. The process and selected indicators were analyzed based on their frequency distribution and percentage.

Results

The literature search yielded 6,202 works. In addition, national and international cancer guidelines were obtained from official database reports. A total of 35 articles and 20 reports regarding cancer indicators were finally selected for data synthesis. Based on them, 254 core sets of cancer indicators were identified. The selected indicators were classified into six domains based on the continuum of cancer care and survivor's life cycle, namely, primary prevention (61, 24.0%), secondary prevention (46, 18.1%), treatment (85, 33.5%), quality of care (33, 13.0%), survivor management (33, 13.0%), and end-of-life care (14, 5.5%).

Conclusion

There is a growing interest in developing specific areas of cancer care. Cancer indicators can help organizations, care providers, and patients strive for optimal care outcomes. The identified indicators could guide future innovations by identifying weaknesses in cancer prevention and management.

Increased incidence of dementia following herpesvirus infection in the Korean population

Herpesviruses affect the development of dementia. We investigated the association between herpes infection and subsequent diagnoses of dementia. Data from the National Health Insurance Service of South Korea were used. Patients aged ≥50 years with the relevant diagnostic codes in the reference year 2009 were included and prospectively reviewed from January 2010 to December 2018. All study participants were followed from the index date until the onset of dementia, death, or the study endpoint. The three cohorts comprised 92,095 patients with herpes simplex virus (HSV) infections, 97,323 patients with varicella-zoster virus (VZV) infections, and 183,779 controls. During the follow-up period, 15,831 (17.19%) subjects with HSV infection and 17,082 (17.55%) VZV-infected subjects, compared to 27,028 (14.17%) control subjects, were subsequently diagnosed with dementia (all, P < .001). The adjusted hazard ratio for developing dementia was found to be 1.18 (95% confidence interval [CI]; 1.16-1.20) in HSV and 1.09 (95% CI; 1.07-1.11) in VZV patients (all, P < .001). HSV1 infections such as oral or ocular subtypes, but not HSV2, anogenital subtype, were associated with dementia, including several subtypes such as Alzheimer's disease (AD), vascular dementia, and dementia with Lewy bodies. VZV infection is also associated with AD. In this Korean nationwide population-based cohort study, both HSV and VZV infections were associated with a higher risk of dementia, particularly AD. Among the subtypes of HSV infection, HSV1 is associated with a risk of dementia. Further studies including appropriate public health interventions could evaluate the causality of these relationships.

Population, biomass, and economic value of small ruminants in Ethiopia

Ethiopia has a large population of small ruminants (sheep and goats) which are mostly kept in traditional subsistence production systems that are poorly described. Understanding these different systems, their population structure, biomass, production, and economic value is essential for further analysis and effective policy making. The objective of this study was to quantify these parameters for small ruminant production systems in Ethiopia to use them as a basis for analysis of disease burden within the Global Burden of Animal Diseases program. Population structure and trends of small ruminants were analyzed using data from ten annual national agriculture surveys. A stochastic herd model was used to simulate the small ruminant population, biomass, and economic value. The model was parameterised stochastically using data from statistical databases and the literature, and sensitivity analysis of main model outputs to the stochastic inputs was done. Small ruminants are held across the country mainly managed under two major production systems: the crop-livestock mixed system and the pastoral system. The small ruminant population has grown in the past 10 years with an average annual growth rate of 4.6% for sheep and 6.7% for goats. The national average small ruminant population for 2021 was projected at 96.4 (range 95.3–97.7) million heads and the mean stock biomass was about 2,129 (range 1,680–2,686) million kilograms. The monetary value of the small ruminant population was estimated at USD 5,953 (range 4,369–7,765) million. The annual monetary value of small ruminant production outputs was estimated at USD 1,969 (range 1,245–2,857) million. Although the small ruminant population is large and rapidly growing, contributing about 2% of national annual GDP, the sub-sector is characterized by low productivity, low offtake rates, and a limited range of production outputs with no signs of intensification. Efforts should be made to reduce small ruminant mortality, improve fertility, and better utilize products such as milk to improve the livelihoods of rural households and to benefit the national economy. The approaches developed in this study can be replicated in other systems and countries to reveal trends in the size and value of livestock systems, providing a better understanding of its economic importance and performance.

Public Attitude towards Biobanking: An Italian University Survey

Biobanks have established a critical role in biomedical research by collecting, preserving, organizing, and disseminating biospecimens and related health data, contributing to precision medicine development. Participation in biobanks is influenced by several factors, such as trust in institutions and scientists, knowledge about biobanking, and the consideration of benefit sharing. Understanding public attitudes, fears, and concerns toward biobanking is fundamental to designing targeted interventions to increase trust towards biobanks. The aim of our study was to investigate the level of knowledge and perception of biobanks in students and personnel of the University of Piemonte Orientale. An online questionnaire was designed and administered via e-mail. A total of 17,758 UPO personnel and students were invited to participate in the survey, and 1521 (9.3%) subjects completed the survey. The results showed that 65.0% of the participants were aware of the term "biobank" and knew what the activity of a biobank was, and 76.3% of subjects were willing to provide biospecimens to a research biobank, whereas 67.3% of the respondents were willing to contribute, in addition to biospecimens, their health and lifestyle data. Concerns were raised about the confidentiality of the information (25.6%) and the commercial use of the samples (25.0%). In conclusion, participants were aware of the role that biobanks play in research and were eager to participate for the sake of furthering scientific research. Still, several concerns need to be addressed regarding the confidentiality of the data along with the commercial use of the samples and associated data.

