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In the majority of Middle Eastern countries, consanguineous marriages currently account for 20% to over 50% of all unions with no evidence to suggest a significant decline in their popularity. Consanguinity generally is associated with increased fertility, and mortality is higher among consanguineous progeny due to the expression of detrimental recessive genes. There also is evidence of greater morbidity in children born to consanguineous parents, which may extend into early and late adulthood. With improved primary health care, deaths and disability due to infectious diseases can be expected to decline in prevalence and genetic disorders will absorb an increasing proportion of the future health care budget in the region. Under such circumstances the burden of ill-health will fall disproportionately on communities in which consanguinity is strongly favoured. However, when assessing the overall effects of inbreeding, and to ensure that counselling programmes are devised to match the requirements of the population, it is important that the traditional social and economic benefits associated with marriage to a close relative are fully taken into consideration. It is suggested that there is an urgent need for prospective multi-disciplinary studies into the medical, biological and social consequences of consanguineous marriage with, as an interim measure, the formulation and introduction of training programmes for genetic counsellors recruited from local populations.

Chinese medicine (CM) was extensively used to treat COVID-19 in China. We aimed to evaluate the real-world effectiveness of add-on semi-individualized CM during the outbreak. A retrospective cohort of 1788 adult confirmed COVID-19 patients were recruited from 2235 consecutive linked records retrieved from five hospitals in Wuhan during 15 January to 13 March 2020. The mortality of add-on semi-individualized CM users and non-users was compared by inverse probability weighted hazard ratio (HR) and by propensity score matching. Change of biomarkers was compared between groups, and the frequency of CMs used was analyzed. Subgroup analysis was performed to stratify disease severity and dose of CM exposure. The crude mortality was 3.8% in the semi-individualized CM user group and 17.0% among the non-users. Add-on CM was associated with a mortality reduction of 58% (HR = 0.42, 95% CI: 0.23 to 0.77, $p$ = 0.005) among all COVID-19 cases and 66% (HR = 0.34, 95% CI: 0.15 to 0.76, $p$ = 0.009) among severe/critical COVID-19 cases demonstrating dose-dependent response, after inversely weighted with propensity score. The result was robust in various stratified, weighted, matched, adjusted and sensitivity analyses. Severe/critical patients that received add-on CM had a trend of stabilized D-dimer level after 3–7 days of admission when compared to baseline. Immunomodulating and anti-asthmatic CMs were most used. Add-on semi-individualized CM was associated with significantly reduced mortality, especially among severe/critical cases. Chinese medicine could be considered as an add-on regimen for trial use.

In this paper, we have investigated a diffusive predator–prey model with herd behavior. Also, we considered that the mortality of predators is linear as well as quadratic. Using linear stability analysis, we obtain the condition for diffusive instability and identify the corresponding domain in the space of control parameters. Using extensive numerical simulations, we obtain non-Turing spatiotemporal patterns in the model with linear mortality of predators, and Turing pattern formation, namely, spotted pattern and mixed pattern (spots-stripes) in model with quadratic mortality of predators. The results focus on the effect of the changing mortality rates of predator in pattern dynamics of a diffusive predator–prey model and help us in the better understanding of the dynamics of the predator–prey interaction in real environment.

This paper presents an empirical analysis devised to understand the complex relationship between extreme temperatures and mortality in 16 Asian countries where more than 50% of the world's population resides. Using a country-year panel on mortality rates and various measures of high temperatures for 1960–2015, the analysis produces two primary findings. First, high temperatures significantly increase annual mortality rates in Asia. Second, this increase is larger in countries with cooler climates where high temperatures are infrequent. These empirical estimates can help inform climate change impact projections on human health for Asia, which is considered to be highly vulnerable to climate change. The results indicate that unabated warming until the end of the century could increase annual mortality rates by more than 40%, highlighting the need for concrete and rapid actions to help individuals and communities adapt to climate change.

