Increase In Life Expectancy Research Articles

Perspectives on the currently available pharmacotherapy for wet macular degeneration.

Wet age-related macular degeneration (w-AMD) is a leading cause of visual impairment globally, with its prevalence expected to rise alongside increasing life expectancy. The current standard treatment involves frequent intravitreal injections of anti-VEGF agents, which although revolutionary, pose significant burdens on both patients and healthcare services. This review explores current and emerging pharmaceutical treatments for w-AMD, focusing on their pharmacokinetics, pharmacodynamics, efficacy, and safety. Promising developments include extending treatment intervals with newer anti-VEGF agents like brolucizumab and faricimab, biosimilars offering cost-effective options, and exploring innovative drug delivery methods such as subretinal gene therapy. Combination therapies, gene therapies, and novel agents like KSI-301 and OPT-302 show potential for improving treatment outcomes and reducing treatment burden. While current treatments for w-AMD have significantly advanced with the advent of anti-VEGF therapies, their limitations in terms of treatment burden and incomplete responses have spurred research into diverse alternative approaches. These innovative strategies offer hope for improving patient outcomes and reducing healthcare burdens, suggesting a promising future for w-AMD management.

Effect of Longevity on Economic Growth, Accounting for Variability in Demographic Transition: Evidence for Pakistan using ARDL Bounds Testing Approach

Rising longevity due to access to better health services affects the growth and composition of the population differently than birth rates. In addition, empirical evidence of the effects of rising longevity on standards of living is ambiguous. From the perspective of developing nations, it is important to understand how rising longevity affects national prosperity, as this allows governments to develop programs for increasing investment in the health sector. This study explicitly tested varying intertemporal impacts of rising longevity on the GDP per capita of Pakistan between 1967 and 2020. An Autoregressive Distributed Lag (ARDL) bounds testing approach to cointegration was used to estimate and compare short-run and long-run estimates of longevity. The results indicated that a 1% increase in longevity increased the growth rate of GDP per capita in Pakistan by 0.64% in the long-run. In addition, a 1% increase in life expectancy at birth above 62 years increased economic growth by an additional 0.009%. In general, the estimated effect of increased longevity varied by stages of demographic transition in Pakistan.

Assessment of the effect of using immunomodulatory drugs for emergency prevention of experimental plague caused by a virulent strain of the main subspecies Yersinia pestis

Introduction. Immunomodulatory drugs (IMD) have great potential to increase the nonspecific reactivity of the organism in a set of measures for emergency prevention of plague. The purpose of the work is to evaluate the protective effectiveness of the use of IMD of different groups in experiments on modeling infection with a highly virulent strain of the plague microbe. Materials and methods. IMD (rIFN-γ — recombinant interferon-gamma, PO — azoximer bromide, synthetic immunomodulatory oligopeptides O1, O2, O3) was administered to white mice and guinea pigs subcutaneously thrice by the schedule 3 days, 1 day, and 1 hour prior the infection with a virulent test strain of plague Yersinia pestis 231 (708) at dose from 1 to 625 CFU. In addition, the effect of IMD on the production of IFN-γ and interleukin-10 was investigated in white mice before infection. Results. The study of the effect of IMD on the survival of unvaccinated biomodels made it possible to establish that only rIFN-γ and PO increase the survival of two types of laboratory animals by 20–50% and significantly increase the LD50. All tested IMD contribute to an increase in the average life expectancy of biomodels by at least one day. An increase in spontaneous and mitogen-induced cytokine production was found only in white mice receiving rIFN-γ and PO, which correlates with animal survival rates. Conclusion. The obtained data indicate the effectiveness of the use of IMD, especially rIFN-γ and PO in protecting the macroorganisms from infection with Y. pestis, which determines the prospects for research on the further improvement of emergency prevention of plague.

The twin challenges of longevity and climate change in controlling antimicrobial resistance

The twin challenges of longevity and climate change in controlling antimicrobial resistance

Efficacy and Safety of Surgical Resection in Elderly Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.

