United Nations population estimates and projections with special reference to the Arab world.
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Africa↗
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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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Cognition enhancing or neuroprotective compounds for the treatment of cognitive disorders: why? when? which?
Neurodegenerative disorders such as Alzheimer's disease, Lewy-Body dementia, Parkinson's disease and cerebrovascular dementia result in an insidious cognitive and behavioural decline culminating in the development of severe dementia. Based on current population projections it has been estimated that by 2050 the number of individuals over 65 will increase to 1.1 billion worldwide and as a consequence, the number of cases of dementia to 37 million. Faced with such an enormous public health and socio-economic burden it is evident that the importance of therapeutic intervention aimed at either finding a cure or preventing disease progression cannot be overstated. The aim of the present paper is to present an overview, in the context of a brain aging continuum, at what stage cognition enhancing and/or neuroprotective intervention strategies aimed at stabilising and/or preventing neurodegenerative disease could demonstrate potential clinical benefit. In particular, the clinical identification of patients with mild cognitive impairment and age-associated memory impairment which may represent a 'transition' state between normal aging and dementia is discussed as a potential clinical population cohort targeted for early intervention in dementia. Considering the wide spectrum of cognitive and psychotic effects in dementia juxtaposed with the neuropathological evolution of the disease, it is clear that a variety of therapeutic intervention(s) will be required in order, to at the least, stabilise disease progression. Evidently, since Alzheimer's disease is by far the most prevalent form of dementia, and will undoubtedly serve as the benchmark for any future treatment of dementia, an update of current symptomatic and disease-modifying therapeutic approaches (cholinergic, glutamatergic, nootropics, beta-amyloid cascade inhibitors) will be reviewed.
Aged↗
Population-based clinical projects: bridging community-based and public health concepts.
Changes in the healthcare delivery system have shifted nursing curricula to a community-based focus. For public health nursing faculty, this shift requires that population-based clinical projects bridge community-based nursing concepts with those of public health. The authors describe four innovative examples of population-based clinical projects that incorporate core public health functions and public health interventions into the learning process.
Clinical Competence↗
Determining Ontario's supply and requirements for ophthalmologists in 2000 and 2005: 1. Methods.
BACKGROUND: We performed a study to determine the supply of and requirements for ophthalmologists in Ontario in 2000 and 2005. In this paper we describe our methods. METHODS: The future supply of ophthalmologists was estimated by means of iterative multiple regression analysis using the baseline number of ophthalmologists, the number of ophthalmology residents and the numbers of ophthalmologists entering and exiting the workforce between 1989 and 2004. Data were obtained from the Ontario Physician Human Resource Data Centre, Statistics Canada, the Ontario Ministry of Finance and residency program directors of Ontario universities. We calculated requirements using four models. The physician:population ratio method used an ophthalmologist:population ratio (1:29,650) proposed by the Royal College of Physicians and Surgeons of Canada and Statistics Canada population projections for 2000 and 2005. The utilization-based, substitution and needs-based models used Ontario Health Insurance Plan data for 1995. The supply and requirements are expressed as full-time equivalents, defined as the average number of minutes worked by ophthalmologists in 1995. The 401 ophthalmologists practising in Ontario in 1995 accounted for 452 full-time equivalents. INTERPRETATION: Incorporating the results of several requirement models increases the reliability and acceptability of estimates of physician workforce requirements.
Female↗
Extent to which low-level use of antiretroviral treatment could curb the AIDS epidemic in sub-Saharan Africa.
