Over the past few decades, social and economic changes have had substantial effects on health and wellbeing in Russia. We aimed to use data from the Global Burden of Diseases, Injuries, and Risk ...Factors Study 2016 (GBD 2016) to evaluate trends in mortality, causes of death, years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and associated risk factors in Russia from 1980 to 2016.
We estimated all-cause mortality by use of a multistage modelling process that synthesised data from vital registration systems, surveys, and censuses. A composite measure of health loss due to both fatal and non-fatal disease burden (DALYs) was calculated as the sum of YLLs and YLDs for each age, sex, year, and location. Health progress was evaluated in comparison with patterns of change in similar countries by use of the Socio-demographic Index that was developed for GBD 2016.
Following rapid decreases in life expectancy after the collapse of the Soviet Union, life expectancy at birth in Russia improved between 2006 and 2016. The all-cause mortality rate decreased by 16·6% (95% uncertainty interval 9·4–33·8) between 1980 and 2016. This overall decrease encompasses the cycles of sharp increases and plateaus in mortality that occurred before 2005. Child mortality decreased by 57·5% (53·5–61·1) between 2000 and 2016. However, compared with countries at similar Socio-demographic Index levels, rates of mortality and disability in Russia remain high and life expectancy is low. Russian men have a disproportionate burden of disease relative to women. In 2016, 59·2% (55·3–62·6) of mortality in men aged 15–49 years and 46·8% (44·5–49·5) of mortality in women were attributable to behavioural risk factors, including alcohol use, drug use, and smoking.
Trends in mortality in Russia from 1980 to 2016 might be related to complicated patterns of behavioural risk factors associated with economic and social change, to shifts in disease burden, and to changes in the capacity of and access to health care. Ongoing mortality and disability from causes and risks amenable to health-care interventions and behaviour modifications present opportunities to continue to improve the wellbeing of Russian citizens.
Bill & Melinda Gates Foundation.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Background
The greatest potential to reduce the burden of stroke is by primary prevention of first‐ever stroke, which constitutes three quarters of all stroke. In addition to population‐wide ...prevention strategies (the ‘mass’ approach), the ‘high risk’ approach aims to identify individuals at risk of stroke and to modify their risk factors, and risk, accordingly. Current methods of assessing and modifying stroke risk are difficult to access and implement by the general population, amongst whom most future strokes will arise. To help reduce the burden of stroke on individuals and the population a new app, the Stroke RiskometerTM, has been developed. We aim to explore the validity of the app for predicting the risk of stroke compared with current best methods.
Methods
752 stroke outcomes from a sample of 9501 individuals across three countries (New Zealand, Russia and the Netherlands) were utilized to investigate the performance of a novel stroke risk prediction tool algorithm (Stroke RiskometerTM) compared with two established stroke risk score prediction algorithms (Framingham Stroke Risk Score FSRS and QStroke). We calculated the receiver operating characteristics (ROC) curves and area under the ROC curve (AUROC) with 95% confidence intervals, Harrels C‐statistic and D‐statistics for measure of discrimination, R2 statistics to indicate level of variability accounted for by each prediction algorithm, the Hosmer‐Lemeshow statistic for calibration, and the sensitivity and specificity of each algorithm.
Results
The Stroke RiskometerTM performed well against the FSRS five‐year AUROC for both males (FSRS = 75·0% (95% CI 72·3%–77·6%), Stroke RiskometerTM = 74·0(95% CI 71·3%–76·7%) and females FSRS = 70·3% (95% CI 67·9%–72·8%, Stroke RiskometerTM = 71·5% (95% CI 69·0%–73·9%), and better than QStroke males – 59·7% (95% CI 57·3%–62·0%) and comparable to females = 71·1% (95% CI 69·0%–73·1%). Discriminative ability of all algorithms was low (C‐statistic ranging from 0·51–0·56, D‐statistic ranging from 0·01–0·12). Hosmer‐Lemeshow illustrated that all of the predicted risk scores were not well calibrated with the observed event data (P < 0·006).
Conclusions
The Stroke RiskometerTM is comparable in performance for stroke prediction with FSRS and QStroke. All three algorithms performed equally poorly in predicting stroke events. The Stroke RiskometerTM will be continually developed and validated to address the need to improve the current stroke risk scoring systems to more accurately predict stroke, particularly by identifying robust ethnic/race ethnicity group and country specific risk factors.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
The Nitrogen/Oxygen Recharge System (NORS) for the International Space Station (ISS) Program was required as part of the Space Shuttle retirement efforts to sustain the ISS life support systems. The ...system is designed around a 7000 psia Oxygen or Nitrogen Recharge Tank Assembly which is able to be utilized both internally and externally to the ISS. Material selection and usage were critical to ensure oxygen compatibility for the design, while taking into consideration toxicity, weldability, brazability and general fabrication and assembly techniques. The system uses unique hardware items such a composite overwrap pressure vessel (COPV), high pressure mechanical gauges, compact regulators and valves, quick disconnects, metal tubing and flexhoses. Numerous challenges and anomalies were encountered due to the exotic nature of this project which will be discussed in detail. The knowledge gained from these anomalies and failure resolutions can be applied to more than space applications, but can also be applicable to industry pressurized systems.
Materials samples were exposed to the low Earth orbit (LEO) environment as part of the MISSE- 6 and -7B flight experiments. Optical properties, thickness/mass loss, surface elemental analysis, visual ...and microscopic analysis for surface change are some of the techniques employed in this investigation. Effects of molecular contamination are discussed. Where possible, the MISSE-6 and -7B results are compared to analyses from other LEO experiments.
The Komplast materials experiment was designed by the Khrunichev Space Center, together with other Russian scientific institutes, and has been carried out by Mission Control Moscow since 1998. The ...purpose is to study the effect of the low earth orbit (LEO) environment on exposed samples of various spacecraft materials. The Komplast experiment began with the launch of the first International Space Station (ISS) module on November 20, 1998. Two of eight experiment panels were retrieved during Russian extravehicular activity in February 2011 after 12 years of LEO exposure, and were subsequently returned to Earth by Space Shuttle "Discovery" on the STS-133/ULF-5 mission. The retrieved panels contained an experiment to detect micrometeoroid and orbital debris (MMOD) impacts, radiation sensors, a temperature sensor, several pieces of electrical cable, both carbon composite and adhesive-bonded samples, and many samples made from elastomeric and fluoroplastic materials. Our investigation is complete and a summary of the results obtained from this uniquely long-duration exposure experiment will be presented.
Materials samples were exposed to the low Earth orbit (LEO) environment as part of the MISSE-7B flight experiment for 18 months. Optical properties, thickness/mass loss, surface elemental analysis, ...visual and microscopic analysis for surface change are some of the techniques employed in this investigation. Where possible, the MISSE-7B results are compared to analyses from other LEO experiments. ISS materials currently flying on MISSE-8 are also discussed.
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