The Profile of Glucose Lowering Therapy in Persons with Type 2 Diabetes Mellitus in an Aging Russian Population

We aimed to analyze the profile of glucose lowering therapy (GLT) in persons with diabetes mellitus type 2 (DM2) in an aging Russian population. A random population sample (n = 3898, men/women, 55−84) was examined in Novosibirsk, during 2015−2018 (HAPIEE Project). The design of the present work is a cross-sectional study. DM2 was defined in those with a history of DM2 receiving GLT, or at a level of fasting plasma glucose (FPG) ≥7.0 mmol/L. The entire DM2 group was included in the analysis (n = 803); of these, 476 persons were taking GLT and were included in the analysis at stage 2. Regular GLT medication intake for 12 months was coded with ATC. In studied sample, the prevalence of DM2 was 20.8%. Among subjects with DM2, 59% of individuals received GLT, 32% did not. Glycemic control (FPG < 7.0 mmol/L) was achieved in every fifth participant with DM2 (35% in those receiving GLT). In frequency of GLT use, biguanides ranked in first place (75%), sulfonylurea derivatives in second (35%), insulins in third (12%), and iDPP-4 in fourth (5%). Among those receiving GLT, 24% used combined oral therapy, and 6% used insulin-combined therapy. In conclusion, in a population sample aged 55−84 examined in 2015−2018, glycemic control was achieved in every fifth participant with DM2, and in every third participant receiving GLT. The proportion of participants using new GLT drugs was small, and there was a lack of HbA1c monitoring for intensive glycemic control.

Genetic Diversity of Venturia inaequalis in Latvia Revealed by Microsatellite Markers

Apple scab caused by the ascomycete Venturia inaequalis is an economically significant disease worldwide. The annual sexual reproduction of V. inaequalis leads to high variation, changes in the population's genetic structure and adaptations to the changing environment, including overcoming the host's resistance. The objective of this study is to characterise and assess the genetic diversity of V. inaequalis populations in two main apple-growing regions in Latvia. In total, 143 V. inaequalis isolates were collected from Latvia, six reference strains with known virulence were obtained from other countries, and all strains were genotyped by 12 SSR markers. The SSR markers were highly variable and informative, identifying 158 alleles that ranged from two to 29 per locus. The Bayesian clustering identified three genetic lineages among the Latvian isolates that did not correlate to the geographic origin, host genotype, organ (leaves or fruits) from which the pathogen was isolated, time of collection, and type of isolation (single conidium or ascospore). The possible relatedness to virulence was detected when reference strains with known virulence were included in the analysis. Our findings correspond with previous studies demonstrating that V. inaequalis in Europe has a high genetic diversity within populations, but low diversity among the populations.

Aging and hypertension in kidney function decline: A 10 year population-based study

Background

Aging is associated with a physiological decline in kidney function (KFD). In this study, we aimed to describe the impact of age on the rate of KFD and its interplay with risk factors for chronic kidney disease (CKD), considering mainly hypertension (HT), in the general population.

Materials and methods

Participants of European descent, aged 35-75, were recruited from a populational cohort in Lausanne, Switzerland. Participants with a 10 year follow-up were selected. KFD was defined as the difference in estimated glomerular filtration rate (eGFR) between baseline and follow-up, divided by the observation period. Multivariate linear regressions were used with KFD as the outcome and age as the main predictor. HT was tested as a modifying factor.

Results

We included 4,163 participants with mean age 52.2 ± 10.4, 44.7% men, 31.9% HT, and 5.0% diabetics. Mean baseline eGFR was 85.9 ± 14.6 ml/min/1.73 m². Mean KFD was -0.49 ± 1.08 ml/min/1.73 m² per year with 70% of participants decreasing their eGFR during follow-up. The relationship between age and KFD was non-linear and age was divided in tertiles. Old participants had faster rates of KFD as compared to young and middle-age participants (p < 0.001). A significant interaction was found between age and HT on KFD prediction (p < 0.001). In HT participants, KFD was significantly different across tertiles of age (p < 0.001). On contrary, KFD was not different across tertiles of age in non-HT participants.

Conclusion

A physiological KFD is present over time in the general population. Age contributes non-linearly to the rate of this decline with older subjects declining the fastest. The presence of HT is a major contributing factor in this setting as KFD worsened with age only in hypertensive participants. Thus, HT represents an important pathological factor aggravating the age-related physiological decline in eGFR in the general population.

