Showing papers by "Auckland University of Technology published in 2017"

Health Effects of Overweight and Obesity in 195 Countries over 25 Years.

Abstract: BACKGROUND Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain. METHOD ...

Global, regional, and national burden of neurological disorders, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016

Abstract: Summary Background Comparable data on the global and country-specific burden of neurological disorders and their trends are crucial for health-care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study provides such information but does not routinely aggregate results that are of interest to clinicians specialising in neurological conditions. In this systematic analysis, we quantified the global disease burden due to neurological disorders in 2015 and its relationship with country development level. Methods We estimated global and country-specific prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for various neurological disorders that in the GBD classification have been previously spread across multiple disease groupings. The more inclusive grouping of neurological disorders included stroke, meningitis, encephalitis, tetanus, Alzheimer's disease and other dementias, Parkinson's disease, epilepsy, multiple sclerosis, motor neuron disease, migraine, tension-type headache, medication overuse headache, brain and nervous system cancers, and a residual category of other neurological disorders. We also analysed results based on the Socio-demographic Index (SDI), a compound measure of income per capita, education, and fertility, to identify patterns associated with development and how countries fare against expected outcomes relative to their level of development. Findings Neurological disorders ranked as the leading cause group of DALYs in 2015 (250·7 [95% uncertainty interval (UI) 229·1 to 274·7] million, comprising 10·2% of global DALYs) and the second-leading cause group of deaths (9·4 [9·1 to 9·7] million], comprising 16·8% of global deaths). The most prevalent neurological disorders were tension-type headache (1505·9 [UI 1337·3 to 1681·6 million cases]), migraine (958·8 [872·1 to 1055·6] million), medication overuse headache (58·5 [50·8 to 67·4 million]), and Alzheimer's disease and other dementias (46·0 [40·2 to 52·7 million]). Between 1990 and 2015, the number of deaths from neurological disorders increased by 36·7%, and the number of DALYs by 7·4%. These increases occurred despite decreases in age-standardised rates of death and DALYs of 26·1% and 29·7%, respectively; stroke and communicable neurological disorders were responsible for most of these decreases. Communicable neurological disorders were the largest cause of DALYs in countries with low SDI. Stroke rates were highest at middle levels of SDI and lowest at the highest SDI. Most of the changes in DALY rates of neurological disorders with development were driven by changes in YLLs. Interpretation Neurological disorders are an important cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of expanding population numbers and ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. The number of patients who will need care by clinicians with expertise in neurological conditions will continue to grow in coming decades. Policy makers and health-care providers should be aware of these trends to provide adequate services. Funding Bill & Melinda Gates Foundation.

Global Burden of Stroke

Abstract: On the basis of the GBD (Global Burden of Disease) 2013 Study, this article provides an overview of the global, regional, and country-specific burden of stroke by sex and age groups, including trends in stroke burden from 1990 to 2013, and outlines recommended measures to reduce stroke burden. It shows that although stroke incidence, prevalence, mortality, and disability-adjusted life-years rates tend to decline from 1990 to 2013, the overall stroke burden in terms of absolute number of people affected by, or who remained disabled from, stroke has increased across the globe in both men and women of all ages. This provides a strong argument that "business as usual" for primary stroke prevention is not sufficiently effective. Although prevention of stroke is a complex medical and political issue, there is strong evidence that substantial prevention of stroke is feasible in practice. The need to scale-up the primary prevention actions is urgent.

Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015

Abstract: Importance Elevated systolic blood (SBP) pressure is a leading global health risk. Quantifying the levels of SBP is important to guide prevention policies and interventions. Objective To estimate the association between SBP of at least 110 to 115 mm Hg and SBP of 140 mm Hg or higher and the burden of different causes of death and disability by age and sex for 195 countries and territories, 1990-2015. Design A comparative risk assessment of health loss related to SBP. Estimated distribution of SBP was based on 844 studies from 154 countries (published 1980-2015) of 8.69 million participants. Spatiotemporal Gaussian process regression was used to generate estimates of mean SBP and adjusted variance for each age, sex, country, and year. Diseases with sufficient evidence for a causal relationship with high SBP (eg, ischemic heart disease, ischemic stroke, and hemorrhagic stroke) were included in the primary analysis. Main Outcomes and Measures Mean SBP level, cause-specific deaths, and health burden related to SBP (≥110-115 mm Hg and also ≥140 mm Hg) by age, sex, country, and year. Results Between 1990-2015, the rate of SBP of at least 110 to 115 mm Hg increased from 73 119 (95% uncertainty interval [UI], 67 949-78 241) to 81 373 (95% UI, 76 814-85 770) per 100 000, and SBP of 140 mm Hg or higher increased from 17 307 (95% UI, 17 117-17 492) to 20 526 (95% UI, 20 283-20 746) per 100 000. The estimated annual death rate per 100 000 associated with SBP of at least 110 to 115 mm Hg increased from 135.6 (95% UI, 122.4-148.1) to 145.2 (95% UI 130.3-159.9) and the rate for SBP of 140 mm Hg or higher increased from 97.9 (95% UI, 87.5-108.1) to 106.3 (95% UI, 94.6-118.1). Loss of disability-adjusted life-years (DALYs) associated with SBP of at least 110 to 115 mm Hg increased from 148 million (95% UI, 134-162 million) to 211 million (95% UI, 193-231 million), and for SBP of 140 mm Hg or higher, the loss increased from 95.9 million (95% UI, 87.0-104.9 million) to 143.0 million (95% UI, 130.2-157.0 million). The largest numbers of SBP-related deaths were caused by ischemic heart disease (4.9 million [95% UI, 4.0-5.7 million]; 54.5%), hemorrhagic stroke (2.0 million [95% UI, 1.6-2.3 million]; 58.3%), and ischemic stroke (1.5 million [95% UI, 1.2-1.8 million]; 50.0%). In 2015, China, India, Russia, Indonesia, and the United States accounted for more than half of the global DALYs related to SBP of at least 110 to 115 mm Hg. Conclusions and Relevance In international surveys, although there is uncertainty in some estimates, the rate of elevated SBP (≥110-115 and ≥140 mm Hg) increased substantially between 1990 and 2015, and DALYs and deaths associated with elevated SBP also increased. Projections based on this sample suggest that in 2015, an estimated 3.5 billion adults had SBP of at least 110 to 115 mm Hg and 874 million adults had SBP of 140 mm Hg or higher.

Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research

Abstract: Additional co-authors: Endre Czeiter, Marek Czosnyka, Ramon Diaz-Arrastia, Jens P Dreier, Ann-Christine Duhaime, Ari Ercole, Thomas A van Essen, Valery L Feigin, Guoyi Gao, Joseph Giacino, Laura E Gonzalez-Lara, Russell L Gruen, Deepak Gupta, Jed A Hartings, Sean Hill, Ji-yao Jiang, Naomi Ketharanathan, Erwin J O Kompanje, Linda Lanyon, Steven Laureys, Fiona Lecky, Harvey Levin, Hester F Lingsma, Marc Maegele, Marek Majdan, Geoffrey Manley, Jill Marsteller, Luciana Mascia, Charles McFadyen, Stefania Mondello, Virginia Newcombe, Aarno Palotie, Paul M Parizel, Wilco Peul, James Piercy, Suzanne Polinder, Louis Puybasset, Todd E Rasmussen, Rolf Rossaint, Peter Smielewski, Jeannette Soderberg, Simon J Stanworth, Murray B Stein, Nicole von Steinbuchel, William Stewart, Ewout W Steyerberg, Nino Stocchetti, Anneliese Synnot, Braden Te Ao, Olli Tenovuo, Alice Theadom, Dick Tibboel, Walter Videtta, Kevin K W Wang, W Huw Williams, Kristine Yaffe for the InTBIR Participants and Investigators

Prevalence, Incidence, and Mortality of Stroke in China: Results from a Nationwide Population-Based Survey of 480 687 Adults.

Abstract: Background:China bears the biggest stroke burden in the world. However, little is known about the current prevalence, incidence, and mortality of stroke at the national level, and the trend in the ...

