Adult Mortality Research Articles

Blowin’ in the wind: Long-term downwind exposure to air pollution from power plants and adult mortality

We estimate the causal effects of long-term exposure to air pollution emitted from fossil fuel power plants on adult mortality. We leverage quasi-experimental variation in daily wind patterns, which is further instrumented by the county orientation from the nearest power plant. We find that the county’s fraction of days spent downwind of plants within 20 miles in the last 10 years is associated with increased mortality from COVID-19 through the third peak in mortality in January 2021. This effect is more pronounced in fenceline communities with high poverty rates, low health insurance coverage, and low educational attainment.

Medium to long-term ventricular assist device support in adults with congenital heart disease

Heart failure is the leading cause of morbidity and mortality in adults with congenital heart disease. Though for many in this population, heart transplantation is not possible or requires longer wait times necessitating prolonged circulatory support. Medium to long-term durable ventricular assist device therapy provides a possible solution. We analyzed outcomes of nine patients with congenital heart disease and at least 3 years of durable mechanical support, all age 18 or older at time of ventricular assist device implantation at our affiliated pediatric and adult hospitals. Palliated congenital anatomies varied and included biventricular physiologies as well as single ventricle with Fontan circulation. Median duration of support was 4.2 years including three patients successfully bridged to transplant averaging 2.1 years on the waitlist. Device-related complications were infrequent with HeartMate 3, a feasible and sustainable option for either bridge to transplant or destination strategies in adults with congenital heart disease.

Association Between Systemic Inflammation Markers and Cardiovascular Mortality in Adults with Metabolic Dysfunction-Associated Steatotic Liver Disease

Background and AimIdentifying metabolic dysfunction-associated steatotic liver disease (MASLD) patients at increased risk of cardiovascular mortality remains an unmet clinical need. We investigated the ability of four systemic inflammation markers to identify cardiovascular mortality risk in MASLD patients. Methods and ResultsThis cohort study included 4,787 MASLD patients from the National Health and Nutrition Examination Survey (NHANES) from 2005 through 2018. The weighted Cox proportional hazards model was used to assess the relationship between four systemic indicators of inflammation and cardiovascular mortality. During a median (IQR) follow-up of 7.0 (3.8-10.3) years, 567 all-cause mortality and 174 cardiovascular mortality were recorded. Compared to the first quartile of systemic inflammation levels, the HRs of cardiovascular mortality in the fourth quartile were 3.22 (95% CI 1.83-5.66) for SII, 2.74 (95% CI 1.32-5.69) for SIRI, 3.69 (95% CI 1.87-7.28) for NLR, and 1.83 (95% CI 1.05-3.20) for PLR. For predicting 10-year cardiovascular mortality, SIRI (AUC=0.70) and NLR (AUC=0.69) were superior to SII (AUC=0.60) and PLR (AUC=0.52). Stratification of MASLD patients based on the optimal cutoff values revealed an HR of 2.67 (95% CI 1.65-4.32) for cardiovascular mortality with SIRI > 1.23, and an HR of 2.39 (95% CI 1.51-3.79) with NLR > 2.18. Combining systemic inflammation markers with the Fibrosis-4 Score can provide more accurate prognostic information for MASLD patients. ConclusionsSIRI and NLR outperformed SII and PLR in predicting the risk of cardiovascular mortality, proving to be useful tools for risk stratification in MASLD patients.

The association between Naples Prognostic Score and all-cause and cardiovascular mortality in the general population with Metabolic Syndrome: a cohort study