Temporal changes and gender differences related to orofacial symptoms in two cohorts of 75-year-old Swedish subjects examined in 2007 and 2017: A repeated cross-sectional study

OBJECTIVES

To compare two cohorts of 75-year-old persons, born 10 years apart, in regard to reported symptoms related to temporomandibular disorders (TMD) and orofacial complaints with special reference to gender differences.

MATERIAL AND METHODS

In 2007, a questionnaire comprising questions on social factors, general and oral health, and a series of attitude-related questions was mailed to all individuals born in 1932 living in two Swedish counties (N = 5195), and in 2017 to all born in 1942 (N = 7204). The response rate for the cohort examined in 2007 was 71.9% (n = 3735) and 70.7% (n = 5091) for the cohort examined in 2017. Bivariate statistical analyses were applied.

RESULTS

Reported bruxism and pain from the temporomandibular joint were significantly higher in the 1942 cohort compared to the 1932 cohort, while reports of oral lesions and daytime dry mouth were lower. Women reported problems significantly more frequently in most of the domains investigated in both 2007 and 2017, that is, TMD, burning mouth, sensitive teeth, oral lesions, taste changes, daytime/night-time dry mouth, except bad breath.

CONCLUSIONS

TMD-related symptoms increased while complaints from oral lesions and daytime mouth dryness decreased between 2007 and 2017. Temporal changes were otherwise few, but the findings underline the gender inequalities that exist, to the disadvantage of women. This must be considered when planning for clinical care/dental education to appropriately address the needs of older people.

Differential Sex-Specific Effects of Angiotensin-Converting Enzyme Inhibition and Angiotensin Receptor Blocker Therapy on Arterial Function in Hypertension: CALIBREX Trial

BACKGROUND

Increased arterial stiffness is associated with adverse cardiovascular outcomes. We studied the sex-specific impact of angiotensin antagonists on vascular function in hypertension with the hypothesis that their effects on arterial stiffness may be variable in men and women.

METHODS

In 141 hypertensive participants with mild cognitive impairment (age 65.9±7.7, 57% female), candesartan (up to 32 mg, n=77) or lisinopril (up to 40 mg, n=64) were administered to achieve blood pressure <140/90 mm Hg. Pulse wave velocity, central pulse pressure, and central augmentation index were measured using applanation tonometry (SphygmoCor, Australia). Multivariate linear regression and mixed model analyses were performed using intention-to-treat and per protocol analyses for those completing the study.

RESULTS

Blood pressure reduction was similar among candesartan and lisinopril groups. Compared with candesartan, lisinopril therapy resulted in lower pulse wave velocity (0.5±0.8 versus -0.7±0.4 m/s, respectively; P=0.003) and central pulse pressure (-1±3 versus -7±4 mm Hg; P=0.03) after 1 year. There was a significant interaction by sex whereby the improvements in pulse wave velocity and central pulse pressure with lisinopril compared with candesartan were only observed in women. In contrast, there was greater improvement in augmentation index with candesartan compared with lisinopril (-4±7% versus -1.5±8%; P=0.05), with no sex differences.

CONCLUSIONS

Despite equipotent antihypertensive effects, lisinopril was more effective than candesartan at lowering arterial stiffness in women. In contrast, candesartan was more effective than lisinopril in improving pulse wave reflections in both sexes. These findings demonstrate differential sex-specific effects of renin-angiotensin system antagonists on arterial function in hypertension that may contribute to long-term cardiovascular and neurocognitive outcomes in this population.

High HDL (High-Density Lipoprotein) Cholesterol Increases Cardiovascular Risk in Hypertensive Patients

BACKGROUND

Emerging evidence suggests that elevated circulating levels of HDL-C (high-density lipoprotein cholesterol) could be linked to an increased mortality risk. However, to the best of our knowledge, the relationship between HDL-C and specific cardiovascular events has never been investigated in patients with hypertension.

METHODS

To fill this knowledge gap, we analyzed the relationship between HDL-C levels and cardiovascular events in hypertensive patients within the Campania Salute Network in Southern Italy.

RESULTS

We studied 11 987 patients with hypertension, who were followed for 25 534 person-years. Our population was divided in 3 groups according to the HDL-C plasma levels: HDL-C<40 mg/dL (low HDL-C); HDL-C between 40 and 80 mg/dL (medium HDL-C); and HDL-C>80 mg/dL (high HDL-C). At the follow-up analysis, adjusting for potential confounders, we observed a total of 245 cardiovascular events with a significantly increased risk of cardiovascular events in the low HDL-C group and in the high HDL-C arm compared with the medium HDL-C group. The spline analysis revealed a nonlinear U-shaped association between HDL-C levels and cardiovascular outcomes. Interestingly, the increased cardiovascular risk associated with high HDL-C was not confirmed in female patients.

CONCLUSIONS

Our data demonstrate that there is a U-shaped association between HDL-C and the risk of cardiovascular events in male patients with hypertension.