Building Information Modelling (BIM) uptake: Clear benefits, understanding its implementation, risks and challenges

Abstract: Rapid advancement of technology continues to leverage change and innovation in the construction industry. Continued digitization of the industry offers the opportunity to totally reinvent contemporary construction design and delivery practice for future development. Building Information Modelling (BIM) within the context of Architecture, Engineering & Construction (AEC) has been developing since the early 2000s and is considered to be a key technology. Despite major technical advancements in BIM, it has not been fully adopted and its definitive benefits have not been fully capitalized upon by industry stakeholders. The lack of widespread uptake of BIM appears to be linked to the risks and challenges that are potentially impeding its effectiveness. This paper aims to discuss the reality of BIM, its widespread benefits and current level of uptake. The risks and challenges associated with the adoption of BIM, as well as recommendations regarding how future BIM adoption could be developed are also highlighted.

Serious Games and Gamification for Mental Health: Current Status and Promising Directions

Abstract: Computer games are ubiquitous and can be utilized for serious purposes such as health and education. "Applied games" including serious games (in brief, computerized games for serious purposes) and gamification (gaming elements used outside of games) have the potential to increase the impact of mental health internet interventions via three processes. First, by extending the reach of online programs to those who might not otherwise use them. Second, by improving engagement through both game-based and "serious" motivational dynamics. Third, by utilizing varied mechanisms for change, including therapeutic processes and gaming features. In this scoping review, we aim to advance the field by exploring the potential and opportunities available in this area. We review engagement factors which may be exploited and demonstrate that there is promising evidence of effectiveness for serious games for depression from contemporary systematic reviews. We illustrate six major categories of tested applied games for mental health (exergames, virtual reality, cognitive behavior therapy-based games, entertainment games, biofeedback, and cognitive training games) and demonstrate that it is feasible to translate traditional evidence-based interventions into computer gaming formats and to exploit features of computer games for therapeutic change. Applied games have considerable potential for increasing the impact of online interventions for mental health. However, there are few independent trials, and direct comparisons of game-based and non-game-based interventions are lacking. Further research, faster iterations, rapid testing, non-traditional collaborations, and user-centered approaches are needed to respond to diverse user needs and preferences in rapidly changing environments.

Joining of carbon fibre reinforced polymer (CFRP) composites and aluminium alloys-A review

Abstract: This paper investigates comprehensive knowledge regarding joining CFRP and aluminium alloys in available literature in terms of available methods, bonding processing and mechanism and properties. The methods employed comprise the use of adhesive, self-piercing rivet, bolt, clinching and welding to join only CFRP and aluminium alloys. The non-thermal joining methods received great attention though the welding process has high potential in joining these materials. Except adhesive bonding and welding, other joining methods require the penetration of metallic pins through joining parts and therefore, surface preparation is unimportant. No model is found to predict the properties of jointed structures, which makes it difficult to select one over another in applications. The choice of bonding methods depends primarily on the specific applications. The load-bearing mechanism of bolted joints is predominantly the friction that is the first stage resistance. Hybrid joints performance is enhanced by combining rivets, clinch or bolts with adhesives.

Deep-Cascade: Cascading 3D Deep Neural Networks for Fast Anomaly Detection and Localization in Crowded Scenes

Abstract: This paper proposes a fast and reliable method for anomaly detection and localization in video data showing crowded scenes. Time-efficient anomaly localization is an ongoing challenge and subject of this paper. We propose a cubic-patch-based method, characterised by a cascade of classifiers, which makes use of an advanced feature-learning approach. Our cascade of classifiers has two main stages. First, a light but deep 3D auto-encoder is used for early identification of “many” normal cubic patches. This deep network operates on small cubic patches as being the first stage, before carefully resizing the remaining candidates of interest, and evaluating those at the second stage using a more complex and deeper 3D convolutional neural network (CNN). We divide the deep auto-encoder and the CNN into multiple sub-stages, which operate as cascaded classifiers. Shallow layers of the cascaded deep networks (designed as Gaussian classifiers, acting as weak single-class classifiers) detect “simple” normal patches, such as background patches and more complex normal patches, are detected at deeper layers. It is shown that the proposed novel technique (a cascade of two cascaded classifiers) performs comparable to current top-performing detection and localization methods on standard benchmarks, but outperforms those in general with respect to required computation time.

