Annual Population Research Articles

Epidemiological Trends and Projections of Incidence, Prevalence, and Disease Related Mortality Associated With Peripheral Arterial Disease: Observations Using Nationwide Danish Data

Peripheral arterial disease (PAD) trends remain unclear because contemporary data are sparse and conflicting. This nationwide cohort study quantified changes in PAD incidence, prevalence, and all cause mortality, and projected prevalence development through to 2040. Population based registries covering the entire Danish population aged ≥ 40 years from 2000 to 2018 were linked to assess trends in PAD incidence, prevalence, and all cause mortality, overall and by sex and age groups. Based on observed trends in incidence and mortality, and estimated future annual age distribution and population mortality, the PAD prevalence through to 2040 was projected. The Danish population aged 40 - 99 years in 2000 - 2018 included 4 811 281 individuals, among whom 145 870 incident PAD diagnoses were identified. The age and sex standardised PAD incidence decreased from 2.26 per 1 000 person years in 2000 to 1.65 in 2018 (incidence RR 0.74, 95% CI 0.72 - 0.77). The incidence was approximately 20% higher in men than women but declined similarly over time. Concurrently, PAD prevalence in the Danish adult population increased from 1.3% to 1.6% (prevalence ratio 1.28, 95% CI 1.26 - 1.30). Among patients aged ≥ 80 years, the prevalence reached 5.7% in women and 7.9% in men. The age and sex standardised annual mortality among patients with PAD decreased from 9.8% in 2000 to 7.2% in 2018 (mortality ratio 0.75, 95% CI 0.72 - 0.78). Projections of PAD prevalence demonstrated that the rising PAD prevalence will continue until around 2030, followed by a decline towards 2040. Among individuals aged ≥ 80 years, the prevalence was projected to plateau at 8.9% for men and 6.2% for women before declining. Within an unselected nationwide population, the incidence and all cause mortality of PAD have declined over the last two decades. Concurrently, prevalence increased and is projected to increase further over the coming decade, emphasising the growing burden of this common atherosclerotic disease in ageing populations.

Geospatial analytics of driving mechanism of land subsidence in Gulf Coast of Texas, United States

Land subsidence has been an ongoing issue for over a century along the Gulf Coast of Texas in the United States. This study assesses and models the factors contributing to land subsidence covering fifty-six (56) counties along the Gulf of Mexico coastline from Louisiana to the border of Mexico, approximately 300,000 km2. Geospatial statistical techniques and regression models were employed to investigate and predict the fundamental causes of land subsidence by integrating multiple datasets such as Global Navigation Satellite System (GNSS) (147 stations), groundwater extraction (78,420 wells), hydrocarbon production (84,424 wells), precipitation, and population growth. In the last two decades, the overall population rose by 33 % and the compound annual population growth rate increased from 2.08 to 4.10 % in Montgomery, Waller, Fort Bend, and Chambers counties. Emerging hotspot analysis reveals that the groundwater level is persistently declining and the regression model (R2 = 0.92) tested over Harris County predicts that the population growth significantly contributes to land subsidence in this region. The groundwater withdrawal rate is increased from 23 to 96.6 billion gallons in Harris, Montgomery, and Fort Bend counties in the last two decades. A prolonged drought from 2010 to 2015 due to low precipitation affected all fifty-six counties. Oil production increased eightfold and a high extraction rate of 19.5 to 40.1 million bbl/yr of oil in Karnes County was recorded within the last 20 years. The regression model (R2 = 0.73) over this county suggests that oil extraction is a primary contributing factor to the observed subsidence. Although the gas extraction rates for all counties are decreasing over time, some counties in the southern part of the Gulf Coast Aquifer show relatively higher extraction rates. For the first time, this research determines that all fifty-six counties along the Gulf Coast of Texas are undergoing land subsidence and experiencing high population growth, groundwater withdrawal, and hydrocarbon extraction.

