Produtividade de feijão comum cv. Pérola pelo emprego de ácidos húmicos no tratamento de sementes

O objetivo deste trabalho foi estudar o efeito de ácidos húmicos no tratamento de sementes de feijoeiro sobre a produtividade e suas componentes em condições de campo. Sementes de feijão cv. ‘Pérola’ foram tratadas com promotor de crescimento Rhal S1® (18% de ácidos húmico + 1,5% de ácidos fúlvicos), nas doses de 0, 100, 200, 300, 400, 500 e 600 mL da solução para cada 100 kg de sementes. Em seguida, as sementes tratadas foram semeadas manualmente (15 sementes por metro linear), obedecendo ao delineamento em blocos casualizados (DBC). Os resultados foram submetidos à análise de regressão. As equações de regressão obtiveram resposta quadrática para todas as variáveis analisadas em função das doses aplicadas. As plantas de feijão responderam pelo aumento do número de vagens por planta e número de grãos por vagem até a dose de 200 mL de Rhal S1® 100 Kg-1 sementes e a massa de 100 grãos (g) e produtividade de plantas (kg/ha) aumentou até a dose de 100 mL de Rhal S1® 100 Kg-1 sementes, configurando-se na melhor dose para proporcionar incrementos na produtividade

Capitalismo dependente e políticas sociais: tensões e contradições

RESUMOA percepção de que há avanços sociais mesmo com o estabelecimento de políticas sociais de cunho neoliberal, permite que se indage sobre o capitalismo brasileiro e suas características estruturais. Chama a atenção o fato de que uma política social cuja estrutura é neoliberal como o programa Bolsa Família tenha permitido a setores da população brasileira um ganho de vida subjetivo e objetivo. Diante deste fato, questiona-se sobre o tipo de capitalismo que aqui se desenvolveu, suas contradições, possibilidades e limitações tanto do ponto de vista do capital como do ponto de vista humano e de garantia de direitos.Palavras-chave: Capitalismo Dependente; Políticas Sociais; Garantia de Direitos.ABSTRACTThe perception that there are social advances even with the establishment of social policies of neoliberal nature, allows us to inquire about Brazilian capitalism and its structural characteristics. It is noteworthy that a social policy whose structure is neoliberal such as the Bolsa Familia program has allowed sectors of the Brazilian population a subjective and objective gain in life. Given this fact, one wonders about the type of capitalism that has been developed here, its contradictions, possibilities and limitations from the point of view of capital as well as from the human point of view and of guaranteeing rights.Keywords: Dependent Capitalism; Social Policies; Guarantee of Rights.RESUMENLa percepción de que hay adelantos sociales aun con el establecimiento de políticas sociales de corte neoliberal, permite que se indague sobre el capitalismo brasileño y sus características estructurales. Llama la atención el hecho que una política social cuya estructura es neoliberal, como la Beca-Familia, haya permitido a sectores de la familia brasileña un recurso de vida a la vez subjetivo y objetivo. Ante ese hecho, uno se pregunta sobre el tipo de capitalismo que acá se desarrolló, sus contradicciones, posibilidades y limitaciones, tanto desde el punto de vista del capital, como del humano y de la garantía de derechos.Palabras-clave: Capitalismo Dependiente; Políticas Sociales; Garantía de Derechos

Hospitalizações por pneumoconioses no Sudeste Brasileiro, entre 2011 e 2020 / Hospitalization for pneumoconiosis in Southeast Brazil, between 2011 and 2020