Quantifying ingested debris in marine megafauna: a review and recommendations for standardization

Abstract: Plastic pollution has become one of the largest environmental challenges we currently face. The United Nations Environment Program (UNEP) has listed it as a critical problem, comparable to climate change, demonstrating both the scale and degree of the environmental problem. Mortalities due to entanglement in plastic fishing nets and bags have been reported for marine mammals, turtles and seabirds, and to date over 690 marine species have been reported to ingest plastics. The body of literature documenting plastic ingestion by marine megafauna (i.e. seabirds, turtles, fish and marine mammals) has grown rapidly over the last decade, and it is expected to continue grow as researchers explore the ecological impacts of marine pollution. Unfortunately, a cohesive approach by the scientific community to quantify plastic ingestion by wildlife is lacking, which is now hindering spatial and temporal comparisons between and among species/organisms. Here, we discuss and propose standardized techniques, approaches and metrics for reporting debris ingestion that are applicable to most large marine vertebrates. As a case study, we examine how the use of standardized methods to report ingested debris in Northern Fulmars (Fulmarus glacialis) has enabled long term and spatial trends in plastic pollution to be studied. Lastly, we outline standardized metric recommendations for reporting ingested plastics in marine megafauna, with the aim to harmonize the data that are available to facilitate large-scale comparisons and meta-analyses of plastic accumulation in a variety of taxa. If standardized methods are adopted, future plastic ingestion research will be better able to inform questions related to the impacts of plastics across taxonomic, ecosystem and spatial scales.

Agribusiness supply chain risk management: A review of quantitative decision models

Abstract: Supply chain risk management is a large and growing field of research. However, within this field, mathematical models for agricultural products have received relatively little attention. This is somewhat surprising as risk management is even more important for agricultural supply chains due to challenges associated with seasonality, supply spikes, long supply lead-times, and perishability. This paper carries out a thorough review of the relatively limited literature on quantitative risk management models for agricultural supply chains. Specifically, we identify robustness and resilience as two key techniques for managing risk. Since these terms are not used consistently in the literature, we propose clear definitions and metrics for these terms; we then use these definitions to classify the agricultural supply chain risk management literature. Implications are given for both practice and future research on agricultural supply chain risk management.

Precise Two‐Photon Photodynamic Therapy using an Efficient Photosensitizer with Aggregation‐Induced Emission Characteristics

Abstract: Two-photon photodynamic therapy (PDT) is able to offer precise 3D manipulation of treatment volumes, providing a target level that is unattainable with current therapeutic techniques. The advancement of this technique is greatly hampered by the availability of photosensitizers with large two-photon absorption (TPA) cross section, high reactive-oxygen-species (ROS) generation efficiency, and bright two-photon fluorescence. Here, an effective photosensitizer with aggregation-induced emission (AIE) characteristics is synthesized, characterized, and encapsulated into an amphiphilic block copolymer to form organic dots for two-photon PDT applications. The AIE dots possess large TPA cross section, high ROS generation efficiency, and excellent photostability and biocompatibility, which overcomes the limitations of many conventional two-photon photosensitizers. Outstanding therapeutic performance of the AIE dots in two-photon PDT is demonstrated using in vitro cancer cell ablation and in vivo brain-blood-vessel closure as examples. This shows therapy precision up to 5 µm under two-photon excitation.

Taxonomy of the order Mononegavirales: update 2017

Abstract: In 2017, the order Mononegavirales was expanded by the inclusion of a total of 69 novel species. Five new rhabdovirus genera and one new nyamivirus genus were established to harbor 41 of these species, whereas the remaining new species were assigned to already established genera. Furthermore, non-Latinized binomial species names replaced all paramyxovirus and pneumovirus species names, thereby accomplishing application of binomial species names throughout the entire order. This article presents the updated taxonomy of the order Mononegavirales as now accepted by the International Committee on Taxonomy of Viruses (ICTV).