Determination of safe sites of intramuscular arm injections and its relevance to the community

Background and Introduction

Intramuscular injections are usually given in the arm or the gluteal region. Needle insertions done through the intramuscular route in the arm are almost always administered at a point 1 - 2 cm above the insertion of the deltoid. However, this site is not such an ideal one as found by certain other workers. Hence, this study was done to establish a series of safe determinant points in and around the arm in the South Indian population of the state of Telangana.

Materials and Methods

The five proven safe injection points were tested through needle insertions by observing sterile aseptic precautions in the arms of 370 subjects at the outpatient department of a national level medical research institute after obtaining their consent following the universal safety protocol.

Results

The points I [1 to 2 cm above deltoid insertion], II [a point midway between the midpoint of arm and insertion of deltoid] and III [midpoint between anterior acromion and deltoid insertion] were found to be safe for administering intramuscular arm injections in this subset of the population.

Conclusion

This explains the erratic course of the anterior branches of the axillary nerve in different geographical populations. Hence, needle insertion points for arm intramuscular injections need to be determined according to the region.

Hidden Risk: Arrhythmogenic Genes in the General Population

The past 2 decades have seen the development of large-scale DNA biobanks associated with phenotypic information of the general population. Examples of these efforts are the UK Biobank, BioVU at Vanderbilt and MyCode. These repositories were designed to generate information to enable a precision medicine approach to diagnose, prevent, and treat human disease.

Captivity induces large and population-dependent brain transcriptomic changes in wild-caught cane toads (Rhinella marina)

Gene expression levels are key molecular phenotypes at the interplay between genotype and environment. Mounting evidence suggests that short-term changes in environmental conditions, such as those encountered in captivity, can substantially affect gene expression levels. Yet, the exact magnitude of this effect, how general it is, and whether it results in parallel changes across populations are not well understood. Here, we take advantage of the well-studied cane toad, Rhinella marina, to examine the effect of short-term captivity on brain gene expression levels, and determine whether effects of captivity differ between long-colonized and vanguard populations of the cane toad's Australian invasion range. We compared the transcriptomes of wild-caught toads immediately assayed with those from toads captured from the same populations but maintained in captivity for seven months. We found large differences in gene expression levels between captive and wild-caught toads from the same population, with an over-representation of processes related to behaviour and the response to stress. Captivity had a much larger effect on both gene expression levels and gene expression variability in toads from vanguard populations compared to toads from long-colonized areas, potentially indicating an increased plasticity in toads at the leading edge of the invasion. Overall, our findings indicate that short-term captivity can induce large and population-specific transcriptomic changes, which has significant implications for studies comparing phenotypic traits of wild-caught organisms from different populations that have been held in captivity.

Novel Zoonotic Avian Influenza A(H3N8) Virus in Chicken, Hong Kong, China

Zoonotic and pandemic influenza continue to pose threats to global public health. Pandemics arise when novel influenza A viruses, derived in whole or in part from animal or avian influenza viruses, adapt to transmit efficiently in a human population that has little population immunity to contain its onward transmission. Viruses of previous pandemic concern, such as influenza A(H7N9), arose from influenza A(H9N2) viruses established in domestic poultry acquiring a hemagglutinin and neuraminidase from influenza A viruses of aquatic waterfowl. We report a novel influenza A(H3N8) virus in chicken that has emerged in a similar manner and that has been recently reported to cause zoonotic disease. Although they are H3 subtype, these avian viruses are antigenically distant from contemporary human influenza A(H3N2) viruses, and there is little cross-reactive immunity in the human population. It is essential to heighten surveillance for these avian A(H3N8) viruses in poultry and in humans.

Liver blood marker testing in UK primary care: a UK wide cohort study, 2004-2016

OBJECTIVE

We aimed to determine (1) the temporal trends of liver enzyme testing in UK general practice and (2) how these vary among different subgroups at risk of chronic liver disease (CLD).

DESIGN

Retrospective cohort study.

SETTING

UK primary care database (Clinical Practice Research Datalink (CPRD)), 2004-2016.

PARTICIPANTS

Patients aged 18 years or over, registered in the CPRD from 1 January 2004 to 31 December 2016.

OUTCOME MEASURES

The frequency of testing recorded within the study period in general practice was calculated for: alanine aminotransferase (ALT); aspartate aminotransferase (AST); gamma glutamyl transferase (GGT); alkaline phosphatase (ALP); bilirubin and platelets. Analyses were conducted in subgroups of patients at high risk of developing liver disease.

RESULTS

The study cohort included 2 912 066 individuals with median follow-up of 3.2 years. The proportion of patients with at least one measurement for ALT, ALP, bilirubin or platelet test gradually increased over the course of the study period and fell for AST and GGT. By 2016, the proportion of the population receiving one of more tests in that year was: platelet count 28.0%, ALP 26.2%, bilirubin 25.6%, ALT 23.7%, GGT 5.1% and AST 2.2%. Those patients with risk factors for CLD had higher proportions receiving liver marker assessments than those without risk factors.

