64 research outputs found

    Replacement of soybean meal with varying inclusions of black soldier fly larvae in albino wistar rats as a model for monogastric animals

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    D├╝nya genelinde g─▒da yetersizli─či ve g─▒da g├╝venli─či dikkate al─▒nd─▒─č─▒nda alternatif yem kaynaklar─▒ pazar─▒n ├Ânde gelen tercihlerindendir. Kara Asker Sine─či ise uygun maliyeti, ekolojik olmas─▒, s├╝rd├╝r├╝lebilirli─či ayr─▒ca i┼č g├╝c├╝ ve arazi ihtiyac─▒n─▒n d├╝┼č├╝k olmas─▒ sebebiyle son derece dikkat ├žeken bir ├╝r├╝nd├╝r. Kara Asker Sine─či larvalar─▒n─▒n getirdi─či kazan─▒mlar hayvan sa─čl─▒─č─▒n─▒n s├╝rd├╝r├╝lebilirli─či a├ž─▒s─▒ndan da bir gereklilik haline gelmi┼čtir. AB, bu ├╝r├╝n├╝n k├╝mes hayvanlar─▒, bal─▒klar, domuzlar, kediler, k├Âpekler, b─▒ld─▒rc─▒nlar, ├Ârdekler, s├╝r├╝ngenler, ku┼člar ve laboratuvar hayvanlar─▒n─▒ beslemek i├žin kullan─▒m─▒na m├╝saade vermi┼čtir. Kara Asker Sine─či larvas─▒, hayvan beslemenin yan─▒ s─▒ra tar─▒mda da kullan─▒larak biyolojik at─▒klar─▒n olu┼čumunu azaltmakta, organik g├╝bre ve biyoyak─▒t ihtiyac─▒n─▒ kar┼č─▒lamaktad─▒r. Bu ├žal─▒┼čman─▒n amac─▒, Wistar albino ratlar─▒n beslenmesinde farkli duzeylerde soya k├╝spesinin yerine kullanilan Kara Asker Sine─či larvalar─▒n─▒n performans, kan parametreleri ve histopatolojik parametrelere etkilerini tespit etmek i├žin yap─▒lm─▒┼čt─▒r. Bu ├žal─▒┼čmada yar─▒s─▒ di┼či yar─▒s─▒ erkek olmak ├╝zere toplam 80 rat kullan─▒lm─▒┼čt─▒r. T├╝m ratlar 5 farkl─▒ deney grubuna ayr─▒l─▒p her deney grubu 8 erkek ve 8 di┼či olmak ├╝zere toplam 16 rattan olu┼čmaktad─▒r. Alt gruplar her birinde 2 rat olacak ┼čekilde ayr─▒ kafeslere al─▒nm─▒┼člard─▒r. Ratlar─▒n rasyonundaki soya k├╝spesi, %0 (kontrol), %5, %10, %15 ve %20 oranlar─▒nda Kara Asker Sine─či larvas─▒ unu ile de─či┼čtirilmi┼čtir. Kara Asker Sine─či larvas─▒n─▒n canl─▒ a─č─▒rl─▒k art─▒┼č─▒, ortalama yem t├╝ketimi, hematolojik ve serum biyokimya parametreleri, doku ve serum oksidatif stres parametreleri ve histopatolojik bulgular ara┼čt─▒r─▒lm─▒┼čt─▒r. ├çal─▒┼čma sonunda t├╝m ratlardan kan ve doku ├Ârnekleri al─▒narak hematoloji ve serum biyokimya parametreleri analiz edildi. Kan ve doku (karaci─čer, b├Âbrek ve kalp) ├Ârneklerinin bir k─▒sm─▒ biyokimya laboratuvar─▒nda serum oksidatif parametrelerinin analizi i├žin -18 ┬░C'de sakland─▒. Karaci─čer, b├Âbrek, kalp, testisler, yumurtal─▒klar, uterus ve duodenum gibi dokular formalin i├žeren steril kavanozlara al─▒nd─▒ ve histopatolojik inceleme i├žin analiz edildi. ├çal─▒┼čmada kullan─▒lan yemler, soya k├╝spesi ve Kara Asker Sine─či larvas─▒ndan al─▒nan ├Ârnekler besin madde profili analizi i├žin T├╝bitak Marmara Ara┼čt─▒rma Merkezi'ne g├Ânderilmi┼čtir. Yem ├Ârnekleri ilgili laboratuvarda kuru madde, ham k├╝l, ham protein, ham ya─č, ham lif, ya─č asidi bile┼čimi ve amino asit bile┼čimi a├ž─▒s─▒ndan analiz edilmi┼čtir. ─░statistiksel analizlerden ├Ânce de─čerler ├╝zerinde normallik testi yap─▒lm─▒┼č, veriler