As pneumoconioses são um grupo de pneumopatias irreversíveis causadas pela inalação de partículas tóxicas em ambiente de trabalho. Essas moléstias podem cursar com insuficiência respiratória crônica, tuberculose, taxas expressivas de hospitalização, uso prolongado de medicações, além do afastamento obrigatório da ocupação. O objetivo do presente trabalho consiste em analisar as internações hospitalares por pneumoconioses na Região Sudeste, entre os anos de 2011 e 2020. Trata-se de um estudo ecológico a partir de dados secundários de domínio público vinculados ao Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS). Totalizaram-se 1.953 internações, das quais o menor número foi registrado em 2011 (n=123; 6,2%), enquanto o maior foi em 2019 (n=284; 14,5%). Notou-se correlação entre o avance do tempo e o aumento no número de atendimentos (p=0,014; r2=0,7406), o que aponta para tendências futuras de novas hospitalizações. Houve destaque para o caráter de urgência (n=1.798; 92,1%); estados de São Paulo (n=708; 36,3%) e Minas Gerais (n=704; 36,0%); sexo masculino (n=1.260; 64,5%); e faixas etárias 50 a 59 anos (n=383; 19,6%) e 60 a 69 anos (n=379; 19,4%). Além disso, 242 casos evoluíram para óbito (letalidade hospitalar de 12,4%). O perfil de distribuição de óbitos concentrou-se no Rio de Janeiro (n=84; 34,7%) e São Paulo (n=81; 33,5%); homens (n=153; 63,2%); e idade 80 anos ou mais (n=65; 26,9%). Observaram-se 3 vezes mais chances de óbitos em  pessoas com idade 80 anos ou mais (95%IC=2,2-4,2; p<0,0001); além de 2 vezes mais chances de óbito entre casos residentes no Rio de Janeiro (95%IC=1,6-2,8; p<0,0001). Em contrapartida, houve menores chances de falecimento entre internados com faixa etária de 20 a 29 anos (OR=0,2; 95%IC=0,07-0,7; p=0,0033) e provenientes de Minas Gerais (OR=0,6; 95%IC=0,4-0,8; p=0,0015). No que concerne aos gastos, totalizaram-se R$2.688.871,22. Portanto, com a finalidade de reduzir internações, óbitos e custos é imperativa a implementação de intervenções. Ações de educação em saúde direcionadas à prevenção de agravos e ao esclarecimento da importância do uso de equipamentos de proteção individual são essenciais. Indica-se ainda a maior fiscalização das empresas; e a detecção e conduta precoces para melhor prognóstico do paciente por meio da realização anual de radiografias de tórax e bienal de testes de função pulmonar.

Tetralogia de Fallot no Brasil: compreendendo a existência

Introduction: Tetralogy of Fallot involves four specific heart problems. Firstly, there is pulmonary stenosis, characterized by the narrowing of the pathway that carries blood from the heart to the lungs, hindering blood flow. Right ventricular hypertrophy is another characteristic, where the muscle of the right ventricle of the heart becomes thicker due to increased workload caused by pulmonary stenosis. Methodology: The present study adopted a descriptive epidemiological approach with the aim of analyzing cases of Tetralogy of Fallot among live births in Brazil from 2012 to 2021. Data collection utilized the Live Birth Information System (SINASC), made available by DATASUS. Results: In the group of individuals born with Tetralogy of Fallot, the analysis of variables reveals valuable information about demographic characteristics and perinatal conditions. Regarding the "Race/Ethnicity" variable, out of the 943 cases registered, 588 (62.35%) were classified as white, 51 (5.41%) as black, 10 (1.06%) as yellow, 267 (28.31%) as brown, and 27 (2.86%) had race/ethnicity recorded as unknown. Conclusion: A profound understanding of congenital heart diseases not only saves lives but also significantly improves the quality of life for affected individuals.Introdução: A Tetralogia de Fallot envolve quatro problemas cardíacos específicos. Em primeiro lugar, há a estenose pulmonar, caracterizada pelo estreitamento da via que conduz o sangue do coração para os pulmões, dificultando o fluxo sanguíneo. A hipertrofia ventricular direita é outra característica, onde o músculo do ventrículo direito do coração torna-se mais espesso devido ao aumento da carga de trabalho provocado pela estenose pulmonar. Metodologia: O presente estudo adotou uma abordagem epidemiológica descritiva com o objetivo de analisar os casos de Tetralogia de Fallot entre os nascidos vivos no Brasil no período de 2012 a 2021. Para a coleta de dados, utilizou-se o Sistema de Informações sobre Nascidos Vivos (SINASC), disponibilizado pelo DATASUS Resultado: No grupo de nascidos com Tetralogia de Fallot, a análise das variáveis revela informações valiosas sobre características demográficas e condições perinatais. Em relação à variável "Cor/Raça", dos 943 casos registrados, 588 (62,35%) eram classificados como brancos, 51 (5,41%) como pretos, 10 (1,06%) como amarelos, 267 (28,31%) como pardos, e 27 (2,86%) tiveram a cor/raça registrada como ignorada Conclusão: A compreensão profunda das cardiopatias congênitas não apenas salva vidas, mas também melhora significativamente a qualidade de vida dos indivíduos afetados

Tumor miofibroblástico inflamatório do pulmão : Inflammatory myofibroblastic tumor of the lung

