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

Osteoprogenitor cells culture on 3-D hydroxyapatite-collagen composite under static and dynamic conditions

L’organisme humain présente de nombreuses constantes de régénération tissulaires et c’est cette caractéristique essentielle qui maintient l’équilibre physiologique. Toutefois, l’existence de lésions importantes provoquée par un déséquilibre interne ou externe peut empêcher l’organisme de s’auto-régénerer. Dans ce cas, l’application des biomatériaux développés pour des applications biomédicales peuvent améliorer le processus de guérison. Pour les applications en tissus durs, les biomatériaux doivent posséder des propriétés similaires aux matrices naturelles tant sur le plan biologique que physico-mécanique. Dans les applications en bioingénierie osseuse, les composites à base de collagène (Col) et d’hydroxiapatite (HA) sont devenus tellement performant qu’ils peuvent être classifiés comme des matériaux biomimétiques. Cette thèse propose la production d’une matrice 3-D poreuse à base d’HA et de Col (50:50wt%). Ce composite réticulé par le glutaraldéhyde a été caractérisé par des différentes techniques et servira de support pour la culture cellulaire. Des cellules estromales ostéoprogénitrices ont été cultivées dans un environnement statique et dynamique (deux vitesse de flux) et leurs capacités de colonisation ainsi que leurs comportements d’adhésion, de prolifération, de différentiation seront observés. A travers les résultats de diffraction de rayons X et de spectroscopie infrarouge, il est possible d’affirmer la présence dans la matrice collagène d’une phase minérale peu cristalline constituée par de l’hydroxiapatite carbonatée du type-B déficiente en calcium. La viabilité cellulaire a été fortement influencée par les systèmes de culture au cours des 21 jours. Les résultats du système dynamique en haute vitesse montrent une excellente capacité du composite à supporter les processus cellulaires. Les cellules sont capables d’adhérer, de proliférer et de coloniser la matrice tridimensionnelle.The progress in Tissue Engineering area allows the development of biomaterials that mimic the properties of natural tissues. For biomedical applications in mineralized tissues, composites based on hydroxyapatite (HA) and collagen (Col) have presented good results when implanted in vivo. The aim of this work was to produce a 3-D matrix and to observe the cell behaviour when stromal cells are cultured in contact with HA-Col scaffold under static and dynamic conditions. For in vitro biological evaluation, osteoprogenitor human cells (Stro+1A cells) were grown and their colonization capacity and adhesion, proliferation and differentiation behaviour were quantified. Two perfusion flow rates (0,03ml/min and 0,3ml/min) were proposed for dynamic culture. The HA-Col composite was prepared by reorganization of Col fibrils simultaneously with HA crystal nucleation and precipitation from calcium and phosphate rich solutions. Afterwards, the composites were crosslinked and sterilized by gamma radiation. Stro+1A cells were inoculated (5x105 cells/sample) into the scaffolds and cultured over 21 days in a humid incubator at 37°C and 5% CO2. Infrared spectroscopy and X-ray diffraction results suggested a calcium-deficient hydroxyapatite as mineral phase. About cell culture, the cell number increased under higher flow rate dynamic culture. By scanning electron microscopy and histological sections, we observed cells adhered and spread inside colonized scaffolds

Cultivo de células osteoprogenitoras em compósito 3-D hidroxiapatita-colágeno sob condições estática e dinâmica

The progress in Tissue Engineering area allows the development of biomaterials that mimic the properties of natural tissues. For biomedical applications in mineralized tissues, composites based on hydroxyapatite (HA) and collagen (Col) have presented good results when implanted in vivo. The aim of this work was to produce a 3-D matrix and to observe the cell behaviour when stromal cells are cultured in contact with HA-Col scaffold under static and dynamic conditions. For in vitro biological evaluation, osteoprogenitor human cells (Stro+1A cells) were grown and their colonization capacity and adhesion, proliferation and differentiation behaviour were quantified. Two perfusion flow rates (0,03ml/min and 0,3ml/min) were proposed for dynamic culture. The HA-Col composite was prepared by reorganization of Col fibrils simultaneously with HA crystal nucleation and precipitation from calcium and phosphate rich solutions. Afterwards, the composites were crosslinked and sterilized by gamma radiation. Stro+1A cells were inoculated (5x105 cells/sample) into the scaffolds and cultured over 21 days in a humid incubator at 37°C and 5% CO2. Infrared spectroscopy and X-ray diffraction results suggested a calcium-deficient hydroxyapatite as mineral phase. About cell culture, the cell number increased under higher flow rate dynamic culture. By scanning electron microscopy and histological sections, we observed cells adhered and spread inside colonized scaffolds.L’organisme humain présente de nombreuses constantes de régénération tissulaires et c’est cette caractéristique essentielle qui maintient l’équilibre physiologique. Toutefois, l’existence de lésions importantes provoquée par un déséquilibre interne ou externe peut empêcher l’organisme de s’auto-régénerer. Dans ce cas, l’application des biomatériaux développés pour des applications biomédicales peuvent améliorer le processus de guérison. Pour les applications en tissus durs, les biomatériaux doivent posséder des propriétés similaires aux matrices naturelles tant sur le plan biologique que physico-mécanique. Dans les applications en bioingénierie osseuse, les composites à base de collagène (Col) et d’hydroxiapatite (HA) sont devenus tellement performant qu’ils peuvent être classifiés comme des matériaux biomimétiques. Cette thèse propose la production d’une matrice 3-D poreuse à base d’HA et de Col (50:50wt%). Ce composite réticulé par le glutaraldéhyde a été caractérisé par des différentes techniques et servira de support pour la culture cellulaire. Des cellules estromales ostéoprogénitrices ont été cultivées dans un environnement statique et dynamique (deux vitesse de flux) et leurs capacités de colonisation ainsi que leurs comportements d’adhésion, de prolifération, de différentiation seront observés. A travers les résultats de diffraction de rayons X et de spectroscopie infrarouge, il est possible d’affirmer la présence dans la matrice collagène d’une phase minérale peu cristalline constituée par de l’hydroxiapatite carbonatée du type-B déficiente en calcium. La viabilité cellulaire a été fortement influencée par les systèmes de culture au cours des 21 jours. Les résultats du système dynamique en haute vitesse montrent une excellente capacité du composite à supporter les processus cellulaires. Les cellules sont capables d’adhérer, de proliférer et de coloniser la matrice tridimensionnelle