CONCLUSIONS

The striking finding that AST is now only measured in a fraction of the population has significant implications for routine guidance which frequently expects it. A more nuanced approach where non-invasive markers are targeted towards individuals with risk factors for CLD may be a solution.

Temporal development in survival, and gender and regional differences in the Swedish population of patients with synchronous and metachronous metastatic colorectal cancer

BACKGROUND

Survival in patients with metastatic colorectal cancer (mCRC) has markedly improved in patients included in clinical trials. In population-based materials, improvements were seen until about a decade ago, but it is unclear if survival has continued to improve. It is also unclear if regional or gender differences exist.

MATERIAL AND METHODS

All patients with mCRC (N = 19,566) in Sweden between 2007 and 2016 were identified from the national quality register, SCRCR, with almost complete coverage. Overall survival (OS) from diagnosis of metastatic disease was calculated in two calendar periods, 2007-2011 and 2012-2016. Differences between groups were compared using Cox regression.

RESULTS

Median age was 72 years, 55% were males, synchronous presentation was seen in 13,630 patients and metachronous in 5936. In synchronous disease, the primary tumour was removed more often during the first than the second period (51% vs 41%, p < 0.001). Median OS (mOS) was 14.0 months. It was longer in those with metachronous than synchronous disease (17.6 vs 13.1 months, p < 0.001) and in males (15.0 vs 12.8 months, p < 0.001), and markedly influenced by age and primary location. It was longer in patients diagnosed during the second period than during the first (14.9 vs 13.1 months, HR 0.89 (95% CI 0.86-0.92), p < 0.001). This difference was seen in all subgroups according to sex, age, presentation, and sidedness. mOS was about one month shorter in 1/6 healthcare regions, most pronounced during the first period. Differences in median of up to 5 months were seen between the region with the shortest and longest mOS.

CONCLUSIONS

Overall survival in Swedish patients with mCRC has improved during the past decade but is still substantially worse than reported from clinical trials/hospital-based series, reflecting the selection of patients to trials. Regional differences were seen, but they decreased with time. Women did not have a poorer prognosis in multivariable analyses.

Nitrogen rates and plant density interactions enhance radiation interception, yield, and nitrogen use efficiencies of maize

The contributions of the different leaf layers to maize yields identified as middle leaf > lower leaf > upper leaf, where the vertical photosynthetically active radiation (PAR) in the canopy gradually decreases. We hypothesized that the allocation of more PAR and nitrogen (N) to the highest contributing leaves will would be beneficial for higher yields and N use efficiencies. The N application rate and plant density effectively regulated the canopy light and N distribution. We evaluated the interactive effects of N rate and plant density on the agronomic and ecophysiological characteristics of leaves at different orientations in a 2019/2020 field experiment. In this study, an N application rate of 180 kg ha^-1 coupled with a plant density of 82,500 plants ha^-1 achieved the highest yield and N recovery efficiency (NRE). In contrast to the traditional farming practices in northern China, the density was increased and N rate was reduced. Densification from 52,500 to 82,500 plants ha^-1 increased the population leaf area index (LAI) by 37.1% and total photosynthetically active radiation (TPAR) by 29.2%; however, excessive density (from 82,500 to 97,500 plants ha^-1) drastically reduced the proportion of TPAR by 28.0% in the lower leaves. With increased density, the leaf areas and angles of the upper leaves decreased much more than those of the other leaves, which allowed the middle and lower leaves to access more light, which manifested a smaller extinction coefficient for light (K _L). A high yield (>1,000 kg ha^-1) of maize could be achieved simultaneously with higher NRE; however, it was negatively correlated with internal N use efficiency (IE_N). Higher N concentrations and lower total performance index (PI _total ) in the lower leaves may be an important rationale for the reduction of IE_N in high-yielding maize. Additionally, decreased N rate without yield reduction under higher densities was primarily attributed to the more uniform vertical N distribution [a smaller extinction coefficient for N (K _N)]. These results suggest that the N fertilizer rate can be moderately reduced without a reduction in maize yield under high plant densities in northern China.

Sodium, Potassium and Iodine Intake in an Adult Population of Lithuania

Hypertension is a leading risk factor for cardiovascular events and death. A reduction in salt intake is among the most cost-effective strategies to reduce blood pressure and the risk of cardiovascular diseases. Increasing potassium lowers blood pressure and is associated with lower cardiovascular risk. Adequate iodine intake is important to prevent iodine deficiency disorders. Salt iodization is a key strategy to prevent such deficiency. In Lithuania, no surveys have been performed to directly assess sodium, potassium and iodine consumption. The aim of the present study was to measure sodium, potassium and iodine intake in a randomly selected adult Lithuanian adult population using 24 h urine collections, and to assess knowledge, attitudes and behavior towards salt consumption. Salt and potassium intakes were estimated in 888 randomly selected participants by 24 h urine sodium and potassium excretion and 679 individuals provided suitable 24 h urine samples for the analysis of iodine excretion. Average salt intake was 10.0 (SD 5.3) g/24 h and average potassium intake was 3.3 (SD 1.3) g/24 h. Only 12.5% of participants consumed less than 5 g/24 h of salt. The median value of urinary iodine concentration (UIC) was 95.5 μg/L. Our study showed that average salt intake is twice as high as the maximum level recommended by the World Health Organization while potassium and iodine intakes in Lithuania are below the recommended levels.