The continuing decrease of sandy desert and sandy land in northern China in the latest 10 years

Timely monitoring of the sandy desert and sandy land (SDSL) dynamics and their driving factors is vital for ecological restoration policy-making to combat the expansion of the SDSL. Northern China, being the principal implementation area of ecological restoration projects, is ecologically fragile and encompasses almost all of the SDSL regions in China. To explore and compare the dominant driving factors for SDSL changes by extracting both aeolian activity information and vegetation indices, the SDSL datasets in northern China from 2010 to 2020 were first constructed in this study by the human–computer interactive interpretation method based on the series Landsat image data. The spatiotemporal dynamic characteristics of SDSL were subsequently analyzed, and the dominant driving factors of SDSL changes were further explored via the geodetector model by the fractional vegetation cover trend and the difference of aeolian activity index. The results showed a net decrease of 3,780.25 km2 in the total SDSL area between 2010 and 2020, and the decrease rate was 2.44 times higher in the shorter period of 2015–2020 compared to 2010–2015. The spatial differentiation between the western and eastern parts of the Helan Mountains was prominently exhibited by the relatively higher changed SDSL area in the eastern part (62.74% for aeolian activity weakened and 83.32% for aeolian activity intensified) and the increasingly changed SDSL area in the western part (from 33.09% to 39.60% in aeolian activity weakened and from 13.02% to 19.60% in aeolian activity intensified). Especially, the increased aeolian activity intensified SDSL area has happened on the southern edge of the Gurbantunggut Desert and along both sides of the Tarim River from 2015 to 2020 deserve attention. The co-driving of the multiple driving factors dominated the change of SDSL from 2010 to 2020, with the county mean value of the difference in aeolian activity index (MDAAI) and the county mean value of the trend in fractional vegetation cover (MFVCT) as dependent variables, respectively. Climatic factors of the mean annual average temperature, the mean annual cumulative precipitation, and the mean annual aridity index have a relatively larger explanatory power for the change of SDSL in both MDAAI and MFVCT. Anthropogenic factors of the mean annual afforestation area and the mean annual number of large livestock and sheep and goats (year-end) have a greater explanatory power in MDAAI, while the mean annual number of large livestock and sheep and goats (year-end) and the mean annual population density in MFVCT. In particular, the dependent variable MDAAI is better at identifing the dominant drivers of aeolian activity intensified SDSL area compared to MFVCT, with anthropogenic factors playing a stronger dominant role.

Integrating multi-influencing factor techniques and fuzzy methods to identify recommendation domains for out-scaling conservation agriculture in China

Climate-smart agriculture (CSA) is a global development strategy aimed to address the interlinked challenges of food security and climate change. Expanding the implementation of conservation agriculture (CA), a vital component of CSA, is essential for enhancing agricultural and food security resilience while sustainably managing arable land. However, the extensive heterogeneity of biophysical and socioeconomic conditions presents significant complexities in promoting CA adoption. Addressing these challenges, this study carried out a comprehensive theoretical investigation of biophysical and socioeconomic factors influencing CA adoption and performance, integrating stakeholder feedback to create a systematic and robust evaluation index system for assessing CA suitability. By integrating multi-influencing factor techniques and fuzzy logic methods, we spatially identified suitable areas for CA implementation in China, providing valuable insights for land use policy. The reliability of the models was verified through a sensitivity analysis using the map removal sensitivity analysis method and the extended Fourier amplitude sensitivity test. The results indicated that 29.78% of the cultivated land was unsuitable or marginally suitable for CA, while 29.30 and 40.92% were determined to be moderately suitable and suitable zones, respectively. Suitable cultivated land was primarily distributed in the northern arid and semi-arid regions, the Loess Plateau, the Huang-Huai-Hai Plain, and the Northeast China Plain. Conversely, unsuitable, and marginally suitable cultivated land was predominantly located in the Qinghai Tibet Plateau, Middle-lower Yangtze Plain, Sichuan Basin and surrounding areas, the Yunnan-Guizhou Plateau, and Southern China. The topographical index, annual mean precipitation, humidity index, and population density were identified as the most significant factors influencing CA suitability. The CA suitability maps generated in this study will guide the development and extension agents targeting CA to suitable locations with a high potential impact, thereby maximizing the likelihood of adoption and minimizing the risk of failure.

Demographic and socioeconomic characterization of the Immediate Region of Teófilo Otoni, MG between 1991 and 2010

The Immediate Geographical Region of Teófilo Otoni (RGIm Teófilo Otoni) is composed of 27 municipalities and reveals itself in different demographic and infrastructural conditions from the other regions of the State of Minas Gerais, Brazil. In this sense, the objective of this article is to describe and evaluate the main demographic indicators for the municipalities that make up RGIm Teófilo Otoni between 1991 and 2010 for the purposes of general characterization based on this new spatial arrangement. The database used was obtained from repositories of planning and research institutions, such as the Brazilian Institute of Geography and Statistics (IBGE), Ministry of Health (DATASUS), and the João Pinheiro Foundation (FJP), and allowed the measurement of the following variables: total urban and rural population; distribution of the total population by age group according to sex; degree of urbanization; total fertility rate; annual geometric population growth rate; life expectancy at birth; mortality rate, and Municipal Human Development Index between the years 1991 and 2010, in addition to the migratory dynamics for the year 2010. The characterization allowed us to identify that, although there have been improvements in the demographic and socioeconomic conditions of this portion of the territory of Minas Gerais, the values found remained lagged in comparison to other regions of Minas Gerais. The perspective is that the data presented may help to understand some socio-spatial dynamics for a portion of the state that still lacks research and/or technical-scientific information.