BACKGROUND: Despite growing international pressure to provide HIV-1 treatment to less-developed countries, potential demographic and epidemiological impacts have yet to be characterised. We modelled the future impact of antiretroviral use in South Africa from 2000 to 2005. METHODS: We produced a population projection model that assumed zero antiretroviral use to estimate the future demographic impacts of the HIV-1 epidemic. We also constructed four antiretroviral-adjusted scenarios to estimate the potential effect of antiretroviral use. We modelled total drug cost, cost per life-year gained, and the proportion of per-person health-care expenditure required to finance antiretroviral treatment in each scenario. FINDINGS: With no antiretroviral use between 2000 and 2005, there will be about 276,000 cumulative HIV-1-positive births, 2,302,000 cumulative new AIDS cases, and the life expectancy at birth will be 46.6 years by 2005. By contrast, 110,000 HIV-1-positive births could be prevented by short-course antiretroviral prophylaxis, as well as a decline of up to 1 year of life expectancy. The direct drug costs of universal coverage for this intervention would be US$54 million--less than 0.001% of the per-person health-care expenditure. In comparison, triple-combination treatment for 25% of the HIV-1-positive population could prevent a 3.1-year decline in life expectancy and more than 430,000 incident AIDS cases. The drug costs of this intervention would, however, be more than $19 billion at present prices, and would require 12.5% of the country's per-person health-care expenditure. INTERPRETATION: Although there are barriers to widespread HIV-1 treatment, limited use of antiretrovirals could have an immediate and substantial impact on South Africa's AIDS epidemic.
Africa South of the Sahara↗
The potential effect on hip fracture incidence of mass screening for osteoporosis.
With ageing of the Australian population, treatment of osteoporosis-related hip fractures will impose an increasing burden on the healthcare system. Based on current age-adjusted hip fracture incidence and population projections for New South Wales, we estimated a 90% increase in hip fractures by the year 2021. Contributing significantly to this increase will be the number of men reaching the high risk age group for osteoporotic hip fractures. A suggested solution--screening and appropriate therapy for individuals at high risk of osteoporosis--may have only a modest impact. Our calculations show that, even with optimistic screening and therapy compliance rates, hip fractures could still increase by over 50%. Other approaches need to be further explored.
Aged↗
Family planning programs: efforts and results, 1982-89.
According to a set of 30 indices that assess the strength of large-scale family planning programs in developing countries, a strong upward shift in effort scores occurred between 1982 and 1989. During that period, many countries established or augmented their family planning programs, and effort scores improved in all developing regions and in all four dimensions of effort--policies and stage-setting activities, service and service-related activities, record keeping and evaluation, and availability of contraceptive methods. By region, the sharpest improvement was not in East Asia, where levels were already high, but in sub-Saharan Africa, where the movement was clearly upward, from a low base. Earlier associations between program effort and fertility declines are reaffirmed, additive to the contribution of socioeconomic improvements. In order to compute scores ranging from zero to 30 for each of the 30 indices, a detailed questionnaire was sent to 4-6 respondents in each of 103 developing countries having more than one million population. Respondents included program staff, donor agency personnel, local observers, and knowledgeable foreigners. The scores indicate that developing countries are continuing to move toward more favorable policy positions and stronger implementation of action programs, with consequent fertility effects. For the fertility decline to match the medium population projections of the United Nations, however, a substantial enlargement in the number of contraceptive users is necessary, not only to compensate for the enlarging base of couples, but also to increase the proportion who use contraceptives.
Developing Countries↗
Research organizations in the Department of Veterans Affairs that focus on database analysis.
The Department of Veterans Affairs (VA) established several internal research organizations to analyze the many VA and non-VA databases. The information obtained assists VA in achieving its objective of providing cost-effective, high quality health care for veterans. Each group has a unique and well-defined function. All major informational inputs needed for VA planning are covered by the groups: resource allocation, workload requirements, population projections, and technology assessment, among others. Both managerial and academic research are conducted. The Department of Veterans Affairs has demonstrated flexibility in initiating new research center as the need arises, such as during the recent health care reform debates. The Department of Veterans Affairs has provided for the dissemination of information about research and databases by explicitly including this task as the focus of one group. A drawback to VA's research system is the minimal intercommunication among the groups. Learning about VA's internal research structure can assist other multihospital systems to identify their informational needs and establish suitable research organizations.
Health Care Rationing↗
Cardiovascular disease risk stratification and comparison in a California population.