deney gruplar─▒ aras─▒ndaki fark─▒ analiz etmek i├žin IBM SPSS (V. 24.0) program─▒ taraf─▒ndan ger├žekle┼čtirilen ÔÇťTek Y├Ânl├╝ Varyans Analizi (ANOVA)ÔÇŁ ve ÔÇťKruskal Wallis TestiÔÇŁ kullan─▒larak analiz edilmi┼čtir. Korelasyon analizi i├žin ise ÔÇťPearson TestiÔÇŁ uygulanm─▒┼čt─▒r. ─░statistik sonu├žlar─▒na bak─▒ld─▒─č─▒nda, kontrol grubu ile k─▒yaslanan deney gruplar─▒ i├žin a─č─▒rl─▒k art─▒┼č─▒ ve ortalama yem t├╝ketiminde ├Ânemlilik bulunmam─▒┼čt─▒r (p > 0.05). Ayr─▒ca yap─▒lan analizlerde kontrol grubu ile k─▒yasland─▒─č─▒nda, MCHC, PDW, MPV, P-LCR, ├╝rik asit, ALT, ALP, LDL, HDL, total kolesterol, karaci─čer ve b├Âbrek MDA ve GSH ve doku TOS ve TAS parametrelerinde erkek ve di┼či ratlar da cinsiyet dikkate al─▒nmaks─▒z─▒n beraber de─čerlendirildi─činde ├Ânemli d├╝zeyde farkl─▒l─▒klar g├Âr├╝lm├╝┼čt├╝r (p < 0.05). Bununla beraber cinsiyete ├Âzg├╝ etki olarak MCV, MCHC, PLT, RDW-CV, LDL, HDL, ALP erkek ratlarda, total kolesterol, lenfosit, PDW, PCT, kreatinin, total protein, ALT, kalsiyum, fosfor, OSI, GSH (kalp) ise di┼či ratlarda istatistiksel olarak anlaml─▒ bulunmu┼čtur (p < 0.05). Ayr─▒ca serumda, ├╝rik asit, TOS ve TAS; b├Âbrek ve karaci─čerde MDA ve GSH; ba─č─▒rsaklarda ise villus uzunlu─ču hem erkek hem de di┼či ratlarda ├Ânemli d├╝zeyde farkl─▒l─▒klar olu┼čmu┼čken histopatolojik bulgular a├ž─▒s─▒ndan ├Ânemli farkl─▒l─▒klar g├Âr├╝lmemi┼čtir. Sonu├ž olarak, rasyona soya k├╝spesinin yerine %20'ye kadar Kara Asker Sine─či larvas─▒n─▒n d├óhil edilmesinin, ratlarda olumsuz bir etkisinin olmad─▒─č─▒ tespit edilmi┼čtir. Bununla birlikte kan biyokimya parametreleri, sindirim sistem parametreleri ve oksidatif parametreler a├ž─▒s─▒ndan bak─▒ld─▒─č─▒nda %20'ye kadar Kara Asker Sine─či kullan─▒m─▒ ratlar i├žin tavsiye edilebilir.Regarding universal food and feed security, alternate feed resources are the leading market stance. Black Soldier Fly (BSF) is the most well-reputed because of its cost-effectiveness, ecological, sustainability, and less labor and land intensive. Subsequently, the payback of BSF larvae for health sustainability has become a great necessity. EU has legalized it to feed poultry, fish, pigs, cats, dogs, quails, ducks, reptiles, birds, and laboratory animals. BSF larvae farming helps to reduce organic waste removal and in return it provides animal feeding, organic fertilizer and biodiesel as end products. The objective of this study was to evaluate the effect of feeding varying inclusions of BSF larvae to Wistar albino rats as a replacement to soybean meal on blood chemistry, oxidative biomarkers and tissue histopathology parameters. The number of total rats was 80 in this study. Half of the rats were male, and half of them were female. All rats were divided into five groups; each group contained eight subgroups, of which the first four contained male rats and the following four included female rats. In this way, each group had 16 total rats, 8 male and 8 female, and each subgroup