Trends and projections in surgical stabilization of glenohumeral instability in the United States from 2009 to 2030: rise of the Latarjet procedure and fall of open Bankart repair.

Advances in surgical techniques have improved the ability to address recurrent glenohumeral instability via arthroscopic capsulolabral repair and bone-restoring procedures such as the Latarjet procedure. Given the paucity of studies analyzing temporal trends in the surgical management of glenohumeral instability, the purpose of this study was to assess trends in the treatment of anterior, posterior, and multidirectional instability over a 10-year period and model projections to 2030. Using the IBM Watson MarketScan national database, we identified all patients who underwent glenohumeral instability procedures from 2009 to 2018. Procedures were identified using Current Procedural Terminology codes for open Bankart, Latarjet, anterior bone block, posterior bone block, multidirectional capsular shift, and arthroscopic Bankart procedures. Sample weights provided by the database were used to calculate national estimates. US Census Bureau annual population data were used to calculate incidence. Future projections to 2030 were modeled using Poisson and linear regression. There were an estimated 446,072 glenohumeral instability cases from 2009 to 2018. The per capita incidence (per 100,000) remained constant, from 14.8 in 2009 to 14.5 in 2018. Arthroscopic Bankart procedures comprised the highest number of procedures throughout the study period, accounting for 89% of all procedures in 2009 and 93% in 2018. The number of open Bankart procedures decreased by 65% from 2009 to 2018, whereas the number of Latarjet procedures showed a 250% increase over the same period. Patient demographics did not change over the study period, and male patients aged 18-25 years comprised the largest demographic group undergoing anterior instability procedures. Multidirectional instability procedures exhibited the least pronounced sex differences. Future modeling from 2018 to 2030 projected a continued steady rise in arthroscopic Bankart procedures (from 40,000 to 49,000 cases/yr), rapid growth in Latarjet procedures (from 1370 to 4300 cases/yr), and continued decline in open Bankart procedures (from 1000 to 250 cases/yr). Arthroscopic Bankart repair continues to be the most common glenohumeral instability procedure in the United States. From 2009 to 2018, the incidence of open Bankart procedures declined whereas the incidence of Latarjet procedures markedly increased. Future projections to 2030 mirrored these findings. These data may provide an enhanced understanding of the evolution of surgical treatment of glenohumeral instability within the United States, laying the foundation for continued prospective studies into the appropriate indications and advancements in surgical techniques.

The burden of stomach cancer mortality by county, race, and ethnicity in the USA, 2000–2019: a systematic analysis of health disparities

There are persistent disparities in stomach cancer mortality among racial-ethnic groups in the USA, but the extent to which these patterns vary geographically is not well understood. This analysis estimated age-standardised mortality for five racial-ethnic groups, in 3110 USA counties over 20 years, to describe spatial-temporal variations in stomach cancer mortality and disparities between racial-ethnic groups. Redistribution methods for insufficient cause of death codes and validated small area estimation methods were applied to death registration data from the US National Vital Statistics System and population data from the US National Center for Health Statistics to estimate annual stomach cancer mortality rates. Estimates were stratified by county and racial-ethnic group (non-Latino and non-Hispanic [NL] American Indian or Alaska Native [AIAN], NL Asian or Pacific Islander [Asian], NL Black [Black], Latino or Hispanic [Latino], and NL White [White]) from 2000 to 2019. Estimates were corrected for misreporting of racial-ethnic group on death certificates using published misclassification ratios. We masked (ie, did not display) estimates for county and racial-ethnic group combinations with a mean annual population of less than 1000; thus, we report estimates for 3079 (of 3110) counties for the total population, and 474, 667, 1488, 1478, and 3051 counties for the AIAN, Asian, Black, Latino, and White populations, respectively. Between 2000 and 2019, national age-standardised stomach cancer mortality was lowest among the White population in every year. Nationally, stomach cancer mortality declined for all racial-ethnic groups across this time period, with the most rapid declines occurring among the Asian (percent decline 48.3% [45.1-51.1]) and Black populations (42.6% [40.2-44.6]). Mortality among the other racial-ethnic groups declined more moderately, decreasing by 36.7% (35.3-38.1), 35.1% (32.2-37.7), and 31.6% (23.9-38.0) among the White, Latino, and AIAN populations, respectively. Similar patterns were observed at the county level, although with wide geographic variation. In 2019, a majority of counties had higher mortality rates among minoritised racial-ethnic populations compared to the White population: 81.1% (377 of 465 counties with unmasked estimates for both racial-ethnic groups) among the AIAN population, 88.2% (1295 of 1469) among the Latino population, 99.4% (663 of 667) among the Asian population, and 99.9% (1484 of 1486) among the Black population. However, the size of these disparities ranged widely across counties, with the largest range from 0.3 to 17.1 among the AIAN population. Stomach cancer mortality has decreased substantially across populations and geographies in the USA. However, disparities in stomach cancer mortality among racial-ethnic groups are widespread and have persisted over the last two decades. Local-level data are crucial to understanding the scope of this unequal burden among minoritised groups in the USA. National Institute on Minority Health and Health Disparities; National Heart, Lung, and Blood Institute; National Cancer Institute; National Institute on Aging; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Office of Disease Prevention; and Office of Behavioral and Social Sciences Research, National Institutes of Health (contract #75N94019C00016).