Impact of Socioeconomic Status and Residence Distance on Infant Heart Disease Outcomes in Canada

Background Socioeconomic status (SES) impacts clinical outcomes associated with severe congenital heart disease (sCHD). We examined the impact of SES and remoteness of residence (RoR) on congenital heart disease (CHD) outcomes in Canada, a jurisdiction with universal health insurance. Methods and Results All infants born in Canada (excluding Quebec) from 2008 to 2018 and hospitalized with CHD requiring intervention in the first year were identified. Neighborhood level SES income quintiles were calculated, and RoR was categorized as residing <100 km, 100 to 299 km, or >300 km from the closest of 7 cardiac surgical programs. In-hospital mortality at <1 year was the primary outcome, adjusted for preterm birth, low birth weight, and extracardiac pathology. Among 7711 infants, 4485 (58.2%) had moderate CHD (mCHD) and 3226 (41.8%) had sCHD. Overall mortality rate was 10.5%, with higher rates in sCHD than mCHD (13.3% versus 8.5%, respectively). More CHD infants were in the lowest compared with the highest SES category (27.1% versus 15.0%, respectively). The distribution of CHD across RoR categories was 52.3%, 21.3%, and 26.4% for <100 km, 100 to 299 km, and >300 km, respectively. Although SES and RoR had no impact on sCHD mortality, infants with mCHD living >300 km had a higher risk of mortality relative to those living <100 km (adjusted odds ratio [aOR], 1.43 [95% CI, 1.11-1.84]). Infants with mCHD within the lowest SES quintile and living farthest away had the highest risk for mortality (aOR, 1.74 [95% CI, 1.08-2.81]). Conclusions In Canada, neither RoR nor SES had an impact on outcomes of infants with sCHD. Greater RoR, however, may contribute to higher risk of mortality among infants with mCHD.

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.

Association between Serum Magnesium Levels and Mortality in a Community-Based Population: The Yamagata (Takahata) Study

The element magnesium (Mg) is involved in various metabolic reactions within the human body, and its deficiency is considered a risk factor for several diseases. In this study, we investigated the relationship between serum Mg levels and mortality in a community-based population. We prospectively assessed the association between serum Mg levels at enrollment and all-cause mortality in 1,314 participants who underwent a community health examination. The mean serum Mg level was 2.4 (±0.2) mg/dL. Patients with serum Mg levels ≤2.3 mg/dL constituted the low Mg group, while those with serum Mg ≥2.4 mg/dL constituted the high Mg group. Ninety-three (7.1%) patients died during the 10-y follow-up period. Kaplan-Meier analysis revealed that all-cause mortality was significantly higher in the low Mg group (log-rank p<0.05). Cox proportional hazards analysis revealed a significant association in the unadjusted model (hazard ratio [HR] 1.72, 95% confidence intervals [CI] 1.14-2.58, p<0.01) and in the fully adjusted model (HR 1.73, 95% CI 1.09-2.76, p<0.05). This association was particularly strong in males (HR 2.08, 95% CI 1.19-3.63, p<0.05). Low serum Mg levels were significantly associated with the risk of all-cause mortality among males in a community-based Japanese population.

Demographic and Regional Trends of Hypertrophic Cardiomyopathy-Related Mortality in the United States, 1999 to 2019

BACKGROUND

Hypertrophic cardiomyopathy (HCM)-related mortality has been decreasing within the United States; however, persistent disparities in demographic subsets may exist. In this study, we assessed nationwide trends in mortality related to HCM among people ≥15 years of age in the United States from 1999 to 2019.

METHODS

Trends in mortality related to HCM were assessed through a cross-sectional analysis of the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiological Research database. Age-adjusted mortality rates per 1 000 000 people and associated annual percent changes with 95% CIs were determined. Joinpoint regression was used to assess the trends in the overall, demographic (sex, race and ethnicity, age), and regional groups.

RESULTS

Between 1999 and 2019, 39 200 HCM-related deaths occurred. In the overall population, age-adjusted mortality rate decreased from 11.2 in 1999 to 5.4 in 2019. Higher mortality rates were observed for males, Black patients, and patients ≥75 years of age. Large metropolitan counties experienced pronounced declines in age-adjusted mortality rate over the study period. In addition, California had the highest overall age-adjusted mortality rate.

CONCLUSIONS

Over the past 2 decades, HCM-related mortality has decreased overall in the United States. However, demographic and geographic disparities in HCM-related mortality have persisted over time and require further investigation.

