Life Expectancy in 2040: What Do Clinical Experts Expect?

Cell Encapsulation and 3D Bioprinting for Therapeutic Cell Transplantation

The promise of cell therapy has been augmented by introducing biomaterials, where intricate scaffold shapes are fabricated to accommodate the cells within. In this review, we first discuss cell encapsulation and the promising potential of biomaterials to overcome challenges associated with cell therapy, particularly cellular function and longevity. More specifically, cell therapies in the context of autoimmune disorders, neurodegenerative diseases, and cancer are reviewed from the perspectives of preclinical findings as well as available clinical data. Next, techniques to fabricate cell-biomaterials constructs, focusing on emerging 3D bioprinting technologies, will be reviewed. 3D bioprinting is an advancing field that enables fabricating complex, interconnected, and consistent cell-based constructs capable of scaling up highly reproducible cell-biomaterials platforms with high precision. It is expected that 3D bioprinting devices will expand and become more precise, scalable, and appropriate for clinical manufacturing. Rather than one printer fits all, seeing more application-specific printer types, such as a bioprinter for bone tissue fabrication, which would be different from a bioprinter for skin tissue fabrication, is anticipated in the future.

Health Benefits of Strategies for Carbon Mitigation in US Transportation, 2017‒2050

Objectives. To quantify health benefits and carbon emissions of 2 transportation scenarios that contrast optimum levels of physical activity from active travel and minimal air pollution from electric cars. Methods. We used data on burden of disease, travel, and vehicle emissions in the US population and a health impact model to assess health benefits and harms of physical activity from transportation-related walking and cycling, fine particulate pollution from car emissions, and road traffic injuries. We compared baseline travel with walking and cycling a median of 150 weekly minutes for physical activity, and with electric cars that minimized carbon pollution and fine particulates. Results. In 2050, the target year for carbon neutrality, the active travel scenario avoided 167 000 deaths and gained 2.5 million disability-adjusted life years, monetized at $1.6 trillion using the value of a statistical life. Carbon emissions were reduced by 24% from baseline. Electric cars avoided 1400 deaths and gained 16 400 disability-adjusted life years, monetized at $13 billion. Conclusions. To achieve carbon neutrality in transportation and maximize health benefits, active travel should have a prominent role along with electric vehicles in national blueprints. (Am J Public Health. 2022; 112(3):426-433. https://doi.org/10.2105/AJPH.2021.306600).

An alginate-based encapsulation system for delivery of therapeutic cells to the CNS

Treatment options for neurodegenerative conditions such as Parkinson's disease have included the delivery of cells which release dopamine or neurotrophic factors to the brain. Here, we report the development of a novel approach for protecting cells after implantation into the central nervous system (CNS), by developing dual-layer alginate beads that encapsulate therapeutic cells and release an immunomodulatory compound in a sustained manner. An optimal alginate formulation was selected with a view to providing a sustained physical barrier between engrafted cells and host tissue, enabling exchange of small molecules while blocking components of the host immune response. In addition, a potent immunosuppressant, FK506, was incorporated into the outer layer of alginate beads using electrosprayed poly-ε-caprolactone core–shell nanoparticles with prolonged release profiles. The stiffness, porosity, stability and ability of the alginate beads to support and protect encapsulated SH-SY5Y cells was demonstrated, and the release profile of FK506 and its effect on T-cell proliferation in vitro was characterized. Collectively, our results indicate this multi-layer encapsulation technology has the potential to be suitable for use in CNS cell delivery, to protect implanted cells from host immune responses whilst providing permeability to nutrients and released therapeutic molecules.

Novel composite cell encapsulation system: dual-layer, micro-scale beads maintain cell survival while releasing immunomodulatory FK506 in a sustained manner. This biotechnology platform could be applicable for treatment of CNS and other disorders.

Demographic perspectives on the rise of longevity

This article reviews some key strands of demographic research on past trends in human longevity and explores possible future trends in life expectancy at birth. Demographic data on age-specific mortality are used to estimate life expectancy, and validated data on exceptional life spans are used to study the maximum length of life. In the countries doing best each year, life expectancy started to increase around 1840 at a pace of almost 2.5 y per decade. This trend has continued until the present. Contrary to classical evolutionary theories of senescence and contrary to the predictions of many experts, the frontier of survival is advancing to higher ages. Furthermore, individual life spans are becoming more equal, reducing inequalities, with octogenarians and nonagenarians accounting for most deaths in countries with the highest life expectancy. If the current pace of progress in life expectancy continues, most children born this millennium will celebrate their 100th birthday. Considerable uncertainty, however, clouds forecasts: Life expectancy and maximum life span might increase very little if at all, or longevity might rise much faster than in the past. Substantial progress has been made over the past three decades in deepening understanding of how long humans have lived and how long they might live. The social, economic, health, cultural, and political consequences of further increases in longevity are so significant that the development of more powerful methods of forecasting is a priority.

Routine Assessment of Health Impacts of Local Transportation Plans: A Case Study From the City of Los Angeles

OBJECTIVES

To determine the health impacts of three future scenarios of travel behavior by mode for the City of Los Angeles, California, and to provide specific recommendations for how to conduct health impact assessments of local transportation plans on a more routine basis.