: With increased life expectancy, the management of elderly hepatocellular carcinoma (HCC) patients became a crucial issue, yet it is still challenging due to comorbidities and high surgical risks. While surgical resection is considered as primary treatment for eligible HCC patients, systematic evidence on its outcomes in elderly patients remains scarce. In this review, we aimed to analyze the efficacy and safety outcomes of surgical resection in elderly HCC patients. : The studies included in this meta-analysis were selected from Ovid-MEDLINE, Ovid-Embase, CENTRAL, KoreaMed, KMbase, and KISS databases following a predefined protocol. Efficacy outcomes included overall survival and disease-free survival, while the safety outcomes included postoperative mortality and complications. : Patients in the elderly group (≥65 years) who underwent surgery exhibited non-inferior overall survival (hazard ratio [HR], 1.26; 95% confidence interval [CI], 0.92 to 1.74) and disease-free survival (HR, 1.03; 95% CI, 0.99 to 1.08) compared to the non-elderly group. Overall postoperative mortality exhibited no statistical difference (odds ratio [OR], 1.07; 95% CI, 0.87 to 1.31), but 30-day, 90-day, and in-hospital mortality were higher in the elderly group. The incidence of overall complications was higher in the elderly group (OR, 1.44; 95% CI, 1.22 to 1.69). Sensitivity analysis for the super elderly group (≥80 years) showed significantly higher in-hospital mortality compared to the non-super elderly group (OR, 2.51; 95% CI, 1.16 to 5.45). : The efficacy outcome of surgical resection in the elderly HCC patients was not worse than that in the non-elderly HCC patients, while in-hospital mortality and complications rates were higher. Therefore, surgical resection should be purposefully considered in the elderly population, with careful candidate selection.

The Antibiotic Era: A Golden Age and Its Challenges

Antibiotics have revolutionised medicine, helping to reduce infection-related deaths and increase life expectancy globally. They have enabled life-prolonging medical procedures and the foundation for advancements in medicine. This review explores the historical significance of antibiotics in healthcare, underscores the challenges of antibiotic resistance, and emphasises the importance of responsible antibiotic usage. It advocates for developing new antibiotics to combat resistant bacteria and ensure the continued effectiveness of antibiotic therapy in healthcare. A comprehensive search was conducted using academic databases like PubMed, Google Scholar, Web of Science, Science Direct and other search engines. The results were refined using filters, advanced search options, and relevant articles retrieved from the search. Antibiotics target and destroy bacterial cells, and each antibiotic type functions differently. However, the overuse and misuse of antibiotics, along with reduced economic incentives and challenging regulatory requirements, have resulted in antibiotic-resistant bacteria emerging, which is a cause for concern worldwide. The rapid emergence of antibiotic-resistant bacteria endangers the effectiveness of antibiotics that have saved millions of lives and transformed medicine. Antibiotics are essential in medicine, but resistance is a growing concern. New antibiotics need to be developed, and using them wisely is key to maintaining their effectiveness and positive impact on healthcare.

Clinical and economic implications of using daratumubab with lenalidomide in the 1st and 2nd lines of therapy for multiple myeloma patients

