Increase In Premature Mortality Research Articles

Связь между участием в боевых действиях и риском коморбидных кардиометаболических, сердечно-сосудистых заболеваний у ветеранов Афганской войны

Recently, socio-political and economic transformations in the world community have led to an increase in the number of interethnic, religious, territorial and a number of other conflicts. These contradictions and the increase in the number of armed clashes lead to disruption of people’s mental and physical health. In addition, cardiovascular diseases occupy a leading position in Kazakhstan, as well as throughout the world, in the structure of disability and the increase in premature mortality among adults. Thus, as a result of the study, we identified a high prevalence of cardiovascular diseases in veterans of the Afghan War, where arterial hypertension (AH) was most often diagnosed in 55.9% and coronary heart disease (CHD) in 30.7% of veterans. On the other hand, the number of problems of comorbid conditions is increasing in those studied with IHD and cerebrovascular diseases (CVD) (in 100%), in second place is IHD and hypertension (in 82.4%), next in frequency is osteoarthritis (OA) (in 35.8%), neuropsychiatric disorders (in 27.5%), diabetes mellitus (DM) type 2 (in 18.3%). Accordingly, the clinical picture of the disease changes, which leads to an increase in the frequency of hospitalizations, the duration of inpatient treatment, and the effectiveness of drug therapy for patients decreases. Thus, despite the length of time that has passed, the traumatic event continues to affect the psycho-emotional and physiological state of war veterans, becoming chronic. Mainly reflected in the form of disorders of cardiovascular and cardiometabolic diseases, complicated by combined pathologies. The need for earlier identification of individuals with cardiac and metabolic diseases and optimization of rehabilitation interventions remains an important area of research to ensure appropriate care and support the overall well-being and quality of life of veterans.

Mortality rates for Parkinson’s disease are increasing in Spain. An age-period-cohort and joinpoint analysis of mortality rates from 1981 to 2020

BackgroundMortality in Parkinson’s disease is increasing worldwide, but Spanish data need further study. ObjectiveTo analyse the mortality trends of Parkinson’s disease in Spain between 1981 and 2020. MethodsThis observational retrospective study assessed the Parkinson’s disease mortality data from 1981 to 2020 collected from the National Statistics Institute of Spain. Age-standardised mortality rates were analysed by age and sex groups, detecting significant mortality trends through a joinpoint analysis. Age-period-cohort effect and potential years of life lost analyses were conducted. The European standard population of 2013 was considered for the analyses. ResultsA total of 88 034 deaths were assessed. The overall age-standardised mortality rate rose throughout the period from 3.67 to 8.57 per 100 000 inhabitants. Mortality rates in men were higher than in women, 11.63 versus 6.57 deaths per 100 000 inhabitants. The sex ratio showed an increase in premature mortality in men during 2020. The overall joinpoint analysis recorded a rise in mortality, primarily since the 20th century, mainly in male and older groups, that matched with a period effect. The age effect was detected, confirming higher mortality at an older age. The analysis of potential years of life lost detected a growth in this rate, changing from 0.66 in 1981 to 1.06 in 2020. ConclusionsMortality data for Parkinson’s disease in Spain rose significantly in forty years. Mortality rate was higher in the male and age group above 75 years of age. The sex ratio showed premature mortality in men in 2020, which will need further study.

Changes in the Level of Premature Mortality in the Polish Population Due to Selected Groups of Cardiovascular Diseases before and during the Pandemic of COVID-19.