Background and aimThe Naples prognostic score (NPS) is a recognized inflammatory and nutritional scoring system used as a prognostic indicator in various cancers and, more recently, in non-cancer diseases. Its association with mortality in individuals with Metabolic Syndrome (MetS) is understudied. This study aims to investigate the link between NPS and both all-cause and cardiovascular disease (CVD) mortality in adults with MetS. Methods and resultsThis study included individuals with MetS from the National Health and Nutrition Examination Survey (NHANES) 1999-2016. Mortality data were linked to National Death Index records up to December 31, 2019. MetS was defined using NCEP ATP III criteria. NPS was calculated using serum albumin, total cholesterol, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio, classifying participants into three groups. Survival differences were assessed using Kaplan-Meier analysis and Log-rank tests. Cox proportional hazards regression determined hazard ratios (HR) with 95% confidence intervals (CI). The study included 13,757 participants, with 2,744 (19.95%) in the low group, 9,140 (66.44%) in the medium group, and 1,873 (13.61%) in the high group. Over a median follow-up of 9.16 years, there were 3,292 all-cause deaths and 1,136 cardiovascular deaths. Compared to the low group, the high group had adjusted HRs of 1.74 (95% CI: 1.51, 2.01) for all-cause mortality and 1.60 (95% CI: 1.25, 2.04) for cardiovascular mortality (all P for trend < 0.01). ConclusionsNPS is a significant prognostic indicator for both all-cause and cardiovascular mortality in individuals with MetS, showing a positive correlation with mortality risk, reinforcing its potential clinical utility.

Intersection of Race, Age, and Mortality in Young Adults in the United States Renal Data System

Intersection of Race, Age, and Mortality in Young Adults in the United States Renal Data System

Serum Uric Acid and the Risk of Cardiovascular and All-Cause Mortality in Community-Dwelling Older Adults

Serum Uric Acid and the Risk of Cardiovascular and All-Cause Mortality in Community-Dwelling Older Adults

Comparisons of Mortality, Wait-Listing, and Transplantation Outcomes of Young Adults in the United States Renal Data System (USRDS)

Comparisons of Mortality, Wait-Listing, and Transplantation Outcomes of Young Adults in the United States Renal Data System (USRDS)

Association of oral hypofunction with aspiration pneumonia, fractures, and mortality in older Japanese adults.

In Japan's public health system, dentists can assess and intervene in oral hypofunction cases. However, the associations between oral hypofunction and health outcomes and costs remain unclear. This study aimed to identify these associations. This retrospective cohort study using a Japanese health insurance claims database included 45 916 individuals aged ≥65 years who underwent dental examinations for oral hypofunction. The primary outcomes were incidence rates of aspiration pneumonia, femoral or vertebral fractures and all-cause mortality. Secondary outcomes were annual medical and dental costs. We used competing risk regression and Cox models to estimate primary outcomes, and gamma regression models for secondary outcomes. The adjusted hazard ratios were 0.84 (95% CI 0.74-0.96) for the incidence of aspiration pneumonia, 1.11 (1.02-1.21) for the incidence of femoral or vertebral fractures and 1.27 (1.07-1.50) for all-cause mortality in individuals with oral hypofunction compared with those without. The adjusted relative risk was 1.05 (1.01-1.10) for annual medical costs and 0.94 (0.81-1.09) for annual dental costs in individuals with oral hypofunction compared with those without. Individuals with oral hypofunction were at increased risk of femoral or vertebral fractures and all-cause mortality, and they incurred significantly higher annual medical costs, compared with those without this condition. Notably, they showed a lower risk of aspiration pneumonia, suggesting potential benefits of dental intervention. Integrating dental care into medical strategies might be necessary to improve health outcomes and reduce healthcare costs for those with oral hypofunction. Geriatr Gerontol Int 2024; 24: 1053-1059.

Kaposi's sarcoma-associated herpesvirus infection and its association with all-cause and cardiovascular mortality in the general adults: A prospective cohort study.

