Life Table Research Articles

CBTRUS Statistical Report: American Brain Tumor Association & NCI Neuro-Oncology Branch Adolescent and Young Adult Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2016-2020.

Recent analyses have shown that, whereas cancer survival overall has been improving, it has not improved for adolescents and young adults ages 15-39 years (AYA). The clinical care of AYA with primary brain and other central nervous system (CNS) tumors (BT) is complicated by the fact that the histopathologies of such tumors in AYA differ from their histopathologies in either children (ages 0-14 years) or older adults (ages 40+ years). The present report, as an update to a 2016 publication from the Central Brain Tumor Registry of the United States and the American Brain Tumor Association, provides in-depth analyses of the epidemiology of primary BT in AYA in the United States and is the first to provide biomolecular marker-specific statistics and prevalence by histopathology for both primary malignant and non-malignant BT in AYA. Between 2016 and 2020, the annual average age-specific incidence rate (AASIR) of primary malignant and non-malignant BT in AYA was 12.00 per 100,000 population, an average of 12,848 newly diagnosed cases per year. During the same period, an average of 1,018 AYA deaths per year were caused by primary malignant BT, representing an annual average age-specific mortality rate of 0.96 per 100,000 population. When primary BT were categorized by histopathology, pituitary tumors were the most common (36.6%), with an AASIR of 4.34 per 100,000 population. Total incidence increased with age overall; when stratified by sex, the incidence was higher in females than males at all ages. Incidence rates for all primary BT combined and for non-malignant tumors only were highest for non-Hispanic American Indian/Alaska Native individuals, whereas malignant tumors were more frequent in non-Hispanic White individuals, compared with other racial/ethnic groups. On the basis of histopathology, the most common molecularly defined tumor was diffuse glioma (an AASIR of 1.51 per 100,000). Primary malignant BT are the second most common cause of cancer death in the AYA population. Incidence rates of primary BT overall, as well as specific histopathologies, vary significantly by age. Accordingly, an accurate statistical assessment of primary BT in the AYA population is vital for better understanding the impact of these tumors on the US population and to serve as a reference for afflicted individuals, for researchers investigating new therapies, and for clinicians treating these patients.

Examining a 12-year experience within Kazakhstan’s national heart transplantation program

Kazakhstan has one of the lowest heart transplantation (HTx) rates globally, but there are no studies evaluating the outcomes of HTx. This study aimed to provide a comprehensive analysis of the national HTx program over a 12-year period (2012–2023). Survival analysis of the national HTx cohort was conducted using life tables, Kaplan‒Meier curves, and Cox regression methods. Time series analysis was applied to analyze historical trends in HTx per million population (pmp) and to make future projections until 2030. The number of patients awaiting HTx in Kazakhstan was evaluated with a regional breakdown. The pmp rates of HTx ranged from 0.06 to 1.08, with no discernible increasing trend. Survival analysis revealed a rapid decrease in the first year after HTx, reaching 77.0% at 379 days, with an overall survival rate of 58.1% at the end of the follow-up period. Among the various factors analyzed, recipient blood levels of creatinine and total bilirubin before surgery, as well as the presence of infection or sepsis and the use of ECMO after surgery, were found to be significant contributors to the survival of HTx patients. There is a need for public health action to improve the HTx programme.

Performance and preference of larval parasitoid, Microplitis pallidipes (Hymenoptera: Braconidae), on 2 Spodoptera pest species.

Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae) and Spodoptera litura (Fabricius) are the main pests on corn (Poaceae: Gramineae). The performance of the larval wasp, Microplitis pallidipes Szépligeti (Hymenoptera: Braconidae), was reported on S. frugiperda and S. litura. In this study, we evaluated host selectivity, constructed an age-stage, 2-sex life table, and assessed the pest control potential of M. pallidipes against these 2 pests under laboratory conditions. In a 2-choice host preference experiment, M. pallidipes exhibited a stronger preference for S. frugiperda over S. litura and a distinct preference for second instars. We also investigated the parasitism of females that were either unfed or fed with 10% honey-water solution under different host densities and found that the highest parasitism rate was observed when M. pallidipes were fed with honey-water solution on the first day after mating and a presented female wasp:host ratio of 1:90. In a nonselective assay, M. pallidipes successfully completed a full generation on both hosts. However, the parasitoids exhibited higher fitness and population growth potential when reared on S. frugiperda, with a net reproductive rate (R0) of 24.24, an intrinsic rate of increase (r) of 0.20 per day, a finite rate of increase (λ) of 1.23 per day, and a mean generation time (T) of 15.69 days. This study elucidates the performance of M. pallidipes on 2 Spodoptera host species and offers insights into its biological control potential on lepidopteran pests.