Retrospective analysis of pulmonary cryptococcosis and extrapulmonary cryptococcosis in a chinese tertiary hospital

Cryptococcosis is an invasive fungal disease with increased morbidity in China over the past two decades. Cryptococci can infect immunocompromised hosts as well as immunocompetent ones. In this study, we reviewed data of 71 inpatients with cryptococcosis at Ningbo First Hospital from May 2010 to May 2020 and compared the clinical profiles of pulmonary cryptococcosis (PC) and extrapulmonary cryptococcosis (EPC). Of 71 patients (38 males, 33 females), 70 were non-HIV. The annual inpatient population increased dramatically, especially in the PC group. PC was confirmed in 77.46% (55/71) of cases by pathology. The rest were EPC including intracranial infection (15.49%, 11/71) and cryptococcemia (7.04%, 5/71). Compared with PC, a larger proportion of EPC patients were found to have immunocompromised conditions judged by predisposing factors (p < 0.01), or detectable humoral or cellular immunodeficiency. Fever and headache were more common in EPC patients (p < 0.001). Patients with EPC had lower serum sodium level (p = 0.041), lower monocyte counts (p = 0.025) and higher C-reactive protein (p = 0.012). In our study, the sensitivity of cryptococcus antigen detection for EPC was 100% regardless of sample type, while serum lateral flow assay (LFA) tested negative in 25% (5/20) of PC. Immunocompromised hosts are more likely to suffer from EPC than PC.

Seasonal Dynamics of Aphid Flights and Cotton Leafroll Dwarf Virus Spread in Alabama.

Cotton leafroll dwarf virus (CLRDV) is an introduced Polerovirus (Family: Solemoviridae) of cotton, Gossypium hirsutum L., in the U.S. The only vector known to transmit this virus to cotton is the cotton aphid, Aphis gossypii Glover; however, there are seven other species of aphids (Hemiptera: Aphididae) reported to colonize cotton in the southeastern U.S.: Protaphis middletonii (Thomas), Rhopalosiphum rufiabdominale (Sasaki), Aphis craccivora Koch, Macrosiphum euphorbiae Thomas, Myzus persicae (Sulzer), Smythurodes betae Westwood, and Aphis fabae Scopoli. Little to no information is available on annual population dynamics of these species in the southeastern U.S. The timing of CLRDV spread to cotton plantings is also unknown. The objective of this study was to monitor the population dynamics of eight cotton-feeding aphid species concurrent with the spread of CLRDV at three different locations in Alabama. Aphids were monitored weekly for two years with yellow pan traps, and sentinel plants were deployed weekly to monitor CLRDV spread throughout the cotton-growing season. During the two years, most CLRDV spread at all locations occurred when A. gossypii was actively dispersing in the field. Early season spread at sites in south and central Alabama, when A. gossypii was not abundant, suggests additional aphid vectors are possible.

Evaluating the importance of individual heterogeneity in reproduction to Weddell seal population dynamics using integral projection models.