Acute infection, if not rapidly and accurately detected, can lead to sepsis, organ failure and even death. Current detection of acute infection as well as assessment of a patient’s severity of illness are imperfect. Characterization of a patient’s immune response by quantifying expression levels of specific genes from blood represents a potentially more timely and precise means of accomplishing both tasks. Machine learning methods provide a platform to leverage this host response for development of deployment-ready classification models. Prioritization of promising classifiers is dependent, in part, on hyperparameter optimization for which a number of approaches including grid search, random sampling and Bayesian optimization have been shown to be effective. We compare HO approaches for the development of diagnostic classifiers of acute infection and in-hospital mortality from gene expression of 29 diagnostic markers. We take a deployment-centered approach to our comprehensive analysis, accounting for heterogeneity in our multi-study patient cohort with our choices of dataset partitioning and hyperparameter optimization objective as well as assessing selected classifiers in external (as well as internal) validation. We find that classifiers selected by Bayesian optimization for in-hospital mortality can outperform those selected by grid search or random sampling. However, in contrast to previous research: 1) Bayesian optimization is not more efficient in selecting classifiers in all instances compared to grid search or random sampling-based methods and 2) we note marginal gains in classifier performance in only specific circumstances when using a common variant of Bayesian optimization (i.e. automatic relevance determination). Our analysis highlights the need for further practical, deployment-centered benchmarking of HO approaches in the healthcare context.

This study examines the health capacity to work among older persons in Japan—that is, how much longer older persons can work based on their health status using nationwide population-based surveys. We first examine how much older persons could work if they worked as much as those with the same mortality rate in the past (Milligan–Wise method). Second, we estimate how much older persons could work if they worked as much as younger persons in similar health (Cutler, Meara, and Richards-Shubik method). The results from both methods underscore a large work capacity among older persons in Japan. In particular, we observe a larger work capacity for the better educated and a negligible difference across regions. Moreover, we find an excess of part-time work, suggesting the need to enhance the flexibility of the choice of working style.

The effect of 5, 10, 20, 40 and 80 mg/kg b. wt. of hydroalcoholic extract of geriforte (an Ayurvedic herbal medicine) administered intraperitoneally was studied on the radiation-induced mortality in mice exposed to 10 Gy of γ-radiation. Treatment of mice with different doses of geriforte consecutively for 5 days before irradiation delayed the onset of mortality and reduced the symptoms of radiation sickness when compared with the non-drug treated irradiated controls. A maximum protection was observed for 10 mg/kg geriforte, where a highest number of survivors were reported by 30 days post-irradiation and further experiments were carried out using this dose of geriforte. The mice were treated with 10 mg/kg b. wt. geriforte or double distilled water (DDW) and exposed to 7, 8, 9, 10 and 11 Gy of gamma radiation and observed for the induction of symptoms of radiation sickness and mortality up to 30 days post-irradiation. The geriforte treatment protected the mice against the GI death as well as bone marrow deaths and the dose reduction factor (DRF) was found to be 1.14. Toxicity study showed that geriforte was non-toxic up to a dose of 4250 mg/kg, where no drug-induced mortality was observed. The LD₅₀ dose of geriforte was found to be 4750 mg/kg b. wt. To understand the mechanism of action of geriforte, free radical scavenging activity of the drug was evaluated. Geriforte was found to scavenge ^•OH, O₂^•-ABTS^•+ and NO^• in a dose-dependent manner. Our study demonstrates that geriforte is a good radioprotective agent and the optimum protective dose of 10 mg/kg was 1/475th of the LD₅₀ dose.

We consider the following matrix reachability problem: given r square matrices with entries in a semiring, is there a product of these matrices which attains a prescribed matrix? Similarly, we define the vector (resp. scalar) reachability problem, by requiring that the matrix product, acting by right multiplication on a prescribed row vector, gives another prescribed row vector (resp. when multiplied on the left and right by prescribed row and column vectors, gives a prescribed scalar). We show that over any semiring, scalar reachability reduces to vector reachability which is equivalent to matrix reachability, and that for any of these problems, the specialization to any r ≥ 2 is equivalent to the specialization to r = 2. As an application of these reductions and of a theorem of Krob, we show that when r = 2, the vector and matrix reachability problems are undecidable over the max-plus semiring (ℤ∪{-∞}, max,+). These reductions also improve known results concerning the classical zero corner problem. Finally, we show that the matrix, vector, and scalar reachability problems are decidable over semirings whose elements are "positive", like the tropical semiring (ℤ∪{+∞}, min,+).