Survival Analysis of Low-Birth-Weight Neonates in NICU At Dr. Wahidin Sudirohusodo Hospital Makassar, Indonesia

Background: Currently, children face the highest risk of death during the neonatal phase. UNICEF data shows that in 2022, globally, approximately 2.3 million children died in the first month of life, accounting for about 6,400 neonatal deaths per day. The aim is determining the survival proportion of neonates, hazard ratios, and maternal factors influencing the survival of low-birth-weight neonates. Methodology: A retrospective cohort study design using secondary data from 183 medical records of low-birth-weight neonates from 2020 to 2022. Kaplan-Meier analysis and life table were used to observe the time frame and survival proportion, as well as differences among independent variable groups. Cox regression analysis was conducted to estimate hazard ratios and the influence of independent variables. Results: Gestational age (p=0.028, HR=2.7948, CI 95% = 1.1197-6.9757), ANC visits (p=0.000, HR=2.7057, CI 95% = 1.6320-4.4857), and maternal employment status (p=0.023, HR=2.6546, CI 95% = 1.1430-6.1651) are statistically significant variables that influence the survival of low-birth-weight neonates. Conclusions: The survival proportion of low-birth-weight neonates is 60.80%. Gestational age, ANC visits, and maternal employment status significantly contribute to the survival of low-birth-weight neonates.

Age-specific and cause-specific mortality contributions to the socioeconomic gap in life expectancy in Germany, 2003–21: an ecological study

Age-specific and cause-specific mortality contributions to the socioeconomic gap in life expectancy in Germany, 2003–21: an ecological study

Disaggregating Death Rates of Age-Groups Using Deep Learning Algorithms

Reliable estimates of age-specific vital rates are crucial in demographic studies, while ages are, in most cases, commonly grouped in bins of five years. Indeed, public health and national systems require single age-specific data to achieve accurate social planning. This paper introduces a deep learning approach for splitting the abridged death rates, providing a more comprehensive perspective on the indirect age-specific vital rates estimation from grouped data. Additionally, we contribute to the existing literature by introducing a multi-population (countries and genders) approach, providing reliable estimates considering the heterogeneity of longevity dynamics over age, years, and across populations. We also contribute to the state of the art in indirect estimation by introducing, for the first time, a multi-population indirect estimation leveraging subnational data. Our model accurately captures mortality dynamics by age over time and among different populations. We prove the model’s ability to estimate reliable predictions of age-specific mortality rates by also studying how the hyperparameters’ choice affects the model reliability and analyzing the age-specific relative differences between the real and the estimated mortality rates.

Age-specific mortality trends in heart failure over 25 years: a retrospective Danish nationwide cohort study