Identifying and accounting for unobserved individual heterogeneity in vital rates in demographic models is important for estimating population-level vital rates and identifying diverse life-history strategies, but much less is known about how this individual heterogeneity influences population dynamics. We aimed to understand how the distribution of individual heterogeneity in reproductive and survival rates influenced population dynamics using vital rates from a Weddell seal population by altering the distribution of individual heterogeneity in reproduction, which also altered the distribution of individual survival rates through the incorporation of our estimate of the correlation between the two rates and assessing resulting changes in population growth. We constructed an integral projection model (IPM) structured by age and reproductive state using estimates of vital rates for a long-lived mammal that has recently been shown to exhibit large individual heterogeneity in reproduction. Using output from the IPM, we evaluated how population dynamics changed with different underlying distributions of unobserved individual heterogeneity in reproduction. Results indicate that the changes to the underlying distribution of individual heterogeneity in reproduction cause very small changes in the population growth rate and other population metrics. The largest difference in the estimated population growth rate resulting from changes to the underlying distribution of individual heterogeneity was less than 1%. Our work highlights the differing importance of individual heterogeneity at the population level compared to the individual level. Although individual heterogeneity in reproduction may result in large differences in the lifetime fitness of individuals, changing the proportion of above- or below-average breeders in the population results in much smaller differences in annual population growth rate. For a long-lived mammal with stable and high adult-survival that gives birth to a single offspring, individual heterogeneity in reproduction has a limited effect on population dynamics. We posit that the limited effect of individual heterogeneity on population dynamics may be due to canalization of life-history traits.

Poster 201: Trends and Projections in Surgical Stabilization of Glenohumeral Instability in the United States from 2009 to 2030: Rise of the Latarjet and Fall of the Open Bankart

Objectives: Advances in surgical techniques have improved the ability to addressrecurrent glenohumeral instability via arthroscopic capsulolabral repair and bonerestoring procedures such as Latarjet. Given the paucity of studies analyzing temporaltrends in surgical management of glenohumeral instability, the purpose of this studywas to assess trends in treatment of anterior, posterior, and multidirectional instabilityover a 10-year period and model projections to 2030. Methods: Using IBM Watson Marketscan national database, all patients thatunderwent glenohumeral instability procedures from 2009 to 2018 were identified.Procedures were identified using common procedural terminology (CPT) codes foropen Bankart Repair, Latarjet, anterior bone block, posterior bone block,multidirectional capsular shift, and arthroscopic Bankart procedures. Sample weightsprovided by the database were utilized to calculate national estimates. The UnitedStates (U.S.) Census Bureau annual population data were utilized for calculatingincidence. Future projections to 2030 were modeled using Poisson and linearregression. Results: There were an estimated 446,072 glenohumeral instability cases from 2009-2018. Per capita (per 100,000) incidence remained constant, from 14.8 in 2009 to 14.5in 2018. Arthroscopic Bankart comprised the highest number of procedures throughoutthe study period, accounting for 89% of all procedures in 2009 and 93% in 2018. OpenBankart procedures decreased by 65% from 2009 to 2018, while there was a 250%increase in Latarjet procedures over the same period. Patient demographics did notchange over the study period, and males aged 18-25 comprised the largestdemographic group undergoing anterior instability procedures. Multidirectionalinstability procedures exhibited the least pronounced gender differences. Futuremodeling from 2018-2030 projected continued steady rise in arthroscopic Bankart(40,000-49,000 case/yr), rapid growth in Latarjet (1370-4300 cases/yr), and continueddecline in open Bankart (1000-250 cases/yr) procedures. Conclusions: Arthroscopic Bankart continues to be the most common glenohumeralinstability procedure in the U.S. From 2009 to 2018, incidence of open Bankartprocedures declined while Latarjet procedures markedly increased. Future projectionsto 2030 mirrored these findings. These data may provide an enhanced understandingof the evolution of surgical treatment of glenohumeral instability within the U.S. layingthe foundation for continued prospective studies into the appropriate indications andadvancements in surgical techniques. [Table: see text][Table: see text]

Demographic Development and Social-Demographic Policy in Zambia

The purpose of the study was to identify trends in demographic development and features of the socio-demographic policy of the Republic of Zambia in the context of the demographic transition. The main research method is the statistical analysis of the demographic data of the current registration and population censuses of the Republic. The sources of information are demographic statistics and demographic surveys presented in the materials of national agencies and international organizations of the UN system. Zambia is on the path of the demographic transition, but so far remains one of the youngest countries in the world in terms of the average age of the population. The annual population growth rate remains significant at the level of 2.5-3%. The country maintains a high birth rate. As a large cohort of young people enter their reproductive years, the population of the Republic is expected to double in the next 25 years. The demographic situation may exacerbate some socio-economic problems, including an increase in demand for jobs, a shortage of medical care and social services. In this situation, the state socio-demographic policy of Zambia, although focused on the UN Sustainable Development Goals until 2030, has not yet fully responded to demographic changes. By 2030, the authorities of the Republic of Zambia have set the achievement of a prosperous nation with an average income as the goal of the country’s development by 2030. In this context, the health of the workforce remains an important component. It is considered that a healthy workforce will allow the country to increase productivity and gain a significant demographic dividend.