consisted of two rats in one cage. The rats were fed with 0, 5, 10, 15, and 20% inclusions of BSF larvae meal as replacement to soybean meal. The effect of BSF larvae on body weight gain, average feed intake, hematological and serum biochemical parameters, tissue and serum oxidative stress parameters, and histopathological findings were seen. At the end of the study, the blood and tissue samples were collected from all rats. The blood samples were immediately analysed for hematological and serum biochemical parameters. Some of the blood and tissue (liver, kidney, and heart) samples were stored at -18 ┬░C for serum oxidative parameters analysis which was performed at the Biochemistry lab. Tissues including liver, kidney, heart, testis, ovaries, uterus and duodenum were collected in sterile jars containing formalin and were analysed for histopathalogical analaysis. The experimental feeds, soybean and BSF larvae samples were sent to the TUBITAK Marmara Research Centre for their nutritional profile analysis. The feed samples were analysed for dry matter, crude ash, crude protein, crude fat, crude fiber, fatty acid and amino acid composition. The statistical analysis showed weight gain and average feed intake to be non-significant (p > 0.05) for all experimental groups compared to control. For statistical analysis, first of all, the normality test of the data was performed by descriptive statistics. On the basis of the normality test, the data was further analysed by One way Analysis of Variance (ANOVA) or Kruskal Wallis test (KWH) which were performed by IBM SPSS (V. 24.0) to analyse the difference between experimental groups. For Correlational analysis PearsonÔÇÖs test was performed. The statistical analysis showed that MCHC, PDW, MPV, P-LCR, uric acid, ALT, ALP, LDL, HDL, cholesterol total, liver, and kidney MDA and GSH, and tissue TOS and TAS were significant (p < 0.05) compared to the control as the male and female combined effect. However, as a gender-specific effect, MCV, MCHC, PLT, RDW-CV, LDL, non-HDL, ALP and cholesterol total in male rats and lymphocytes, PDW, PCT, creatinine, protein total, ALT, calcium, phosphorous, OSI, GSH (heart) in female rats were statistically significant (p < 0.05) compared to the control. Moreover, uric acid, TOS and TAS in serum, MDA and GSH in kidney and liver, and villus length were significant in both male and female rats and there were not any considerable histopathological changes. Convincingly, up to 20% inclusion of BSF larvae as replacement to soybean meal is effective for feeding rats without causing any negative effect on health and nutrient absorption. An improvement in blood chemistry, intestinal histopathology and oxidative parameters in response to partial inclusion of BSFL up to 20% is recommend for use in lab animals.This thesis was supported by Afyon kocatepe University Scientific Research Project Coordination Unit (BAPK) with the project number ÔÇť21. SA─×.BIL.15