Despite advances in heart failure care reducing mortality in clinical trials, it remains unclear whether real-life cohorts have had similar improvements in life expectancy across the age spectrum. We aimed to investigate how mortality trends changed in patients with heart failure over the past 25 years, stratified by age groups. Using Danish nationwide registries, we identified patients with new-onset heart failure aged 18-95 years. The 5-year all-cause mortality risk and the absolute risk difference of mortality between patients with heart failure and age-matched and sex-matched heart failure-free controls were assessed using Kaplan-Meier estimates and multivariable Cox regression models. Mortality trends were analysed across five calendar periods (1996-2000, 2001-05, 2006-10, 2011-15, and 2016-20) and three age groups (<65 years, 65-79 years, and ≥80 years). 194 997 patients with heart failure were included. Mortality significantly decreased from 1996-2000 (66% [95% CI 65·5-66·4]) to 2016-20 (43% [42·1-43·4]), with similar results shown in all age groups (<65 years: 35% [33·9-36·1] to 15% [14·6-16·3]; 65-79 years: 64% [63·1-64·5] to 39% [37·6-39·6]; and ≥80 years: 84% [83·1-84·3] to 73% [71·7-73·9]). Adjusted mortality rates supported these associations. The absolute risk difference declined notably in younger age groups (<65 years: 29·9% [28·8-31·0] to 12·7% [12·0-13·4] and 65-79 years: 41·1% [40·3-41·9] to 25·1% [24·4-25·8]), remaining relatively stable in those aged 80 years or older (30·6% [29·9-31·3] to 28% [27·2-28·8]). Over 25 years, there has been a consistent decrease in mortality among patients with heart failure across age groups, albeit less prominently in patients aged 80 years or older. Further insight is needed to identify effective strategies for improving disease burden in older patients with heart failure. None. For the Danish translation of the abstract see Supplementary Materials section.

The association between disability and mortality: a mixed-methods study

Globally, 1·3 billion people have a disability and are more likely to experience poor health than the general population. However, little is known about the mortality or life expectancy gaps experienced by people with disabilities. We aimed to undertake a systematic review and meta-analysis of the association between disability and mortality, compare these findings to the evidence on the association of impairment types and mortality, and model the estimated life expectancy gap experienced by people with disabilities. We did a mixed-methods study, which included a systematic review and meta-analysis, umbrella review, and life expectancy modelling. For the systematic review and meta-analysis, we searched MEDLINE, Global Health, PsycINFO, and Embase for studies published in English between Jan 1, 2007, and June 7, 2023, investigating the association of mortality and disability. We included prospective and retrospective cohort studies and randomised controlled trials with a baseline assessment of disability and a longitudinal assessment of all-cause mortality or cause-specific mortality. Two reviewers independently assessed study eligibility, extracted the data, and assessed risk of bias. We did a random-effects meta-analysis to calculate a pooled estimate of the mortality rate ratio for people with disabilities compared with those without disabilities. We did an umbrella review of meta-analyses examining the association between different impairment types and mortality. We used life table modelling to translate the mortality rate ratio into an estimate of the life expectancy gap between people with disabilities and the general population. The systematic review and meta-analysis is registered with PROSPERO, CRD42023433374. Our search identified 3731 articles, of which 42 studies were included in the systematic review. The meta-analysis included 31 studies. Pooled estimates showed that all-cause mortality was 2·24 times (95% CI 1·84-2·72) higher in people with disabilities than among people without disabilities, although heterogeneity between the studies was high (τ2=0·28, I2=100%). Modelling indicated a median gap in life expectancy of 13·8 years (95% CI 13·1-14·5) by disability status. Cause-specific mortality was also higher for people with disabilities, including for cancer, COVID-19, cardiovascular disease, and suicide. The umbrella review identified nine meta-analyses, which showed consistently elevated mortality rates among people with different impairment types. Mortality inequities experienced by people with disabilities necessitate health system changes and efforts to address inclusion and the social determinants of health. National Institute for Health and Care Research, Rhodes Scholarship, Indonesia Endowment Funds for Education, Foreign, Commonwealth and Development Office (Programme for Evidence to Inform Disability Action), and the Arts and Humanities Research Council.

Biology and life table parameters of Paralobesia viteana (Lepidoptera: Tortricidae), grown on different grape cultivars.

