Adult Mortality Research Articles

An Audit of the Fifth Irish Hip Fracture Standard in patients >=70 years following hip fracture

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

Optimizing Opioid Prescriptions in Geriatric Populations at Nottingham University Hospitals Foundation Trust (NUH)

Abstract Background Severe pain is associated with adverse outcomes in the geriatric populations (Ref -Pain and Mortality in Older Adults: The Influence of Pain Phenotype - PubMed (nih.gov)). Currently it is recommended in local and national guidelines (Ref -Guidance on the management of pain in older people | Age and Ageing | Oxford Academic (oup.com), Clinical Guidelines Policy (koha-ptfs.co.uk)) that the following be implemented to geriatric patients being prescribed strong opioid medication Methods A multi-disciplinary team involving doctors, pharmacists, nurses and the NUH quality improvement team was involved in all aspects of this project. Initial data collection was done between 1st August 2023 to 1st March 2024. We intend to carry out further data collection between April and August 2024 after our proposed interventions. Data collection was carried out using the EPMA prescribing platform. Results Data collected from 1st August 2023 to 1st March 2024 only 70% of patients in health care of the elderly (HCOE) wards had correctly prescribed oxycodone as their strong opioid analgesia. It was noted that 37% of HCOE patients have had morphine incorrectly prescribed at least once during their admission. Only 11% of strong opioid prescriptions on HCOE wards in NUH had a review scheduled. A. Whilst 73% of patients had laxatives co-prescribed only 25% had anti-emetics co-prescribed. Conclusion From our initial results there is an obvious need for improvement in terms of guideline adherence. We will aim to collect further data and we will put into place interventions in a ‘PDSA’ manner to improve this.

Association between nut consumption and mortality risk: a 20-year cohort study in Korea with a stratified analysis by health-related variables.

Although nuts are a well-known healthy food group, the relationship between nut consumption and mortality remains unclear, particularly among Asians. This prospective cohort study examined the association between nut consumption and the risk of all-cause, cardiovascular disease (CVD), and cancer mortality in Korean adults. Data from two cohorts (the Ansan-Ansung and Health-Examinees) from the Korean Genome and Epidemiology Study were used. A total of 114,140 individuals aged 40-79 years were included in the data analyses. Nut consumption was assessed using a validated semi-quantitative food frequency questionnaire and categorized into four groups: non-consumers, less than 1 serving/week, 1-2 servings/week, and 2 or more servings/week (one serving was 15g of nuts). Mortality outcomes were determined based on the 2001-2021 death records from Statistics Korea. Cox proportional hazard regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality across nut consumption categories. A stratified subgroup analysis by health-related variables was also performed. During a mean follow-up of 12.3 years, 4,559 deaths were recorded. After adjusting for covariates, the HR for all-cause mortality was 0.877 (95% CI = 0.772-0.996, p for trend = 0.006) in individuals with a nut consumption of 2 or more servings/week compared with that in non-consumers. Multivariable HRs for CVD mortality were 0.800 (95% CI = 0.681-0.939) in individuals consuming less than 1 serving/week, 0.656 (95% CI = 0.469-0.918) in those consuming 1-2 servings/week, and 1.009 (95% CI = 0.756-1.347) in those consuming 2 or more servings/week compared with that in non-consumers (p for trend = 0.080). No association was observed between nut consumption and cancer mortality. Stratified analysis identified significant interactions in the association between nut consumption and all-cause mortality by age, body mass index, and physical activity. Nut consumption was linearly associated with the reduced risk of all-cause mortality and showed a non-linear dose-response relationship with CVD mortality in Koreans, but had no association with cancer mortality. The effects of nut consumption, which have been inadequately investigated in this population, varied across different subgroups. These findings suggest that incorporating nuts into the diet should be encouraged for long-term health of Korean adults.

