80936 research outputs found
Sort by
Global age-sex-specific all-cause mortality and life expectancy estimates for 204 countries and territories and 660 subnational locations, 1950–2023: a demographic analysis for the Global Burden of Disease Study 2023
No full textBACKGROUND: Comprehensive, comparable, and timely estimates of demographic metrics-including life expectancy and age-specific mortality-are essential for evaluating, understanding, and addressing trends in population health. The COVID-19 pandemic highlighted the importance of timely and all-cause mortality estimates for being able to respond to changing trends in health outcomes, showing a strong need for demographic analysis tools that can produce all-cause mortality estimates more rapidly with more readily available all-age vital registration (VR) data. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) is an ongoing research effort that quantifies human health by estimating a range of epidemiological quantities of interest across time, age, sex, location, cause, and risk. This study-part of the latest GBD release, GBD 2023-aims to provide new and updated estimates of all-cause mortality and life expectancy for 1950 to 2023 using a novel statistical model that accounts for complex correlation structures in demographic data across age and time. METHODS: We used 24 025 data sources from VR, sample registration, surveys, censuses, and other sources to estimate all-cause mortality for males, females, and all sexes combined across 25 age groups in 204 countries and territories as well as 660 subnational units in 20 countries and territories, for the years 1950-2023. For the first time, we used complete birth history data for ages 5-14 years, age-specific sibling history data for ages 15-49 years, and age-specific mortality data from Health and Demographic Surveillance Systems. We developed a single statistical model that incorporates both parametric and non-parametric methods, referred to as OneMod, to produce estimates of all-cause mortality for each age-sex-location group. OneMod includes two main steps: a detailed regression analysis with a generalised linear modelling tool that accounts for age-specific covariate effects such as the Socio-demographic Index (SDI) and a population attributable fraction (PAF) for all risk factors combined; and a non-parametric analysis of residuals using a multivariate kernel regression model that smooths across age and time to adaptably follow trends in the data without overfitting. We calibrated asymptotic uncertainty estimates using Pearson residuals to produce 95% uncertainty intervals (UIs) and corresponding 1000 draws. Life expectancy was calculated from age-specific mortality rates with standard demographic methods. For each measure, 95% UIs were calculated with the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS: In 2023, 60·1 million (95% UI 59·0-61·1) deaths occurred globally, of which 4·67 million (4·59-4·75) were in children younger than 5 years. Due to considerable population growth and ageing since 1950, the number of annual deaths globally increased by 35·2% (32·2-38·4) over the 1950-2023 study period, during which the global age-standardised all-cause mortality rate declined by 66·6% (65·8-67·3). Trends in age-specific mortality rates between 2011 and 2023 varied by age group and location, with the largest decline in under-5 mortality occurring in east Asia (67·7% decrease); the largest increases in mortality for those aged 5-14 years, 25-29 years, and 30-39 years occurring in high-income North America (11·5%, 31·7%, and 49·9%, respectively); and the largest increases in mortality for those aged 15-19 years and 20-24 years occurring in Eastern Europe (53·9% and 40·1%, respectively). We also identified higher than previously estimated mortality rates in sub-Saharan Africa for all sexes combined aged 5-14 years (87·3% higher in GBD 2023 than GBD 2021 on average across countries and territories over the 1950-2021 period) and for females aged 15-29 years (61·2% higher), as well as lower than previously estimated mortality rates in sub-Saharan Africa for all sexes combined aged 50 years and older (13·2% lower), reflecting advances in our modelling approach. Global life expectancy followed three distinct trends over the study period. First, between 1950 and 2019, there were considerable improvements, from 51·2 (50·6-51·7) years for females and 47·9 (47·4-48·4) years for males in 1950 to 76·3 (76·2-76·4) years for females and 71·4 (71·3-71·5) years for males in 2019. Second, this period was followed by a decrease in life expectancy during the COVID-19 pandemic, to 74·7 (74·6-74·8) years for females and 69·3 (69·2-69·4) years for males in 2021. Finally, the world experienced a period of post-pandemic recovery in 2022 and 2023, wherein life expectancy generally returned to pre-pandemic (2019) levels in 2023 (76·3 [76·0-76·6] years for females and 71·5 [71·2-71·8] years for males). 