In the years 2020 and 2021, the COVID-19 pandemic disrupted Poland's health care system and caused a high number of excess deaths. After nearly 30 years of continuous dynamic increase in the life expectancy of the Polish population and a decrease in premature mortality that led to a reduction in the health gap between Poland and Western European countries, regrettably, a decline in life expectancy was recorded. For males, the decline amounted to 2.3 years and, for females, to 2.1 years. The aim of this study was to assess changes in the level of premature mortality due to selected cardiovascular diseases in Poland before and during the COVID-19 pandemic. Time trends of deaths of patients under the age of 65 due to ischemic heart disease, cerebrovascular disease and aortic aneurysm were analyzed by gender and age groups. The joinpoint model was used in determining time trends. Premature mortality due to all of the cardiovascular diseases analyzed had been declining steadily by about 5% per year since 2008. However, at the end of the second decade of the 21st century, a significant change in the dynamics of the trend was observed, particularly with regard to deaths from ischemic heart disease, which since 2018 caused premature mortality increases of 10% per year in the female population. In the male population, an increase of nearly 20% per year has been observed since 2019. The changes also affected premature mortality due to cerebrovascular disease. After nearly three decades of significant decline in premature mortality from cardiovascular diseases in Poland, there was a reversal in the trend, in particular as regards ischemic heart disease. The unfavorable changes intensified in the subsequent two years. The simultaneous increase in the number of cardiovascular incidents ending in death and the decline in access to prompt diagnosis and effective treatment may explain the unfavorable changes in the deaths caused by cardiovascular disease and the increase in premature mortality due to cardiovascular disease.

CURRENT TRENDS AND AVAILABILITY OF INJECTABLE THERAPY IN PAKISTAN FOR MANAGEMENT OF DIABETES MELLITUS

Background: Diabetes is a metabolic disorder and is a growing healthcare problem in South Asian countries. The management guidelines provided by American Diabetes Association (ADA) have provided a thorough approach for the use of oral and injectable therapies. Current statistics indicate an increase in premature mortality, which poses a severe danger to global prosperity. Sulphonylureas, biguanides, alpha glucosidase inhibitors and thiazolidinediones are examples of recent generations of drugs that have been created as a result of scientific and technological developments and have a high efficacy in reducing hyperglycemia. Objectives: This communication aims to connote the trends and availability of injectable therapy in lower middle income countries. Methodology: We reviewed a number of studies (published between 2010-2020), a market survey for availability and the Drug Regulatory Authority of Pakistan official website for the registration status of newly registered injectable therapy for managing diabetes mellitus. Results: Novel classes of drugs that have been developed as potential targets for diabetes treatment drugs include Incretin mimics, Amylin analogues, GIP analogues, Peroxisome proliferator-activated receptors, and dipeptidyl peptidase-4 inhibitor. In Pakistan and other parts of the world, getting new insulin products in sufficient quantities has always been demanding. A list of imported insulin and GLP-1 products and their availability in lower middle income countries like Pakistan, India and Bangladesh is made so as to meet international standards. Conclusion: This short communicatiob shows the availability of Injectable therapy for management of diabetes in Pakistan.

Illness Perception and Medication Adherence among Adult Patients with Type 2 Diabetes Mellitus: A Scoping Review

(1) Background: Type 2 diabetes mellitus (T2DM) is a global disease with a compelling impact on developed and developing economies across the globe. The World Health Organization (WHO) (2020) reported a global prevalence of 8.5% in 2014 among adults aged at least 18 years. Consequently, the condition led to a 5% increase in premature mortality from 2000 to 2016. Aim: The scoping review sought to examine illness perception and medication adherence among adult patients with T2DM. (2) Methods: The study was conducted in 2021 and covered articles published in English in the last five years. PubMed, MEDLINE, CINAHL, and ScienceDirect were the primary search engines used to generate the required scholarly records. A total of 20 studies met the inclusion criteria. (3) Results: The 20 studies selected for the scoping review covered different themes on the overall concept of illness perception and medication adherence in adults with Type 2 Diabetes Mellitus. Each study presented unique implications for research and influence on the policymaking relating to the treatment or the management of type 2 diabetes mellitus in adults of different aged groups. (4) Conclusions: The studies reveal both high and low adherence to medications in adults with type 2 diabetes mellitus. The management and treatment of the condition depend on the uptake of oral hypoglycemic agents or insulin as well as the recommended therapies to enhance the clinical outcomes of the patients.

Extracellular Vesicles in Preeclampsia: Can Small Packages Carry a Big Punch?