To investigate the association between Kaposi's sarcoma-associated herpesvirus (KSHV)/human herpesvirus 8 (HHV8) infection and both all-cause and cardiovascular mortality in a representative cohort of US adults, data from the National Health and Nutrition Examination Survey III (NHANES III; 1988‒1994) were analyzed, including 13,993 participants aged 18‒90 years who underwent KSHV serology evaluations. Mortality outcomes were ascertained through December 2019 using the National Death Index. Cox proportional hazards models were employed to examine the association between KSHV seropositivity and mortality, adjusting for potential confounders such as age, sex, ethnicity, body mass index, and serum TG. Over a median follow-up period of 26.5 years, 5503 deaths were recorded. KSHV seropositivity was associated with an increased hazard of all-cause mortality (Hazard Ratio [HR]: 1.32, 95% Confidence Interval [CI]: 1.03‒1.69) and cardiovascular mortality (HR: 1.58, 95% CI: 1.00‒2.50) after adjusting for age, sex, ethnicity, and body mass index. Notably, the association between KSHV infection and all-cause mortality persisted among women (HR: 1.32, 95% CI: 1.02‒1.72) after adjusting for all confounders, whereas the association with cardiovascular mortality was only statistically significant for men (HR: 1.90, 95% CI: 1.02, 3.53).KSHV infection may represent an independent risk factor for all-cause and cardiovascular mortality among US adults. These findings highlight the need for further research to validate these associations in independent populations and to elucidate the biological mechanisms underlying the observed increased mortality associated with KSHV infection.

Yellow mealworm: effects of adults breeding density on adults and larvae performances from an industrial perspective

A key aspect to optimise the Tenebrio molitor (TM) farm productivity is to find an optimal breeding density for adults. To this purpose, this study investigated, from an industrial perspective, the impact of 4 breeding densities (D1, D2, D3 and D4, equal to 0.8, 1.1, 1.3 and 1.6 adults/cm2, respectively) on mortality and reproductive performances of TM adults and larvae. Two weeks after pupae emergence, TM adults were randomly assigned to the four groups and housed in 48 breeding crates (60 x 40 x 14.5 cm; 12 crates/group). The trial consisted in 4 consecutive weeks of adults breeding (each week represented one oviposition), and 8 weeks of larvae growth. From each week of oviposition, a batch of larvae was obtained for a total of 4 batches of larvae (48 crates/batch). Larvae of each batch were grown until 8 weeks of age, corresponding to the period required to reach the selling size. Larvae were kept in the original crates until the 5th weeks of age, after which they were divided into additional crates to ensure a density of 4.2 larvae/cm2 and a final weight of 1500 g of larvae/crate (0.6 g of larvae/cm2). For each oviposition week, TM adult’s mortality, eggs hatchability, BW, feed intake, chemical composition and fatty acids (FAs) profile were evaluated, while ovary weight was measured at weeks 1 and 4. The number of larvae was monitored at week 5 of age while their chemical composition at week 5 and 8. Larvae feed intake and BW were monitored over the 8-weeks growth period. Individual feed intake and BW of adults increased with increasing breeding density (P<0.0001 and P<0.05, respectively). With increasing adults breeding density, the number of larvae per crate increased (P<0.001) while the grams of larvae/gram of adult decreased (R2=0.8856). Larvae from groups D2, D3 and D4 showed higher feed intake per crate and higher individual and total final BW than D1 (P<0.001). However, the feed conversion ratio (FCR) worsened with increasing breeding density (P<0.001). D4 larvae had higher percentages of protein (P<0.001), lipids (P<0.05) and cholesterol (P<0.001) compared to larvae from other groups. Concluding, a breeding density of 0.8 adults/cm2 maximised both grams of larvae produced/grams of adults and larvae FCR. However, breeding densities above 0.8 adults/cm2, resulted in a higher number of produced larvae per crate with a greater final mass weight making a density of 1.6 adults/cm2 the preferable choice from and industrial perspective.

Evaluation of A Non-Nucleoside Inhibitor of the RSV RNA-Dependent RNA Polymerase in Translatable Animals Models

Respiratory Syncytial Virus (RSV) causes severe respiratory infections and concomitant disease resulting in significant morbidity and mortality in infants, elderly, and immunocompromised adults. Vaccines, monoclonal antibodies, and small molecule antivirals are now either available, or in development, to prevent and treat RSV infections. Although, rodent and non-rodent preclinical animal models have been used to evaluate these emerging agents there is still a need to improve our understanding of the pharmacokinetic (PK)-pharmacodynamic (PD) relationships, within and between animal models to enable better design of human challenge studies and clinical trials. Herein, we report a PKPD evaluation of MRK-1, a novel small molecule non-nucleoside inhibitor of the RSV L polymerase protein, in the semi-permissive cotton rat and African green monkey models of RSV infection. These studies demonstrate a strong relationship between in vitro activity, in vivo drug exposure, and pharmacodynamic efficacy as well as revealing limitations of the cotton rat RSV model. Additionally, we report unexpected horizontal transmission of human RSV between co-housed African green monkeys, as well as a lack of drug specific resistant mutant generation. Taken together these studies further our understanding of these semi-permissive animal models and offer the potential for expansion of their preclinical utility in evaluating novel RSV therapeutic agents.

