A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010

BACKGROUND Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed changes in burden attributable to risk factors over time. METHODS We estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010. We estimated exposure distributions for each year, region, sex, and age group, and relative risks per unit of exposure by systematically reviewing and synthesising published and unpublished data. We used these estimates, together with estimates of cause-specific deaths and DALYs from the Global Burden of Disease Study 2010, to calculate the burden attributable to each risk factor exposure compared with the theoretical-minimum-risk exposure. We incorporated uncertainty in disease burden, relative risks, and exposures into our estimates of attributable burden. FINDINGS In 2010, the three leading risk factors for global disease burden were high blood pressure (7·0% [95% uncertainty interval 6·2-7·7] of global DALYs), tobacco smoking including second-hand smoke (6·3% [5·5-7·0]), and alcohol use (5·5% [5·0-5·9]). In 1990, the leading risks were childhood underweight (7·9% [6·8-9·4]), household air pollution from solid fuels (HAP; 7·0% [5·6-8·3]), and tobacco smoking including second-hand smoke (6·1% [5·4-6·8]). Dietary risk factors and physical inactivity collectively accounted for 10·0% (95% UI 9·2-10·8) of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium. Several risks that primarily affect childhood communicable diseases, including unimproved water and sanitation and childhood micronutrient deficiencies, fell in rank between 1990 and 2010, with unimproved water and sanitation accounting for 0·9% (0·4-1·6) of global DALYs in 2010. However, in most of sub-Saharan Africa childhood underweight, HAP, and non-exclusive and discontinued breastfeeding were the leading risks in 2010, while HAP was the leading risk in south Asia. The leading risk factor in Eastern Europe, most of Latin America, and southern sub-Saharan Africa in 2010 was alcohol use; in most of Asia, North Africa and Middle East, and central Europe it was high blood pressure. Despite declines, tobacco smoking including second-hand smoke remained the leading risk in high-income north America and western Europe. High body-mass index has increased globally and it is the leading risk in Australasia and southern Latin America, and also ranks high in other high-income regions, North Africa and Middle East, and Oceania. INTERPRETATION Worldwide, the contribution of different risk factors to disease burden has changed substantially, with a shift away from risks for communicable diseases in children towards those for non-communicable diseases in adults. These changes are related to the ageing population, decreased mortality among children younger than 5 years, changes in cause-of-death composition, and changes in risk factor exposures. New evidence has led to changes in the magnitude of key risks including unimproved water and sanitation, vitamin A and zinc deficiencies, and ambient particulate matter pollution. The extent to which the epidemiological shift has occurred and what the leading risks currently are varies greatly across regions. In much of sub-Saharan Africa, the leading risks are still those associated with poverty and those that affect children.

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Background The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. Methods Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk–outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990–2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. Findings All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8–58·5) of deaths and 41·6% (40·1–43·0) of DALYs. Risks quantified account for 87·9% (86·5–89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. Interpretation Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.

Association of microRNA 17–92 cluster host gene (MIR17HG) polymorphisms with breast cancer

Breast cancer incidence and mortality rates are increasing despite our current knowledge on the disease. Ninety-five percent of breast cancer cases correspond to sporadic forms of the disease and are believed to involve an interaction between environmental and genetic determinants. The microRNA 17–92 cluster host gene (MIR17HG) has been shown to regulate expression of genes involved in breast cancer development and progression. Study of single-nucleotide polymorphisms (SNPs) located in this cluster gene could help provide a further understanding of its role in breast cancer. Therefore, this study investigated six SNPs in the MIR17HG using two independent Australian Caucasian case–control populations (GRC-BC and GU-CCQ BB populations) to determine association to breast cancer susceptibility. Genotyping was undertaken using chip-based matrix assisted laser desorption ionisation time-of-flight (MALDI-TOF) mass spectrometry (MS). We found significant association between rs4824505 and breast cancer at the allelic level in both study cohorts (GRC-BC p = 0.01 and GU-CCQ BB p = 0.03). Furthermore, haplotypic analysis of results from our combined population determined a significant association between rs4824505/rs7336610 and breast cancer susceptibility (p = 5 × 10−4). Our study is the first to show that the A allele of rs4824505 and the AC haplotype of rs4824505/rs7336610 are associated with risk of breast cancer development. However, definitive validation of this finding requires larger cohorts or populations in different ethnical backgrounds. Finally, functional studies of these SNPs could provide a deeper understanding of the role that MIR17HG plays in the pathophysiology of breast cancer.