(Anesth Analg. 2022;134:710–712) Globally, 9%, 5%, and 1.2% of pregnancies are complicated by preeclampsia, developing preeclampsia, and eclampsia, respectively. These complicated pregnancies represent 8% to 16% of maternal pregnancy deaths in high-income countries. In addition, these medical conditions often result in persistent vascular dysfunction after delivery, increased risk of lifelong hypertension and cardiovascular disease, diabetes, stroke, renal failure, and a 40% increase in premature mortality for the mother. In the child, hypertensive disorders often result in preterm delivery and subsequent severe complications of prematurity. This article analyzes two primary possible causes for preeclampsia and their corresponding studies.

First year of the pandemic: Years of Life Lost due to COVID-19 in Serbia

Abstract Background The first case of COVID-19 in Serbia was reported on 6th March 2020. Since then, Serbia has registered several epidemic peaks, which have led to a considerable increase in premature mortality. Basic evaluation of COVID-19 premature mortality burden needs to include frequency of COVID-19 deaths among different age-groups. Methods All-cause mortality data disaggregated by age and sex, population estimates and remaining life expectancy for different age-groups were acquired from the Statistical Office of the Republic of Serbia. Years of Life Lost (YLL) due to COVID-19 were calculated for the period from March to December 2020. European Standard Population was used for calculating age-standardized mortality rates. We acknowledge the support from the BoCO-19 - The Burden of Disease due to COVID-19 project coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe. Results In 2020, there were 127,572 YLLs due to COVID-19, with 81,147 of YLLs (63.6%) attributable to men and 46,425 (36.4%) to women. Contribution of COVID-19 to the total all-cause YLL was also higher in men comparing to women: 11.39% and 7.80%, respectively. Three epidemic peaks were observed in 2020, together composing two thirds (65.6%) of total YLLs due to COVID-19. December was the month with the greatest burden, accounting for 45.8% of all YLLs due to COVID-19. Crude YLL rate for COVID-19 was 1849.1 per 100,000, or 1733.5 per 100,000 after standardization. Conclusions Registered COVID-19 deaths accounted for one tenth of total YLLs in Serbia in 2020, with men contributing almost twice as much to that number compared to women. On average, 12.32 YLLs originated from each registered COVID-19 death. Further studies need to assess the impact of the COVID-19 epidemic on avoidable mortality trends in Serbia. Key messages • COVID-19 deaths comprised one tenth of all-cause YLLs, with two-thirds of COVID-19 YLLs attributable to men. • To reduce premature mortality burden, epidemic peaks need to be prevented.

499 Seizures in a Dish: Demonstrating and Analyzing Coordinated Network Activity in Human and Mouse Brain Slice with Calcium Imaging

INTRODUCTION: Childhood epilepsy is a common and often devastating disease, and chronic seizures lead to a significant increase in premature mortality and developmental delay. Focal cortical dysplasia (FCD), a malformation of cortical development, is the primary cause of pharmacoresistant epilepsy in children undergoing resective surgery. There are no targeted medical or surgical therapies for FCD patients who have failed surgery or who are not surgical candidates. METHODS: Human tissue from patients with MCDs was resected during epilepsy surgery. Comparison tissue from CD1 mouse brains was also used. 400-µm brain slices were made with a vibratome. The slices were then incubated the slices in Fluo-8L, a low-affinity calcium-sensitive indicator for 40-180 minutes. Slices were imaged using an sCMOS imager at 15 fps on an upright microscope and standard patch-clamp rig with a custom-built temperature-controlled chamber with high aCSF flow rate (5-15mL per minute) to optimize tissue oxygenation. Network bursts are induced with a pro-ictal ACSF containing high potassium (8 mM) and 4-aminopyridine (100 micromolar). RESULTS: We developed a workflow for calcium imaging in human tissue as follows. Preliminary semi-manual analysis on each image stack was performed using ImageJ. Image stacks were motion corrected using the NoRMCorre algorithm and then processed using the calcium imaging analysis workflow (CaImAn) appropriate for 1-photon imaging. Hundreds of cells can be analyzed simultaneously. Ictal network activity may be induced with the pro-ictal ACSF, or with gabazine (1 mM, a GABA-A receptor antagonist, data not shown). CONCLUSION: We have demonstrated the feasibility of performing ex vivo calcium imaging to directly study the aberrant epileptic networks in human MCD tissue resected from children with intractable epilepsy. In future work, we will use this novel technique to uncover network anomalies underlying the epileptic networks in this disorder.