Study protocol: process and outcome evaluation of the Walk with Ease program for fall prevention

BackgroundFalls are the leading cause of injury related morbidity and mortality in older adults. Primary and secondary prevention strategies that address modifiable risk factors are critically important to reduce the number of falls and fall related injuries. A number of evidence-based fall prevention programs are available, but few offer potential for broad dissemination and public health impact due to implementation barriers, such as a need for trained program leaders and clinicians.MethodsThe study will use a randomized controlled trial design to evaluate incorporating physical therapy exercises (primary prevention strategy) within an existing intervention called Walk with Ease. While Walk with Ease has an established evidence-base related to the management of arthritis pain and symptoms, the present study will determine the potential to also reduce falls and fall risk in community-dwelling older adults. The integrated process and outcome evaluation will determine the relative effectiveness of individually-prescribed exercises (compared to standardized exercises) as well as the potential of ‘habit training’ resources (relative to generic behavior prompts) to improve compliance with exercises in this population.DiscussionThe study, conducted through a local clinical-community partnership will advance both the science and practice of community-based fall prevention programming, while also informing implementation strategies needed to promote broader dissemination.Trial registrationClinicalTrials.gov, NCT05693025, Registered January 20, 2023, Updated March 1, 2023.

Assessment of Piper longum L. (Piperaceae) leaves toxicity on the adults of Tribolium castaneum (Herbst, 1797) (Coleoptera: Tenebrionidae)

BackgroundNumerous insect pests attack stored grains causing both qualitative and quantitative losses. The most damaging pest that infests dry stored produce is the red flour beetle, Tribolium castaneum, a secondary pest of stored goods. This pest, especially in its adult stage, exhibits resistance to chemical insecticides, thereby rendering the traditional pesticides ineffective in controlling it. Phyto-derivatives, which are strong insecticides and also ecologically benign, have gained interest as non-chemical solutions for controlling this pest. Hence, the objective of this study was to investigate the potential of Piper longum leaf extract insecticidal action as an environmentally benign insecticide for the first time against the adults of T. castaneum. In this study, P. longum leaf ethanol extract was tested against the adults of T. castaneum by petri dish bioassay method. Ad hoc studies to verify significant mortality for the initial confirmation of adulticidal activity were conducted for 24 h at different dosages of 62.5, 125, 250, 500 and 1000 mg/L of P. longum leaf ethanol extract. Thereafter, dosages set at 10, 20, 30 and 40 mg/L for the fractions of P. longum leaf ethanol extract were conducted. Prior to this, the leaf extract of this plant was subjected to column chromatography for fractionation. The fractions tested for adulticidal activity were subjected to gas chromatography–mass spectroscopy.ResultsSignificant adulticidal action with 100% adult mortality was observed in ethanol extract of P. longum leaves. Among the fourteen fractions (F0–F13) obtained tested, only fractions, F5, F10 and F13, demonstrated adulticidal activity, and the remaining fractions displayed poor activity. One hundred per cent morality was noted in T. castaneum adults after 96 h at 40 mg/L in F5 and F10, and in F13 at 20 mg/L, and their respective LD50 values were 17.6, 26.6 and 10.0 mg/L. The fractions F5, F10 and F13 contained fatty acids, viz., hexadecanoic acid, dotriacontane and heptacosane in F5; tetradecanoic acid and nonadecanoic acid in F10; and octadecanoic acid, aspartame and tridecanoic acid in F13, revealed through gas chromatography–mass spectroscopy.ConclusionsThe results of the study showed that P. longum ethanol leaf extract revealed significant adulticidal activity and is a promising toxic agent to the adults of T. castaneum. The fatty acids in the ethanolic leaf extract fractions of P. longum could have caused toxicity to the adults of T. castaneum. According to the current literature survey, this is the first research report on the adulticidal activity of P. longum leaf extracts against the adults of T. castaneum.