The significance of SARC-F score in one-year all-cause mortality of adults with high nutritional risk with cancer

The significance of SARC-F score in one-year all-cause mortality of adults with high nutritional risk with cancer

Women exposed to famine in early gestation have increased mortality up to age 76 years.

We have previously shown that exposure to famine in early gestation was associated with poorer adult health and, in women, with reduced survival up to age 64. Here, we explore the association between prenatal famine exposure and mortality up to age 76 for men and women separately. We studied adult mortality (>18 years) in men (n = 989) and women (n = 1002) born as term singletons around the time of the 1944-1945 Dutch famine. We compared overall and cause-specific mortality among men and women exposed to famine in late, mid, or early gestation to that among unexposed persons (born before or conceived after the famine) using Cox regression. In total, 500 persons (25.1%) had died after age 18. Women exposed to famine in early gestation had higher overall (HR 1.49, 95% CI 1.00, 2.23), cancer (HR 2.17, 95% CI 1.32,3.58) and cardiovascular mortality (HR 2.33, 95% CI 0.91, 5.95) compared to unexposed women. Mortality rates among men were not different between exposure groups. This study showed that women, but not men, exposed to famine in early gestation had increased overall, cardiovascular and cancer mortality up to age 76. Although prenatal famine exposure affects adult health of both men and women, it seems to only lead to increased mortality among women.

Improving Sphenophorus levis Adult Mortality Through Solid Insecticide Applications and Increased Insecticide Dose.

The sugarcane weevil (Sphenophorus levis Vaurie, 1978) is currently considered the most important sugarcane pest in Brazil, causing significant yield losses. Application methods of insecticides for S. levis control have not been effective, mostly due to the insect's cryptic behavior below the soil surface which suppresses the correct placement of insecticide active ingredients on target. Two experiments were conducted using an innovative bioassay methodology that simulates sugarcane field conditions to effectively evaluate S. levis adult mortality and insecticide residues in the soil under different treatments. The first experiment aimed to assess the efficacy of two liquid- and solid-applied insecticides, while the second aimed to examine the effect of increasing the dose of lambda-cyhalothrin + thiamethoxam on S. levis adult control. The novel bioassays simulated liquid and solid insecticide applications on sugarcane by exposing S. levis adults to chemical residuals on rhizomes and in soil after insecticide application. In the first experiment, low S. levis adult control was detected (< 53% mortality) across all treatments, where both solid and liquid applications of lambda-cyhalothrin + thiamethoxam provided greater efficacy levels than imidacloprid and control treatments, respectively. Solid applications maintained higher insecticide concentrations in the soil for longer periods than liquid insecticide applications, providing maximum insect control levels 7days after application. The second experiment revealed that solid applications at higher insecticide doses significantly improved control of S. levis adult (76.7% mortality) and resulted in greater insecticide concentrations in the soil compared to the recommended label rate (58.8% mortality).

A Dirt(y) World in a Changing Climate: Importance of Heat Stress in the Risk Assessment of Pesticides for Soil Arthropods.