The grape berry moth, Paralobesia viteana (Clemens), is an important pest of cultivated grapes in eastern North America. Damage is caused directly by larval feeding of grape clusters and indirectly by increasing fruit susceptibility to fungal and bacterial pathogens. Despite the impact of grape berry moth on grapes being widely recognized, there is a lack of understanding of the influence that different grape cultivars may have on grape berry moth development, reproduction, and population dynamics. In this study, we constructed age-stage 2-sex life tables for grape berry moth fed on 5 grape cultivars: Concord, Niagara, Riesling, Chambourcin, and Vidal, to examine the effects of diet on insect population development, survival, reproduction, and demographic parameters such as net reproductive rate, intrinsic rate of increase, finite rate of increase, and mean generation time. Our findings reveal that grape cultivar significantly influenced the neonate wandering period, larval developmental time, adult and female longevity, pupal weight, adult preoviposition period, oviposition period, mean generation time, age-stage-specific life expectancy, and reproductive value of P. viteana. However, diet type did not affect grape berry moth total fecundity or other demographic parameters. The highest female reproductive value was observed at 30-40 days of age, indicating that control tactics implemented during this time frame would have the greatest impact on reducing population increase. This study provides critical information on the effects of different grape cultivars on grape berry moth development, reproduction, and demography. These insights could lead to the development of management strategies that improve pest control and reduce economic losses in vineyards.

Measures of Lifespan Length and Variation Using a Mixture Model: The Case of Egypt

Abstract Monitoring the changes in mortality patterns and levels requires studying mortality models and measures of lifespan length and variation. Measures of lifespan length and variation can be obtained from life tables or from mortality modes. In this paper, measures of lifespan length and variation are presented for mixture model introduced by Zanotto, L., V. Canudas-Romo, and S. Mazzuco. 2021. “A Mixture-Function Mortality Model: Illustration of the Evolution of Premature Mortality.” European Journal of Population 37 (1): 1–27. This was applied to the case of Egypt for males and females in the period 1950–2021. The mixture model was able to fit Egypt’s mortality pattern well for both males and females. The calculated measures of lifespan length and variation show that there is an increasing longevity and a declining variation of age at death distribution across time for both males and females.

Regional Variation in Lifetime Probability of Admission to Residential Aged Care in Australia

Objectives This paper aims to apply a novel demographic technique to update – and extend to sub-national regions – estimates of the lifetime probability of admission to residential aged care. Methods Making optimal use of Australian data sources on aged care usage, mortality and population, this study adopts a two-population life table approach to produce an updated set of national probability estimates and first-time regional estimates. Results The probability of admission generally increases with age: nationally, lifetime probability at age 65 is 50% for women and 37% for men, rising to 55% and 46%, respectively, at age 85. This general pattern varied somewhat across regions. Discussion The regional results point to inequities in the uptake of care, thereby informing providers, governments, aged care advocates and anyone interested in equity of access.

Predictors of contraceptive discontinuation in Rwanda: evidence from demographic and health survey 2019–2020

BackgroundDespite advancements, Rwanda continues to face challenges regarding contraceptive discontinuation. The 2019–2020 Rwanda Demographic and Health Survey (DHS) reported a 30% discontinuation rate among women within the first year of use. This study analyses predictors of discontinuation using this DHS data, with the goal of strengthening Rwanda’s family planning programs.MethodsData from the 2019-20 Rwanda DHS (14,634 women aged 15–49) was examined. A two-stage sampling design informed the survey. Life table methods and Cox proportional hazard models were used to analyze discontinuation rates, median usage duration across contraceptive methods, and the influence of demographic and other factors.ResultsResults indicated a progressive rise in contraceptive discontinuation over different period: 16.69% at 6 months, 29.29% at 12 months, and 47.21% at 24 months. Pills and male condoms showed higher discontinuation probabilities early on. While injectables and LAM initially showed lower discontinuation, rates rose significantly by the 24th month. Health concerns and side effects were the primary reasons cited for discontinuation. The Cox proportional hazards analysis revealed significant factors influencing discontinuation: contraceptive method, desire for pregnancy, husband’s disapproval, access/availability, and the desire for a more effective method.ConclusionThis study highlights substantial contraceptive discontinuation rates in Rwanda, particularly for pills and injectables. Method type, health concerns, side effects, and method failure were associated with discontinuation. Interventions should focus on improving contraceptive continuation and investigating alternative methods with lower discontinuation tendencies.

Colonization of Piriformospora indica enhances rice resistance against the brown planthopper Nilaparvata lugens.