Insights on Poverty-based Inequality in Old-age Mortality in India

BackgroundAs the global population ages, understanding the effect of poverty on old-age mortality becomes increasingly important, especially in India, which is undergoing significant demographic and socio-economic changes. Although previous research has established a link between poverty and mortality, there is a critical need for panel studies to investigate this relationship specifically among older adults. This study addresses this gap by using panel data to examine the association between initial poverty status and subsequent mortality among older adults in India. Additionally, it explores the factors contributing to mortality disparities between poor and non-poor older adults.MethodsWe analyzed panel data from two rounds of the India Human Development Survey. The age-sex standardized old-age mortality rates for poor and non-poor older adults were calculated using direct standardization. Mortality disparities were evaluated through bivariate and proportion tests, as well as multivariable logistic regression analyses. The Fairlie decomposition technique was employed to identify factors contributing to these disparities, with sensitivity analyses performed to ensure the robustness of the findings.ResultsThe age-sex standardized old-age mortality rate for the poor was 31.9 per 100 people, with a 1.15 times higher likelihood of mortality [95% CI: (1.04,1.27)] between round-I to round-II compared to non-poor counterparts. Factors such as household wealth (33.6%), social class (17.1%), education (12%), and occupation (4.3%) were significant indicators of the poverty gap in old-age mortality. Surprisingly, chronic diseases, age, and gender negatively affect mortality disparity, while higher mortality in extended families suggests a weakening traditional support system.ConclusionThe findings underscore the importance of addressing ageist attitudes and enhancing social safety nets and affordable healthcare for older adults, who face higher risks of poverty and premature death. The elevated mortality among those in prolonged poverty cycles highlights the need for policymakers to reconsider universal support policies for older individuals. Specifically, if non-poor older adults have longer lifespans, policies centred solely on poor may not effectively address the needs of all older individuals.

Parenthood and All-cause Mortality in Older Adults with Schizophrenia: A Multicenter 5-Year Prospective Study.

The large body of literature examining the association between parenthood and mortality in the general population contrasts with a lack of studies among older adults with schizophrenia. Identifying potential protective factors of premature death in this population is important to help guide prevention measures. Here, we examined whether all-cause and cause-specific mortality rates significantly differ between older adults with schizophrenia with and without children, during a 5-year follow-up. We used data from a 5-year prospective multicenter sample of older adults with an ICD-10 diagnosis of schizophrenia (aged 55 years or more) recruited in France. We performed a forward stepwise logistic regression to examine the association between parenthood and all-cause mortality, including only those independent variables that best explain outcome. Of 323 older adults with schizophrenia, 133 (41.2%) had children (mean age=67.0, SD=6.1), whereas 190 were without children (mean age=67.2, SD=6.6). Following adjustments, parenthood was significantly associated with lower all-cause mortality compared to patients without children in this population (21.1% (n=28) versus 35.8% (n=68); AOR=0.50; 95%CI=0.27-0.94; p=0.032), without significant sex differences in this association. Parenthood could be protective against mortality among older patients with schizophrenia who live in France. Further research is needed to understand the specific mechanisms underlying this association.

Dietary inflammatory index and all-cause mortality in adults with COPD: a prospective cohort study from the NHANES 1999-2018.