PREDIKSI KEBUTUHAN AIR BERSIH PDAM TIRTA MUSI PALEMBANG (STUDI KASUS WTP BORANG)

PDAM Tirta Musi Palembang is a government-owned enterprise engaged in water treatment services,where water that is not dirty is processed and converted into clean water that is ready and suitable forhuman consumption. The increase in annual population has an impact on the increasing growth in thenumber of customers who need clean water. However, the Water Treatment Plant (WTP) or WaterTreatment Plant (IPA) still does not provide full services to all city environments, one of which is at thePalembang City Form WTP. The source of WTP processing comes from the Borang River and intake 1 ilir.The customer population is projected to increase to 22,434 in 2023 based on Geometric analysis with acalculation of customer needs of 218.04 liters/second. The pump used at WTP Borang has a capacity of200 liters / second and uses 2 pumps, so WTP Borang can still meet customer needs. The amount of waterdischarge required during maximum days and peak hours is 239.84 liters / second and 327.06 liters /second respectively. With this situation, it is predicted that the community's clean water needs in 2023 canbe fulfilled by WTP Borang.

Interspecific interactions, human proximity, and season affect spatiotemporal structure of a Mojave Desert wetlands rodent community with a highly endangered species

We analyzed the influences of interspecific interactions and environmental factors on rodent community assembly in Mojave Desert wetlands that support the endangered Amargosa vole (Microtus californicus scirpensis). A total of 4927 rodents in six species were captured from 2010 to 2021 within 15 marshes, most frequently including Amargosa voles, harvest mice (Reithrodontomys megalotis), and house mice (Mus musculus), an invasive species. The structure of the community varied considerably over time and by marsh, driven mainly by reductions in harvest mice and increases in Amargosa voles and house mice between 2014 and 2017, and then reductions in Amargosa voles between 2018 and 2021. Northern marshes were dominated by voles, and southern marshes by house mice. Primary determinants of rodent capture rates were interspecific interactions, human proximity, and season. There was a significant inverse relationship between vole and house mouse captures per session, suggesting competitive exclusion. Distance to the nearest town was positively associated with the numbers of voles and negatively associated with the numbers of harvest mice, suggesting that voles may be more sensitive to human disturbance than other rodents. Amargosa voles and harvest mice had annual population cycles with peaks between July and September occurring 6–7 months after rainfall. Our results allow for valuable insight into the influences on community dynamics in desert rodents and highlight that conservation efforts that support Amargosa voles may simultaneously help control house mouse abundance and expansion.

Combining multiple geostatistical analyses to assess the past, present, and future of fragile Mediterranean deltaic environments

Littoral plains in general and those of the Mediterranean rivers and ramblas, are highly vulnerable territories. Understanding the past and present conditions of these areas is the best strategy to design efficient land management plans to prevent degradation such as pollutants, soil sealing, erosion, etc. in the near and medium future. In this research, different mapping techniques (land-use changes in twelve different years using manually digitalisation and field observations, from 1956 to 2019, and pattern analysis using ecological landscape indexes), multivariate statistical analyses (Spearman rank coefficient and Principal Component Analysis), and predictive models (Markov chain) are combined to assess the past, current, and future status of the Vélez River delta (Málaga province, Southern Spain), a representative vulnerable territory situated in the popular touristic area of Costa del Sol. We also included a demographic analysis using annual population census data (current inhabitants and projections) and a climate trend analysis (Mann-Kendall test) considering temperatures, precipitations and wind data. Our results demonstrate that the drastic urbanization, including new settlements, roads, and ways, has negatively impacted the delta area, even the alluvial plain, beaches, and natural sand deposits. From 1956 to 2019, >70 ha of deltaic area have been lost. The largest category of land-use, cultivated fields, accounted for up to 72.4 % of the total delta area in 1984. However, this was reduced to 41.1 % by 2019. The alluvial plain and beaches/sand deposits started from 9.3 and 11.8 %, and decreased to 5.2 and 5.9 %, respectively. Also, climate change (especially in temperature) could affect some spatial patterns. Predictive models reveal that it is likely that abandoned spaces, sand deposits, and beaches, will be transformed into new urban areas and, to a lesser extent, into cultivated fields. We concluded that the conservation of the cultivated lands, although decreasing in the area over the studied period, obtained the highest correlation with the delta conservation. Therefore, we affirm that efficient plans, which promote specific changes in land use, would contribute to stopping the degradation of the delta such as pollution of natural areas or soil sealing. Specifically, a plan should be developed to preserve sustainable agriculture and control urban sprawl.