Poor Glycaemic Control and its Associated Factors among Type 2 Diabetes Mellitus Patients in Southern Part of Peninsular Malaysia: A Registry-based Study

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a growing global health concern that is likely to reach a pandemic level by 2030 and is one of the leading causes of death globally. Recently, T2DM has been causing an increase in premature mortality including in developing countries.
 AIM: This study aimed to determine the prevalence and the factors associated with poor glycaemic control among Type 2 diabetes mellitus (T2DM) patients in Segamat, Malaysia. 
 METHOD: The study population was selected from the National Diabetic Registry (NDR) database between June 2019 and September 2020 which included a total of 3,100 patients. General and clinical information were retrieved from the registry. Glycaemic control was categorised as good (HbA1c ≤6.5 %) or poor (HbA1c >6.5%). Univariable and multivariable logistic regression were performed to assess the factors of poor glycaemic control
 RESULTS: More than half (59.2%) of the patients had poor glycaemic control. As high as 55.1% of older patients (≥60 years old) had poorer glycaemic control. Most patients with poor glycaemic control (62.0%) were obese. Multiple logistic regression analysis revealed that age (≥60 years old), ethnicity (Malay and Indian), more than 10 years of diabetes, obesity, early diabetes onset before 40 years, and dyslipidaemia were associated with poor glycaemic control.
 CONCLUSION: These findings can provide the necessary guidance for the stakeholders in identifying T2DM patients at risk of poor glycaemic control so that early preventive measures and organised care can be provided for the patients.

Environmental and health consequences of shore power for vessels calling at major ports in India

To reduce local air pollution, many ports in developed countries require berthed ships to use shore-based electricity instead of burning diesel to meet their electricity requirement for loads such as lights, cargo-handling equipment, and air conditioning. The benefits of this strategy in developing countries remain understudied. Based on government data for all major ports in India, we find that switching from high-sulfur fuel to shore power reduces hoteling emissions of particulate matter (PM2.5) by 88%; SO2 by 39%; NO x by 85%; but increases CO2 emissions by 12%. Switching from low-sulfur fuel reduces hoteling emissions of PM2.5 by 46% and NO x by 84% but increases SO2 emissions by 240% and CO2 emissions by 17%. The lifetime cost savings from the switch to electricity are $73 M for high-sulfur fuel and $370 M for low-sulfur fuel. We estimate that switching from high-sulfur fuel to shore power might avoid at most a couple of dozen premature deaths each year, whereas switching from low-sulfur fuel could lead to a slight increase in premature mortality. Therefore, policymakers must first clean up power generation for shore power to be a viable strategy to improve air quality in Indian port cities.

Mortalidade prematura por doenças crônicas não transmissíveis e cobertura da atenção básica: análise dos indicadores

Objetivo: avaliar a taxa de Mortalidade prematura por Doenças Crônicas Não Transmissíveis (DCNT) e sua associação com a Cobertura populacional pelas equipes de Atenção Básica nos municípios de Santa Catarina. Método: estudo transversal que utilizou dados secundários do banco de dados oficiais do Estado. Os indicadores Mortalidade prematura por DCNT e Cobertura populacional pelas equipes de Atenção Básica nos anos 2017 e 2018, foram coletados em 2019. Os dados foram analisados no Statistical Package for the Social Sciences versão 25.0, para estatística descritiva e apresentados por média e desvio padrão. Utilizou-se teste de correlação de Spearman para as variáveis em estudo. Resultados: houve aumento nas taxas de Mortalidade prematura por DCNT e redução na Cobertura populacional pelas equipes de Atenção Básica, sem associação significativa entre esses indicadores. Conclusão: o aumento da Mortalidade prematura por DCNT e o não cumprimento das metas pactuadas requerem avaliação das ações realizadas na Atenção Básica.