Chronic inflammation is closely linked to Chronic Obstructive Pulmonary Disease (COPD); however, the impact of the Dietaryq Inflammatory Index (DII) on mortality among COPD patients remains uncertain. To assess the correlation between the DII and all-cause mortality in COPD patients using data from the National Health and Nutrition Examination Survey (NHANES). We conducted a retrospective cohort study on 1,820 COPD patients from the NHANES dataset (1999-2018). The influence of DII on mortality was evaluated using multivariate Cox regression, smoothing spline fitting, and threshold effect analysis. Additionally, Kaplan-Meier survival analysis was performed to compare survival curves among different DII groups. Subgroup analyses and E-values identified sensitive cohorts and assessed unmeasured confounding. Over an average follow-up of 91 months, multivariate Cox regression models revealed a significant positive correlation between DII scores and mortality risk, with each unit increase in DII associated with a 10% higher risk of death (HR: 1.10, 95% CI: 1.03-1.16; P = 0.002). Among the DII tertiles, individuals in the second tertile (T2: 1.23-2.94) experienced a 67% increase in mortality risk compared to those in the lowest tertile (T1: -5.28-1.23) (HR: 1.67, 95% CI: 1.26-2.21; p < 0.001). The third tertile (T3) did not show a statistically significant increase in mortality risk (HR: 1.30, 95% CI: 0.98-1.72; p=0.074). A restricted cubic spline analysis indicated a significant nonlinear association between DII and all-cause mortality (p = 0.021). Threshold effect analysis further revealed that below a DII of 2.19, there was a significant increase in all-cause mortality risk (HR = 1.19, 95% CI: 1.07-1.33; p = 0.002), while at or above this threshold, the risk increase was not statistically significant (HR=0.89, 95% CI: 0.68-1.15; p = 0.380). Kaplan-Meier analysis revealed significant differences in survival curves among DII tertiles (p < 0.001), with the lowest DII tertile showing the highest survival probability. Both subgroup and sensitivity analyses confirmed the robustness of these findings. DII is positively correlated with mortality risk in COPD patients, showing nonlinear characteristics and threshold effects, underscoring its prognostic value.

Acaricidal Efficacy of Abamectin against Tetranychus urticae Populations When Combined with Entomopathogenic Fungi

Tetranychus urticae (Acari: Tetranychidae) is a widespread and serious mite pest that infests tomato plants and causes economic losses worldwide. We investigated the acaricidal efficacy of two isolates of entomopathogenic fungi (EPF) Metarhizium robertsii (WG-7) and Beauveria bassiana (WG-12) alone and in combination with abamectin when applied topically to tomato leaf discs in the laboratory against T. urticae. We also evaluated the establishment and proliferation of T. urticae mite life stages on tomato plants in the greenhouse after application of each of the above treatments. The combination of abamectin with each EPF caused 100% mortality in T. urticae immatures after 2 days while each EPF or abamectin alone caused moderate mortality, not exceeding 74.2% 3 days post-exposure. Complete (100%) mortality of adults was observed after 5 days in leaf discs treated with M. robertsii plus abamectin whereas B. bassiana plus abamectin caused 100% mortality after 7 days. The mean number of eggs, emerged immatures, and adults were significantly reduced on both sides of the leaves (i.e., abaxial and adaxial sides) after using the combined application of M. robertsii or B. bassiana plus abamectin, compared to abamectin alone and controls. Our results reveal that the acaricidal efficacy of abamectin combined with either EPF was significantly better in managing the T. urticae life stages than either treatment alone under greenhouse conditions.

Molecular characterization and functional analysis of genes mediating emamectin benzoate action to the pinewood nematode (Bursaphelenchus xylophilus)

Emamectin benzoate (EB) is a highly effective and low-toxicity pesticide for the control of Bursaphelenchus xylophilus. However, its action mechanism in B. xylophilus has not yet been verified. Here, the genes (Bxy-glc-1, Bxy-glc-2, Bxy-glc-4, and Bxy-avr-14) encoding the glutamate-gated chloride channel (GluCl) of B. xylophilus were analysed and cloned. Functional validation of the target genes was conducted using RNAi and pathogenicity detection assays. The results of the bioinformatics analysis showed that the four GluCl genes contained the Cys-loop region and three transmembrane structural domains. Molecular docking and molecular dynamics simulation predictions revealed that BXY-GLC-2, BXY-GLC-4, and BXY-GLC-1 all had strong binding affinities to EB, and BXY-AVR-14 had no binding affinity to EB. The expression and in situ hybridisation of Bxy-glc-1, Bxy-glc-2, Bxy-glc-4, and Bxy-avr-14 was significantly higher in adult B. xylophilus than at other developmental stages. Interference of Bxy-glc-1, Bxy-glc-2, and Bxy-glc-4 significantly reduced adult mortality relative to the control group, and interference of Bxy-avr-14 did not have a significant on adult mortality. Adult mortality was lowest in the combined Bxy-glc-2 + Bxy-glc-4 treatment group, followed by the Bxy-glc-1 + Bxy-glc-2 and Bxy-glc-1 + Bxy-glc-4 groups. No significant changes were observed in the mortality rate of the Bxy-avr-14 group and the combination of the other three genes. The dsBxy-glc-1, dsBxy-glc-2, and dsBxy-glc-4 groups accelerated the progression of pine wilt disease induced by EB relative to the sole EB-treated group. Our results confirmed that Bxy-glc-1, Bxy-glc-2, and Bxy-glc-4 are target genes of GluCl in B. xylophilus.

