Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17 : analysis for the Global Burden of Disease Study 2017

Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1–65·8), 17·4% (7·7–28·4), and 59·5% (34·2–86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health

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

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

Don’t pull the plug! the Drosophila mating plug preserves fertility

Mating plugs are hardened structures—typically a coagulation of seminal fluid components—that are transferred to, or formed within, the female reproductive tract of numerous animal species (both mammals and insects). Analysis of the role(s) of the mating plug in reproduction has been conducted in a wide array of diverse species. These structures have been proposed to have a multitude of functions, which include altering female re-mating rate, acting as a barrier to re-mating and being required for sperm storage or sperm movement to occur in mated females. A recent analysis of the Drosophila melanogaster mating plug has shown that proper formation of the structure is required for optimal fertility in flies: the Drosophila mating plug is required to retain the ejaculate within the female reproductive tract once mating has terminated. Here, we discuss the possible implications of the Drosophila mating plug in the fertility of this species in light of these new results

Uso da metodologia de coleta total de excretas na determinação da energia metabolizável em rações para frangos de corte ajustadas ou não quanto aos níveis de vitaminas e minerais Adjustment of the total excreta collection method for metabolizable energy determination of broiler chicken fedstuffs: consideration of vitamin and micro-minerals levels in the test diet

Avaliou-se neste estudo a influência dos teores de vitaminas e microminerais da ração-teste na determinação dos valores de energia metabolizável aparente (EMA) e energia metabolizável aparente corrigida pelo nitrogênio retido (EMAn) do farelo de soja. Foram comparadas rações-teste ajustadas ou não para as quantidades de cloreto de colina e premix de vitaminas e microminerais em relação à ração-referência. Adotou-se o método tradicional de coleta total de excretas utilizando-se 360 pintos de corte machos e fêmeas da linhagem Ross de 15 a 23 dias de idade, alojados em baterias metálicas com bandejas coletoras de excretas. As aves foram distribuídas em esquema de blocos casualizados, de acordo com o andar das baterias, com dois tratamentos e 12 repetições de dez aves (cinco machos e cinco fêmeas). Em um tratamento, efetuou-se a substituição de 40% da ração-referência por farelo de soja, enquanto no outro, além dessa substituição, ajustaram-se as quantidades de cloreto de colina e dos premixes de vitaminas e microminerais com base na ração-referência. Os valores médios e os respectivos erros-padrão para EMA e EMAn (kcal/kg) do farelo de soja, com base na matéria natural, foram 2.462±29,62 e 2.269±25,80 para ração ajustada e 2.353±26,18 e 2.191±23,88 para ração não ajustada. O ajuste das quantidades de cloreto de colina e do premix de vitaminas e microminerais na ração-teste propiciou maiores valores de EMA e EMAn do farelo de soja em relação à ração não-ajustada. É importante ajustar as quantidades de vitaminas e microminerais nas rações-teste em experimentos visando determinar a energia metabolizável de ingredientes para aves.<br>The objective of this study was to evaluate the effects of vitamin and micromineral levels adjustment in the test diet on the total collection method for determination of apparent metabolizable energy (EMA) and apparent metabolizable energy corrected by nitrogen retention (EMAn) of soybean meal. Two treatments were compared: the test diet without or with adjustments in the amounts of choline chloride and vitamin-micromineral premix, when 40% of the reference diet was replaced with soybean meal. The traditional total feces collection method was used, with 360 Ross broilers from 15 to 23 days old. The chickens were allotted to batteries as a randomized block design, with two treatments and 12 ten-birds replicates (five males and five females). Mean values and respective standard errors for EMA and EMAn (kcal/kg) of soybean meal, as-fed basis, were of 2,462±29.62 and 2,269±25.80 for the adjusted diet and 2,353±26.18 and 2,191±23.88 for the diet without vitamin and micromineral adjustment. Adjustments of the amounts of choline choride and vitamin-micromineral premix in the test diet led to higher EMA and EMAn compared to the control test diet with no adjustments. Therefore, vitamin and micromineral levels in the test diet should be adjusted to the reference diet in experiments determining the metabolizable energy of feedstuffs used in poultry diets

Influência do estádio de maturação na colheita e temperatura de secagem de grãos de trigo sobre os valores de energia metabolizável aparente corrigida (EMAc) em frangos de corte Influence of grain maturity stage at harvest and drying temperatures on AMEn of wheat grains for poultry

Foi avaliada a influência do estádio de maturação (nível de umidade) e o processo de secagem (temperatura) do trigo sobre os valores de composição química e de Energia Metabolizável Aparente corrigida para retenção de nitrogênio (EMAc) pelo método de coleta total em frangos de corte. O trigo foi colhido com 13, 16, 20 ou 30% de umidade e submetido a 40, 70 e 100&ordm;C de temperaturas na secagem, excetuando-se a umidade de 13%, considerado como o trigo seco na lavoura. O maior valor de EMAc (3326 kcal/kg) do trigo foi obtido no tratamento em que se utilizou trigo colhido com 16% de umidade e submetido à secagem de 40&ordm;C. A temperatura na secagem e umidade de colheita altera o valor nutricional do trigo. É necessário conhecer o melhor estádio de maturação na colheita e o processo de secagem do trigo, considerando sua variação nutritiva e posterior emprego em rações avícolas.<br>An experiment was performed to evaluate the chemical composition values and Apparent Metabolizable Energy corrected for nitrogen excretion (AMEn) of wheat grain harvested at different maturity stage (13, 16, 20 and 30% of humidity levels) and drying temperatures (40, 70 and 100 &ordm;C). The grain with 13% of humidity level was considered dried at harvest and was not submitted to drying. The level of 16% of grain humidity at harvesting and the drying temperature of 40 &ordm;C provided the highest AMEn wheat value (3326 kcal/kg, as fed basis). Harvesting humidity and drying temperature affected the nutritional value of wheat. It is necessary to know the best maturity stage at harvest and drying temperatures of wheat grains regarding the variability on its nutritive value and inclusion into poultry diets