Opinion: Why we need an international agreement on marine plastic pollution

Abstract: Plastic pollution is strewn across beaches and in oceans, bays, and estuaries. Tiny particles of plastic debris (often called microplastics) are so pervasive in aquatic ecosystems that we find them in seafood (1) and table salt (2). Marine organisms ingest or are entangled by plastic, sometimes with fatal consequences. Research suggests plastic pollution may impact biodiversity, ecosystem services, food security, and human health. In short, plastic pollution is a global threat. Plastics are accumulating across the globe at an astounding pace, even in remote places like the one pictured here—the uninhabited Henderson Island in the South Pacific. The time is ripe for an international agreement with measurable reduction targets to lessen the plastic pollution in the world’s oceans. Reprinted with permission from ref. 19. Despite the ubiquity, persistence, and cross-boundary nature of plastic pollution, stemming it is not an insurmountable task. Motivation for addressing the issue is building at the international level. The time is ripe for the initiation of an international agreement with measurable reduction targets to lessen the plastic pollution in the world’s oceans. An estimated 4.4–12.7 million metric tons of plastic are added to the oceans annually (3). Like many other contaminants (such as greenhouse gases and ozone-depleting substances), plastic is not constrained by national boundaries, because it migrates via water and air currents and settles in benthic sediments. More than 50% of the ocean’s area sits beyond national jurisdiction, including the infamous “garbage patches” in oceanic gyres where plastic accumulates. Plastic can affect organisms at every level of biological organization—altering gene expression, cells and tissues, causing death, and altering population size and community structure (4). Microplastics can impair reproduction and development (5) and alter how species function, disperse, and assemble (4, 6). These impacts, combined with evidence for accelerating plastic production and emissions into … [↵][1]2To whom correspondence should be addressed. Email: chelsea.rochman{at}utoronto.ca. [1]: #xref-corresp-1-1

A Systematic Review of Wearable Patient Monitoring Systems --- Current Challenges and Opportunities for Clinical Adoption

Abstract: The aim of this review is to investigate barriers and challenges of wearable patient monitoring (WPM) solutions adopted by clinicians in acute, as well as in community, care settings. Currently, healthcare providers are coping with ever-growing healthcare challenges including an ageing population, chronic diseases, the cost of hospitalization, and the risk of medical errors. WPM systems are a potential solution for addressing some of these challenges by enabling advanced sensors, wearable technology, and secure and effective communication platforms between the clinicians and patients. A total of 791 articles were screened and 20 were selected for this review. The most common publication venue was conference proceedings (13, 54%). This review only considered recent studies published between 2015 and 2017. The identified studies involved chronic conditions (6, 30%), rehabilitation (7, 35%), cardiovascular diseases (4, 20%), falls (2, 10%) and mental health (1, 5%). Most studies focussed on the system aspects of WPM solutions including advanced sensors, wireless data collection, communication platform and clinical usability based on a specific area or disease. The current studies are progressing with localized sensor-software integration to solve a specific use-case/health area using non-scalable and `silo' solutions. There is further work required regarding interoperability and clinical acceptance challenges. The advancement of wearable technology and possibilities of using machine learning and artificial intelligence in healthcare is a concept that has been investigated by many studies. We believe future patient monitoring and medical treatments will build upon efficient and affordable solutions of wearable technology.

Chronic Adaptations to Eccentric Training: A Systematic Review

Abstract: Resistance training is an integral component of physical preparation for athletes. A growing body of evidence indicates that eccentric strength training methods induce novel stimuli for neuromuscular adaptations. The purpose of this systematic review was to determine the effects of eccentric training in comparison to concentric-only or traditional (i.e. constrained by concentric strength) resistance training. Searches were performed using the electronic databases MEDLINE via EBSCO, PubMed and SPORTDiscus via EBSCO. Full journal articles investigating the long-term (≥4 weeks) effects of eccentric training in healthy (absence of injury or illness during the 4 weeks preceding the training intervention), adult (17–35 years), human participants were selected for the systematic review. A total of 40 studies conformed to these criteria. Eccentric training elicits greater improvements in muscle strength, although in a largely mode-specific manner. Superior enhancements in power and stretch-shortening cycle (SSC) function have also been reported. Eccentric training is at least as effective as other modalities in increasing muscle cross-sectional area (CSA), while the pattern of hypertrophy appears nuanced and increased CSA may occur longitudinally within muscle (i.e. the addition of sarcomeres in series). There appears to be a preferential increase in the size of type II muscle fibres and the potential to exert a unique effect upon fibre type transitions. Qualitative and quantitative changes in tendon tissue that may be related to the magnitude of strain imposed have also been reported with eccentric training. Eccentric training is a potent stimulus for enhancements in muscle mechanical function, and muscle-tendon unit (MTU) morphological and architectural adaptations. The inclusion of eccentric loads not constrained by concentric strength appears to be superior to traditional resistance training in improving variables associated with strength, power and speed performance.