Association of beta blockers and mortality in adults with septic shock: systematic review and meta-analysis of randomized clinical trial.

Septic shock still entails significant morbidity and mortality, with the heart being affected due to catecholamine overexpression and direct injury from sepsis. Therefore, the effect of β-blocking the receptors to improve performance is promising when attempting to reverse tachycardia and reduce mortality. We conducted a comprehensive search across five databases for studies published up to 28 January 2024, using a PICO strategy. Ten studies were identified for quantitative analysis and included in our meta-analysis. Our meta-analysis evaluated 28-day in-hospital mortality risk across nine randomized controlled trials (RCTs) involving a total of 1,121 adults with septic shock. We found an association between β-blocker use and reduced overall mortality (OR 0.57; 95% CI 0.34-0.98; I 2: 56%). This effect was significant in the esmolol subgroup (OR 0.47; 95% CI 0.26-0.82; I 2: 32%), but not in the landiolol subgroup (OR 0.98; 95% CI 0.0-1,284.5; I 2: 72%). Additionally, the intervention group shows a significant reduction in HR and lactate levels, as well as an increase in stroke volume index (SVI). In adults with septic shock, β-blockers are associated with a reduction in 28-day in-hospital mortality, a benefit primarily observed with esmolol rather than landiolol. Furthermore, improvements in heart rate (HR) control, lactate levels, and SVI were noted. However, these findings should be interpreted with caution, and further high-quality RCTs comparing different β-blockers are necessary to better elucidate these effects. https://www.crd.york.ac.uk/prospero/, identifier CRD42024513610.

Dying from avoidable causes: a cohort prospective study to understand the characteristics of people with intellectual disabilities at high risk

Purpose This study aims to investigate the demographic and clinical characteristics associated with different risk stratification levels on the Decision Support Tool for Physical Health (DST-PH). The DST-PH was designed to stratify risk of avoidable mortality in adults with intellectual disabilities. Design/methodology/approach A prospective cohort study design was used. Data, including age, gender, ethnicity and completed DST-PH assessments, was collected from adults with intellectual disabilities within an NHS trust in the North-West of England. Descriptive statistics and a risk factor analysis were used to investigate differences between those rating Red, Amber and Green on the DST-PH. Findings Risk factor analysis revealed key clinical indicators linked to avoidable mortality. Notably, those experiencing posture or mobility difficulties, transitions in care, an untreated or unstable mental health condition or significant behavioural problems were identified to be at significantly heightened risk of avoidable death. These findings emphasise the importance of proactively recognising and addressing these experiences, particularly posture- and mobility-related challenges, in individuals with intellectual disabilities. It is important to note this study’s findings are based on a small sample size. Therefore, further research with a larger and more diverse population is recommended to validate and expand upon these results. Originality/value To the authors’ knowledge, this is the first study which has used a risk stratification tool to investigate the clinical and demographic characteristics of individuals with intellectual disability at higher risk of avoidable mortality.