Piriformospora indica is an endophytic fungus that can promote the growth and confer the resistance against diverse stresses in host plants by root colonization. However, the effects of P. indica colonization on improving plant resistance to insect pests are still less explored. The brown planthopper (BPH) Nilaparvata lugens is a serious monophagous pest that causes extensive damage to rice plants. Here, we aimed to evaluate the effects of P. indica colonization on rice resistance against BPH. The colonization of P. indica in the rice roots resisted the damage from BPH. The age-stage, two-sex life table analyses showed that feeding on P. indica-colonized rice plants affected BPH's female adult longevity, oviposition period, fecundity, population parameters and population size. BPH female adults feeding on P. indica-colonized plants excreted less honeydew. P. indica colonization remarkably increased the duration of np, N2, and N3 waveform, as well as the occurrences of N1 and N2, and decreased the duration of N4-b for BPH on rice plants. Meanwhile, the weight of BPH on the colonized plants was significantly lower than the control. In addition, the feeding and oviposition preferences of BPH to P. indica-colonized plants were reduced. qRT-RCR analyses revealed that P. indica colonization induced the expressions of jasmonic acid (JA)- and salicylic acid (SA)-related genes in rice plants. P. indica colonization can reduce BPH performance on rice plants with potentially inhibitory effects on population growth. Collectively, these results support the potential for endophytically colonized P. indica as an effective strategy to improve insect resistance of crops. This article is protected by copyright. All rights reserved.

Gut Microbiota Affects Host Fitness of Fall Armyworm Feeding on Different Food Types

The fall armyworm (FAW), Spodoptera frugiperda, seriously threatens food and cash crops. Maize, wheat, and even rice damage by FAWs have been reported in many areas of China. It is urgent to clarify the mechanism which FAWs adapt to different feeding hosts and develop effective control technologies. Two-sex life tables and 16s rDNA sequencing were used to determine the host fitness and gut microbial diversity of FAWs when fed four different food types. Considering the life history parameters, pupa weight, and nutrient utilization indexes, the host fitness of FAWs when fed different food types changed in descending order as follows: artificial diet, maize, wheat, and rice. The gut microbial composition and the diversity of FAWs when fed different food types were significantly different, and those changes were driven by low-abundant bacteria. The gut microbes of FAWs that were fed with maize had the highest diversity. The functions of the gut microbes with significant abundance differences were enriched in nutrient and vitamin metabolism and other pathways that were closely related to host adaptation. Furthermore, we identified five genera (Acinetobacter, Variovorax, Pseudomonas, Bacillus, and Serratia) and one genus (Rahnella) that were positively and negatively correlated with the host fitness, respectively. This study revealed the possible role of gut microbes in the host adaptation of FAWs.

[Healthy life expectancy: acritical look at the benefits and potential of the demographic health indicator].

Demographic ageing yields many societal consequences that depend strongly on the health status of the population. Special indicators have been developed for tracking and assessing population health, which are referred to with the overarching term healthy life expectancy (HLE). The derivation of HLE is intuitive and easily comprehensible. However, an overly simplistic interpretation hides the extreme complexity inherent in adding the health dimension to the life table. This makes HLE compared to classic life expectancy (LE) extremely sensitive to certain conceptual and methodological features. In the article, this is presented in more detail for three aspects: the underlying definition of health, the choice of survey data as abasis for estimating health status, and the reporting behavior of survey participants. It is shown that the impact on HLE can be enormous, leading to considerable bias in the interpretation of levels and trends, but also in the analysis of differences between populations. Nevertheless, the extension of classical LE to HLE is an important achievement that must not be abandoned. Therefore, the article also discusses ways in which the HLE indicator could be made more robust and reliable. Until this is achieved, however, the high methodological sensitivity of HLE must not be ignored if it is used to assess the health status of populations and as abasis for health policy measures.

Projection of Interspecific Competition (PIC) Matrices: A Conceptual Framework for Inclusion in Population Risk Assessments.