194 (95·1%) of 204 countries and territories experienced at least partial post-pandemic recovery in age-standardised mortality rates by 2023, with 61·8% (126 of 204) recovering to or falling below pre-pandemic levels. There were several mortality trajectories during and following the pandemic across countries and territories. Long-term mortality trends also varied considerably between age groups and locations, demonstrating the diverse landscape of health outcomes globally. INTERPRETATION: This analysis identified several key differences in mortality trends from previous estimates, including higher rates of adolescent mortality, higher rates of young adult mortality in females, and lower rates of mortality in older age groups in much of sub-Saharan Africa. The findings also highlight stark differences across countries and territories in the timing and scale of changes in all-cause mortality trends during and following the COVID-19 pandemic (2020-23). Our estimates of evolving trends in mortality and life expectancy across locations, ages, sexes, and SDI levels in recent years as well as over the entire 1950-2023 study period provide crucial information for governments, policy makers, and the public to ensure that health-care systems, economies, and societies are prepared to address the world's health needs, particularly in populations with higher rates of mortality than previously known. The estimates from this study provide a robust framework for GBD and a valuable foundation for policy development, implementation, and evaluation around the world. FUNDING: Gates Foundation
Helminth extracellular vesicles co‐opt host monocytes to drive T cell anergy
No full textParasitic helminths secrete extracellular vesicles (EVs) into their host tissues to modulate immune responses, but the underlying mechanisms are poorly understood. We demonstrate that Ascaris EVs are efficiently internalised by monocytes in human peripheral blood mononuclear cells and increase the percentage of classical monocytes. Furthermore, EV treatment of monocytes induced a novel anti-inflammatory phenotype characterised by CD14+, CD16−, CC chemokine receptor 2 (CCR2−) and programmed death-ligand 1 (PD-L1)+ cells. In addition, Ascaris EVs induced T cell anergy in a monocyte-dependent mechanism. Targeting professional phagocytes to induce both direct and indirect pathways of immune modulation presents a highly novel and efficient mechanism of EV-mediated host-parasite communication. Intra-peritoneal administration of EVs induced protection against gut inflammation in the dextran sodium sulphate model of colitis in mice. Ascaris EVs were shown to affect circulating immune cells and protect against gut inflammation; this highlights their potential as a subject for further investigation in inflammatory conditions driven by dysregulated immune responses. However, their clinical translation would require further studies and careful consideration of ethical implications
Real-world outcomes of total body irradiation-based conditioning in allogeneic hematopoietic stem cell transplantation: A single-center retrospective study
No full textSystem size and energy dependence of the mean transverse momentum fluctuations at the LHC
No full textEvent-by-event fluctuations of the event-wise mean transverse momentum, ⟨pT⟩, of charged particles produced in proton–proton (pp) collisions at s = 5.02 TeV, Xe–Xe collisions at sNN = 5.44 TeV, and Pb–Pb collisions at sNN = 5.02 TeV are studied using the ALICE detector based on the integral correlator ⟨⟨ΔpTΔpT⟩⟩. The correlator strength is found to decrease monotonically with increasing produced charged-particle multiplicity measured at midrapidity in all three systems. In Xe–Xe and Pb–Pb collisions, the multiplicity dependence of the correlator deviates significantly from a simple power-law scaling as well as from the predictions of the HIJING and AMPT models. The observed deviation from power-law scaling is expected from transverse radial flow in semicentral to central Xe–Xe and Pb–Pb collisions. In pp collisions, the correlation strength is also studied by classifying the events based on the transverse spherocity, S0, of the particle production at midrapidity, used as a proxy for the presence of a pronounced back-to-back jet topology. Low-spherocity (jetty) events feature a larger correlation strength than those with high spherocity (isotropic). The strength and multiplicity dependence of jetty and isotropic events are well reproduced by calculations with the PYTHIA 8 and EPOS LHC models
Art. 144
No full textCommento dell'art. 144 del Codice dei beni culturali e del paesaggio (d.lgs. 42/2004
Corpus Callosum to Choroid Plexus Distance for the Prenatal Diagnosis of Partial Agenesis or Hypoplasia of the Corpus Callosum: A Multicenter Study
No full textObjectives-Prenatal diagnosis of partial agenesis (pACC) or hypoplasia of the corpus callosum (CC) is hindered by the lack of objective and reproducible ultrasound signs. The aim of this study was to report the role of a new ultrasound sign, the distance between the choroid plexus (CP) of the third ventricle and the distal part of the CC, in identifying fetuses with partial agenesis (pACC) or hypoplasia of CC. Methods-Retrospective multicenter case-control study including fetuses with pACC or hypoplasia of the CC confirmed at post-natal imaging or autopsy. The distance between the CP of the third ventricle and its ratio with the length of the CC were compared with unaffected cases on stored images assessed by 2 different examiners. Intraclass correlation, Bland-Altman, univariate, and multivariate logistic regression analyses were