Association between longitudinal changes in phase angle and mortality rate in adults critically ill with COVID‐19: A retrospective cohort study

AbstractBackgroundPhase angle (PhA) obtained by bioelectrical impedance analysis (BIA) works as a predictor of clinical outcomes. Specific cutoff values for longitudinal changes and their relationship with clinical outcomes are still undetermined for patients with critical illness. Thus, the aim of this study was to analyze the association between longitudinal changes in PhA during intensive care unit (ICU) stay and all‐cause 90‐day mortality in patients critically ill with COVID‐19.MethodsThis was a retrospective cohort study of adults critically ill with COVID‐19 undergoing invasive mechanical ventilation with a length of stay &gt;14 days. BIA was performed at ICU admission and at days 7 and 14 of ICU stay; PhA and hydration parameters were collected. Differences between survivors and nonsurvivors were assessed. Longitudinal changes were evaluated using repeated‐measures analysis of variance. A receiver operating characteristics curve for PhA declined (%) during the first 14 days, and all‐cause 90‐day mortality was performed. Survival probability was reported using hazard ratios (HR).ResultsOne‐hundred nine patients were included. The change in the value of PhA was close to 17.1%. Nonsurvivors had a higher prevalence of individuals with a decrease in PhA &gt;22.2% (area under the curve = 0.65) in the first 14 days in comparison with survivors (70% vs 34.8%, P &lt; 0.01). PhA decrease &gt;22.2% at 14 days was a significant predictor of all‐cause 90‐day mortality (HR = 2.2, 95% CI 1.71–3.6, P = 0.04).ConclusionChanges in PhA are associated with all‐cause 90‐day mortality. Future studies should be directed to interventions to prevent changes in this nutrition marker.

Projections of Extreme Temperature–Related Deaths in the US

ImportanceExtreme heat in the US is increasing due to climate change, while extreme cold is projected to decline. Understanding how extreme temperature along with demographic changes will affect population health is important for devising policies to mitigate the health outcome of climate change.ObjectiveTo assess the burden of extreme temperature–related deaths in the contiguous US currently (2008-2019) and estimate the burden in the mid–21st century (2036-2065).Design, Setting, and ParticipantsThis cross-sectional study used historical (1979-2000) daily mean temperatures to calculate monthly extreme heat (&amp;amp;gt;97.5th percentile value) and extreme cold days (&amp;amp;lt;2.5th percentile value) for all contiguous US counties for 2008 to 2019 (current period). Temperature projections from 20 climate models and county population projections were used to estimate extreme temperature–related deaths for 2036 to 2065 (mid–21st century period). Data were analyzed from November 2023 to July 2024.ExposureCurrent monthly frequency of extreme heat days and projected mid–21st century frequency using 2 greenhouse gas emissions scenarios: Shared Socioeconomic Pathway (SSP)2-4.5, representing socioeconomic development with a lower emissions increase, and SSP5-8.5, representing higher emissions increase.Main Outcomes and MeasuresMean annual estimated number of extreme temperature–related excess deaths. Poisson regression model with county, month, and year fixed effects was used to estimate the association between extreme temperature and monthly all-cause mortality for older adults (aged ≥65 years) and younger adults (aged 18-64 years).ResultsAcross the contiguous US, extreme temperature days were associated with 8248.6 (95% CI, 4242.6-12 254.6) deaths annually in the current period and with 19 348.7 (95% CI, 11 388.7-27 308.6) projected deaths in the SSP2-4.5 scenario and 26 574.0 (95% CI, 15 408.0-37 740.1) in the SSP5-8.5 scenario. The mortality data included 30 924 133 decedents, of whom 15 573 699 were males (50.4%), with 6.3% of Hispanic ethnicity, 11.5% of non-Hispanic Black race, and 79.3% of non-Hispanic White race. Non-Hispanic Black adults (278.2%; 95% CI, 158.9%-397.5%) and Hispanic adults (537.5%; 95% CI, 261.6%-813.4%) were projected to have greater increases in extreme temperature–related deaths from the current period to the mid–21st century period compared with non-Hispanic White adults (70.8%; 95% CI, −5.8% to 147.3%).Conclusions and RelevanceThis cross-sectional study found that extreme temperature–related deaths in the contiguous US were projected to increase substantially by mid–21st century, with certain populations, such as non-Hispanic Black and Hispanic adults, projected to disproportionately experience this increase. The results point to the need to mitigate the adverse outcome of extreme temperatures for population health.