Accounting for intraspecific and interspecific competition when assessing the effects of chemical and nonchemical stressors is an important uncertainty in ecological risk assessments. We developed novel projection of interspecific competition (PIC) matrices that allow for analysis of population dynamics of two or more species exposed to a given stressor(s) that compete for shared resources within a landscape. We demonstrate the application of PIC matrices to investigate the population dynamics of two hypothetical fish species that compete with one another and have differences in net reproductive rate and intrinsic rate of population increase. Population status predictions were made under scenarios that included exposure to a chemical stressor that reduced fecundity for one or both species. The results of our simulations demonstrated that measures obtained from the life table and Leslie matrix of an organism, including net reproductive rate and intrinsic rate of increase, can result in erroneous conclusions of population status and viability in the absence of a consideration of resource limitation and interspecific competition. This modeling approach can be used in conjunction with field monitoring efforts and/or laboratory testing to link effects due to stressors to possible outcomes within an ecosystem. In addition, PIC matrices could be combined with adverse outcome pathways to allow for ecosystem projection based on taxonomic conservation of molecular targets of chemicals to predict the likelihood of relative cross-species susceptibility. Overall, the present study shows how PIC matrices can integrate effects across the life cycles of multiple species, provide a linkage between endpoints observed in individual and population-level responses, and project outcomes at the community level for multiple generations for multiple species that compete for limited resources. Environ Toxicol Chem 2024;00:1-17. Published 2024. This article is a U.S. Government work and is in the public domain in the USA.

Evaluation of liver transplantation services in Kazakhstan from 2012 to 2023

There is a scarcity of publications evaluating the performance of the national liver transplantation (LTx) program in Kazakhstan. Spanning from 2012 to 2023, it delves into historical trends in LTx surgeries, liver transplant centers, and the national cohort of patients awaiting LTx. Survival analysis for those awaiting LTx, using life tables and Kaplan–Meier, is complemented by time series analysis projecting developments until 2030. The overall per million population (pmp) LTx rate varied from 0.35 to 3.77, predominantly favoring living donor LTx. Liver transplant center rates ranged from 0.06 to 0.40. Of 474 LTx patients, 364 on the waiting list did not receive transplantation. The 30-day and 1-year survival rates on the waiting list were 87.0% and 68.0%, respectively. Viral hepatitis and cirrhosis prevalence steadily rose from 2015 to 2023, with projections indicating a persistent trend until 2030. Absent targeted interventions, stable pmp rates of LTx and liver transplant centers may exacerbate the backlog of unoperated patients. This study sheds light on critical aspects of the LTx landscape in Kazakhstan, emphasizing the urgency of strategic interventions to alleviate the burden on patients awaiting transplantation.

Old but gold: The use of multiregional life tables and the place-of-birth-dependent approach for studying recent internal migration in Italy

There has been a significant shift in migratory behavior within Italy over time. The origins and destinations of the migration flows, which were previously characterized by a clear prevalence of moving from the south to the center-north, are now much more heterogeneous and complex. Despite the important progress achieved in the past 20 years, the measurement of internal migration remains a contentious topic in international research. Using data provided by the Italian National Institute of Statistics, we applied Rogers&amp;rsquo; multiregional model place-of-birth-dependent approach to assess the internal migration flows that occurred in Italy in the period 2002 &amp;ndash; 2013. This approach provides accurate measurements of internal migration, noting in particular the years of life expectancy for each birth cohort living in each geographical Italian macroregion (northeast, northwest, center, and south). The results indicate that the northwest is the main area of destination for internal migration. The birth cohort in the south is the one that has the greatest number of years of life expectancy in other macroregions. Interestingly, this cohort is the only one characterized by a predominantly male migratory model.

Magnitude and determinants of excess total, age-specific and sex-specific all-cause mortality in 24 countries worldwide during 2020 and 2021: results on the impact of the COVID-19 pandemic from the C-MOR project

IntroductionTo examine the impact of the COVID-19 pandemic on mortality, we estimated excess all-cause mortality in 24 countries for 2020 and 2021, overall and stratified by sex and age.MethodsTotal, age-specific...

Trends in Life Expectancy in Residential Long-Term Care by Sociodemographic Position in 1999–2018: A Multistate Life Table Study of Finnish Older Adults

Trends in Life Expectancy in Residential Long-Term Care by Sociodemographic Position in 1999–2018: A Multistate Life Table Study of Finnish Older Adults