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Aging in world history
\"Contemporary concerns about aging societies have stimulated interest in past ways of growing old, and whilst historians have investigated the experience of the aged, cultural representations of old age, and the phenomenon of demographic ageing, however the literature has been overwhelmingly western. This study reviews the world-wide literature on aging and seeks to move beyond received wisdom about attitudes and experiences running from the ancient world to the present.Aging in World History will introduce students and general readers to historical ways of thinking about aging in two senses: the experience of individuals and the transformation of populations. The first section introduces theoretical concerns, understandings of \"natural\" or \"traditional\" ways of growing old, and diverse cultural prescriptions and representations. The second section covers key issues from the medieval to the early modern era. The third section looks at transitions to modernity, whilst the final part explores the contemporary world, before concluding with an overview of past, present and future\"-- Provided by publisher.
Book
Bayesian Probabilistic Projection of International Migration
We propose a method for obtaining joint probabilistic projections of migration for all countries, broken down by age and sex. Joint trajectories for all countries are constrained to satisfy the requirement of zero global net migration. We evaluate our model using out-of-sample validation and compare point projections to the projected migration rates from a persistence model similar to the method used in the United Nations' World Population Prospects, and also to a state-of-the-art gravity model.
Journal Article
Use of durvalumab in stage III non‐small‐cell lung cancer based on eligibility for the PACIFIC study
Background Durvalumab following concurrent chemoradiotherapy is standard treatment for unresectable stage III non‐small‐cell lung cancer based on the results of the PACIFIC trial. Based on trial criteria, not all patients are eligible for durvalumab in routine clinical practice. Methods We evaluated eligibility for durvalumab in a real‐world clinical setting and the impact of eligibility on outcomes. Consecutive patients treated with concurrent chemoradiotherapy at two tertiary centers between January 2015 and June 2022 were assessed. Clinical characteristics and outcomes were evaluated based on eligibility criteria for the PACIFIC trial. Results A total of 126 patients were included. Seventy patients (56%) were eligible for durvalumab. Ineligibility was associated with shorter progression‐free survival of 9.7 months versus 18.4 months (hazard ratio [HR] 0.61, 95% confidence interval [CI] 0.39–0.95, p = 0.029) and overall survival of 26.4 months versus 58.7 months (HR 0.47, 95% CI 0.28–0.80, p = 0.005). Common reasons for ineligibility were history of previous malignancy (32%) and progressive disease or death during chemoradiotherapy (25%). Ineligible patients who received durvalumab had similar outcomes to eligible patients who received durvalumab. Conclusions In a real‐world cohort, adjuvant durvalumab is safe and beneficial in a substantial proportion of patients who would not have been eligible for the PACIFIC trial. We focused on a cohort of 126 patients with stage III non‐small‐cell lung cancer and evaluated eligibility for the PACIFIC study and durvalumab on outcomes. A large proportion of our cohort were ineligible for the PACIFIC study (44%). Trial eligibility led to improved outcome regardless of receipt of durvalumab. However, durvalumab was also safe and beneficial in many patients who were ineligible for the PACIFIC trial. This data provides further evidence that durvalumab use is safe and beneficial in a real‐world setting.
Journal Article
Will Limited Land, Water, and Energy Control Human Population Numbers in the Future
Nearly 60% of the world's human population is malnourished and the numbers are growing. Shortages of basic foods related to decreases in per capita cropland, water, and fossil energy resources contribute to spreading malnutrition and other diseases. The suggestion is that in the future only a smaller number of people will have access to adequate nourishment. In about 100 years, when it is reported that the planet will run out of fossil energy, we suggest that a world population of about two billion might be sustainable if it relies on renewable energy technologies and also reduces per capita use of the earth's natural resources.
Journal Article
Eligibility of Sacubitril–Valsartan in a Real-World Heart Failure Population: A Community-Based Single-Centre Study
Abstract
Aims
This study aims to investigate the eligibility of the Prospective Comparison of Angiotensin Receptor–Neprilysin Inhibitor (ARNI) with ACE inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) study to a real-world heart failure population.
Methods and results
Medical records of all heart failure patients living within the catchment area of Umeå University Hospital were reviewed. This district consists of around 150 000 people. Out of 2029 patients with a diagnosis of heart failure, 1924 (95%) had at least one echocardiography performed, and 401 patients had an ejection fraction of ≤35% at their latest examination. The major PARADIGM-HF criteria were applied, and 95 patients fulfilled all enrolment criteria and thus were eligible for sacubitril–valsartan. This corresponds to 5% of the overall heart failure population and 24% of the population with ejection fraction ≤ 35%. The eligible patients were significantly older (73.2 ± 10.3 vs. 63.8 ± 11.5 years), had higher blood pressure (128 ± 17 vs. 122 ± 15 mmHg), had higher heart rate (77 ± 17 vs. 72 ± 12 b.p.m.), and had more atrial fibrillation (51.6% vs. 36.2%) than did the PARADIGM-HF population.