Associations of nighttime sleep, midday napping, and physical activity with all-cause mortality in older adults: the Seniors-ENRICA cohorts

Associations of nighttime sleep, midday napping, and physical activity with all-cause mortality in older adults: the Seniors-ENRICA cohorts

Age-specific all-cause mortality trends in the UK: Pre-pandemic increases and the complex impact of COVID-19

ObjectivesThis study aims to analyse age-specific all-cause mortality trends in the UK before and after COVID-19 emergence to determine if pre-pandemic trends contributed to increased mortality levels in the post-pandemic era. Study designStatistical analysis of UK mortality data. MethodsWe utilised age-structured population and mortality data for all UK countries from 2005 to 2023. Mortality rates were calculated for each age group, and excess mortality was estimated using the Office for National Statistics (ONS) method. ResultsOur most concerning finding is an increase in all-cause mortality rates for middle-aged adults (30–54 years) starting around 2012. The COVID-19 pandemic may have further impacted these rates, but the pre-existing upward trend suggests that current elevated mortality rates might have been reached regardless of the pandemic. This finding is more alarming than the slowdown in the decline of cardiovascular disease death rates for individuals under 75 noted by the British Heart Foundation. ConclusionOur results highlight the importance of considering both immediate pandemic impacts and long-term mortality trends in public health strategies. This underscores the need for targeted interventions and improved healthcare planning to address both ongoing and future challenges.

Temperature dependence of mosquitoes: Comparing mechanistic and machine learning approaches.

Mosquito vectors of pathogens (e.g., Aedes, Anopheles, and Culex spp. which transmit dengue, Zika, chikungunya, West Nile, malaria, and others) are of increasing concern for global public health. These vectors are geographically shifting under climate and other anthropogenic changes. As small-bodied ectotherms, mosquitoes are strongly affected by temperature, which causes unimodal responses in mosquito life history traits (e.g., biting rate, adult mortality rate, mosquito development rate, and probability of egg-to-adult survival) that exhibit upper and lower thermal limits and intermediate thermal optima in laboratory studies. However, it remains unknown how mosquito thermal responses measured in laboratory experiments relate to the realized thermal responses of mosquitoes in the field. To address this gap, we leverage thousands of global mosquito occurrences and geospatial satellite data at high spatial resolution to construct machine-learning based species distribution models, from which vector thermal responses are estimated. We apply methods to restrict models to the relevant mosquito activity season and to conduct ecologically plausible spatial background sampling centered around ecoregions for comparison to mosquito occurrence records. We found that thermal minima estimated from laboratory studies were highly correlated with those from the species distributions (r = 0.87). The thermal optima were less strongly correlated (r = 0.69). For most species, we did not detect thermal maxima from their observed distributions so were unable to compare to laboratory-based estimates. The results suggest that laboratory studies have the potential to be highly transportable to predicting lower thermal limits and thermal optima of mosquitoes in the field. At the same time, lab-based models likely capture physiological limits on mosquito persistence at high temperatures that are not apparent from field-based observational studies but may critically determine mosquito responses to climate warming. Our results indicate that lab-based and field-based studies are highly complementary; performing the analyses in concert can help to more comprehensively understand vector response to climate change.