Objective: to assess clinical and economic implications of adding daratumumab (Dara) to the “lenalidomide + dexamethasone” (Rd) treatment program in early lines of therapy for patients with multiple myeloma (MM) ineligible for high-dose chemotherapy (HDCT) with subsequent autologous hematopoietic stem cell transplantation (autoHPSCT).Material and methods. Partitioned survival model was developed to compare overall survival in the treatment programs of MM patients in the 1st to 3rd lines of therapy. The following treatment options were included in the analysis: 1st line – Dara+Rd; 2nd line – “carfilzomib + lenalidomide” (K+Rd) or “ixazomib + lenalidomide” (Ixa+Rd) triplets; 3rd line – pomalidomide (Pom+dex) and Rd+(Dara+Rd)+(Pom+dex) versus Rd+(K/Ixa+Rd)+(Pom+dex/Dara). Probabilities of transition between health states (progression-free, progressed disease, and death) were based on published clinical data. Lifetime direct healthcare costs and incremental cost-effectiveness ratios (ICERs) per 1 life year gained were calculated from a Russian health care perspective. The indicator of the difference in costs between current and expected practice was used in budget impact analysis.Results. Dara+Rd combination increased life expectancy by 1.04 years (+16.05%) and 0.95 years (+14.57%) per patient, and in the target population (n=955) by 995.48 and 903.40 years for (Dara+Rd)+(K+Rd)+(Pom+dex) and (Dara+Rd)+(Ixa+Rd)+(Pom+dex) treatment programs, respectively, compared to Rd use in the 1st line. The ICER per 1 life year gained for Dara+Rd in 1st line therapy was 8.95 mln rubles for (Dara+Rd)+(K+Rd)+(Pom+dex) and 8.41 mln rubles for (Dara+Rd)+(Ixa+Rd)+(Pom+dex). It's lower than the median ICER of 13.64 million per 1 life year gained for antitumor drugs used to treat cancer of lymphatic and hematopoietic tissues (reference ICER). Dara+Rd triplet is used in 2nd line therapy after Rd, the number of life years gained in the target population due to greater efficacy is higher by 291.50 years compared with K+Rd and by 203.93 years compared with Ixa+Rd. The ICER per 1 life year gained for Dara+Rd is also lower than the ICER reference value: 9.25 mln rubles versus 13.64 mln rubles. The budget impact analysis showed that using Dara in early stages of MM therapy does not increase drug provision costs in the target population.Conclusion. The obtained results allowed to conclude that it is economically feasible to add Dara to the 1st and 2nd lines of therapy in lenalidomide treatment programs for MM patients who are not candidates for HDCT with autoHPSCT.

An effective complex approach to the management of patients with chronic musculoskeletal low back pain and pains in other body sites

Low back pain (LBP) is a major public health problem globally. As life expectancy increases, the number of people with LBP will further increase in the coming decades. LBP is the leading cause of work productivity and activity impairment worldwide, therefore training of neurologists, primary care physicians, and general practitioners for timely and accurate diagnosis of LBP, as well as effective treatment of patients with LBP is an economically and socially significant challenge for medical practice. The clinical case describes the successful management of a female patient with LBP. It provides a modern, clear and effective approach to the diagnosis and treatment of musculoskeletal LBP. The typical comorbid disorders and factors that contribute to the pain syndrome chronicity are presented. The female patient was treated using a complex approach that included disease awareness conversations, kinesiotherapy, and pharmacotherapy in the form of a 10-day nonsteroidal anti-inflammatory drug (NSAID) course. Nimesil (nimesulide) with proven efficacy and safety in the treatment of musculoskeletal pain has become a drug of choice. It should be noted that nimesulide was prescribed to the patient from the first days of treatment concurrently with the beginning of a training course in kinesiology. The patient experienced a rapid pain relief while taking pharmacotherapy, which played an important role in supporting adherence to recommendations for increasing physical activity and taking training courses in kinesiology. The patient reported a significant decrease in pain on Day 10. After 1.5-month treatment, the pain regressed and she returned to her normal daily activities. The presented approach to therapy allows to provide LBP patients with a relatively fast pain relief, and the 6-month follow up period demonstrated sustainability of the therapeutic effect achieved.

Understanding referral of patients with cancer in rural Ethiopia: a qualitative study

BackgroundCancer incidence is increasing in Ethiopia mainly due to increased life expectancy, while oncological capacities remain limited. Strong referral linkages between different levels of the healthcare system are key to provide timely access to cancer care. In this qualitative study, we assessed limitations and potential of cancer patient referral in the rural Southwest of Ethiopia.MethodsWe held four focus group discussions (FGD) with health professionals at one primary and three secondary hospitals and conducted eight in-depth interviews (IDI) with the hospitals´ medical executives and local health bureau representatives. Data was analysed inductively using thematic analysis and emerging themes were categorized within the revised concept of access by Penchansky and Saurman.ResultsThe inevitable referral of patients with cancer in the rural Southwest of Ethiopia is characterized by the absence of clear communication protocols and the lack of formal referral linkages. The newly implemented hub-system has improved emergency referrals and could be expanded to non-emergency referrals, sensitive to the needs of advanced oncological care. Liaison officers can pave the way but need to be trained and equipped adequately. Referred patients struggle with inadequate transportation systems, the lack of accommodation close to specialized facilities as well as the inability to navigate at those sites due to language barriers, illiteracy, and stigmatization. Few Non-Governmental Organizations (NGOs) help but cannot compensate the limited governmental support. The shortage of medications at public hospitals leads to patients being directed to costly private pharmacies. In the light of those challenges, cancer remains to be perceived as a “death sentence” within the rural communities.ConclusionsStandardized referral linkages and a multi-faceted support network throughout the cancer care continuum are necessary to make oncology care accessible to Ethiopia´s large rural population.