Lifestyle interventions for the treatment of women with gestational diabetes

Abstract: This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the effects of lifestyle interventions in treating women with gestational diabetes.

Bio-banding in Sport: Applications to Competition, Talent Identification, and Strength and Conditioning of Youth Athletes

Abstract: This article was published in Strength & Conditioning Journal on 01 April 2017 available at http://dx.doi.org/10.1519/SSC.0000000000000281

Effectiveness of an Individualized Training Based on Force-Velocity Profiling during Jumping

Abstract: Ballistic performances are determined by both the maximal lower limb power output (Pmax) and their individual force-velocity (F-v) mechanical profile, especially the F-v imbalance (FVimb): difference between the athlete’s actual and optimal profile. An optimized training should aim to increase Pmax and/or reduce FVimb. The aim of this study was to test whether an individualized training program based on the individual F-v profile would decrease subjects’ individual FVimb and in turn improve vertical jump performance. FVimb was used as the reference to assign participants to different training intervention groups. 84 subjects were assigned to three groups: an “optimized” group divided into velocity-deficit, force-deficit and well-balanced sub-groups based on subjects’ FVimb, a “non-optimized” group for which the training program was not specifically based on FVimb and a control group. All subjects underwent a 9-week specific resistance training program. The programs were designed to reduce FVimb for the optimized groups (with specific programs for sub-groups based on individual FVimb values), while the non-optimized group followed a classical program exactly similar for all subjects. All subjects in the three optimized training sub-groups (velocity-deficit, force-deficit and well-balanced) increased their jumping performance (12.7±5.7% ES= 0.93±0.09, 14.2±7.3% ES= 1.00±0.17, and 7.2±4.5% ES= 0.70±0.36 respectively) with jump height improvement for all subjects, whereas the results were much more variable and unclear in the non-optimized group. This greater change in jump height was associated with a markedly reduced FVimb for both force-deficit (57.9±34.7% decrease in FVimb) and velocity-deficit (20.1±4.3%) subjects, and unclear or small changes in Pmax (-0.40±8.4% and +10.5±5.2%, respectively). An individualized training program specifically based on FVimb (gap between the actual and optimal F-v profiles of each individual) was more efficient at improving jumping performance (i.e. unloaded squat jump height) than a traditional resistance training common to all subjects regardless of their FVimb. Although improving both FVimb and Pmax has to be considered to improve ballistic performance, the present results showed that reducing FVimb without even increasing Pmax lead to clearly beneficial jump performance changes. Thus, FVimb could be considered as a potentially useful variable for prescribing optimal resistance training to improve ballistic performance.

Falls in Parkinson's disease: A complex and evolving picture.

Abstract: Falls are a major determinant of poor quality of life, immobilization, and reduced life expectancy in people affected by Parkinson's disease (PD) and in older adults more generally. Although many questions remain, recent research has advanced the understanding of this complex problem. The goal of this review is to condense new knowledge of falls in PD from prodromal to advanced disease, taking into account risk factors, assessment, and classification as well as treatment. The fundamental steps of clinical and research-based approaches to falls are described, namely, the identification of fall risk factors, clinical and instrumental methods to evaluate and classify fall risk, and the latest evidence to reduce or delay falls in PD. We summarize recent developments, the direction in which the field should be heading, and what can be recommended at this stage. We also provide a practical algorithm for clinicians.© 2017 International Parkinson and Movement Disorder Society.

Sex Differences in Long-Term Mortality After Stroke in the INSTRUCT (INternational STRoke oUtComes sTudy): A Meta-Analysis of Individual Participant Data

Abstract: Background—Women are reported to have greater mortality after stroke than men, but the reasons are uncertain. We examined sex differences in mortality at 1 and 5 years after stroke and identified f...