Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings: Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1–4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0–8·4) while the total sum of global YLDs increased from 562 million (421–723) to 853 million (642–1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6–9·2) for males and 6·5% (5·4–7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782–3252] per 100 000 in males vs s1400 [1279–1524] per 100 000 in females), transport injuries (3322 [3082–3583] vs 2336 [2154–2535]), and self-harm and interpersonal violence (3265 [2943–3630] vs 5643 [5057–6302]). Interpretation: Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Modeling sediment yield in semi-arid pasture micro-catchments, NW Iran

Modeling sediment yield is a complex task because of the nonlinearity of natural processes intervening at slope and basin scale. In this study slope steepness, vegetation cover, and soil properties along with sediment yield were studied in 20 pasture micro-catchments in a semi-arid region, NW Iran in order to understand and predict sediment yield. The micro-catchments included only one first-order gully and drain toward a rock check dam in the outlet. The sediment yield of each micro-catchment was calculated using the measurement of sediment mass in the check dams for a 16-year period (1994–2010). Relationships between sediment yield and drainage characteristics were analyzed using correlation matrix and multiple linear regression method. Based on the results, sediment yield in the micro-catchments varied from 0.29 Mg ha−1 y−1 to 14.81 Mg ha−1 y−1, with an average of 5.04 Mg ha−1 y−1. It was significantly related to slope steepness, vegetation cover, and soil organic matter using a linear regression equation (R2 = 0.87, p < 0.001). The slope, vegetation, and soil organic matter explained about 44%, 23%, and 20% of total variance in sediment yield, respectively. The spatial validation of the model using data from eight different micro-catchments located nearby showed that the model efficiency is 0.94. Therefore, the model can be used for predicting sediment yield in this and similar study area, with a high degree of accuracy

Algae Removal by Electro-coagulation Process, Application for Treatment of the Effluent from an Industrial Wastewater Treatment Plant

Background: Although stabilization ponds and lagoons are suitable treatment processes due to simplicity of operation and low per capital costs, the effluents of these systems have too high of a total suspended solids concentration to be discharged into receiving waters. This problem is mainly caused by algae. In this study, an electro-coagulation reactor was examined to re­move algae from the final effluent of the wastewater treatment plant belong to Bu-Ali Industrial Estates (Hamadan City).  Methods: For the continuous flow electro-coagulation reactor used in these experiments three aluminum anodes were util­ized. This type of metal was selected because it could introduce the flocculation agent into the effluent, thereby algae could be removed by both mechanisms of electro-flotation and electro-flocculation. Results: The results of treatment were remarkably good and the efficiencies of total suspended solids (TSS) and chlorophyll a removal reached to as high as 99.5% and about 100% by applying a power input of about 550 W. In fact, this level of power input was needed for complete removal of algae in a low retention time of 15 minutes. Meanwhile, by applying less power input of about 100Wdm-3, the required time for a relatively same treatment was reached to 30 minutes.Conclusion: It is expected that this method which is also known as a multiple contaminants removal process will be consid­ered as a suitable alternative for final polishing of effluents from lagoons and similar treatment systems.&nbsp

UV-Lamp Intensity Determination Without Use of Radiometer

Background and Objectives: Measurement of light intensity is a recommended practice for insuring the delivery of required germicidal dose in disinfection operations by UV lamps. Use of sensitive to light chemicals which is the base of actionometeric methods could be considered as a suitable manner for estimating the intensity of UV lamp in circumstances that special radiometers are not available."nMaterials and Methods: lodide-iodate mixture was used as an actinometer for this study. The light intensities of a UV lamp (LP 25W) were first determined by a special UVC ‌radiometer at certain distances from the lamp. Then the test of determining the suitable period of time for irradiation of actinometer was accomplished.  Finally، the color changes of iodide - iodate solutions at the predetermined distances were evaluated at the wavelength of 352 nm. The latter analysis can be done by a common (visible) spectrophotometer."nResults:‌ Results indicated that use of this actinometer is more suitable at the distances of 35 to 60 cm from the center of the lamp bulb، since iodode-iodate solution has a detectable color change at this range of distance in one minute irradiation which may be considered as a reasonable time for actionmeteric operations."nConclusion:  Although all kinds of actinometers should not be regarded as precise as special radiometers and there would be need to use pure chemicals for actinometeric determination of light intensity، it can be claimed that the recommended procedure in this study which is the newest actinometeric method can be used in acceptable evaluation of UV intensity with least difficulty in providing necessary instruments