Association between plasma long-chain polyunsaturated n-3 fatty acids concentrations and cognitive function: findings from NHANES III

BackgroundWith increased life expectancy, cognitive decline has emerged as a prevalent neurodegenerative disorder.ObjectiveThis study aimed to examine the correlation between concentrations of Plasma long-chain n-3 polyunsaturated fatty acids (LCPUFAs) and cognitive performance in elderly Americans.MethodsData were analyzed from older adults enrolled in two NHANES cycles. Participants completed four cognitive assessments, including the Immediate Recall Test (IRT), Delayed Recall Test (DRT), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). Linear regression and restricted cubic spline modeling examined associations between plasma LCPUFAs levels and cognitive test outcomes.ResultsThe cohort included 610 adults aged 69 years on average, 300 (49.2%) males and 310 (50.8%) females. The median LCPUFAs concentration was 309.4 μmol/L, with an interquartile range of 244.7–418.9 μmol/L. In unadjusted and adjusted generalized linear regression model analyses, circulating LCPUFAs exhibited significant positive correlations with DRT performance. No relationships were detected among those with chronic conditions (chronic heart failure, stroke, diabetes). A significant association between LCPUFAs levels and DRT scores was evident in males but not females.ConclusionPlasma LCPUFAs concentrations were significantly associated with DRT performance in males free of chronic illnesses, including heart failure, stroke, and diabetes.

Influencing factors of home hospice care needs of family caregivers of the older adult with chronic diseases at the end of life in China: a cross-sectional study

IntroductionWith increased life expectancy in the Chinese population coupled with chronic disease the care needs of people at the end of life are attracting much attention. Home hospice care can help the dying older adult achieve comfort and maintain their dignity at home. However, dying at home means great responsibility and challenge for family caregivers, and there are many unmet needs. The study aimed to investigate the home hospice care needs of family caregivers of older adult people with chronic diseases at the end of life in China, and to analyze the influencing factors of home hospice care needs of caregivers.MethodsIn this cross-sectional study, from May to September 2023, 4 community health service centers were selected by stratified sampling from seven administrative districts in Jinzhou City, Liaoning Province, where home hospice care was piloted. Then 224 family caregivers were selected from the communities of seven community service centers by simple random sampling method. A general information questionnaire and the home hospice care needs questionnaire developed by our research group were used to investigate. Univariate analysis was used to compare the differences in the scores of different characteristics, and the factors with significant differences were selected for multivariate linear regression analysis to determine the final influencing factors.ResultsThe total score of hospice care needs of family caregivers was 121.61 ± 15.24, among which the end-of-life knowledge need dimension score was 24.04 ± 2.71, the highest score index was 80.13%, while the symptom control need score was 15.58 ± 3.39, the lowest score index was 62.32%. In addition, Caregivers with caregiving experience, dying older adult with longer disease duration, and dying older adult with higher levels of education were the factors influencing the total need for home hospice care among family caregivers, with a variance explained of 22.7%.DiscussionThe needs of family caregivers of the terminally ill older adult are high, and healthcare professionals should implement services to meet their multidimensional needs and improve the quality of care according to the factors affecting their needs.

COLPOSACROPEXIA ROBÓTICA PARA EL TRATAMIENTO DEL PROLAPSO DE ÓRGANOS PÉLVICOS EN MUJERES DE EDAD AVANZADA: ANÁLISIS COMPARATIVO DE LA SEGURIDAD Y EFICACIA FRENTE A MUJERES JÓVENES