Associations of Despair With Suicidality and Substance Misuse Among Young Adults

Deaths of despair is a term that has recently been used to describe the increases in premature mortality from suicides, drug overdoses (particularly from opiates), and alcohol-related liver disease among US adults. Despite the use of the term despair, its role in these causes of premature death has not been empirically tested. To test whether despair among young adults is associated with suicidal thoughts and behavior, alcohol misuse, and drug misuse. The Great Smoky Mountains Study is a Southeastern, mixed urban-rural population-based cohort study conducted from November 10, 1992, to September 22, 2015. A total of 1420 participants originally 9, 11, and 13 years of age were followed up 11 times to 30 years of age (11 230 person-observations). A total of 1154 of 1400 living participants (82.4%) were assessed at 30 years of age. Statistical analysis was performed from May 7, 2019, to April 10, 2020. Participants were assessed with structured interviews for indicators of despair (eg, hopelessness, helplessness, low self-worth, and feeling unloved). Despair was assessed with items from structured interviews: the Child and Adolescent Psychiatric Assessment and the Young Adult Psychiatric Assessment. Structured interviews were used to assess suicidal thoughts and behavior, substance use, and Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) alcohol use disorder and drug use disorder (including opioids) in young adulthood (2424 observations of 1266 individuals between 25 and 30 years of age). This study included 1420 individuals (790 male individuals). During young adulthood (25 and 30 years of age), the 3-month weighted prevalence of any despair was 19.5% (476 of 2424 observations) with 7.6% of participants (201 of 2424 observations) reporting 2 or more despair items. In longitudinal, lagged models, despair scores (range, 0-3) were associated with more suicidal thoughts and behaviors (odds ratio [OR], 1.5; 95% CI, 1.1-2.0), illicit drug use (OR, 1.7; 95% CI, 1.2-2.5), and opioid use (OR, 1.9; 95% CI, 1.1-3.3) but not alcohol use disorder (OR, 0.8; 95% CI, 0.6-1.2). These associations persisted after accounting for sociodemographic factors (eg, poverty and educational level), lagged outcome status, and lagged depression status. The associations between despair and study outcomes were stronger in models accounting for long-term measures of despair extending back to childhood. There was no consistent pattern of moderation by sociodemographic factors. This study's findings suggest an empirical basis for longitudinal associations between despair and several, but not all, precursors of "deaths of despair" in rural Appalachia. Individual despair should be studied as a potential factor associated with morbidity and impairment in young adulthood.

Economic assessment of the damage caused by sudden death in the workplace in the leading sectors of the region’s economy

Introduction. Research on the health status of workers in various sectors of the economy of the Republic of Bashkortostan (RB) shows an increase in premature mortality of people of working age in the workplace from general diseases. A few works on this topic are devoted to determining the damage that this causes to the economy in territorial and sectoral terms. A new aspect of the study is the economic assessment of losses from deaths that are sudden in nature, occur in the workplace, and are classified in the investigation as an accident not related to production. The aim of the study is to perform an economic assessment of the damage caused by sudden death in the workplace due to industrial accidents with a fatal outcome from general diseases in organizations of the leading sectors of the economy of the RB. Materials and methods . The economic assessment of the damage caused by sudden death in the workplace due to total diseases among employees in the leading sectors of the economy of the RB is based on the following data: the average annual number of employees in the economy by type of economic activity (TEA); gross regional product in basic prices; the average monthly nominal accrued wages of employees of foreign trade organizations; the number of fatalities in the workplace due to total diseases; the number of working years lost due to the occurrence of an employee’s premature death. Damage in the context of the leading sectors of the region’s economy, as well as the total amount of damage for 2014-2018 were calculated in a tabular way. The results were processed using the MS Excel package. Results. The greatest damage from industrial accidents with fatal results from total diseases was observed in the manufacturing industry. For 2017-2018, the amount of damage in terms of under-produced gross regional product in the leading sectors of the economy amounted to 102.37 million rubles. The total amount of economic damage for 2014-2018, calculated on the basis of the average monthly nominal accrued wages, for all foreign trade activities amounted to 231.574 million rubles. According to this indicator, the amount of damage from industrial accidents with a fatal outcome from total diseases increased from 35.233 million rubles (2014) to 63.793 million rubles (2018), i.e. by 1.8 times. Conclusions. To reduce the amount of economic damage and prevent labor losses, measures to prevent sudden deaths from total diseases in the workplace, especially in enterprises with a high value of this indicator, have the greatest effect. The data obtained can be used in planning investments in prevention programs to prevent and reduce the risk of sudden death from general diseases in the workplace.

