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Promising ideas and directions for further research into biology of aging are discussed using analysis of the age-related kinetics of organisms’ mortality. It is shown that the traditional evolutionary theory explaining aging by decreasing force of natural selection with age is not consistent with the data on age-related mortality kinetics. The hypothesis of multistage destruction of organisms with age, including the rate-limiting stage of transition to a state of non-specific vulnerability (“non-survivor”), is discussed. It is found that the effect of the COVID-19 coronavirus infection on mortality is not additive (as it was the case with the Spanish flu epidemic in 1918), but multiplicative (proportional) for ages over 65 years.

Background . The outbreak of COVID-19 has attracted the attention of the whole world. Our study aimed to describe illness progression and risk profiles for mortality in non-survivors.Methods . We retrospectively analyzed 155 patients with COVID-19 in Wuhan and focused on 18 non-survivors among them. Briefly, we compared the dynamic profile of biochemical and immune parameters and drew an epidemiological and clinical picture of disease progression from disease onset to death in non-survivors. The survival status of the cohort was indicated by a Kaplan–Meier curve.Results . Of the non-survivors, the median age was 73.5 years, and the proportion of males was 72.2%. Five and 13 patients were hospital-acquired and community-acquired infection of SARS-CoV-2, respectively. The interval between disease onset and diagnosis was 8.5 days (IQR, [4–11]). With the deterioration of disease, most patients experienced consecutive changes in biochemical parameters, including lymphopenia, leukocytosis, thrombocytopenia, hypoproteinemia, as well as elevated D-dimer and procalcitonin. Regarding the immune dysregulation, patients exhibited significantly decreased T lymphocytes in the peripheral blood, including CD3+T, CD3+CD4+Th, and CD3+CD8+Tc cells. By the end of the disease, most patients suffered from severe complications, including ARDS (17/18; 94.4%), acute cardiac injury (10/18; 55.6%), acute kidney injury (7/18; 38.9%), shock (6/18; 33.3%), gastrointestinal bleeding (1/18; 5.6%), as well as perforation of intestine (1/18; 5.6%). All patients died within 45 days after the initial hospital admission with a median survivor time of 13.5 days (IQR, 8–17).Conclusions . Our data show that patients experienced consecutive changes in biochemical and immune parameters with the deterioration of the disease, indicating the necessity of early intervention.

With the ongoing global burden of COVID-19, identifying reliable biomarkers to predict disease severity remains a clinical priority. Melatonin, a hormone with immunomodulatory and antioxidant properties, has garnered attention for its potential role in regulating inflammation during viral infections. However, the relationship between serum melatonin levels and COVID-19 severity remains poorly understood. This study aimed to evaluate the correlation between serum melatonin concentration and COVID-19 severity to identify potential prognostic biomarkers. A cohort study was conducted, including patients diagnosed with COVID-19 between June 2020 and July 2022. Serum melatonin levels in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) were measured and analyzed in relation to disease severity and oxygen requirements. In addition, serum melatonin level between survivors and non-survivors were also compared in this study. Patients not requiring oxygen therapy exhibited significantly higher serum melatonin levels (45.09 pg/mL) compared to those requiring intensive oxygen therapy (32.17 pg/mL) ( p < 0.0001). Median serum melatonin levels were 41.57 pg/mL in survivors and 24.79 pg/mL in non-survivors ( p = 0.0005). In addition, non-survivors with symptoms such as respiratory distress and stress displayed lower serum melatonin compared to survivors ( p = 0.0022). Serum melatonin concentration at admission was found to be significantly lower in patients with critical or fatal COVID-19, suggesting that serum melatonin levels may serve as a potential biomarker for disease severity.

Compare rates, clinical characteristics, and outcomes of paediatric palliative care consultation in children supported on extracorporeal membrane oxygenation admitted to a single-centre 16-bed cardiac or a 28-bed paediatric ICU. Retrospective review of clinical characteristics and outcomes of children (aged 0-21 years) supported on extracorporeal membrane oxygenation between January, 2017 and December, 2019 compared by palliative care consultation. One hundred children (N = 100) were supported with extracorporeal membrane oxygenation; 19% received a palliative care consult. Compared to non-consulted children, consulted children had higher disease severity measured by higher complex chronic conditions at the end of extracorporeal membrane oxygenation hospitalisation (5 versus. 3; p < 0.001), longer hospital length of stay (92 days versus 19 days; p < 0.001), and higher use of life-sustaining therapies after decannulation (79% versus 23%; p < 0.001). Consultations occurred mainly for longitudinal psychosocial-spiritual support after patient survived device deployment with a median of 27 days after cannulation. Most children died in the ICU after withdrawal of life-sustaining therapies regardless of consultation status. Over two-thirds of the 44 deaths (84%; n = 37) occurred during extracorporeal membrane oxygenation hospitalisation. Palliative care consultation was rare showing that palliative care consultation was not viewed as an acute need and only considered when the clinical course became protracted. As a result, there are missed opportunities to involve palliative care earlier and more frequently in the care of extracorporeal membrane survivors and non-survivors and their families.

