43 research outputs found
Managing and Optimization of Energy Consumption and Offering Strategies to Materialize It
Undoubtedly, one of the most important challenges in this century in the world is energy crisis. On one hand, shortage of energy resources and its growing consumption and on the other hand , extreme usage of energy by different societies has endangered future life of human, polluted the environment and wasted national capitals. There are different methods to protect environment. The most common is saving that is not obtainable without correct management of energy as well as culture-making for correct using of energy. This paper tries to introduce useful and practical strategies to optimize energy consumption including Nanohnology, natural gas energy consumption, floor heat systems in buildings, using natural light and Building Energy Management System (BEMS
Managing and Optimization of Energy Consumption and Offering Strategies to Materialize It
Undoubtedly, one of the most important challenges in this century in the world is energy crisis. On one hand, shortage of energy resources and its growing consumption and on the other hand , extreme usage of energy by different societies has endangered future life of human, polluted the environment and wasted national capitals. There are different methods to protect environment. The most common is saving that is not obtainable without correct management of energy as well as culture-making for correct using of energy. This paper tries to introduce useful and practical strategies to optimize energy consumption including Nanohnology, natural gas energy consumption, floor heat systems in buildings, using natural light and Building Energy Management System (BEMS
Response to Cardiac Resynchronization Therapy in Cardiomyopathy Patients with Right Bundle Branch Block
Background: The use of cardiac resynchronization therapy (CRT) in heart failure patients with right bundle branch block (RBBB) is under debate. We present early and late echocardiographic characteristics of a series of heart failure patients with RBBB who underwent CRT.Â
Methods: In this retrospective descriptive study, 18 patients with RBBB in the surface electrocardiogram underwent CRT between 2005 and 2015. All the patients had the New York Heart Association functional class III/IV, a left ventricular ejection fraction (LVEF) â€35%, and a QRS duration â„120 milliseconds. The median follow-up duration was 19 months. The echocardiographic response was based on a â„5% increase in LVEF.Â
Results: Within 48 hours after CRT implantation, LVEF increased from 24.58%±7.08% before to 28.46±8.91% after CRT (P=0.005) and to 30.00±9.44% at follow-up (P=0.008). Among the 18 patients, 12 (66.7%) were responders within 48 hours after CRT. The following baseline echocardiographic parameters were higher in the responders than in those without an increased LVEF, although the difference did not reach statistical significance: septal-to-lateral wall delay (48.33±33.53 vs 43.33±38.82 ms), anteroseptal-to-posterior wall delay (41.7±1.75 vs 38.33±18.35 ms), and interventricular mechanical delay (48.50±21.13 vs 31.17±19.93 ms). The mean QRS duration was higher in the responders than in the non-responders (183.58±40.69 vs 169.00±27.36 ms). Death was reported in 3 out of the 18 patients (16.7%) at follow-up. The 3 deceased patients had a higher baseline interventricular mechanical delay than those who survived.Â
Conclusion: Our results indicated that patients with RBBB might benefit from CRT. Further, patients with higher intra and interventricular dyssynchrony and a wider QRS may show better responses
Investigating the Relationship Between High Levels of Angiotensin II in Plasma and the Rate of Deterioration in Hypertensive Patients to COVID-19
Introduction: The COVID-19 crisis poses a heightened risk to vulnerable populations. Considering factors influencing deterioration, complications, and mortality, it is especially important to pay attention to these groups, including persons with hypertension (HTN) and diabetes. This study aimed to investigate the correlation between the angiotensin II (ANG II) level and the disease severity and clinical course in COVID-19 patients. Methods: A cross-sectional study was conducted on 50 COVID-19 patients (mean age 59.1±20) admitted to Sinai hospital in Hamedan. The blood samples of the patients were taken during hospitalization and discharge, and the plasma ANG II level was measured using an enzyme-linked immunosorbent assay kit. The quantitative comparison was analyzed with paired t test and qualitative comparison with the chi-square test. The correlation of variables was checked with the Pearson test, and P<0.05 was considered statistically significant. Results: Overall, 44%, 16%, and 10% of COVID-19 patients had HTN, cardiovascular disease (CVD), and 10% diabetes, respectively. The oxygen level of 82% of the patients was below 90, of which 68% were intubated, and the lowest oxygen levels were observed in patients with HTN and CVD with 2 deaths. The primary and secondary examination of the ANG II level demonstrated that its level was significantly higher during illness compared to full recovery and decreased during recovery. Conclusion: The ANG II level is related to the severity of the disease in the early stages of 2019- nCoV infection. Therefore, HTN or other diseases that affect the level of ANG II in the blood can increase the severity of the disease
Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17
Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4â40·7) to 50·3% (50·0â50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1â46·5) in 2017, compared with 28·7% (28·5â29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2â89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664â711) of the 1830 (1797â1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6â80·7) of countries from 2000 to 2017, and in 53·9% (50·6â59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation
Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019
Background: Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10â24 years during the past three decades. Methods: Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolute numbers and age-standardised rates per 100 000 population by sex, age group (10â14, 15â19, and 20â24 years), and sociodemographic index (SDI) with 95% uncertainty intervals (UIs). We report percentage changes in deaths and DALYs between 1990 and 2019. Findings: In 2019, 369 061 deaths (of which 214 337 [58%] were transport related) and 31·1 million DALYs (of which 16·2 million [52%] were transport related) among adolescents aged 10â24 years were caused by transport and unintentional injuries combined. If compared with other causes, transport and unintentional injuries combined accounted for 25% of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout adolescence, transport and unintentional injury fatality rates increased by age group. The unintentional injury burden was higher among males than females for all injury types, except for injuries related to fire, heat, and hot substances, or to adverse effects of medical treatment. From 1990 to 2019, global mortality rates declined by 34·4% (from 17·5 to 11·5 per 100 000) for transport injuries, and by 47·7% (from 15·9 to 8·3 per 100 000) for unintentional injuries. However, in low-SDI nations the absolute number of deaths increased (by 80·5% to 42 774 for transport injuries and by 39·4% to 31 961 for unintentional injuries). In the high-SDI quintile in 2010â19, the rate per 100 000 of transport injury DALYs was reduced by 16·7%, from 838 in 2010 to 699 in 2019. This was a substantially slower pace of reduction compared with the 48·5% reduction between 1990 and 2010, from 1626 per 100 000 in 1990 to 838 per 100 000 in 2010. Between 2010 and 2019, the rate of unintentional injury DALYs per 100 000 also remained largely unchanged in high-SDI countries (555 in 2010 vs 554 in 2019; 0·2% reduction). The number and rate of adolescent deaths and DALYs owing to environmental heat and cold exposure increased for the high-SDI quintile during 2010â19. Interpretation: As other causes of mortality are addressed, inadequate progress in reducing transport and unintentional injury mortality as a proportion of adolescent deaths becomes apparent. The relative shift in the burden of injury from high-SDI countries to low and lowâmiddle-SDI countries necessitates focused action, including global donor, government, and industry investment in injury prevention. The persisting burden of DALYs related to transport and unintentional injuries indicates a need to prioritise innovative measures for the primary prevention of adolescent injury. Funding: Bill & Melinda Gates Foundation
Global burden of 369 diseases and injuries in 204 countries and territories, 1990â2019: a systematic analysis for the Global Burden of Disease Study 2019
Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990â2010 time period, with the greatest annualised rate of decline occurring in the 0â9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10â24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10â24 years were also in the top ten in the 25â49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50â74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens
Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1â70.8) million) to 6.4% (58.3 (47.6â70.7) million), but is predicted to remain above the World Health Organizationâs Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8â38.5) million) in 2000 to 6.0% (55.5 (44.8â67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic
Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019
Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019.
Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10â14 and 50â54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66â2·79) in 2000 to 2·31 (2·17â2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5â137·8) in 2000 to a peak of 139·6 million (133·0â146·9) in 2016. Global livebirths then declined to 135·3 million (127·2â144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4â27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8â67·6) in 2000 to 73·5 years (72·8â74·3) in 2019. The total number of deaths increased from 50·7 million (49·5â51·9) in 2000 to 56·5 million (53·7â59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1â10·3) in 2000 to 5·0 million (4·3â6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0â6·3) in 2000 to 7·7 billion (7·5â8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1â60·8) in 2000 to 63·5 years (60·8â66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019