used to analyze the data. Results-One hundred and four (29 with pACC or hypoplasia of the CC and 75 controls) were included in the analysis. At univariate analysis, fetuses with pACC or hypoplasia had a larger transverse diameter (3.9 +/- 0.7 versus 5.3 +/- 1.6 mm; P < .001) and an increased area (31.6 +/- 8.8 versus 41.6 +/- 15.6 mm(2); P < .001) of the CSP compared to unaffected cases. Fetuses with pACC or hypoplasia of the CC had a shorter distance between the CP of the third ventricle and the distal part of the CC (1.6 +/- 0.9 versus 8.4 +/- 1.8; P < .001) and a higher ratio between the length of the CC and the distance between the CP of the third ventricle and the CC (13.5 +/- 9.3 versus 2.6 +/- 0.5; P < .001) compared to controls. At multivariate logistic regression analysis, the distance between the CP and the CC (OR: 0.67, 95% CI 0.5-0.7, per 1 mm increase; P < .001) and the ratio between the CC length and the distance between the CP and the CC (OR: 1.4, 95% CI 1.0-1.6; per 1 mm increase; P < .001) were independently associated with pACC or hypoplasia of the CC. Conclusions-Fetuses with pACC or hypoplasia of the CC had a shorter distance between the distal part of the CC and the CP of the third ventricle and a higher ratio of this measurement with the length of the CC. Further prospective study aimed at longitudinally evaluate the relationship between the CC and the CP of the third ventricle are needed to confirm these findings and to elucidate whether these measurements can be integrated in the diagnostic algorithm applied to fetuses with suspected pACC or hypoplasia of the CC
La responsabilità dell'ente. I criteri di imputazione. Il gruppo di imprese
No full textCriteri di imputazione soggettivi e oggettivi, interesse e vantaggio, reati colposi, sicurezza sul lavoro, apicali e subordinati, problematica dei gruppi di imprese nazionali e internazionali, critica alla giurisprudenza sull'"interesse di gruppo
Selpercatinib plus cemiplimab in RET positive medullary thyroid cancer patient with skin cancers
No full textBackground: Remarkable advancements in the therapeutic armamentarium for medullary thyroid cancer (MTC) have been observed in the last 10 years. The current understanding of driver mutations, such as RET and RAS, has enabled the development of new therapies for advanced and metastatic disease, demonstrating improved efficacy. Patient Findings: A patient with RET-positive hereditary MTC developed multiple skin cancers (basal cell and squamous cell carcinomas) along with progression of MTC after 12 years of treatment with vandetanib. Once surgery to manage skin cancers has been excluded, the patient received a combination of selpercatinib and cemiplimab, and has been on this treatment at the full dose for 15 months, with ongoing therapy. Summary: The combination of selpercatinib and cemiplimab was possible, with no new safety signals observed
In Vivo Performance Evaluation of an FOPID Controller for Closed-Loop Anesthesia
No full textIn this article, we design and evaluate a fractional-order proportional-integral-derivative (FOPID) controller for the regulation of total intravenous anesthesia (TIVA). In particular, the FOPID controller has been designed to regulate the patient’s depth of hypnosis (DoH), measured via the bispectral index (BIS) monitor, by coadministrating both the hypnotic and analgesic drugs used in TIVA. Separate tunings are obtained for the induction phase and for the maintenance phase. For the former, a methodology based on the minimization of the integrated absolute error (IAE) has been employed, while for the latter, the isodamping design approach has been applied. Experiments carried out on ten patients undergoing plastic surgery show that the FOPID controller meets the clinical requirements for each one of the ten patients without requiring any manual intervention from the anesthesiologist. Notably, the controller provided a fast rejection of disturbances without provoking harmful overdosing episodes
Scoring probability maps on the basketball court through Spatial Point Pattern ana
No full textMeasuring shooting performances on the basketball court is crucial for understanding game dynamics and enhancing strategic decision-making. Accurate scoring probability evaluation offers insights that directly impact coaching decisions and players development. Spatial statistics and, in particular, point process analyses provide an ideal framework to accomplish these tasks. In this paper, we model the spatially-varying intensity of shots using classical point pattern methods, taking into account the outcome of each shot (i.e., made or missed). This approach lets us capture the spatial nature of shooting, going beyond traditional binary outcome models. By estimating the shot intensity at different locations, we derive scoring probabilities that reflect shooting performances across the court. Then, we create scoring probability maps, offering a clear visualization of shooting efficiency by location. These maps enable the coaching staff to better understand shooting dynamics and enhance their strategic planning. Our approach is validated through a case study using data from the Italian Basketball First League (LBA), provided by a professional club, ensuring high data quality and real-world relevance