METHODS

We used the Integrated Transportation and Health Impact Model to assess the health impacts of the Los Angeles Mobility Plan 2035 by using environmental impact report data on miles traveled by mode under alternative implementation scenarios as inputs. The Integrated Transportation and Health Impact Model links region-wide changes in travel behavior to population exposures to physical activity, air pollution, and traffic collisions and associated health outcomes and costs.

RESULTS

The largest impacts were on cardiovascular disease through increases in physical activity. Reductions in air pollution-related illnesses were more modest. Traffic injuries and deaths increased across all scenarios but were greatly reduced through targeted roadway safety enhancements accounted for outside the model.

CONCLUSIONS

By establishing miles travelled as the metric for transportation impacts of statewide and regional plans, states can leverage existing data sources to more routinely consider health impacts as part of environmental impact reports. While not insurmountable, challenges remain regarding the incorporation of land use and roadway safety strategies into health impact estimates.

Protecting the gains: What changes are needed to prevent a reversal of the downward cardiovascular disease mortality trend?

AIMS

Cardiovascular disease (CVD) mortality has decreased over 60% over the past 50 years in the United States; however, emerging data indicate CVD incidence may be rising because of shifting demographics, increasing risk factor prevalence, and competing needs for limited resources. We projected CVD mortality from 2015 to 2040 given varying informed assumptions regarding changes in risk factor prevalence, uptake of current therapeutic options, and future innovations.

METHODS

A microsimulation model was used to project US CVD mortality trends. National Health and Nutrition Examination Survey data were used to estimate population-level trends in CVD risk factors. Risk factors were used to generate Framingham Risk Scores for cohorts of 1 000 000 individuals from the general population to determine each individuals' CVD risk. Annual cardiovascular incidence, prevalence, and mortality were projected for scenarios differing by uptake of current therapies, anticipated pharmaceutical innovations with variable efficacy, risk factor prevalence, and changes in health disparities.

RESULTS

When incorporating a demographic shift, continued changes in risk factors, current treatment utilization, and no major innovations, we predicted the CVD mortality rate would increase 41% by 2040. If innovations providing incremental benefits equal to those associated with the introduction of statins are identified and widely utilized, CVD mortality could remain constant through 2040. With more efficacious innovations, CVD mortality could be further reduced.

CONCLUSIONS

Given demographic and risk prevalence changes, increasing access and adherence to current preventative therapeutics could slow the expected mortality increase, but new therapies may be needed to maintain the downward trend in CVD deaths.

Shared pathological pathways of Alzheimer's disease with specific comorbidities: current perspectives and interventions

Alzheimer's disease (AD) belongs to one of the most multifactorial, complex and heterogeneous morbidity-leading disorders. Despite the extensive research in the field, AD pathogenesis is still at some extend obscure. Mechanisms linking AD with certain comorbidities, namely diabetes mellitus, obesity and dyslipidemia, are increasingly gaining importance, mainly because of their potential role in promoting AD development and exacerbation. Their exact cognitive impairment trajectories, however, remain to be fully elucidated. The current review aims to offer a clear and comprehensive description of the state-of-the-art approaches focused on generating in-depth knowledge regarding the overlapping pathology of AD and its concomitant ailments. Thorough understanding of associated alterations on a number of molecular, metabolic and hormonal pathways, will contribute to the further development of novel and integrated theranostics, as well as targeted interventions that may be beneficial for individuals with age-related cognitive decline.

Health and greenhouse gas mitigation benefits of ambitious expansion of cycling, walking, and transit in California

The purpose of this research was to quantify health co-benefits and carbon reductions of preferred scenarios of California regional transportation plans and alternatives with ambitious levels of active transport. The alternatives were designed to examine the efficacy of independent contributions of walking, bicycling, and transit at levels consistent with the U.S. Surgeon General recommendation for physical activity. Using data from travel and health surveys, vital statistics, collision databases, and outputs from regional and statewide travel models, the Integrated Transport and Health Impacts Model estimated the change in the population disease burden, as measured by deaths and disability adjusted life years (DALYs), due to a shift from a 2010 baseline travel pattern to an alternative. Health pathways modeled were physical activity and road traffic injuries. The preferred scenarios increased statewide active transport from 40.5 to 53.4 min person-1 w-1, which was associated with an annual decrease of 909 deaths and 16,089 DALYs. Sensitivity analyses that accounted for 2040 projected age- and sex-specific population characteristics and cause-specific mortality rates did not appreciably alter the annual change in deaths and DALYs on a population basis. The ambitious, maximal alternatives increased population mean travel duration to 283 min person-1 w-1 for walking, bicycling, or transit and were associated a reduction in deaths and DALYs from 2.5 to 12 times greater than the California preferred scenarios. The alternative with the largest health impact was bicycling 283 min person-1 w-1 which led to 8,543 fewer annual deaths and 194,003 fewer DALYs, despite an increase in bicyclist injuries. With anticipated population growth, no alternative achieved decreases in carbon emissions but bicycling had the greatest potential for slowing their growth. Alternatives that included transit similarly reduced carbon emissions, but with less health benefit. Aggressive expansion of active transport is an efficacious, but underutilized policy option with significant health co-benefits for mitigating greenhouse gases.