Who is online? A latent class analysis of internet activities and determinant characteristics of older people

As Italy is the European country with the highest percentage of adults aged over 60, growing concerns have emerged about how the ageing population is living in an era of increasing digitalisation. According to the capability approach framework, Internet services can enable older adults to achieve social inclusiveness and independence, only if the variety of digital activities includes a large number of active ageing parameters. This is the first study that explores Internet use by Italian older adults and identifies latent groups of Internet users. We elaborated 13,597 responses from an Italian representative annual population survey and 40 different online activities were analysed using an Exploratory Factor Analysis and further elaborated together with sociodemographic variables in a Latent Class Analysis. Three classes of older Internet users were identified: Utilitarian, Familiar and Enjoyment users. The findings support the existence of heterogeneous older Internet users, at the same time showing the importance of personal characteristics to predict class membership. Being female, widowed, having a low income, being poorly educated, living alone, and having various comorbidities predicted fewer online activities. From a policy perspective, this study highlights that targeted training programmes together with improvements to digital infrastructures are essential to increase the level of Internet activities in later life as is the need for policies in favour of the disadvantaged groups in the older population.

Mortality rates of acute types of coronary artery disease and sudden cardiac death in the Russian regions in 2019-2021

Aim. To compare standardized mortality rates (SMR) from acute types of coronary artery disease (CAD) and sudden cardiac death (SCD) with an assessment of their regional variability in the Russian Federation in 2019-2021.Material and methods. Rosstat data on the average annual population and the number of deaths in one-year age groups for 2019-2021 in 82 Russian subjects from acute types of CAD and SCD were analyzed using following ICD-10 codes: I21.0-9 (acute primary) myocardial in­­farction (MI), I22.0-9 (recurrent MI), I20, I24.1-9 (other forms of acute coronary artery disease), I46.1 (SCD). SMR was calculated based on the European standard per 100,000 population. Average regional SMR values (M±SD), coefficients of variation (СV), nonparametric Wilcoxon T-test with Bonferroni adjustment were calculated (differences were considered significant at р&lt;0,05).Results. The average regional values of SMR from the sum of causes (acute types of CAD and SCD for 2019, 2020 and 2021) did not change significantly and amounted to 52,3±33,72; 53,84±36,17; 53,58±34,55, respectively. The annual increase in the average regional SMR for this period was noted from acute MI — 23,59±11,01; 24,85±10,92; 25,73±11,38, and other OF CAD — 19,47±26,17, 19,78±27,45; 20,54±26,79, respectively, in 2019, 2020 and 2021. A significant decrease in SMR occurred only from recurrent MI: from 7,19±5,38 to 6,97±5,97 in 2019-2020 (p=0,048) and to 4,99±4,25 in 2021 (p=0,023 to 2020). In 18 constituent entities of the Russian Federation, an annual decrease in SMR was noted, and in the rest — multidirectional changes. The increase in SMR from acute MI took place in 23 subjects of the Russian Federation with a minimum CV in 2020 and 2021 (44%). The maximum CV for SMD was recorded in 2021 (169%).Conclusion. Mortality from acute types of CAD and SMD for 2019-2021 in the Russian Federation was characterized by a stable level and high regional variability. The problem of improving the criteria for establishing acute types of CAD and SMD as the initial cause of death remains relevant in the absence or insufficiency of data for universal criteria for MI.

Trends in mortality rates from chronic forms of coronary heart disease in the regions of the Russian Federation in 2017–2021