A Metabolomic Analysis of the Hispanic Paradox

INTRODUCTIONObesity has increased in prevalence among Latinos in the United States over the last several decades and continues to trend upward. The current obesity rate for this population is 34.4%, which is significantly higher than that of the general American population (28.7%). However, increased body fat and excessive weight are not necessarily associated with an increase in premature mortality.METHODSIn this cross‐sectional analysis, we used a metabolomic analysis to look at the mechanisms behind the Hispanic Paradox. To do this, we examined the role dietary intake, body mass index (BMI; kg/m2), and generational level (GL) played on serum metabolomic fingerprints in 70 Mexican Americans (26 male, 44 female). Metabolomic phenotypes of plasma were measured using liquid chromatography tandem‐mass spectrometry (LC‐MS).RESULTSThere was no significant metabolic separation among BMI groups (normal weight = BMI < 25; overweight = 25 £ BMI < 30; obese = BMI ³ 30), suggesting that the metabolome remains unchanged despite an increase in BMI. When stratified for caloric intake (< 2200 kcal/d vs > 2200 kcal/d), a log‐transformed OPLS‐DA model showed clear separation in men, while females remained relatively unchanged. Only one metabolite, pipecolinic acid (P = .009; fold change = 3.43), was significantly greater among obese women relative to their non‐obese counterparts, whereas no metabolites were significantly different among men with different BMI status. A log‐transformed PLS‐DA model found similar results between GLs 1, 2, and 3–5 Mexican Americans, potentially signifying the resistance to alteration of the female metabolome. A significant metabolite between the female generation levels was N‐acetylethanolamine, an anti‐inflammatory, analgesic, and satiety producing compound. Additionally, a pathway analysis of significant metabolites between men and women revealed significant alterations in branched‐chain amino acid (BCAA) and aromatic amino acid (AAA) profiles and mechanisms, both prevalent in obesity and type 2 diabetes (T2DM).CONCLUSIONWhile Mexican American males demonstrated variance in metabolic profiles when examined for caloric intake and generational level, the metabolome of female participants showed resilience and largely remained unaffected. Further research is needed to better understand how significant pathways associated with comorbidities may not affect the relatively consistent metabolome of Mexican Americans.

