Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods: We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings: In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation: The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.Valery L. Feigin … Andrew T Olagunju … Lalit Yadav … et al. (The 2019 Stroke Collaborators

Community-led comparative genomic and phenotypic analysis of the aquaculture pathogen Pseudomonas baetica a390T sequenced by Ion semiconductor and Nanopore technologies

Pseudomonas baetica strain a390T is the type strain of this recently described species and here we present its high-contiguity draft genome. To celebrate the 16th International Conference on Pseudomonas, the genome of P. baetica strain a390T was sequenced using a unique combination of Ion Torrent semiconductor and Oxford Nanopore methods as part of a collaborative community-led project. The use of high-quality Ion Torrent sequences with long Nanopore reads gave rapid, high-contiguity and -quality, 16-contig genome sequence. Whole genome phylogenetic analysis places P. baetica within the P. koreensis Glade of the P. fluorescens group. Comparison of the main genomic features of P. baetica with a variety of other Pseudomonas spp. suggests that it is a highly adaptable organism, typical of the genus. This strain was originally isolated from the liver of a diseased wedge sole fish, and genotypic and phenotypic analyses show that it is tolerant to osmotic stress and to oxytetracycline.Microbial Biotechnolog

Probablistic properties of wave climates

SIGLEAvailable from British Library Document Supply Centre- DSC:DX90859 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Comparing students' performance in self-directed and directed self-learning in College of Medicine, University of Bisha

الملخص: أهداف البحث: تزيد استراتيجية التعلم المرتكز على الطالب من احتمالية تخريج أطباء أكفاء ومعتمدين على أنفسهم وقادرين على حل المشكلات. اعتمدت كلية الطب بجامعة بيشة التعلم الموجه ذاتيا ممثلا بالتعلم القائم على حل المشكلات، والتعلم الذاتي الموجه ممثلا بالتعلم القائم على الفريق. طريقة البحث: تم جمع ما مجموعه 502 سؤالا من أسئلة متعددة الخيارات من اختبارات منتصف المقرر والامتحانات النهائية من قبل خبراء المواد ذات الصلة من تسع دورات خلال الفترة من سبتمبر 2020 حتى يونيو 2023 والتي اعتمدت التعلم القائم على حل المشكلات والتعلم القائم على الفريق؛ 247 سؤالا متعدد الأسئلة تتعلق بالتعلم القائم على حل المشكلات و255 سؤالا يتعلق بالتعلم القائم على الفريق. تم استخدام التحليل السيكومتري لتحديد الأسئلة الصعبة والسهلة والأمثل. نقطة ثنائية حيث تشير إلى نقطة ثنائية ضعيفة وهامشية وجيدة وممتازة على التوالي. وأخيرا، تمت محاولة عدد المشتتات الوظيفية بنسبة تزيد عن 5% من المرشحين. النتائج: لا توجد فروق ذات دلالة إحصائية في أداء الطلاب في الاسئلة متعددة الاختيارات المتعلقة بالتعلم المبني على المشكلات (يمثل أداة التعلم الموجه ذاتيا للمجموعات الصغيرة)، والتعلم المبني على الفريق (يمثل أداة التعلم الموجه ذاتيا للمجموعات الكبيرة) فيما يتعلق بمؤشر الصعوبة، ووظائف تشتيت الانتباه. الاستنتاجات: لوحظ أنه لا يوجد فرق في أداء الطلاب سواء تم استخدام التعلم القائم على حل المشكلات أو التعلم القائم على الفريق لتعلم مقررات العلوم الطبية الأساسية. يحتاج التعلم في مجموعات صغيرة مثل التعلم القائم على حل المشكلات إلى موارد أكثر مقارنة بالتعلم في مجموعات كبيرة كما هو الحال في التعلم القائم على الفريق، وبالتالي يمكن لأي كلية أن تقرر استراتيجية التعلم المعتمدة على مواردها وعدد طلابها. Abstract: Background: Student-centered learning strategy increases the likelihood of graduation of competent, self-dependent, and problem-solving physicians. The University of Bisha, College of Medicine (UBCOM) adopted self-directed learning (SDL) represented by problem-based learning (PBL), and directed self-learning (DSL) represented by team-based learning (TBL). Aim: To compare the students’ performance in SDL and DSL among UBCOM students. Methodology: A total of 502 multiple choice questions (MCQs) from the mid-course and final exams were collected by the relevant subject experts from nine courses during the period from September 2020 till June 2023 that adopted PBL and TBL; 247 MCQs related to PBL and 255 related to TBL. Psychometric analysis was used to determine difficult, easy, and optimum questions (≤25%, ≥90%, and 26–89%, respectively). Point biserial as 0.40 which indicate poor, marginal, good, and excellent point biserial, respectively. Finally, the number of functional distractors was attempted by >5% of the candidates. Results: No significant differences were noted for the students’ performance in MCQs related to PBL (representing self-directed, small group learning tool), and TBL (representing directed-self, large group learning tool) regarding difficulty index (DI), point biserial, and distractors functionality. Conclusion: It has been observed that there is no difference in students’ performance whether PBL or TBL is used for learning Basic Medical Science courses. Small group learning such as PBL needs more resources in comparison to large group learning as in TBL, therefore any institute can decide on the adopted learning strategy depending on its resources and the number of students

Promoting walking amongst older patients in rehabilitation: are accelerometers the answer?

The role of physical activity amongst older people in inpatient rehabilitation settings has been little studied. Walking has a number of potential benefits for older people in rehabilitation but it is not known whether increased walking improves outcomes in this population. Until now mobility monitoring has not been possible in routine practice. Recently tri-axial accelerometers have been validated for ambulatory activity monitoring in older adults. Accelerometry has the potential to explore the role of walking in older patients in rehabilitation. Providing data regarding activity levels may improve patient motivation and assist clinicians with activity prescription. Future research could determine the relationship between activity levels and patient outcomes