Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods: We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings: Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation: Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding: Bill & Melinda Gates Foundation

Search for a Higgs boson decaying into γ*γ→ℓℓγ with low dilepton mass in pp collisions at √s=8 TeV

A search is described for a Higgs boson decaying into two photons, one of which has an internal conversion to a muon or an electron pair ( ℓℓγ ). The analysis is performed using proton–proton collision data recorded with the CMS detector at the LHC at a centre-of-mass energy of 8 TeV, corresponding to an integrated luminosity of 19.7 fb −1 . The events selected have an opposite-sign muon or electron pair and a high transverse momentum photon. No excess above background has been found in the three-body invariant mass range 12

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Laboratory Spectroscopy and Herschel and APEX Observations of Light Hydride Species

Observations of CH+, J = 1 − 0 and 2 − 1 near 0.835 and 1.67 THz with Herschel/HIFI and of 13CH+, J = 1 − 0 near 0.830 THz with APEX revealed their rest frequencies to be higher than the accepted values by 21 and 30 km s-1, respectively. Very recent laboratory measurements of the J = 1 − 0 transition frequencies of CH+, 13CH+ and CD+ and fits to these as well as electronic spectral data resolved the descrepancies. The laboratory spectroscopic situation will be reviewed for selected cationic light hydride species

Supplementary Material for: Oxidized Docosahexaenoic Acid Species and Lipid Peroxidation Products Increase Amyloidogenic Amyloid Precursor Protein Processing

One of the main characteristics of Alzheimer's disease (AD) is the β-amyloid peptide (Aβ) generated by β- and γ-secretase processing of the amyloid precursor protein (APP). Previously it has been demonstrated that polyunsaturated fatty acids (PUFAs), especially docosahexaenoic acid (DHA), are associated with a reduced risk of AD caused by decreased Aβ production. However, in epidemiological studies and nutritional approaches, the outcomes of DHA-dependent treatment were partially controversial. PUFAs are very susceptible to reactive oxygen species and lipid peroxidation, which are increased during disease pathology. In line with published results, lipid peroxidation was elevated in human postmortem AD brains; especially 4-hydroxy-nonenal (HNE) was increased. To investigate whether lipid peroxidation is only a consequence or might also influence the processes leading to AD, we analyzed 7 different oxidized lipid species including 5 oxidized DHA derivatives and the lipid peroxidation products of ω-3 and ω-6 PUFAs, HNE and 4-hydroxy-hexenal, in human neuroblastoma cells and mouse mixed cortical neurons. In the presence of oxidized lipids Aβ and soluble β-secreted APP levels were elevated, whereas soluble α-secreted APP was decreased, suggesting a shift from the nonamyloidogenic to the amyloidogenic pathway of APP processing. Furthermore, β- and γ-secretase activity was increased by oxidized lipids via increased gene expression and additionally by a direct effect on β-secretase activity. Importantly, only 1% oxidized DHA was sufficient to revert the protective effect of DHA and to significantly increase Aβ production. Therefore, our results emphasize the need to prevent DHA from oxidation in nutritional approaches and might help explain the divergent results of clinical DHA studies

Características morfológicas de cultivares de soja convencionais e Roundup ReadyTM em função da época e densidade de semeadura Morphologic characteristic of the conventional soybean genotype and Roundup ReadyTM according to the sowing season and seed densities

O trabalho tem como objetivo verificar a influência de diferentes densidades e épocas de semeadura em genótipos convencionais e Roundup ReadyTM (RR), nas características morfológicas de plantas de soja. O experimento foi conduzido em Jari, Rio Grande do Sul (RS). A primeira semeadura foi realizada dentro da época indicada para a cultura (novembro), e a segunda, após a época indicada (janeiro), com as cultivares 'CEP/CD 41', 'CD 201', 'Fundacep 39',' Fundacep 44', 'CD 205', 'BRS 133', 'Fundacep 45', 'A 6001 RG', 'Mágica', 'AL72' e 'A 8100 RG', nas densidades de 250, 400 e 550 mil sementes aptas ha-1, na safra 2005/2006. O delineamento experimental utilizado foi blocos ao acaso, com parcelas subsubdivididas e quatro repetições. Foram avaliados o ciclo das cultivares, a altura de plantas, a altura de inserção do primeiro legume, o número de ramos planta-1 e de ramos m-2, o número de nós na haste principal planta-1 e na haste principal m-2, o rendimento biológico (RB) e o índice de colheita (IC). A semeadura em janeiro ocasiona redução no ciclo da cultura, na altura de plantas, na altura de inserção do primeiro legume, no número de nós planta-1 e de RB e no atraso da semeadura. O aumento da densidade de sementes não proporcionou aumento na estatura de plantas e altura de inserção do primeiro legume, nas cultivares RR. O período do ciclo que é mais afetado com atraso da semeadura é o vegetativo. O IC foi menor na semeadura em novembro; no entanto, o RB foi maior.<br>This paper has the objective to evaluate the influence of seed densities and sowing season in conventional soybean genotype and Roundup ReadyTM (RR), in the morphological characteristic of soybean plant. The experiments were conducted in Jari-RS, Brazil. The first seeding was done within the time prescribed for the crop(November), and the second, after the time indicated (January), with the cultivars 'CEP/CD 41', 'CD 201', 'Fundacep 39', 'Fundacep 44', 'CD 205', 'BRS 133', 'Fundacep 45', 'A 6001 RG', 'Mágica, AL72' and A '8100 RG', at densities of 250, 400 and 550 thousand seed seeds suitable ha-1 in the 2005/2006 harvest. The experiment design was randomized blocks with split plots, with four replications. The cultivars cycle, plant height, height of first pod insertion, number of branches plant-1, branches m-2, nodes' number of the main stem plant-1, nodes main stem m-2, biological yield (RB) and harvest index (IC). Sowing in January causes reduction in the crop cycle, plant height, height of first pod insertion, number of nodes plant-1 and RB and the increase in seed density not increased the height of first pod insertion in RR cultivars. The period cycle that is most affected by the delayed sowing is the vegetative. The IC sowing in November was lower, but the RB was larger