Lucien Levy-Bruehl, Albert Einstein, Franz Oppenheimer, Arthur Liebert and his son, Paul Tillich, unidentified woman and Mrs. Charles Blondel outside the Grand Hotel Curhaus during the Davoser Hochschulkurse; Davos, Switzerland Portraits Groups

The Davoser Hochschulkurse took place for the first time in 1928. Mainly university teachers from Germany, France, Switzerland (perhaps elsewhere) offered lectures to students recovering from tuberculosis at the health resort in the Swiss mountains. The lecturers were accommodated at the Grand Hotel Curhaus, where the lectures also took place.

Ephrussi Family Collection 1792-1958

Family tree, explanation

Vänner, kolleger och gynnare : Namngivningen av de finska fästningsverken under Augustin Ehrensvärds tid

Under 1700-talets andra hälft hörde Sveriges nya fästningar i öst (Helsingfors, Sveaborg, Lovisa och Svartholm) till rikets största satsningar. Fästningsprojektet leddes med undantag av ett par avbrott av Augustin Ehrensvärd (1710 1772). När arbetet tog fart namngavs de enskilda fästningsverken i så gott som alla fall efter samtida personer. Under Ehrensvärds tid tillämpades denna namngivning på omkring femtio av Sveaborgs och Helsingfors fästningsverk samt på Lovisas och Svartholms totalt aderton verk. Genom personerna de knöts till berättar namnen en hel del om Augustin Ehrensvärds samtid och omvärld. Hur de gjorde det är denna avhandlings huvudfråga. Källmaterialet utgörs av relationsritningar och brev, medan de teoretiska ramarna står att finna i nätverksteori och onomastiska teorier om namnmönster. Ehrensvärd förklarade sin namngivningspraxis för sin överordnade, tronföljaren Adolf Fredrik, 1749 i samband med att Gustavssvärd med fästningsverk namngavs: tanken var att namnge bastioner efter de som bidragit till arbetets framgång och att namnge utanverk efter officerare vid fästningsbygget. Innebörden av Ehrensvärds ord framgår ur namnbeståndet. De största grupperna består av ämbetsmän och militärer. Med de som bidragit till arbetets framgång avsågs sålunda den lokala eliten: landshövdingar som involverats i fästningsbygget samt högre och lägre militärer som tjänstgjorde vid fästningarna. Redan från början syns en klar hierarki i namngivningen. Medan landshövdingarna och de högre militärerna tillägnades bastioner, fick de lägre officerarna se mindre fästningsverk namngivna efter sig, helt i enlighet med Ehrensvärds egen beskrivning. Utanför de ovan nämnda grupperna, hedrades en hel del personer som inte konkret hade engagerats i fästningsbygget. Denna namngivning kan förklaras å ena sidan inom ramen för Ehrensvärds sociala nätverk och å andra sidan mot bakgrund av riksdagspolitiken i frihetstidens Sverige. Av de två förklaringsmodeller bör Ehrensvärds personliga vänskaper ses som en bidragande orsak, medan de politiska motiven utgjorde en avgörande orsak. Som en del av Ehrensvärds nätverk kan de gynnare ses som hade stöttat Ehrensvärd under hans karriär samt hans närmaste medarbetare vid fästningsbygget, ofta officerer han själv handplockat. Namngivningens politiska aspekt syns i det stora antalet riksråd som tillägandes bastionnamn. Vid sidan om riksråden hedrades också talmän vid de samtida riksdagarna. En komparativ studie i namngivningen av fästningsverk vid samtida och äldre svenska fästningar framhäver Ehrensvärd som en innovativ namngivare. Fästningsverk namngivna efter kungligheter verkar ha varit en norm, som också Ehrensvärd anknöt till genom ett fåtal namn. Däremot var namn efter personer inte vanliga, vilket gav den Ehrensvärdska namngivningen en förhållandevis stark anknytning till samtiden. Denna aspekt bekräftas om namnen ses mot bakgrund av 1700-talets uppfattning om ära och äregirighetens samhälleliga nytta. I denna uppfattning syns bakgrunden till förekomsten av personer med både hög och låg status i Ehrensvärds namngivning. Sammanfattningsvis speglar namnen på de finska fästningsverken sin samtid genom den byråkratiska, militära och politiska elit de representerar samt genom motiveringen till dem.