The rise in global temperatures and increasing severity of heat waves pose significant threats to soil organisms, disrupting ecological balances in soil communities. Additionally, the implications of environmental pollution are exacerbated in a warmer world, as changes in temperature affect the uptake, transformation and elimination of toxicants, thereby increasing the vulnerability of organisms. Nevertheless, our understanding of such processes remains largely unexplored. The present study examines the impact of high temperatures on the uptake and effects of the fungicide fluazinam on the springtail Folsomia candida (Collembola, Isotomidae). Conducted under non-optimum but realistic high temperatures, the experiments revealed that increased temperature hampered detoxification processes in F. candida, enhancing the toxic effects of fluazinam. High temperatures and the fungicide exerted synergistic interactions, reducing F. candida's reproduction and increasing adult mortality beyond what would be predicted by simple addition of the heat and chemical effects. These findings highlight the need to reevaluate the current ecological risk assessment and the regulatory framework in response to climate changes. This research enhances our understanding of how global warming affects the toxicokinetics and toxicodynamics (TK-TD) of chemicals in terrestrial invertebrates. In conclusion, our results suggest that adjustments to regulatory threshold values are necessary to address the impact of a changing climate.

Sarcopenia and Metabolic Dysfunction-Associated Steatotic Liver Disease: A Narrative Review

The primary objective of modern medicine is to extend human life expectancy. Currently, the majority of hospital patients across various clinical settings are elderly or advanced-age individuals, often with multiple comorbidities and age-related alterations in peripheral tissues. One such alteration is sarcopenia, a progressive decline in muscle mass, strength, and function, which significantly increases the risk of disability and mortality in older adults. Sarcopenia is associated with numerous adverse outcomes, and its underlying mechanisms are the subject of ongoing research. This narrative review discusses the epidemiology, pathophysiology, and diagnostic criteria for sarcopenia. It also examines the connections between sarcopenia and metabolic dysfunction-associated steatotic liver disease (MASLD), highlighting potential treatment approaches for the coexistence of these two pathologies.

Association of Shock Index and Modified Shock Index with Mortality Rate in Emergency Department Trauma Patient

At the emergency room, triage was used to determine which patients were more seriously injured and in need of urgent care. Trauma remains one of the primary causes of morbidity and death even with the use of modern triage techniques. Objective: To find out the relationship between trauma patients' 48-hour mortality and the shock index and modified shock index at Emergency Departments (EDs). Methods: A study was conducted in the Emergency Ward of Ziauddin University Hospital, focusing on patients aged 18-65 who sustained trauma. The study involved 50 trauma patients admitted to a Level I trauma center. Data were collected on heart rate, blood pressure, and shock indices at the time of admission. A shock index cut-off value of 0.9 was used to determine its association with patient outcomes. Data collection involved patients visiting the emergency department, with informed consent obtained. SPSS version 21.0 was used for analysis. Results: The study involved 50 patients, with 25 in each exposed and unexposed group. Exposed patients had a higher average age, higher heart rates, and lower blood pressure. Road traffic accidents were the leading trauma mechanism in both groups. Open wounds were more common in exposed patients. Most exposed patients received intravenous fluids and inotropic support. Patients with a Shock Index ≥ 1 and a Modified Shock Index ≥ 1.3 had higher mortality rates. Conclusion: The study revealed a significant link between medical mortality in older adults and bruises in emergency departments, indicating that SI and Modified SI were effective markers for severity assessment.

Relationship between assesment of physical activity with body mass index and maximum oxygen volume in adult men with overweight and obesity

Background. Non-communicable diseases (NCDs) are the leading cause of early adult mortality, often originating in adolescence. Obesity a prevalent NCD, commonly develops during youth and can measured by body mass index (BMI). Objectives. This study was to describe the relationships between physical activity, as defined by the International Physical Activity Questionnaire (IPAQ), BMI, and maximum oxygen consumption (VO2max) in adult men who are overweight or obese. Materials and methods. This descriptive study utilized the IPAQ-SF, BMI, and VO2max data from 22 medical records of adult men who were overweight or obese, selected using a purposive sampling approach. Outcomes. Physical activity and BMI are negatively correlated, with a p-value of 0.000 and a Pearson correlation coefficient of -0.989. Statistical significance is indicated by the p-value of 0.000, and the Pearson correlation coefficient of 0.884 shows a strong positive association between VO2max and physical activity. BMI and VO2max are negatively correlated, with a p-value of 0.000 and a Pearson correlation coefficient of -0.896. Conclusion. The study indicates a relationship between physical activity and BMI, as well as between physical activity and VO2max. Additionally, there is a relationship between BMI and VO2max. Overall, physical activity, BMI, and VO2max are interrelated in overweight or obese adult men.