Ambient air quality and human health in India

TPS 682: Long-term health effects of air pollutants 2, Exhibition Hall, Ground floor, August 27, 2019, 3:00 PM - 4:30 PM Background: India experiences levels of ambient fine particles (PM2.5) and ozone (O3) amongst the highest globally, where exposure is a leading risk factor for human health. Air pollutant emissions are predicted to increase in India. However, Indian air quality remains understudied and knowledge of the sources causing air pollution is limited. Methods: We quantify the contribution of different sources to the disease burden from ambient air pollution exposure in India and the effects of future air pollution control pathways. We combined high-resolution computer simulations, new observations, and updated exposure-response relationships. Results: Ambient PM2.5 exposure causes 1 million premature deaths each year in India, where large reductions in emissions will be required to reduce the health burden due to the non-linear exposure-response relationship causing health effects to saturate at high exposures. The disease burden from ambient O3 exposure is 200% larger than previously thought, causing 124,000 premature deaths every year. Residential energy use emissions dominate ambient PM2.5 concentrations (52%) and are attributed to 511,000 premature deaths. However, removing these emissions would avert only 256,000 premature deaths due to the non-linear exposure-response relationship. Emissions from land transport dominate the ambient O3 disease burden (35%), followed by power generation (23%). Under current policies to 2050, annual premature mortality from PM2.5 and O3 exposure will increase by 68% and 204%, respectively, due to population ageing and growth increasing susceptibility. Stringent air pollution control pathways can offset the increase in premature mortality from population ageing and growth by 91% (610,000 deaths) for PM2.5 and 45% (335,000 deaths) for O3, and reduce the overall mortality rate from ambient PM2.5 exposure by 15%. Conclusions: The disease burden from air pollution exposure in India is substantial and likely to increase unless stringent air pollution management provide large emission reductions. A focus should be to reduce solid fuel combustion.

Comparative analysis of H2-diesel co-combustion in a single cylinder engine and a chassis dynamometer vehicle

Concerns as to the adverse effects of diesel engine exhaust on urban air quality have resulted in increasingly stringent emissions legislation, with the prospect of many major global cities potentially banning diesel vehicles. Emissions of nitrogen oxides (NOx) and particulate matter (PM) are linked to increases in premature mortality, and the simultaneous control of both pollutants through modified combustion strategies presents a significant challenge. In this work, the effects of displacing diesel fuel with hydrogen on exhaust emissions were investigated in both a single cylinder research engine and in a demonstration vehicle. In the initial stage, tests were undertaken on a supercharged, direct injection, single cylinder diesel research engine at different engine loads, intake air pressures and EGR levels. Hydrogen was aspirated with the intake air, and EGR was simulated by supplying the intake pipe with compressed nitrogen gas. The results showed a reduction in CO2 and particulate emissions with increasing H2 addition, and an increase in NOx emissions at H2 levels greater than 10% of the total input energy to the engine. The next stage involved tests on a chassis dynamometer with a small van equipped with the multi-cylinder version of the single cylinder research engine. The van was fitted with a programmable H2 augmentation system, with H2 addition levels specified by accelerator pedal position. During full drive cycle tests conducted with and without H2 augmentation up to 10%, an average rate of 1 kW of H2 was supplied to the engine. With H2 augmentation, over the total drive-cycle, reductions in CO, NOx and particle number were observed, but a higher total PM mass was recorded.

Increase in premature mortality due to non-communicable diseases in Sri Lanka during the first decade of the twenty-first century

BackgroundGlobally, non-communicable diseases (NCD) are the leading cause of death and more than 40% of NCD deaths are premature occurring before the age of 70 years. In 2012, World Health Assembly declared its commitment to reduce premature NCD mortality by 25% from 2010 to 2025. The trend of premature NCD deaths in Sri Lanka has not been assessed and thus this study was done to assess it between 2001 to 2010.MethodsDeaths due to cardiovascular diseases, cancers, chronic respiratory diseases and diabetes were studied. Premature NCD mortality was assessed using unconditional probability of dying (UPoD) due to NCDs among those aged 30 to 70 years. Number of relevant premature NCD deaths that occurred in each 5-year age interval and the respective mid-year population was used to calculate UPoD.ResultsDuring the period of 2001 to 2010, premature NCD mortality in Sri Lanka increased from 15·8% to 19·1% and males showed higher mortality compared to females throughout the period. Highest mortality was due to cardiovascular diseases followed by cancer and diabetes and all three showed an increasing trend. Chronic respiratory diseases showed an increase until 2004 and dropped thereafter. Among the four NCDs, diabetes revealed the most marked increasing trend in premature mortality during this period.ConclusionsThe data revealed an increasing trend of premature NCD mortality in Sri Lanka between 2001 and 2010 although it has a relatively lower premature NCD mortality rate in the South-East Asian Region. Therefore, reducing premature NCD mortality by 25% from 2010 to 2025 is likely to be a rather challenging task in Sri Lanka and policy level changes need to be taken to achieve this target.