The low-intensity ultrasound effects on MCF7 (human breast adenocarcinoma) and MCF10A (healthy breast cells) have been investigated at different sonication protocol to probe the effectiveness and the selectivity of the ultrasound (US) treatment and to understand the implications between cell mortality, biomechanical interactions and cell elastic modulus. Experiments performed at fixed and variable frequency demonstrated the effectiveness of some protocols in killing carcinogenic cells and the healthy cells insensitivity. Variation of elastic properties of MCF7 cells exposed to US under varying sonication conditions was examined. Sonication was carried out at fixed frequency (as it is usually done in therapy protocols), between 400kHz and 620kHz, following two protocols: (i) at fixed power output; (ii) at fixed voltage of the US generator. Evolution of cell stiffness during the US treatment was monitored via atomic force spectroscopy (AFS). It was found that cell mortality has a similar trend of variation with respect to sonication frequency regardless of the way specimens are exposed to US. Mechanical properties do not show a uniform trend with respect to frequency, but variations of Young’s modulus are more marked near the very low (400–480) kHz or very high frequencies (580–620) kHz. The observed variations may be related to mechanical interactions occurring in the cell culture, suggesting a primacy of the environment on other factors.

This paper considers the production of biomass of two interconnected chemostats in series with biomass mortality and a growth kinetic of the biomass described by an increasing function. A comparison is made with the productivity of a single chemostat with the same mortality rate and with volume equal to the sum of the volumes of the two chemostats. We determine the operating conditions under which the productivity of the serial configuration is greater than the productivity of the single chemostat. Moreover, the differences and similarities in the results corresponding to the case with mortality and the one without mortality, are highlighted. The mortality leads to surprising results where the productivity of a steady state where the bacteria are washed out in the first chemostat is greater than the one where the bacteria are present in both chemostats.

In epidemiological studies associations have been observed consistently and coherently between ambient concentrations of particulate matter and morbidity and mortality. With improvement of measurement techniques, the effects became clearer when smaller particle sizes were considered. Therefore, it seems worthwhile to look at the smallest size fraction available today, namely ultrafine particles (UPs, diameter below 0.1 μm) and to compare their health effects with those of fine particles (FPs, diameter below 2.5 μm). However, there are only few studies available which allow such a comparison.

Four panel studies with asthma patients have been performed in Germany and Finland. A decrease of peak expiratory flow and an increase of daily symptoms and medication use was found for elevated daily particle concentrations, and in three of these studies it was strongest for UPs. One large study on daily mortality is available from Germany. It showed comparable effects of fine and ultrafine particles in all size classes considered. However, FPs showed more immediate effects while UPs showed more delayed effects with a lag of four days between particulate concentrations and mortality. Furthermore, immediate effects were clearer in respiratory cases, whereas delayed effects were clearer in cardiovascular cases.

In total, the limited body of studies suggests that there are health effects, due to both UPs and FPs, which might be independent from each other. If this is confirmed in further investigations, it might have important implications for monitoring and regulation, which until now does not exist for UPs. Data from Germany show that FPs cannot be used as indicator for UPs: the time trends for FPs decreased, while UPs was stable and the smallest size fraction of UPs has continually increased since 1991/92.

Population study is a fundamental unit in social science. Demography concerns itself with the dynamics of population behavior, primarily with respect to the size and structure, as well as movement. China is the largest country in the world, with an immense population of more than 1.3 billion people today, which constitutes almost one-fifth of the world's total. China has a huge population, but a poor foundation with relatively inadequate and unevenly distributed natural resources. These are China's basic national conditions. Population changes may have profound consequences for a wide range of areas in sociology, demography, social policy and others. Insight into these changes is of great value for many purposes, and will benefit researchers and policy makers in different fields. This chapter deals mainly with questions of Chinese population, in particular, the size, characteristics, growth, and the factors affecting the changes in population.