    An incidentally discovered asymptomatic para-aortic paraganglioma with Peutz-Jeghers syndrome

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    Peutz-Jeghers syndrome (PJS) is an autosomal dominant inherited disorder characterized by mucocutaneous melanin pigmentation and gastrointestinal (GI) tract hamartomatous polyps and an increased risk of malignancy. In addition to polyposis, previous studies have reported increased risk of GI and extraGI malignancies in PJS patients, compared with that of the general population. The most common extraintestinal malignancies reported in previous studies are pancreatic, breast, ovarian and testicular cancers.We report the case of a 17-year-old boy who presented with generalized weakness, recurrent sharp abdominal pain and melena, had exploratory laparotomy and ileal resection for ileo-ileal intussusception. Pigmentation of the buccal mucosa was noted. An abdominal computed tomography scan (CT) revealed multiple polyps in small bowel loops. Gastroscopy revealed multiple dimunitive polyps in stomach and pedunculated polyp in duodenum. Colonoscopy revealed multiple colonic polyps. Pathological examination of the polyps confirmed hamartomas with smooth muscle arborization, compatible with Peutz-Jeghers polyps. CT scan guided left para-aortic lymph node biopsy revealed the characteristic features of extra-adrenal para-aortic paraganglioma. Although cases of various GI and extra GI malignancies in PJS patients has been reported, the present case appears to be the first in literature in which the PJS syndrome was associated with asymptomatic extraadrenal para-aortic paraganglioma. Patients with PJS should be treated by endoscopic or surgical resection and need whole-body screening

    Probabilistic measures of HIV-1 transmission in different HIV-1 key population groups of Larkana, Pakistan

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    Objective: To estimate the probability of human immunodeficiency virus (HIV)-1 transmission from different key HIV population groups using probabilistic modelling.Methods: This study was conducted in December 2020. A probabilistic model was used to estimate the probability of HIV-1 transmission from different key HIV population groups in Larkana. Our model was run on three probabilistic assumptions: 1) each replication gave two conceivable results: \u27true\u27 or \u27false\u27; 2) the chance of giving a \u27true\u27 result is the same for each replication; and 3) the replications are independent - \u27true\u27 in one will not impact the likelihood of \u27true\u27 in another.Results: The results estimated the probability of HIV transmission in key HIV population groups in Larkana to range between 0.42-0.54 per trial, where the highest probability of transmission was predicted for men who have sex with men (MSM; 0.54 per trial), followed by transgender (TG; 0.46 per trial) and people who inject drugs (PWID; 0.457 per trial).Conclusions: Our results suggest that there is a high likelihood of HIV transmission by key population groups in Larkana, such as MSM, TG, and PWID. Mathematic models, such as one proposed in our study can aid the HIV and acquired immunodeficiency syndrome (AIDS) control programmes in evaluating and optimising the strategies in controlling transmission of HIV from the key population groups

    Investigating the microstructural and mechanical properties of novel ternary reinforced AA7075 hybrid metal matrix composite

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    This study investigates the comparison of the microstructural and mechanical properties of a novel ternary reinforced AA7075 hybrid metal matrix composite. Four samples, including AA7075 (base alloy), AA7075-5wt % SiC (MMC), AA7075-5wt %SiC-3wt % RHA (s-HMMC), and AA7075-5wt % SiC-3wt % RHA-1wt % CES (n-HMMC) were developed using the stir casting liquid metallurgy route, followed by the heat treatment. The experimental densities corresponded with the theoretical values, confirming the successful fabrication of the samples. A minimum density of 2714 kg/m3 was recorded for the n-HMMC. In addition, the highest porosity of 3.11 % was found for n-HMMC. Furthermore, an increase of 24.4% in ultimate tensile strength and 32.8 % in hardness of the n-HMMC was recorded compared to the base alloy. However, its ductility and impact strength was compromised with the lower values of 5.98 % and 1.5 J, respectively. This was confirmed by microstructural analysis, which reveals that n-HMMC has mixing issues and forms agglomerates in the matrix, which served as the potential sites of stress concentration leading to low impact strength and ductility. Nevertheless, the hybrid composites showed superior mechanical properties over the MMC and its base alloy