EPA-1058 – Mood disorder is associated with excess cardiometabolic health comorbidities and cardiovascular risk factors: cross-sectional study using data from the uk biobank dataset

Introduction Individuals with serious mental illnesses experience poor physical health, particularly increased rates of cardiometabolic disorders. There are corresponding increases in premature mortality. Objectives/aims To assess the nature and extent of cardiometabolic risk factors and comorbidities in bipolar disorder and depression compared to controls. Methods Cross-sectional analysis of records for 502,602 participants within the UK Biobank database. Mood disorder was identified using an internally developed algorithm. Presence of cardiometabolic conditions and risk factors was examined. Multinomial logistic regression analyses were applied. Results Compared to controls, individuals with bipolar and depression were significantly more likely to smoke. Rates of smoking were particularly elevated in the bipolar group, with a RRR of 3.18 (95% CI 2.790–3.632) compared to controls. Individuals with bipolar disorder or severe recurrent depression were significantly more likely to be underweight, and have classes I, II and III obesity. All mood disorders were significantly associated with Class II and Class III obesity. Bipolar disorder was significantly associated with increased rates of hypertension, diabetes, MI, angina and stroke. Severe depression was also associated with an increased risk of hypertension, diabetes, angina and stroke and individuals with moderate depressive disorder showed increased rates of MI, angina and stroke. Rates of ‘no cardiovascular illness’ were significantly reduced across the mood disorder spectrum. Conclusions Individuals with mood disorder have significantly increased rates of both cardiovascular risk factors and cardiometabolic illness. These findings using a large and extensive national dataset highlight a significant health inequality.

Climate change and temperature rise in the Greater Beirut Area: implications on heat-related premature mortality

This study attempts to quantify climate change-induced increase in premature mortality associated with temperature rise with corresponding socioeconomic implications in the context of an urban coastal city, taking the Greater Beirut Area as a study area. Future climatic conditions under four different emissions scenarios were considered to cover a broad spectrum of driving forces and potential social, economic and technologic evolutions. During the first half of the twenty-first century, the expected life losses due to high temperatures in hot days are offset by expected life gains due to improved temperatures in cold days, except under the scenario which characterizes fossil fuel intensive development. By the year 2095, the annual average all-cause premature mortality is expected to increase by 3–15 %, depending on the scenario.

Plenary IV The changing trends of diseases in east and central Europe

Wide health inequalities remain between eastern and western Europe. In 2008 there was a 20 year difference in life expectancy between Dutch men (80.7 years) and Russian men (60.5 years). Premature mortality (before 65 years of age) in some countries of western Europe has fallen to a single digit, but among Russian males it has fluctuated widely in recent decades, and is still about 50%. From the early 1960s the health trends in eastern Europe started to degenerate. In the years 1960–1990 there was a dramatic increase in premature mortality, especially among adult men, with a substantial increase of recorded deaths from CVD, lung cancer, injury, liver cirrhosis, etc. The economic and political changes that occurred in eastern Europe in the early 1990s reversed this trend in the Czech Republic, Hungary, Poland, Slovakia and Slovenia. The cardiovascular mortality started to decline and for the first time since 30 years life expectancy increased and premature mortality levels fell (http://www.hem.waw.pl/). The opposite happened in Russia, the Ukraine, and many other countries of the former Soviet Union. Huge increase in mortality occurred, followed by wide fluctuations. Recent epidemiological analytical research points at vodka (and other strong alcoholic drinks) as the key reason for the observed changes. It seems that the misuse of alcohol in Russia led not only to the increase of the classical alcohol-induced health problems (liver cirrhosis and particularly accidents, suicides, homicides, and unassigned external causes), but also to a large absolute increase in the mortality attributed to “non-MI acute IHD” (ICD-10 124), a cause commonly assigned in Russia, but almost never assigned in western Europe. (Lancet 27 June 2009).