INTRODUCTION: Pelvic organ prolapse is a condition with high prevalence in elderly women. With increasing life expectancy and a desire for improved quality of life, a rise in the frequency of surgical treatments for these women is anticipated. The aim is to compare complication, success, and satisfaction rates among elderly patients (aged >70 years) in comparison to younger women undergoing robotic sacrocolpopexy, thereby assessing the safety and efficacy of this surgery in this group of patients.METHOD: A prospective observational comparative study of 123 robotic sacrocolpopexies conducted between December 2016 and June 2022. Patients were stratified by age (cutoff point: 70 years). Baseline characteristics, type, and grade of prolapse, intra and postoperative data, complications, functional and anatomical outcomes, and satisfaction levels were collected.RESULTS: Among the 123 patients, 62.6% were under 70 years old, while 37.4% were 70 years or older, exhibiting similar baseline characteristics, prolapse grade, and type. The percentages of intraoperative (6.5%) and postoperative complications (4.4-9%) were comparable in both age groups. Furthermore, success and satisfaction rates exceeded 90%, with no significant differences between women under and over 70 years during a two-year follow-up.CONCLUSION: Robotic sacrocolpopexy is at least as effective and safe in women aged 70 years or older as in younger individuals, with no higher rates of intra and postoperative complications and similar rates of anatomical and subjective success.

Robotic sacrocolpopexy for the treatment of pelvic organ prolapse in elderly women: comparative analysis of safety and efficacy versus younger women

IntroductionPelvic organ prolapse is a condition with high prevalence in elderly women. With increasing life expectancy and a desire for improved quality of life, a rise in the frequency of surgical treatments for these women is anticipated. The aim is to compare complication, success, and satisfaction rates among elderly patients (aged >70 years) in comparison to younger women undergoing robotic sacrocolpopexy, thereby assessing the safety and efficacy of this surgery in this group of patients. MethodA prospective observational comparative study of 123 robotic sacrocolpopexies conducted between December 2016 and June 2022. Patients were stratified by age (cutoff point: 70 years). Baseline characteristics, type, and grade of prolapse, intra and postoperative data, complications, functional and anatomical outcomes, and satisfaction levels were collected. ResultsAmong the 123 patients, 62.6% were under 70 years old, while 37.4% were 70 years or older, exhibiting similar baseline characteristics, prolapse grade, and type. The percentages of intraoperative (6.5%) and postoperative complications (4.4-9%) were comparable in both age groups. Furthermore, success and satisfaction rates exceeded 90%, with no significant differences between women under and over 70 years during a two-year follow-up. ConclusionRobotic sacrocolpopexy is at least as effective and safe in women aged 70 years or older as in younger individuals, with no higher rates of intra and postoperative complications and similar rates of anatomical and subjective success.

New Insights into the Relationship between Nutrition and Neuroinflammation in Alzheimer's Disease: Preventive and Therapeutic Perspectives.

Neurodegenerative diseases are progressive brain disorders characterized by inexorable synaptic dysfunction and neuronal loss. Since the most consistent risk factor for developing neurodegenerative diseases is aging, the prevalence of these disorders is intended to increase with increasing life expectancy. Alzheimer's disease is the most common cause of neurodegenerative dementia, representing a significant medical, social, and economic burden worldwide. Despite growing research to reach an early diagnosis and optimal patient management, no disease-modifying therapies are currently available. Chronic neuroinflammation has been recognized as a crucial player in sustaining neurodegenerative processes, along with pathological deposition of misfolded proteins, including amyloid-β and tau protein. Modulating neuroinflammatory responses may be a promising therapeutic strategy in future clinical trials. Among factors that are able to regulate neuroinflammatory mechanisms, diet, and nutrients represent easily accessible and modifiable lifestyle components. Mediterranean diet and several nutrients, including polyphenols, vitamins, and omega-3 polyunsaturated fatty acids, can exert antioxidant and anti-inflammatory properties, impacting clinical manifestations, cognitive decline, and dementia. This review aims to provide an updated overview of the relationship between neuroinflammation, nutrition, gut microbiota, and neurodegeneration. We summarize the major studies exploring the effects of diet regimes on cognitive decline, primarily focusing on Alzheimer's disease dementia and the impact of these results on the design of ongoing clinical trials.

