Thalamic Volume Asymmetry as a Potential Predictor of Vagus Nerve Stimulation Outcomes in Refractory Epilepsy.

Globally, under-five mortality has declined substantially over the past few decades, yet it remains a critical public health challenge. In 2023, an estimated 4.8 million children under 5 years of age died worldwide, equivalent to roughly 13,100 young lives lost every day. The majority of these deaths are from preventable causes, with infectious diseases and neonatal complications continuing to predominate. Although child survival has improved globally, major disparities persist, with the highest burden concentrated in sub-Saharan Africa and South Asia. In Kyrgyzstan, a lower-middle-income country in Central Asia, the under-five mortality rate (U5MR) has fallen to approximately 17 deaths per 1,000 live births as of 2022. Despite this progress, environmental and household-level risks remain important determinants of child health. Air pollution has been identified as the single largest environmental risk factor for premature death and ill-health in Kyrgyzstan, with young children among the most affected. Studies in Bishkek, the capital, report hazardous wintertime levels of particulate matter (PM2.5), largely driven by residential coal use for heating and cooking. Globally, about 2.1 billion people still rely on solid fuels such as wood, coal, crop residues, or dung, often burned in inefficient stoves without proper ventilation. This reliance generates household air pollution (HAP), a major environmental health risk that disproportionately affects women and young children because of their time spent in and around the household environment. In poorly ventilated homes, indoor smoke concentrations can greatly exceed health-based exposure limits.