Evaluation of genetic polymorphisms at 21 autosomal STR loci in Ramgharia Sikh population of Punjab, India

BACKGROUND

STR (Short Tandem Repeat) markers are highly polymorphic markers, which are widely used in forensics DNA analysis and aid to ascertain unique genotype profiles of individuals and determine the genetic diversity of the given population.

AIM

In the present study, an attempt has been made to evaluate the population genetic diversity of the Ramgharia Sikh population of Punjab, India, using 21 autosomal STR loci (D3S1358, vWA, D16S539, CSF1PO, TPOX, D8S1179, D21S11, D18S51, D2S441, D19S433, TH01, FGA, D22S1045, D5S818, D13S317, D7S820, SE33, D10S1248, D1S1656, D12S391, and D2S1338) to augment the emerging forensic database related to the indigenous population of India.

SUBJECTS AND METHODS

For generation of the database, 200 (blood on FTA card) samples were obtained from genetically unrelated Ramgharia Sikhs residing in the state of Punjab. Twenty-one autosomal STR markers were analysed using the Globalfiler^® PCR amplification kit.

RESULTS

With the help of various statistical tools, a total of 232 alleles were observed and 11.048 ± 1.284 (mean ± standard deviation) alleles per locus were recorded. No locus deviated from Hardy Weinberg Equilibrium. SE33 locus was found to be the most polymorphic and exhibited the highest discrimination power, that is, 0.99. Moreover, results further indicated that Ramgharia Sikhs of Punjab showed a high affinity with Bhils of Madhya Pradesh (India). Thus, the studied population showed genetic proximity with the geographically close populations of India and showed significant genetic variations with distant populations, which was evident from the UPGMA tree and Principal Component Analysis plot.

CONCLUSION

Overall, the 21 autosomal STRs were found to be polymorphic in the Ramgharia population and suitable for forensic casework and studies on population genetics.

Genetic epidemiology of human neutrophil antigen variants suggests significant global variability

Human neutrophil antigens possess significant clinical implications especially in the fields of transfusion and transplantation medicine. Efforts to estimate the prevalence of genetic variations underpinning the antigenic expression are emerging. However, there lacks a precise capture of the global frequency profiles. Our article emphasizes the potential utility of maintaining an organized online repository of evidence on neutrophil antigen-associated genetic variants from published literature and reports. This, in our opinion, is an emerging area and would significantly benefit from the awareness and understanding of population-level diversities.

A Methodology of Epidemiologic Study in the General Population Focusing on Food Allergy - China, 2020

Introduction

Adverse reactions to food (ARF) are a major worldwide public health and food safety problem. Among the various causes of ARF, food allergies (FA) are particularly serious as the immune response that is triggered can be fatal even at very low doses. However, the prevalence of ARF and FA in the general population in China is presently unclear. This study aims to determine the epidemiological characteristics and risk factors for ARF and FA, which can be a basis for estimating thresholds for major food allergens.

Methods

This is a multicenter, cross-sectional, epidemiologic survey with a case-control study nested among a selected population in China. Random individuals were recruited using stratified cluster random sampling; ARF and FA were comprehensively assessed using modified EuroPrevall FA Project questionnaires as well as structured interviews, sensitization testing, and double-blind placebo-controlled food challenges (DBPCFC).

Results

This method of epidemiologic study on ARF and FA was a pilot application in Jiangxi Province from January 2020; among the total 21,273 children and adults that completed the questionnaire, 5.8% reported ARF and 4.3% reported FA. ARF were determined to be associated with age, gender, and region. Animal-derived foods were the dominant offending foods, especially shrimp, and skin symptoms were the most commonly reported ARF.

Discussion

This is the first multi-center, large-scale, epidemiologic study on ARF and FA using standardized methods, including DBPCFC, in the Chinese general population. This study presents an important approach to assessing ARF and FA, provides significant insights about the prevalence of ARF and FA, and facilitates support for updating the list of allergenic food labels: which will be essential for improving ARF prevention and management in China.

Deep Population Genomics Reveals Systematic and Parallel Evolution at a Lipopolysaccharide Biosynthetic Locus in Xanthomonas Pathogens That Infect Rice and Sugarcane