Addressing China’s retirement Dilemma: Exploring strategies to balance life expectancy and leisure preference

We construct an overlapping generation model (OLG) that reflects workers’ endogenous retirement intention and retirement age, and examine the effects of increased life expectancy and leisure preference on individuals’ retirement age choice, with a specific focus on China’s unique demographic and economic context. The deepening degree of population aging in China may lead to a series of economic and social challenges if not properly addressed. Our findings suggest that as life expectancy rises, individuals may choose to work longer and retire later to accumulate more resources for their extended retirement years. However, with fewer young people entering the workforce and an increasing older population, labor shortages and pressures on the pension and healthcare systems are of paramount concern. The results have significant implications for policy-making in China, emphasizing the need for strategic adjustments to retirement age policies and leisure preferences to sustain economic growth and manage the aging population crisis.

Effect of Kalavasti and Nasya with Karpasathyadi Taila in the Management of Pakshaghata W. S. R to Hemiplegia – A Comparative Clinical Study

Recentrapid socioeconomic changes have led to a concomitant change in people’s lifestyle, leading to work-related stress and altered food habits, raising the risk of hypertension. Those factors, coupled with an increase in the average life expectancy, are expected to have an impact on the occurrence of stroke disorderin India. In India, these data are more horrible as 64,000 death

Tricuspid valve repair for infective endocarditis.

The progressive increase in the use of implantable electronic devices, vascular access for dialysis and the increased life expectancy of patients with congenital heart diseases has led in recent years to a considerable number of right-side infective endocarditis, especially of the tricuspid valve. Although current guidelines recommend tricuspid valve repair for native tricuspid valve endocarditis, the percentage of valve replacements remains very high in numerous studies. The aim of our study is to analyze our experience in the treatment of tricuspid valve endocarditis with a reparative approach. This case series includes all the patients that underwent surgery for acute or healed infective endocarditis on the native tricuspid valve, at the Cliniques Universitaires Saint-Luc (Bruxelles, Belgium) between February 2001 and December 2020. Thirty-one patients were included in the study. Twenty-eight (90.3%) underwent tricuspid valve repair and 3 (9.7%) had a tricuspid valve replacement with a mitral homograft. The repair group was divided into two subgroups, according to whether a patch was used during surgery or not.Hospital mortality was 33.3% (n = 1) for the replacement group and 7.1% (n = 2) for repair (p = 0.25). Overall survival at 10 years was 75.6% (95% CI: 52-89%). Further, freedom from reoperation on the tricuspid valve at 10 years was 59.3% (95% CI: 7.6-89%) versus 93.7% (95% CI: 63-99%) (p = 0.4) for patch repair and no patch use respectively. Freedom from recurrent endocarditis at 10 years was 87% (95% CI: 51-97%). Considering that tricuspid valve endocarditis is more common in young patients, a repair-oriented approach should be considered as the first choice. In case of extremely damaged valves, the use of pericardial patch is a valid option. If repair is not feasible, the use of a mitral homograft is an additional useful solution to reduce the prosthetic material.

Retrospective analysis of the adverse events during intra-operative and post-operative period in patients who received anesthesia at a tertiary care center in India

Background: Anesthesia is a critical component of modern surgical procedures ensuring patient comfort and safety during surgery. With the increase in life expectancy, more and more geriatric population with various systemic comorbidities have been coming for surgeries. Along with the newer advances in surgical fields, there is increasing demand on the anesthetists to handle complicated cases with innovative solutions. Despite all efforts by a skillful anesthetist, adverse events are bound to occur which needs to be analysed to prevent such adverse events in the future. Hence, this study aims to analyse the adverse events occurring in intra-operative and post-operative period who received anesthesia in our tertiary care centre. Methods: This study is a retrospective cross-sectional study of 5-year duration from January 2018 to January 2023 done at Bhaktivedanta hospital and research institute post obtaining approval from the institutional ethics committee. A total of 163 patients who developed perioperative adverse events were included in the study and their nature of adverse events were analysed. The data was obtained from the registers of the anesthesia department and descriptive statistical analysis of the data was done accordingly. Results: Most common adverse events were of cardiovascular and respiratory origin, followed by miscellaneous and regional anesthesia adverse events and then, very few drug-related adverse events. The patients who developed these adverse events were evidently of ASA grade I and II, implying no direct correlation between adverse events and grading. Conclusions: Reporting and analysis of the adverse events will help better understanding of the lacunae of the reporting system as well as in the development of quality improvement strategies in the future.