This study was designed to identify the need for primary prevention of cardiovascular disease in an HMO population and to develop appropriate interventions for individuals in different risk groups, based on risk stratification and comparison. The analysis is based on a cross-sectional survey of the HMO members of a large employer group. Respondents (n=17,878) were stratified based on the Framingham model; 34% of respondents without cardiovascular disease were classified as moderate to high attributable risk for the disease, and 66% were classified as low attributable risk. Results of logistic regression analyses suggest that, compared with respondents with pre-existing cardiovascular disease, moderate- to high-risk respondents are more likely to smoke, have unhealthy diets, and be overweight, hypertensive, and hypercholesterolemic. More low-risk respondents had unhealthy diets than did those with pre-existing cardiovascular disease. There were no differences between these groups for physical activity and stress. Respondents had fewer modifiable risk factors and healthier lifestyles than did those who were at risk. These findings suggest that primary prevention should be enhanced, especially among those with significantly increased risk for the disease. Moreover, the approaches of this project-population-based risk assessment, stratification, and comparison-were instrumental in identifying the target population and designing appropriate interventions. (c) 2001 by CHF, Inc.
Journal Article↗
The thalamo-caudate versus thalamo-cortical projections as studied in the cat with fluorescent retrograde double labeling.
The distribution of thalamic cells projecting to the head of the caudate and their interrelations with thalamo-cortical cells were studied in the cat with different combinations of fluorescent tracers. Injections in the head of the caudate were combined with the injections in the pericruciate, proreal, suprasylvian, anterior cingulate, occipital and ectosylvian cortices. The following results were obtained: (i) Injections in the head of the caudate resulted in retrograde labeling of thalamic cells medially and laterally to the anteromedial (AM) nucleus, and in the medioventral part of the ventral anterior (VA) nucleus. Further, labeled cells were distributed throughout the anterior intralaminar central medial (CeM), paracentral (Pc) and central lateral (CL) nuclei, and the posterior intralaminar center median-parafascicular complex (CM-Pf). Labeled cells were mainly grouped in the mediodorsal parts of the anterior intralaminar nuclei; they were also found in the more dorsal part of the mediodorsal (MD) nucleus, ventral to the thalamic paraventricular (Pv) nucleus and to the habenular complex. (ii) Thalamo-cortical and thalamo-caudate cells overlapped in the medial part of the VA; in the anterior intralaminar nuclei they were either intermingled or were distributed in separate clusters or longitudinal bands. The two cell populations also overlapped in the posterior intralaminar complex. The greatest overlap occurred with the thalamic cell population projecting to the pericruciate cortex. (iii) Thalamic cells bifurcating to the head of the caudate and to the pericruciate cortex were found lateral to the AM, within the VA, and throughout the anterior intralaminar nuclei, especially in the CeM and in the posterior part of the CL; a few branched cells were also found in the CM. Thalamic cells bifurcating to caudate and anterior suprasylvian cortex were also found in the VA. Very few cells (scattered in the anterior thalamus lateral to the AM, as well as in the CeM, Pc and CL) were found to bifurcate to the head of the caudate and the other cortical fields here examined.
Animals↗
The projection of different retinal ganglion cell classes to the dorsal lateral geniculate nucleus in the hooded rat.
The morphology of retinal ganglion cells which project to different parts of the dorsal lateral geniculate nucleus (DLG) in the hooded rat has been investigated. Small amounts of a retrograde tracer (horseradish peroxidase) were injected into the DLG, then labelled retinal ganglion cells were examined in retinal wholemounts. After injections into different parts of the DLG, differences were noted in the size, morphology and retinal distribution of labelled retinal ganglion cells. Specifically, after injections into the antero-ventral part of the DLG labelled retinal ganglion cells were spread sparsely across the retina, had large cell somas, and many were identified with Class I or Class III morphology. After injections into the postero-dorsal part of the DLG, labelled cells were more densely packed, had smaller somas, and more were identified with Class IIa and Class III morphology. The density of labelled cells was estimated to be no more than 37% of the total retinal ganglion cell density at any retinal position examined. These results show that in the rat, as in other species such as the cat or monkey, the terminals of different classes of retinal ganglion cells are segregated within different subdivisions of the DLG. However, unlike these other species, only a minority of the total retinal ganglion cell population projects to the DLG.
Animals↗
Multimodal Deep Learning and Foundation Models for Early Detection and Forecasting of Plant Diseases.
