Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. Methods: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Findings: Global DALYs increased from 2·63 billion (95% UI 2·44–2·85) in 2010 to 2·88 billion (2·64–3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7–17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8–6·3) in 2020 and 7·2% (4·7–10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0–234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7–198·3]), neonatal disorders (186·3 million [162·3–214·9]), and stroke (160·4 million [148·0–171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3–51·7) and for diarrhoeal diseases decreased by 47·0% (39·9–52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54–1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5–9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0–19·8]), depressive disorders (16·4% [11·9–21·3]), and diabetes (14·0% [10·0–17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7–27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6–63·6) in 2010 to 62·2 years (59·4–64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6–2·9) between 2019 and 2021. Interpretation: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Funding: Bill & Melinda Gates Foundation

Water in Architecture and its Usage in Contemporary Houses Interior Design

As one of the most fundamental natural elements, water has had a great share in the formation and architecture of architectural buildings. This research examines the effect of water and its presence in contemporary houses. Architecture is not merely a tridimensional compound of forms in space, but a manifestation of a sense or a thought in it. According to Feng Shui, the building where we live in can be the cause of balance and health for human being. As a whole, anything around us has active and mobile energies; by designing a building in a way that positive energies can follow around easier, one can easier bring happiness for the dwellers. Feng Shui is based on the harmony among five elements of water, wind, soil, fire and metal. Because of its stream, water removes negative energies and revives and mobilizes positive ones thereby having a great impact on the current of energies. Considering the fact that contemporary houses are small in space, designer does not feel free in the usage of water in internal spaces, thus he/she should utilize patterns that resemble or associate the feeling of water in the living environment. Conceptual, functional and aesthetic basics of water have been examined first via library studies and note taking from various papers and books. Then, the three qualities would be analyzed in Iranian architecture, and the properties of past people will be examined to emphasize material, spiritual and psychological aspects of water. Then, I will assess the philosophical basics of Feng Shui in using water for interior spaces via a qualitative method and content analysis, usage of water based on Feng Shui in interior design and decoration of homes. Considering these concepts, natural possibilities of water in interior architecture and its limitations in interior space design would be assessed and recognized. Finally, some patterns would be presented to use water in interior spaces of contemporary apartments

Flow and heat transfer of nanofluid in a channel partially filled with porous media considering turbulence effect in pores

The flow and heat transfer of Al2O3-water nanofluid in a channel partially filled with porous media is investigated numerically. The turbulence effect in the porous media is taken under consideration in this article. A simple case is simulated first to evaluate the accuracy of the results in comparison with the available data. The turbulent kinetic energy profile is investigated at a flow cross section. The results show that the maximum of turbulent kinetic energy occurs at the clear fluid region in the vicinity of porous media region. The turbulent kinetic energy is decreasing function of the porosity of porous media. The effect of porosity on the variation of turbulent kinetic energy decreases with the increase in the porosity of porous media. The turbulent kinetic energy at clear fluid and porous media regions decreases with the increase in nanofluid concentration from 0.01 to 0.03, and it increases with the increase in nanofluid concentration from 0.03 to 0.05. The temperature of nanofluid increases with the increase in the nanofluid concentration and decrease in the porosity of porous media. It is shown that for this case, with the increase in nanofluid concentration and porosity of porous media, the skin friction coefficient increases and the Nusselt number decreases.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Hypotensive effect of Cichorium intybus extract in rats

Introduction: Oxidative stress is involved in many diseases, including hypertension, kidney failure, and heart disease. This study aimed to evaluate the effect of hydroalcoholic Cichorium intybus extract on blood pressure in rats. Antioxidant activity, phenolic and flavonoid contents of the plant extract were also evaluated. Methods: In this study, 32 male Wistar rats weighing 250-300 g were divided into four groups of eight each. Animals in the control group were administered with normal saline and in the C. intybus groups with extract at 25, 50, and 100 mg/kg for two weeks. Then, the homodynamic parameters were examined by the Power lab. The phenolic and flavonoid contents were also evaluated by a spectrophotometer and the rate of free radical scavenging activity was measured by the diphenyl-1-picyryl-hydrazyl (DPPH) free radical method. Results: The free radical scavenging activity of C. intybus extract was obtained 47.85 of DPPH, and flavonoid and phenolic contents were 8.21 and 27.19 mg/g of dry extract, respectively. Meanwhile, median (MAP), systolic (SAP) and diastolic arterial pressure (DAP) significantly decreased in the 50 mg/kg extract-treated group compared to the control and 200 mg/kg extract-treated groups. Conclusion: Ethanol extract of C. intybus plays a protective role against hypertension, which, in part, might be due to antioxidant compounds of the plant against free radicals

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

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