    Optimizing the Air Conditioning Layouts of an Indoor Built Environment:Towards the Energy and Environmental Benefits of a Clean Room

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    Reducing energy consumption in buildings has received intensified research impetus since the introduction of the decarbonization goals set in the Paris agreement. Many domestic and specialized applications require clean rooms (indoor built environments) for safe and clean operation. Energy efficiency in clean room spaces depends on maintaining livable or required conditions such as temperature, humidity, and particle concentration with minimal use of energy and new carbon dioxide (CO2) emissions. In the literature, parameters such as temperature, relative humidity, particle concentrations, and CO2 emissions are not able to be properly controlled in clean room systems. The designed system in the literature involves high energy consumption and high economic costs. All these factors add novelty to this research, which was a significant research gap in previous studies. This clean room is directly linked to environmental parameters such as ambient temperature, relative humidity, etc. The clean room is also related directly to the building and infrastructure in such a way that there are certain regulatory requirements for designing a clean room. For designing and constructing the controlled environment in a clean room, the English (EN) documents, ISO 9000, and various other standards allow for clean rooms for different types of products. In this research, the designed control configurations properly control the system. Additionally, this system is energy efficient, with positive environmental aspects regarding CO2 emissions. Three control configurations were designed in this research, option A, option B, and option C, and three parameters are controlled in the study. These parameters are room temperature, relative humidity, and CO2 emissions (outside the room). CO2 emissions are controlled outside the room (in the environment). In the last research phase, a comparative analysis of these three control configurations was performed to find an energy-efficient system with fewer CO2 emissions. Control configuration B (option B) provides reliable results regarding an energy-efficient system and fewer CO2 emissions emitted to the environment. In this study, an optimized configuration for the air conditioning system was developed for a clean room (volume 185.6 m3) with a required temperature of 23 ┬░C, relative humidity of 40%, and a particle size of less than 0.3 ╬╝m. Three different design configurations were analyzed using TRNSYS simulation software. The minimization of energy use and CO2 emissions were the objective functions. Energy loads were calculated for each of the configurations by varying the fixed air change per hour and the minimum outdoor air flow rate. The results of a whole year simulation run for control configurations A, B, and show that, on the one hand, the ambient weather conditions of temperature and relative humidity (RH) is varied throughout year and, on the other hand, the clean room temperature was maintain at exactly 23 ┬░C, which is the required set point temperature, for all the three configurations (A, B, and C). Furthermore, the clean room relative humidity was maintained at 36% for configuration A, below the 40% which was the set point for clean room relative humidity, and at 40% for configurations B and C. Configuration B exhibited the minimum energy use (7300 kWh), at a fixed air change per hour value of 20 and a minimum outdoor air flow rate of 150 L/s, with the least amount of CO2 emissions, offering an overall 25% improvement over configurations A and C

    In vitro evaluation of antimicrobial and cytotoxic potential of Epimedium grandiflorum hydroethanolic extract as natural medicine

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    Medicinal plants are used as fundamental and low-cost source for remedy of numbers of infectious and metabolic diseases in developing and developed countries. Current research work was planned to evaluate the antibacterial, antifungal, and cytotoxic potential of hydroethanolic extract of E. grandiflorum. It was found that selected natural medicinal herb have significant (p&lt;0.05) antibacterial activities tested against Bacillus subtilis, Staphylococcus aureus, Pasteurella multocida, Escherichia coli, Klebsiella pneumoniae, Acinetobacter species, Pseudomonas Species and Salmonella Species. The results of bacterial biofilm inhibition also explored that selected natural herb has significant (p&lt;0.05) capacity to prevent the microbial biofilm particularly at higher dose. The results of antifungal activities showed that selected medicinal plant has significant (p&lt;0.05) antifungal potential evaluated against Aspergillus flavus, Aspergillus niger, Aspergillus terreus, Fusarium solani, Alternata alternaria, and Schizophyllum species. Moreover, the results of mutagenicity test and DNA damage preventive test explored that selective medicinal plant has significant (p&lt;0.05) DNA protective capacity or in other words it is non-mutagenic or cytotoxic in nature. It could be concluded that E. grandiflorum could be a potential candidate as therapeutic agent to manage infectious diseases especial bacterial and fungal infections with non-toxic nature