Plant diseases destroy 20-40% of global food production annually, posing a critical threat to food security for a projected population of 9.7 billion by 2050. Conventional diagnostic approaches relying on expert visual assessment are slow, costly, and unsuitable for modern agricultural scales. While deep convolutional neural networks demonstrated early promise, single-modality, image-centric systems consistently fail under real-world field conditions characterized by variable lighting, co-occurring infections, and cultivar diversity. This review synthesizes a decade of progress across four interconnected frontiers: the evolution of deep learning architectures for plant disease detection; the adaptation of foundation models including CLIP, SAM, and DINOv2 to agricultural contexts; the development of multimodal fusion frameworks integrating imagery, environmental, genomic, and hyperspectral data; and the transition from static disease diagnosis to descriptive comparison of reported metrics, which suggested that multimodal approaches frequently reported improved diagnostic performance relative to corresponding single-modality baselines, although direct cross-study comparison was limited by methodological heterogeneity. A systematic review following PRISMA guidelines identifies eligible comparative studies. Descriptive comparison of reported performance metrics across these studies indicated that multimodal approaches generally achieved higher accuracy and sensitivity than single-modality models, particularly for pre-symptomatic disease detection. Eight critical research gaps are identified, including the absence of a unified agricultural foundation model and limited climate-aware forecasting under non-stationary climate projections. A structured research agenda is proposed to accelerate translation from laboratory performance to globally equitable, field-deployable crop protection systems.
convolutional neural networks↗
Prevalence of diabetes mellitus in the elderly of Namwon County, South Korea.
BACKGROUND: Ethnic and geographic differences exist in the prevalence of diabetes mellitus which has increased dramatically in South Korea. A few community-based epidemiologic studies with oral glucose tolerance test were performed in South Korea. The purpose of this study was to determine the prevalence of diabetes mellitus by the World Health Organization (WHO) and the American Diabetic Association (ADA) diagnostic criteria and to investigate their associated risk factors. Also, we compared and analyzed the characteristics of Koreans by WHO and ADA diagnostic criteria. METHODS: Between March 22, 1999 and July 14, 1999, a random sampling of 1,445 residents over 40 years of age in five villages (3 myons and 2 dongs) in Namwon City. Chollabuk-do Province, South Korea was carried out. WHO and ADA diagnostic criteria were used for the prevalence of DM, IGT and IFG. The associated factors of subjects were analyzed. RESULTS: After age adjustment for the population projection of Korea (1999), the prevalence of DM and IGT was 13.7% and 13.8%, respectively, by WHO criteria, while the prevalence of DM, IGT and IFG was 15.8%, 12.8% and 5.7%, respectively, by ADA criteria, and the previous diagnosed diabetics were 5.8% in 665 adults over 40 years of age in the Namwon area. The age-adjusted prevalence of previously diagnosed diabetics was 5.8%. When the subjects classified by both criteria were compared, the level of agreement between WHO and ADA diagnostic criteria, except IFG, was very high (kappa = 0.94; p < 0.001). The ROC curve analysis determined FSG of 114.5 mg/dL (6.4 mmol/L) to yield optimal sensitivity and specificity corresponding to a PP2SG 200 mg/dL (11.1 mmol/L). The prevalence of DM and IGT with ADA diagnostic criteria rose with increasing age (p < 0.05). The body mass index was mean 23.8 +/- 3.4 in all the subjects, 23.75 +/- 3.46 in NGT group and 23.67 +/- 3.16 in DM group, but the differences in the prevalence of DM, IGT and IFG by BMI were not significant. The prevalence of DM rose significantly with the increase in the waist-hip ratio (p < 0.05). The prevalence of DM significantly increased in subjects by increases in blood pressure, and triglyceride and the relative risk in the prevalence of DM was significantly high with dyslipidemia (Odds ratio 2.29, 95% CI: 1.16-3.49). CONCLUSION: The prevalence of Diabetes Mellitus in the population over 40 years of age in Namwon City. South Korea remarkably increased compared with the 1970s and 1980s and was similar to that of the West. Ethnic differences in obesity of normal, DM and IGT subjects and in the effect on the prevalence of DM may exist in the Korean population, but they were not significant. As there is a limit in number, it is considered that a general population-based epidemiologic study on a large scale is required to investigate ethnic and geographic differences for the risk factors of DM in South Korea. The level of agreement, except IFG, by WHO and ADA diagnostic criteria was high, which indicates that these results may show that not only fasting serum glucose but also postprandial 2-h serum glucose are important for diagnosing diabetes in Korean.
Adult↗
Food security in the face of climate change, population growth, and resource constraints: implications for Bangladesh.