Conclusions
Only 24% of our real-world heart failure and reduced ejection fraction population was eligible for sacubitril–valsartan, and the real-world heart failure and reduced ejection fraction patients were significantly older than the PARADIGM-HF population. The lack of data on a majority of the patients that we see in clinical practice is a real problem, and we are limited to extrapolation of results on a slightly different population. This is difficult to address, but perhaps registry-based randomized clinical trials will help to solve this issue.
Journal Article
Guideline‐directed medical therapy rates in heart failure patients with reduced ejection fraction in a diverse cohort
Aims Guideline‐directed medical therapy (GDMT) is recommended for all patients with heart failure with reduced ejection fraction (HFrEF). Despite this, little data exist describing GDMT use in diverse, real‐world populations including the use of vasodilators, prescribed primarily to Black populations. We sought, among a diverse population of HFrEF patients, to determine (1) GDMT use rates and target dosing by medication class and (2) predictors of GDMT use and target dosing by medication class. Methods We utilized electronic health records (EHRs) from Kaiser Permanente (KP) Mid‐Atlantic States, a large integrated health system. Included patients had heart failure and left ventricular ejection fraction (EF) of ≤40% between 2015 and 2021. GDMT was defined by five medication classes—angiotensin‐converting enzyme (ACE) inhibitors (ACEis)/angiotensin receptor blockers (ARBs)/angiotensin receptor–neprilysin inhibitors (ARNis), beta‐blockers (BBs), mineralocorticoid receptor antagonists (MRAs), sodium–glucose cotransporter 2 inhibitors (SGLT2is) and vasodilators (Black patients only). Proportions of patients on GDMT and target dose rates were examined. Logistic regression determined, within each class, predictors of medication use and being at ≥80% of the target dose. Results A total of 3154 patients were included. Among the 93.8% on some form of GDMT, 82.8%, 81.4%, 23.5%, 3.6% and 13.4% were on ACEis/ARBs/ARNis, BBs, MRAs, SGLT2is and vasodilators (Black patients only), respectively. Among treated patients, 45.8%, 21.4%, 77.6%, 100% and 14.7% were treated at ≥80% of the target dose for ACEis/ARBs/ARNis, BBs, MRAs, SGLT2is and vasodilators, respectively. Overall, increasing age, higher EF, atrial fibrillation/flutter, chronic obstructive pulmonary disease (COPD), prior stroke and dementia were associated with decreased odds of GDMT use. Conversely, higher body mass index (BMI), Black race, higher glomerular filtration rate (GFR), recent echo and cardiac defibrillator were associated with increased odds of GDMT use. Among treated, higher BMI, higher systolic blood pressure, haemoglobin A1C ≥ 6.5% and cardiac defibrillator were associated with higher odds of being at ≥80% of the target dose. Conclusions Our study using real‐world data from a diverse health system demonstrated gaps in GDMT use among patients with HFrEF, specifically older patients with more comorbidities.
Journal Article
Worldwide carrier frequency and genetic prevalence of autosomal recessive inherited retinal diseases
One of the major questions in human genetics is what percentage of individuals in the general population carry a disease-causing mutation. Based on publicly available information on genotypes from six main world populations, we created a database including data on 276,921 sequence variants, present within 187 genes associated with autosomal recessive (AR) inherited retinal diseases (IRDs). Assessment of these variants revealed that 10,044 were categorized as disease-causing mutations. We developed an algorithm to compute the gene-specific prevalence of disease, as well as the mutational burden in healthy subjects. We found that the genetic prevalence of AR-IRDs corresponds approximately to 1 case in 1,380 individuals, with 5.5 million people expected to be affected worldwide. In addition, we calculated that unaffected carriers ofmutations are numerous, ranging from 1 in 2.26 individuals in Europeans to 1 in 3.50 individuals in the Finnish population. Our analysis indicates that about 2.7 billion people worldwide (36% of the population) are healthy carriers of at least one mutation that can cause AR-IRD, a value that is probably the highest across any group of Mendelian conditions in humans.
Journal Article
Rapid Growth of the World Population and Its Socioeconomic Results
This article is mainly devoted to the study of socioeconomic opportunities and problems that may arise from the growth of the world’s population. The article identifies the reasons for the increase in world population and analyzes the factors influencing on the process. The article examines the impact of changes on the world’s demographics on socioeconomic development. As a result, the characteristics of possible problems were investigated and evaluated. The study analyzes the issues of demographic change in the world population, the current situation, and opportunities of the world economy in accordance with population statistics and its growth rate. The main purpose of the study is to determine the causes of world population growth, analyze the current demographic situation, and determine and assess the forecast of future growth dynamics. The study discusses, analyzes, and evaluates the problems that can be caused by the growth of the world’s population. The main problem we raise in the study is the mismatch between the rapid growth of the world’s population and the socioeconomic security of the people. That is, if the issue of socioeconomic security is not resolved, the growth of the world’s population would be a global social problem.
Journal Article