    Personalized wearable electrodermal sensing-based human skin hydration level detection for sports, health and wellbeing

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    Personalized hydration level monitoring play vital role in sports, health, wellbeing and safety of a person while performing particular set of activities. Clinical staff must be mindful of numerous physiological symptoms that identify the optimum hydration specific to the person, event and environment. Hence, it becomes extremely critical to monitor the hydration levels in a human body to avoid potential complications and fatalities. Hydration tracking solutions available in the literature are either inefficient and invasive or require clinical trials. An efficient hydration monitoring system is very required, which can regularly track the hydration level, non-invasively. To this aim, this paper proposes a machine learning (ML) and deep learning (DL) enabled hydration tracking system, which can accurately estimate the hydration level in human skin using galvanic skin response (GSR) of human body. For this study, data is collected, in three different hydration states, namely hydrated, mild dehydration (8 hours of dehydration) and extreme mild dehydration (16 hours of dehydration), and three different body postures, such as sitting, standing and walking. Eight different ML algorithms and four different DL algorithms are trained on the collected GSR data. Their accuracies are compared and a hybrid (ML+DL) model is proposed to increase the estimation accuracy. It can be reported that hybrid Bi-LSTM algorithm can achieve an accuracy of 97.83%

    Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

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    Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Findings In 2019, 273 center dot 9 million (95% uncertainty interval 258 center dot 5 to 290 center dot 9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 center dot 72% (4 center dot 46 to 5 center dot 01). 228 center dot 2 million (213 center dot 6 to 244 center dot 7; 83 center dot 29% [82 center dot 15 to 84 center dot 42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global agestandardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 center dot 21% [-1 center dot 26 to -1 center dot 16]), similar progress was not observed for chewing tobacco (0 center dot 46% [0 center dot 13 to 0 center dot 79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 center dot 94% [-1 center dot 72 to -0 center dot 14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Summary Background Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings In 2019, 273 & middot;9 million (95% uncertainty interval 258 & middot;5 to 290 & middot;9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4 & middot;72% (4 & middot;46 to 5 & middot;01). 228 & middot;2 million (213 & middot;6 to 244 & middot;7; 83 & middot;29% [82 & middot;15 to 84 & middot;42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over 10% in seven locations in 2019. Although global age standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: -1 & middot;21% [-1 & middot;26 to -1 & middot;16]), similar progress was not observed for chewing tobacco (0 & middot;46% [0 & middot;13 to 0 & middot;79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (-0 & middot;94% [-1 & middot;72 to -0 & middot;14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

    Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019 : a systematic analysis from the Global Burden of Disease Study 2019

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    Background Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings Globally in 2019, 1.14 billion (95% uncertainty interval 1.13-1.16) individuals were current smokers, who consumed 7.41 trillion (7.11-7.74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27.5% [26. 5-28.5] reduction) and females (37.7% [35.4-39.9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0.99 billion (0.98-1.00) in 1990. Globally in 2019, smoking tobacco use accounted for 7.69 million (7.16-8.20) deaths and 200 million (185-214) disability-adjusted life-years, and was the leading risk factor for death among males (20.2% [19.3-21.1] of male deaths). 6.68 million [86.9%] of 7.69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation In the absence of intervention, the annual toll of 7.69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a dear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

    The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

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    Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe
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