Introdução: Os tumores miofibroblásticos inflamatórios pulmonares são achados patológicos, de apresentação clínica, evolução e prognósticos controversos. Representam de 0,04% -1,2% de todos os tumores pulmonares, sendo mais comuns em crianças e rara sua forma primária em adultos. Possui diagnóstico difícil, pois é fundamentalmente anátomo-patológico. A apresentação clínica e radiográfica são muito variáveis.  Apresentação do caso: sexo masculino, 49 anos de idade, admitido no hospital das clínicas da UFG (Go) com história cronica de 6 meses de dispnea progressiva, com tosse produtiva e sibilos, paciente tinha história de tabagismo (1 maço por dia há 20 anos) hipertensão e asma. Discussão: O tumor miofibroblasto inflamatório de pulmão geralmente é assintomático e descoberto incidentalmente ou apresenta sintomas respiratórios inespecíficos, como tosse, dor torácica , dispneia, hemoptise e sintomas sistêmicos inespecíficos, como febre, mal-estar e perda de peso. Podem estar associados a distúrbios imunológicos e infecções crônicas e podem ocorrer em cicatrizes pulmonares cirúrgicas.  Conclusão: É uma causa rara de tumor primário em adultos, em contrapartida, frequente na população pediátrica e, tem no anatomopatológico seu melhor diagnóstico e tratamento após ressecção cirúrgica completa, o qual indica, de forma usual, um bom prognóstico

Proteinose alveolar pulmonar: Pulmonary alveolar proteinosis

INTRODUÇÃO: A Proteinose Alveolar Pulmonar (PAP) é uma síndrome rara causada pelo acúmulo de surfactante no espaço alveolar, mais comumente encontrada em homens com idade média de 20 a 50 anos. É uma patologia com apresentação clínica variável e de difícil diagnóstico, que pode cursar com dispneia, tosse e dor torácica. APRESENTAÇÃO DO CASO: RSM, sexo masculino, 39 anos,  ex-tabagista de um maço por dia, durante 8 anos, com queixa de dispneia, dor torácica, ventilatório dependente, febre não aferida esporadicamente, tosse seca, raramente produtiva durante a manhã, e cianose de extremidades aos esforços há 4 meses. Após 6 meses, evoluiu com piora do quadro. Prosseguiu a investigação de pneumopatia extensa bilateral, com realização de biópsia pulmonar, confirmando o diagnóstico de PAP. DISCUSSÃO: A tomografia de tórax é o exame inicial a ser solicitado na investigação de PAP, seguido da confirmação com líquido do lavado broncoalveolar. Embora não seja um exame obrigatório, o padrão-ouro é a biópsia pulmonar cirúrgica. O principal tratamento é a lavagem pulmonar, além de fisioterapia e suporte pulmonar. CONCLUSÃO: Ainda que seja uma doença rara, é essencial o diagnóstico diferencial de PAP com quadros de dispneia crônica e progressiva, não explicadas por outras patologias mais prevalentes

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 10–24 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 (10–14, 15–19, and 20–24 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 10–24 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 2010–19, 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 2010–19. 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 low–middle-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, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODErn), to generate cause fractions and cause specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings At the broadest grouping of causes of death (Level 1), non-communicable diseases (NC Ds) comprised the greatest fraction of deaths, contributing to 73.4% (95% uncertainty interval [UI] 72.5-74.1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 186% (17.9-19.6), and injuries 8.0% (7.7-8.2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22.7% (21.5-23.9), representing an additional 7.61 million (7. 20-8.01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7.9% (7.08.8). The number of deaths for CMNN causes decreased by 222% (20.0-24.0) and the death rate by 31.8% (30.1-33.3). Total deaths from injuries increased by 2.3% (0-5-4-0) between 2007 and 2017, and the death rate from injuries decreased by 13.7% (12.2-15.1) to 57.9 deaths (55.9-59.2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000-289 000) globally in 2007 to 352 000 (334 000-363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118.0% (88.8-148.6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36.4% (32.2-40.6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33.6% (31.2-36.1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respirator}, infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990 neonatal disorders, lower respiratory infections, and diarrhoeal diseases were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.Peer reviewe

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: 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 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-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 10–24 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 10–24 years were also in the top ten in the 25–49-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 50–74-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

Global, regional, and national mortality among young people aged 10-24 years, 1950-2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10-24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10-24 years by age group (10-14 years, 15-19 years, and 20-24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10-24 years with that in children aged 0-9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10-24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). Findings In 2019 there were 1.49 million deaths (95% uncertainty interval 1.39-1.59) worldwide in people aged 10-24 years, of which 61% occurred in males. 32.7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32.1% were due to communicable, nutritional, or maternal causes; 27.0% were due to non-communicable diseases; and 8.2% were due to self-harm. Since 1950, deaths in this age group decreased by 30.0% in females and 15.3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10-14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15-19 years was 1.3% in males and 1.6% in females, almost half that of males aged 1-4 years (2.4%), and around a third less than in females aged 1-4 years (2.5%). The proportion of global deaths in people aged 0-24 years that occurred in people aged 10-24 years more than doubled between 1950 and 2019, from 9.5% to 21.6%. Interpretation Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10-24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd