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

Effects of rearing density and dietary tryptophan supplementation on intestinal immune and antioxidant responses in rainbow trout (Oncorhynchus mykiss)

The present study was conducted to assess the effects of dietary tryptophan (Trp) supplementation on intestinal health in rainbow trout (Oncorhynchus mykiss) reared at two stocking densities. For this, the fish were kept at 15 (low density) or 25 (high density) kg m−3 initial densities and fed diets supplemented with 0 (T0), 5 (T5) and 10 (T10) g Trp. kg−1 diet. After 70 days of rearing, the fish intestinal cytokine and antioxidant-related gene expressions as well as oxidative stress were evaluated. Dietary Trp and stocking density showed significant interaction effects on intestinal tumor necrosis factor-alpha (tnfa) (P < .001), interleukin-1beta (il1b) (P = .016), interleukin 8 (il8) (P = .007), interleukin 6 (il6) (P < .001), superoxide dismutase (sod) (P = .019), catalase (cat) (P = .041), and glutathione peroxidase (gpx) (P = .001) gene expression, as well as, superoxide dismutase (SOD) (P < .001), catalase (CAT) (P = .007), glutathione peroxidase (GPx) (P < .001) activities, and malondialdehyde (MDA) (P < .001) levels. Under low stocking density, dietary Trp supplementation induced no significant changes in the cytokines, cat and gpx gene expressions compared to the control group. Intestinal SOD and CAT activities increased, but MDA level decreased in the T5 treatment compared to the T0, under low stocking density. The T10 group showed significantly lower sod gene expression and higher CAT activity compared to the T0 groups at low density. Expression of tnfa, il6, il8, and cat genes increased, but gpx decreased in the T0 group, under the high stocking density. This group, also, showed decrease in SOD and GPx activity, and increase in MDA levels at high stocking density. The T5 treatment showed significant increase in all gene expressions, SOD and GPx activities, with no changes in MDA levels under 25 kg m−3 stocking density, compared to 15 kg m−3. Significant increase in tnfa and cat gene expression and MDA levels, but decrease in CAT activity wwere observed in the T10 treatment, under high stocking density. Overall, dietary Trp at 5 g kg−1 levels intensifies intestinal antioxidant and inflammatory responses to the increase in stocking density, but inhibits MDA elevation. But higher Trp supplementation (10 g kg−1) weakens/inhibits the intestinal gene expressions and antioxidant enzymes activity, with no benefits on oxidative stress. © 2020 Elsevier B.V

Essential oil diversity and molecular characterization of Ephedra species using RAPD analysis

Background and objectives: The genus Ephedra (Ephedraceae) consists of about 40 species of mostly shrubs and rarely small trees around the world. In the present study, the essential oil (EO) diversity and genetic relationships were investigated in six Ephedra species from Iran using Random Amplified Polymorphic DNA (RAPD) markers. Methods: Theplants were collected from two different provinces; Azarbayjan (north-west) and Khorasan (north-east) of Iran. The EOs were obtained by hydro-distillation and analyzed by GC and GC/MS. The DNA was extracted from the aerial parts of the plants using a Qiagen Dneasy Plant Mini Kit. Amplification was performed using decamer RAPD primers. Results: A total of 187 bands were scored and used for the analysis of genetic distances. Genetic distance values ranged from 0.25 to 0.95.The analysis showed the highest genetic diversity (25%) between E. foliata with other species. Ephedra foliata formed a distinct group. Ephedra strobilacea was found to be the most similar to E. sarcocarpa (male).Conclusion: High genetic and EO diversity was demonstrated in this genus which should be further studied in order to make more efficient use of the species and considering relevant conservation programs