INVESTIGATION OF COMBINED EFFECT OF THREE PLANT POWDERS WITH DIATOMACEOUS EARTH AGAINST CALLOSOBRUCHUS MACULATUS

The study was conducted to investigate the combined effects of various plant powders and Silico-sec, a diatomaceous earth, on Callosobruchus maculatus at the research laboratory of the Department of Crop Pest and Soil Management, the Federal University of Technology, Akure. The study included three replications. The treatments consisted of three (3) plant materials derived from the dry flower buds of Eugenia aromatica, seeds of Piper guineense, and leaves of Nicotiana tabacum and their combination with Silico-sec. In one experiment, 0.4g of each plant material was added to 20 C. maculatus adults (10 couples, aged 1-2 days) in 20g of Ife Brown cowpea seeds, all contained within an air-tight plastic container. Another experiment involved the addition of 0.4g mixtures of Silico-sec and each plant powder (E. aromatica, P. guineense, and N. tabacum) in various ratios (1:5, 5:1, 1:10, 10:1, and 1:1) to the same number of C. maculatus adults in 20g of cowpea seeds, also in separate air-tight plastic containers. All the treatments and their combination were laid out in a completely randomized design (CRD) repeated three times. Data were collected at 12, 24, and 48 at p,0hours post-treatment. Oviposition, adult emergence, and seed weight loss were evaluated. The results demonstrated that both the plant powders and Silico-sec were effective in controlling C. maculatus infestation on cowpea by causing significant adult mortality at p&lt; 0.05, reducing oviposition, suppressing F1 adult emergence, and minimizing seed damage. Among single applications, Silico-sec and E. aromatica powder provided the best protection for stored cowpea, yielding the highest adult mortality, lowest oviposition, most suppressed F1 adult emergence, and minimal seed damage. However, the mixture of Silico-sec and P. guineense at ratios of 5:1 and 10:1 offered the best protection, exhibiting significantly higher mortality, lower oviposition rates, suppressed F1 adult emergence, and reduced seed damage compared to other treatments. This study suggests that combination of P. guineense and Silico-sec is particularly effective in controlling cowpea storage pests and could serve as a viable alternative to synthetic insecticides for protecting stored cowpea against C. maculatus.

An Audit of the Fifth Irish Hip Fracture Standard in patients &amp;gt;=70 years following hip fracture

Abstract Background Hip fractures are a significant cause of morbidity and mortality in older adults. Bone health assessment is key in the reduction of future fracture risk. The aim of our study was to examine the adherence to the fifth Irish Hip Fracture Standard in patients &amp;gt;=70 years presenting to Letterkenny University Hospital (LUH) with a hip fracture and to examine the number of patients who were commenced on bone protection. Methods We included patients &amp;gt;=70 years who were admitted under the Orthopaedic service following a hip fracture between January and June 2023 in LUH and were identified the database maintained by the using Fracture Liaison Nurse. Data collected included age, month in which hip fracture occurred, patient resident in Ireland, patient alive/deceased, patient on bone protection prior to fracture, patient commenced on bone protection or patient declined treatment. Data was recorded in a Microsoft excel spreadsheet and was analysed by the clinical audit facilitator. We measured our data against the British Geriatric Society guideline on the use of IV zoledronate following hip fracture. Results 76 patients were admitted to LUH with a hip fracture &amp;gt;=70 years between January and June 2023. 100% of patients were reviewed by the fracture liaison service and following this it was recommended that 46 patients (60%) be commenced on bone protection. A letter was sent to each patient’s General Practitioner outlining the recommendation for bone protection. On follow up only 7/46 (15.2%) had been started on treatment. Conclusion The fracture liaison service is appropriately identifying patients who require treatment, despite this, patients are not starting the necessary bone protection in the community. This has prompted our service to establish an IV zoledronate clinic for patients following hip fracture and to generate a plan for ongoing treatment of this patient cohort.