The advent of high-throughput sequencing and population genomics has enabled researchers to investigate selection pressure at hypervariable genomic loci encoding pathogen-associated molecular pattern (PAMP) molecules like lipopolysaccharide (LPS). Xanthomonas is a model and a major group of phytopathogenic bacteria that infect hosts in tissue-specific manner. Our in-depth population-based genomic investigation revealed the emergence of major lineages in two Xanthomonas pathogens that infect xylem of rice and sugarcane is associated with the acquisition and later large-scale replacement by distinct type of LPS cassettes. In the population of the rice xylem pathogen, Xanthomonas oryzae pv. oryzae (Xoo) and sugarcane pathogens Xanthomonas sacchari (Xsac) and Xanthomonas vasicola (Xvv), the BXO8 type of LPS cassette is replaced by a BXO1 type of cassette in Xoo and by Xvv type LPS cassette in Xsac and Xvv. These findings suggest a wave of parallel evolution at an LPS locus mediated by horizontal gene transfer (HGT) events during its adaptation and emergence. Aside from xylem pathogens, two closely related lineages of Xoo that infect parenchyma of rice and Leersia hexandra grass have acquired an LPS cassette from Xanthomonas pathogens that infect parenchyma of citrus, walnut, and strawberries, indicating yet another instance of parallel evolution mediated by HGT at an LPS locus. Our targeted and megapopulation-based genome dynamic studies revealed the acquisition and dominance of specific types of LPS cassettes in adaptation and success of a major group of phytopathogenic bacteria. IMPORTANCE Lipopolysaccharide (LPS) is a major microbe associated molecular pattern and hence a major immunomodulator. As a major and outer member component, it is expected that LPS is a frontline defense mechanism to deal with different host responses. Limited studies have indicated that LPS loci are also highly variable at strain and species level in plant-pathogenic bacteria, suggesting strong selection pressure from plants and associated niches. The advent of high-throughput genomics has led to the availability of a large set of genomic resources at taxonomic and population levels. This provides an exciting and important opportunity to carryout megascale targeted and population-based comparative genomic/association studies at important loci like those encoding LPS biosynthesis to understand their role in the evolution of the host, tissue specificity, and also predominant lineages. Such studies will also fill major gap in understanding host and tissue specificity in pathogenic bacteria. Our pioneering study uses the Xanthomonas group of phytopathogens that are known for their characteristic host and tissue specificity. The present deep phylogenomics of diverse Xanthomonas species and its members revealed lineage association and dominance of distinct types of LPS in accordance with their origin, host, tissue specificity, and evolutionary success.

Neuroendocrine Tumors: An Analysis of Prevalence, Incidence, and Survival in a Hospital-Based Study in Ecuador

Neuroendocrine tumors (NETs) represent a heterogeneous malignancy group of neoplasms, with a limited amount of data from Latin America. Thus, this observational study aimed to provide data about the prevalence, incidence, and survival rates for NET in Ecuadorian hospitals. The study was conducted using data from the Society for the Fight Against Cancer (SOLCA). We evaluated patients with NETs (2000−2020) using the HJ-Biplot method and Cox proportional hazards. Annual age-adjusted incidence and limited-duration prevalence in multivariable analyses as well as hazard ratios (HRs) for mortality and survival were obtained. In the years 2000−2020, the age-adjusted incidence rate increased by 9-fold in the stomach and by 7-fold in the breast. The incidence rates were 1.38 per 100,000 persons in the lung and at 1.79 per 100,000 persons in gastroenteropancreatic sites (rectum, stomach, and pancreas). The prevalence increased from 0.0027% in 2000 to 0.0736% in 2019 and 0.0245% in 2020. Overall survival was worse for metastatic NETs (HR, 4.061; 95% CI, 1.932−8.540; p < 0.001) and advanced local NETs (HR, 2.348; 95% CI, 1.007−5.475 p < 0.048) than for localized NETs. In conclusion, the NET incidence increased in the last 20 years and survival decreased over time, especially for metastatic tumors in the pancreas and the nostril.

Within-species variation of seed traits of dune engineering species across a European climatic gradient

Within-species variation is a key component of biodiversity and linking it to climatic gradients may significantly improve our understanding of ecological processes. High variability can be expected in plant traits, but it is unclear to which extent it varies across populations under different climatic conditions. Here, we investigated seed trait variability and its environmental dependency across a latitudinal gradient of two widely distributed dune-engineering species (Thinopyrum junceum and Calamagrostis arenaria). Seed germination responses against temperature and seed mass were compared within and among six populations exposed to a gradient of temperature and precipitation regimes (Spiekeroog, DE; Bordeaux, FR; Valencia, ES; Cagliari, IT, Rome, IT; Venice, IT). Seed germination showed opposite trends in response to temperature experienced during emergence in both species: with some expectation, in populations exposed to severe winters, seed germination was warm-cued, whereas in populations from warm sites with dry summer, seed germination was cold-cued. In C. arenaria, variability in seed germination responses disappeared once the seed coat was incised. Seed mass from sites with low precipitation was smaller than that from sites with higher precipitation and was better explained by rainfall continentality than by aridity in summer. Within-population variability in seed germination accounted for 5 to 54%, while for seed mass it was lower than 40%. Seed trait variability can be considerable both within- and among-populations even at broad spatial scale. The variability may be hardly predictable since it only partially correlated with the analyzed climatic variables, and with expectation based on the climatic features of the seed site of origin. Considering seed traits variability in the analysis of ecological processes at both within- and among-population levels may help elucidate unclear patterns of species dynamics, thereby contributing to plan adequate measures to counteract biodiversity loss.