In February 2017, Braz de Aviz, Prefect of the Congregation for Institutes of Consecrated Life and Societies of Apostolic Life, acknowledged in an interview that some 70 “new spiritual movements” were under investigation for abusive behavior committed by their founders. The number of cases that remain undetected is probably large. This article uses the example of these communities to analyze the precarious tension between vulnerability, vulnerance, and resilience. It draws on Céline Hoyeau’s excellent study of those founders of new spiritual movements in France who were later exposed as abusers. It also presents my research on the sacred in its dangerous connection to the victimizing sacrifice. My basic thesis is that exploring the link between vulnerability and resilience is not enough. Rather, vulnerance needs to be systematically included in the analyses. This new approach opens up a more complex understanding of abuse, cover-ups, and disclosure. It can tackle both the vulnerant resilience of the perpetrators and the voluntary vulnerability of survivors in disclosing abuse.

Severe fever with thrombocytopenia syndrome (SFTS), a newly emerging tick-borne viral disease, has been detected in Asia since 2009, and person-to-person transmission is possible. SFTS is characterized by atypical signs, including mild to severe febrile illness similar to that associated with hemorrhagic fever, with 16.2 to 30% mortality. We found that the titers of neutralizing antibodies, play an important role in protective immunity, to SFTS virus (SFTSV) in survivors and healthy residents who lived in endemic areas and who were positive for SFTSV IgG, were higher than those in non-survivor patients. Moreover, the titers were maintained in surviving patients and healthy residents but not in non-surviving patients in South Korea.

The incidence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing since 2008, with Gyeonggi Province in South Korea being particularly vulnerable due to its large number of healthcare facilities. This study examines the trends of CRE occurrence in Gyeonggi Province over the past four years and the epidemiological characteristics of the infected patients. Patients with positive CRE blood cultures admitted to healthcare facilities in Gyeonggi Province from January 2018 to December 2021 were evaluated in this study. Risk factors for CRE-related death were analyzed using data from patients who died within 30 days of the last blood sampling. Older adults aged 70 years and above constituted the majority of patients with CRE bacteremia. Antibiotic use did not significantly affect mortality risk. Non-survivors were more common in tertiary hospitals and intensive care units and included patients with hypertension, malignant tumors, and multiple underlying diseases. Klebsiella pneumoniae was the most common CRE strain, with Klebsiella pneumoniae carbapenemase being the predominant carbapenemase. Our study suggests the endemicity of CRE in Gyeonggi Province and highlights the increasing isolation of CRE strains in South Korean long-term care hospitals within the province. Further, infection control measures and government support specific to each healthcare facility type are crucial.

Background: The infection with coronavirus and non-survivor cases have been escalated since the first inception between January and March 2020. Therefore, reviewing the collated clinical characteristics of non-survivors might assist in current preventive efforts, triaging, and management of survivors. The aim of this review was to summarize the clinical characteristics of non-survivor cases due to the infection caused by a novel coronavirus and to identify the relevant data that might put the new cases at increased mortality. Materials and Methods: We have identified three published articles on novel coronavirus reported during December 01, 2019, to March 15, 2020, which have described the mortality rate in Wuhan, Hubei, China. Results: The mean duration of studies (i.e., the three retrospective studies with 278 cases) was 24.7 days, and the duration of onset to dyspnea was variable between 8 and 5 days. The main reported complications were acute respiratory distress, pneumonia, acute kidney injury, and acute cardiac disease. The overall major comorbidity reported was cardiovascular diseases at 23.7% (66 of 278). The reported overall mortality rate was 8.3% (23 of 278), with the highest mortality rate of 15.0% (6 of 41) reported in Jin Yintan Hospital at Wuhan city. Conclusions: The clinical characteristics of the non-survivors from the novel coronavirus included adult males, aged older than 50 years, having comorbidities of cardiovascular disease, respiratory distress syndrome, acute kidney injury, and diabetes with higher admission to the intensive care unit. The mortality rate was high in two of the reported studies (15.0% and 11.0%), which was decreased in the later-dated study to 3.4%.

Drawn from extensive, new and rich empirical research across the UK, Canada and USA, Queer Spiritual Spaces investigates the contemporary socio-cultural practices of belief, by those who have historically been, and continue to be, excluded or derided by mainstream religions and alternative spiritualities. As the first monograph to be directly informed by 'queer' subjectivities whilst dealing with divergent spiritualities on an international scale, this book explores the recently emerging innovative spaces and integrative practices of queer spiritualities. Its breadth of coverage and keen critical engagement mean it will serve as a theoretically fertile, comprehensive entry point for any scholar wishing to explore the queer spiritual spaces of the twenty-first century.