Unveiling the health consequences of air pollution in the world’s most polluted nations

Air pollution poses a persuasive threat to global health, demonstrating widespread detrimental effects on populations worldwide. Exposure to pollutants, notably particulate matter with a diameter of 2.5 µm (PM2.5), has been unequivocally linked to a spectrum of adverse health outcomes. A nuanced understanding of the relationship between them is crucial for implementing effective policies. This study employs a comprehensive investigation, utilizing the extended health production function framework alongside the system generalized method of moments (SGMM) technique, to scrutinize the interplay between air pollution and health outcomes. Focusing on a panel of the top twenty polluted nations from 2000 to 2021, the findings yield substantial insights. Notably, PM2.5 concentration emerges as a significant factor, correlating with a reduction in life expectancy by 3.69 years and an increase in infant mortality rates by 0.294%. Urbanization is found to increase life expectancy by 0.083 years while concurrently decreasing infant mortality rates by 0.00022%. An increase in real per capita gross domestic product corresponds with an improvement in life expectancy by 0.21 years and a decrease in infant mortality rates by 0.00065%. Similarly, an elevated school enrollment rate is associated with a rise in life expectancy by 0.17 years and a decline in infant mortality rates by 0.00032%. However, a higher population growth rate is found to modestly decrease life expectancy by 0.019 years and slightly elevate infant mortality rates by 0.000016%. The analysis reveals that per capita greenhouse gas emissions exert a negative impact, diminishing life expectancy by 0.486 years and elevating infant mortality rates by 0.00061%, while per capita energy consumption marginally reduces life expectancy by 0.026 years and increases infant mortality rates by 0.00004%. Additionally, economic volatility shock presents a notable decrement in life expectancy by 0.041 years and an increase in infant mortality rates by 0.000045%, with inflationary shock further exacerbating adverse health outcomes by lowering life expectancy by 0.70 years and elevating infant mortality rates by 0.00025%. Moreover, the study scrutinizes the role of institutional quality, revealing a constructive impact on health outcomes. Specifically, the institutional quality index is associated with an increase in life expectancy by 0.66% and a decrease in infant mortality rates by 0.0006%. Extending the analysis to examine the nuanced dimensions of institutional quality, the findings discern that economic institutions wield a notably stronger positive influence on health outcomes compared to political and institutional governance indices. Finally, the results underscore the pivotal moderating role of institutional quality in mitigating the deleterious impact of PM2.5 concentration on health outcomes, counterbalancing the influence of external shocks, and improving the relationships between explanatory variables and health outcome indicators. These findings offer critical insights for guiding evidence-based policy implications, with a focus on fostering resilient, sustainable, and health-conscious societies.

Assessing Trends in Hospitalizations for Breast Cancer among Women in Korea: A Utilization of the Korea National Hospital Discharge In-depth Injury Survey (2006-2020).

Breast cancer poses a significant health threat globally and particularly in Korea, where mortality rates have risen notably. In this study, we analyzed the characteristics of breast cancer patients discharged in Korea over the past 15 years and explored the association between comorbidities and treatment outcomes to propose effective strategies for managing cancer patients. Understanding these dynamics is vital for informing tailored management strategies and optimizing healthcare system sustainability. This study utilized cross-sectional data from the Korea National Hospital Discharge In-depth Injury Survey from 2006 to 2020. Each year, among patients discharged from hospital with 100 beds or more, those identified with breast cancer patients were based on their primary diagnosis code (C50) according to the ICD-10, as recorded in their medical records. Between 2006 and 2020, an estimated 499,281 breast cancer patients were discharged, with an average annual percent change (AAPC) of 5.2% (95% CI 4.2-6.2, p <.05). A notable increase in AAPC was particularly evident among those aged 60 years and old. Across all age groups, there was a consistent increasing trend in the risk of mortality as the CCI score increased (p <.05). The risk of comorbidity was more pronounced in younger age groups compared to older age groups. The increasing life expectancy is expected to lead to a continued rise in the number of elderly breast cancer patients. Countermeasures are needed to address this trend through appropriate diagnosis and treatment planning. Particularly, considering comorbidities in breast cancer treatment plans is necessary to promote positive treatment outcomes, especially in younger breast cancer patients.