Averting biodiversity collapse in tropical forest protected areas

The rapid disruption of tropical forests probably imperils global biodiversity more than any other contemporary phenomenon(1-3). With deforestation advancing quickly, protected areas are increasingly becoming final refuges for threatened species and natural ecosystem processes. However, many protected areas in the tropics are themselves vulnerable to human encroachment and other environmental stresses(4-9). As pressures mount, it is vital to know whether existing reserves can sustain their biodiversity. A critical constraint in addressing this question has been that data describing a broad array of biodiversity groups have been unavailable for a sufficiently large and representative sample of reserves. Here we present a uniquely comprehensive data set on changes over the past 20 to 30 years in 31 functional groups of species and 21 potential drivers of environmental change, for 60 protected areas stratified across the world's major tropical regions. Our analysis reveals great variation in reserve `health': about half of all reserves have been effective or performed passably, but the rest are experiencing an erosion of biodiversity that is often alarmingly widespread taxonomically and functionally. Habitat disruption, hunting and forest-product exploitation were the strongest predictors of declining reserve health. Crucially, environmental changes immediately outside reserves seemed nearly as important as those inside in determining their ecological fate, with changes inside reserves strongly mirroring those occurring around them. These findings suggest that tropical protected areas are often intimately linked ecologically to their surrounding habitats, and that a failure to stem broad-scale loss and degradation of such habitats could sharply increase the likelihood of serious biodiversity declines.

Food patch choice in climbing perch Anabas testudineus (Bloch, 1792)

The current study analysed how the climbing perch Anabas testudineus an air-breathing freshwater fish make choice when a pair of food patches differing in the gain is presented. The results revealed no significant variation in the preference towards the patch of food material cumulated in one place over the same amount of food dispersed in a wider area and located at an equal distance. Additionally, enhancement of the value of dispersed or cumulated patch, by moving it towards the subject fish (spatial discounting) was also found to be ineffective in influencing the food patch utilisation in this species.

Evaluacion de dos variedades de Tempate Jatropha curcas L. Bajo dos metodos de siembra y dos sistemas de labranza en trece localidades de Nicaragua

De la semilla de tempate Jatropha curcus L.se extrae un aceite, que por medio de un proceso industrial sencillo, se obtienen un sustituto del diesel . con el fin de evaluar el efecto de dos metodos de siembraf dos sistemas de labranza sobre dos variedades, se establecieron 13 ensayos de campos en tres regiones del pais la region 11; las localidades de el torrero Cristo Rey,Monte Olivo, San Lucas, Los Vargas y Altos de La cruz (Cerro Negro), Santo Tomás del Norte, Salale, san Nicolas y El terrero. En la region V; Juigalpa y Santo Domingo y en la region VI; Sebaco,cada ensayó incluye ocho combinaciones de los tres factores en estudio (1} variedad (Nicaragua y Cabo Verde), {2) labranza ( convencional y minima), y (3) método de siembra (directa yen bolsa ). Los tratamientos fueron arreglados en un diseño de bloques completo al azar con cuatro re peticiones. Los costos de siembra mas bajos correspondieron a siembra directa con cero labranza y los costos mas a 1 tos fu ero n par a 1 a siembra en bolsa con labranza convencional. La mayor altura de planta se obtuvo con labranza convencional y siembra en bolsa en las localidades de Juigalpa. cristo Rey y El Trreon respectivamente. La variedad Cabo Verde obtuvo los mejores rendimientos en la mayoria de los tratamientos y localidades. En cuanto a manejo labranza convencional combinada con siembra en bolsa produjo los mayores rendimientos. La localidad con mejor rendimiento fue El Torreón con la variedad Cabo verde, labranza convencional y siembra en bolsa.

Early Functional Deficit and Microglial Disturbances in a Mouse Model of Amyotrophic Lateral Sclerosis

11 p.

Unlike Physical Exercise, Modified Environment Increases the Lifespan of SOD1(G93A) Mice However Both Conditions Induce Cellular Changes

8 p.

Charles M. Breder, Jr.: Palmetto Key, 1942

Charles M. Breder and his wife Ethel spent part of the summer of 1942 at the Palmetto Key field station, known today as Cabbage Key, on the west coast of Florida south of Charlotte Harbor. The Palmetto Key field station began in 1938 and ended in 1942 because of World War II. His Palmetto Key diary ran for 95 pages of notes, tables, diagrams, drawings, lists, and business records and this report presents a variety of fascinating entries. Diaries from other years all bear Breder's style of discipline, curiosity, humor, and speculations on nature. The diary was transcribed as part of the Coastal Estuarine Data/Document Rescue and Archeology effort for South Florida. (PDF contaons 24 pages)