Objective. To assess the trend and variability of standardized mortality ratios (SMRs) from chronic forms of coronary heart disease (CHD) in the regions of the Russian Federation (RF) in 2017–2021. Material and methods. The investigation used the 2017–21 Russian Federal State Statistics Service (RFSS) data on the average annual population and the number of deaths in the one-year age groups in 82 RF regions on the basis of the RFSS “Brief Death Cause Nomenclature” (BDCN). The SMRs were calculated on the basis of the European standard per 100,000 population for each region; then the average regional SMRs related to the chronic forms of CHD were determined using 4 BDCN accounting lines. Results. For the period from 2017 to 2019, a decrease was noted in the average regional SMRs from all forms of CHD (from 183.9±68.5 to 176.8±65.3 cases per 100,000 population), but in 2020 and 2021, an increase was recorded in SMRs from CHD (204.3±75.4 and 207.4±76.9 cases per 100,000 population, respectively) as the proportion of these causes decreased in the structure of all-cause mortality in the COVID-19 pandemic period (18.4±7.1% in 2017 and 15.8±5.4% in 2021). there was a decrease in the average regional SMRs from all forms of chronic heart diseases (CHD) (from 183.9±68.5 to 176.8±65.3 cases per 100,000 population), but in 2020 and 2021, an increase in the SMRs from CCHD (204.3±75.4 and 207.4±76.9 cases per 100,000 population, respectively) hand in hand with a reduction in the proportion of these causes in the COVID-19 pandemic period (18.4±7.1% in 2017 and 15.8±5.4% in 2021). Results. For the period from 2017 to 2019, over a 5-year period, an annual consistent decrease was recorded in the SMR from CHD in none Russia’s regions; their annual rise was seen in 4 regions; whereas an unstable trend was noted with a decrease and a rise in SMRs in the others. There was a considerable interregional variability of SMRs from all forms of CHD (in 2017, the maximal SMR differed from the minimal one by 60 times) and from individual forms of CHD (in 2020, the regional minimum and maximum SMRs from I25.1 differed by 500 times). The paper presents hypotheses about the causes of the revealed differences and proposals to modify the accounting of deaths from CHD. Conclusion. There were substantial regional differences with an unstable 5-year trend in SMRs from CHD in the entire and individual accounting forms included in this group in accordance with the ICD. The fact that there are no unified criteria for and approaches to identifying the individual forms of CHD as the main cause of death, including that in the presence of multimorbid pathology complicates understanding the causes of death.

A Service Reconfiguration Bundle for Expanding Access to Peritoneal Dialysis Including for Older Frailer Patients.

Rates of peritoneal dialysis (PD) have been traditionally low in Northern Ireland. With rising numbers of patients reaching end-stage kidney disease, PD is a more cost-effective treatment than haemodialysis and aligns with international goals to increase home-based dialysis options. The aim of our study was to highlight how a service reconfiguration bundle expanded access to PD in Northern Ireland. The service reconfiguration bundle consisted of the appointment of a surgical lead, a dedicated interventional radiologist for fluoroscopically guided PD catheter insertion, and a nephrology-led ultrasound-guided PD catheter insertion service in an area of particular need. All patients in Northern Ireland who had a PD catheter inserted in the year following service reconfigurations were included and prospectively followed up for one-year. Patient demographics, PD catheter insertion technique, setting of procedure, and outcome data were summarised. The number of patients receiving PD catheter insertion doubled to 66 in the year following service reconfigurations. The range of approaches to PD catheter insertion (laparoscopic n = 41, percutaneous n = 24 and open n = 1) allowed a wide range of patients to benefit from PD. Six patients had emergency PD catheter insertion, with four receiving urgent or early start PD. Nearly half (48%, 29/60) of the PD catheters inserted electively were in smaller elective hubs rather than the regional unit. A total of 97% of patients successfully started PD. Patients who experienced percutaneous PD catheter insertion were older [median age 76 (range 37-88) vs. 56 (range 18-84), p < 0.0001] and had less previous abdominal surgery than patients who experienced laparoscopic PD catheter insertion (25%, 6/24 vs. 54%, 22/41, p = 0.05). Through a service reconfiguration bundle, we were able to double our annual incident PD population. This study highlights how flexible models of service delivery introduced as a bundle can quickly deliver expanded access to PD and home therapy.

Canine mortality in Umbria Region (Central Italy): a population-based analysis.

Companion dogs may be valuable sentinels to better understand the environmental determinants of morbidity and mortality in humans. This study aimed to assess the dog population and mortality in Umbria Region. The source of data was the local Canine Registry. Attribute-specific crude mortality rates by sex, age, and breed were produced on a five-year basis (2014-2018). The human ICD-10 was employed to code the causes of deaths. Over 2014-2018, an annual average population of 226,875 specimens and a total of 46,743 deaths were estimated. Mortality rate was higher in young males than in young females. A specific cause of death was reported for 5,209 dogs; the 62.8 per cent (95%CI = 61.4-64.1) was due to external causes. Neoplasms were the fourth cause of death. Differences in mortality between sexes were consistent with human ones. The death registration procedure needs improvement by a systematic coding of the causes. An adjustment of the human ICD could address the lack of a coding system until the introduction of international standards for animals.