Ensuring food security has been one of the major national priorities of Bangladesh since its independence in 1971. Now, this national priority is facing new challenges from the possible impacts of climate change in addition to the already existing threats from rapid population growth, declining availability of cultivable land, and inadequate access to water in the dry season. In this backdrop, this paper has examined the nature and magnitude of these threats for the benchmark years of 2030 and 2050. It has been shown that the overall impact of climate change on the production of food grains in Bangladesh would probably be small in 2030. This is due to the strong positive impact of CO2 fertilization that would compensate for the negative impacts of higher temperature and sea level rise. In 2050, the negative impacts of climate change might become noticeable: production of rice and wheat might drop by 8% and 32%, respectively. However, rice would be less affected by climate change compared to wheat, which is more sensitive to a change in temperature. Based on the population projections and analysis of future agronomic innovations, this study further shows that the availability of cultivable land alone would not be a constraint for achieving food self-sufficiency, provided that the productivity of rice and wheat grows at a rate of 10% or more per decade. However, the situation would be more critical in terms of water availability. If the dry season water availability does not decline from the 1990 level of about 100 Bm3, there would be just enough water in 2030 for meeting both the agricultural and nonagricultural needs. In 2050, the demand for irrigation water to maintain food self-sufficiency would be about 40% to 50% of the dry season water availability. Meeting such a high agricultural water demand might cause significant negative impacts on the domestic and commercial water supply, fisheries, ecosystems, navigation, and salinity management.
Agriculture↗
Revised estimate of the prevalence of multiple sclerosis in the United States.
Using three adjustments, we have revised a 1976 prevalence count for multiple sclerosis in the United States. The adjustments were made to data from a US national survey; they used 1990 population projections from the US Bureau of the Census, and results of investigations conducted in Weld and Larimer Countries, Colorado, and Olmsted County, Minnesota. It is estimated that approximately 250,000 to 350,000 persons in the United States in 1990 had physician-diagnosed multiple sclerosis.
Age Factors↗
The development of multi-epitope vaccines: epitope identification, vaccine design and clinical evaluation.
We have developed efficient methods for epitope identification and vaccine design. Our process for epitope selection based on the combined use of motif analyses, binding assays and immunogenicity evaluations is described. We also describe how the projected population coverage and vaccine design can be optimized. Finally, it is discussed how vaccine potency is evaluated by immunogenicity and antigenicity assays.
Epitopes↗
Disynaptic vestibulospinal and reticulospinal excitation in cat lumbosacral motoneurons: modulation during fictive locomotion.
This study compares some characteristics of the disynaptic excitatory pathways from the lateral vestibular nucleus (LVN) and medial longitudinal fasciculus (MLF) to lumbosacral alpha-motoneurons in the decerebrate cat. We used the spatial facilitation technique to test whether disynaptic LVN and MLF excitatory postsynaptic potentials (EPSPs) are produced by common last-order interneurons in the lumbosacral segments of the spinal cord. Of 77 motoneurons examined, 26 exhibited disynaptic EPSPs from both supraspinal sources. No spatial facilitation was found between LVN and MLF EPSPs in 21 of 24 cells that were adequately tested. In 3 of 23 cells (all flexor motoneurons), some spatial facilitation was found in some but not all trials. These observations suggest that stimulation of the LVN and MLF produces disynaptic EPSPs in motoneurons through largely separate populations of last-order interneurons. Disynaptic MLF and LVN EPSPs showed parallel patterns of modulation during fictive locomotion. Maximal disynaptic EPSP amplitudes occurred during the phase of the step cycle when the recorded motoneuron, whether flexor or extensor, exhibited depolarizing locomotor drive potentials and the corresponding muscle nerve was active. These observations, taken together, suggest that disynaptic LVN and MLF EPSPs are produced in motoneurons by at least four separate populations of segmental last-order excitatory interneurons, with separate populations projecting to flexor versus extensor cells. The results also suggest that the modulation of the disynaptic EPSPs during fictive locomotion is mainly due to premotoneuronal convergence of input from the respective descending systems and from the segmental central pattern generator for locomotion onto common interneurons.
Animals↗
The economic context of past and future Bulgarian fertility.
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Bulgaria↗