Flupyradifurone application: A promising approach to curtail tomato leaf curl New Delhi virus (ToLCNDV) transmission vectored by Bemisia tabaci in potato farming

The whitefly, Bemisia tabaci, serves as a carrier and transmitter of the tomato leaf curl New Delhi virus (ToLCNDV) in potatoes, leading to the emergence of potato apical leaf curl disease. Among the six insecticides tested against B. tabaci, flupyradifurone resulted in the highest mortality of nymphs and adults. Three effective insecticides were then further evaluated for their ability to prevent the acquisition and transmission of ToLCNDV by B. tabaci. Utilizing qPCR techniques, we determined the amount of virus acquired by B. tabaci from virus-positive plants that had undergone prior insecticide treatment. The results revealed a significant reduction in virus levels in the whitefly's body, flupyradifurone was found to be most effective among the tested insecticides in reducing ToLCNDV acquisition. Flupyradifurone also exhibited the highest efficacy in reducing ToLCNDV transmission by B. tabaci. Experiments conducted in the glasshouse 24 h post insecticide application demonstrated the complete prevention of ToLCNDV transmission in all plants treated with flupyradifurone. In the field experiment also, flupyradifurone effectively suppressed whitefly-mediated ToLCNDV transmission for up to 14 days following insecticide application. The findings indicate that the use of flupyradifurone has the potential to manage the vector population and control associated viral disease, which is known to cause significant losses in potato crops.

Trends in Cancer Incidence and Mortality in US Adolescents and Young Adults, 2016-2021.

(1) Background: The incidence rate of early onset-cancer (<50) has increased since 1995. Among younger people, cancers in AYAs (aged 15-39 y) are often biologically distinct tumors from those treated in the pediatric and older adult population. The current study describes trends in the United States for the most recent years including the first year of the COVID-19 epidemic. We aimed to describe the recent incidence and mortality trends of cancers in AYAs (aged 15-39 y). (2) Methods: We used data from the Surveillance, Epidemiology, and End Results (SEER 22) from 1 January 2016 to 31 December 2021. Age-adjusted incidence and mortality rates were assessed by SEER*Stat 8.4.3 for major cancer types by sex, race/ethnicity, age, and metropolitan/nonmetropolitan status. Time trends of age-adjusted incidence and mortality rates were examined by sex and metropolitan/nonmetropolitan status. (3) Results: Age-adjusted overall cancer incidence and mortality rates were stable during this study period. The age-adjusted incidence rates declined significantly for ependymoma, melanoma, carcinomas of lung, bronchus, and trachea, unspecified malignant neoplasms, and non-Hodgkin's lymphoma. Significant increases were found for gastrointestinal tract cancers and non-Kaposi sarcomas. The age-adjusted mortality rate decreased for acute myeloid leukemia, melanoma, carcinomas of liver and intrahepatic bile ducts, kidney and, in women, leukemia. For some cancers, rates differed by sex, race, ethnicity, and geography. Monitoring the rates and time trends of AYA cancer emphasizes the distinct health concern for this age group.

Reproductive aging weakens offspring survival and constrains the telomerase response to herpesvirus in Pacific oysters.

Telomere length (TL) is increasingly recognized as a molecular marker that reflects how reproductive aging affects intergenerational transmissions. Here, we investigated the effects of parental age on offspring survival and the regulation of TL by examining the telomere-elongating activity of telomerase in the Pacific oyster. We assessed the classical hallmarks of aging in parents at three age classes (young, middle-aged, and old) and crossbred them using a split-brood design to examine the consequences of the nine maternal-by-paternal age combinations on their offspring. Reproductive aging leads to increased larval mortality and accelerated telomere shortening in spats, rendering them more susceptible to infection by the Ostreid herpesvirus. Viral exposure stimulates telomerase activity, a response that we identified as adaptive, but weakened by parental aging. While telomerase lengthens a spat's telomere, paradoxically, longer individual TL predicts higher mortality in adults. The telomerase-telomere complex appeared as a conservative biomarker for distinguishing survivors and losers upon exposure to polymicrobial diseases.