Cultivo de células osteoprogenitoras em compósito 3-D hidroxiapatita-colágeno sob condições estática e dinâmica

L organisme humain présente de nombreuses constantes de régénération tissulaires et c est cette caractéristique essentielle qui maintient l équilibre physiologique. Toutefois, l existence de lésions importantes provoquée par un déséquilibre interne ou externe peut empêcher l organisme de s auto-régénerer. Dans ce cas, l application des biomatériaux développés pour des applications biomédicales peuvent améliorer le processus de guérison. Pour les applications en tissus durs, les biomatériaux doivent posséder des propriétés similaires aux matrices naturelles tant sur le plan biologique que physico-mécanique. Dans les applications en bioingénierie osseuse, les composites à base de collagène (Col) et d hydroxiapatite (HA) sont devenus tellement performant qu ils peuvent être classifiés comme des matériaux biomimétiques. Cette thèse propose la production d une matrice 3-D poreuse à base d HA et de Col (50:50wt%). Ce composite réticulé par le glutaraldéhyde a été caractérisé par des différentes techniques et servira de support pour la culture cellulaire. Des cellules estromales ostéoprogénitrices ont été cultivées dans un environnement statique et dynamique (deux vitesse de flux) et leurs capacités de colonisation ainsi que leurs comportements d adhésion, de prolifération, de différentiation seront observés. A travers les résultats de diffraction de rayons X et de spectroscopie infrarouge, il est possible d affirmer la présence dans la matrice collagène d une phase minérale peu cristalline constituée par de l hydroxiapatite carbonatée du type-B déficiente en calcium. La viabilité cellulaire a été fortement influencée par les systèmes de culture au cours des 21 jours. Les résultats du système dynamique en haute vitesse montrent une excellente capacité du composite à supporter les processus cellulaires. Les cellules sont capables d adhérer, de proliférer et de coloniser la matrice tridimensionnelle.The progress in Tissue Engineering area allows the development of biomaterials that mimic the properties of natural tissues. For biomedical applications in mineralized tissues, composites based on hydroxyapatite (HA) and collagen (Col) have presented good results when implanted in vivo. The aim of this work was to produce a 3-D matrix and to observe the cell behaviour when stromal cells are cultured in contact with HA-Col scaffold under static and dynamic conditions. For in vitro biological evaluation, osteoprogenitor human cells (Stro+1A cells) were grown and their colonization capacity and adhesion, proliferation and differentiation behaviour were quantified. Two perfusion flow rates (0,03ml/min and 0,3ml/min) were proposed for dynamic culture. The HA-Col composite was prepared by reorganization of Col fibrils simultaneously with HA crystal nucleation and precipitation from calcium and phosphate rich solutions. Afterwards, the composites were crosslinked and sterilized by gamma radiation. Stro+1A cells were inoculated (5x105 cells/sample) into the scaffolds and cultured over 21 days in a humid incubator at 37C and 5% CO2. Infrared spectroscopy and X-ray diffraction results suggested a calcium-deficient hydroxyapatite as mineral phase. About cell culture, the cell number increased under higher flow rate dynamic culture. By scanning electron microscopy and histological sections, we observed cells adhered and spread inside colonized scaffolds.MULHOUSE-SCD Sciences (682242102) / SudocSudocFranceF

In Vitro Biological Evaluation of 3-D Hydroxyapatite/Collagen (50/50 wt. (%)) Scaffolds

Hydroxyapatite-collagen (HA/Col) composites are potential scaffolds for bone tissue engineering. In this work, three-dimensional (3-D) HA/Col (50/50 wt. (%)) scaffolds were synthesized using a self-assembly method and cross-linked with a 0.125% glutaraldehyde solution. Scaffolds were evaluated in vitro by cytotoxicity testing using MC3T3 cells; proliferation and differentiation were studied using STRO-1A human stromal cells for up to 21 days. Morphological and histological examinations showed a fibrous structure with a good distribution and homogeneous HA particles distribution. By thermogravimetric analysis, a ratio of 1.2 between inorganic and organic phase was found. The scaffolds presented no cytotoxicity when evaluated using three different parameters of cell survival and integrity: 2,3-bis[2-methyloxy-4-nitro-5-sulfophenyl] -2H-tetrazolium-5-carboxanilide (XTT), Neutral Red (NR) and Crystal Violet Dye Elution (CVDE). STRO-1A cells were found to adhere, proliferate and differentiate on the 3-D scaffold, but limited cell penetration was observed

Estudo da morfologia renal após a oclusão da aorta abdominal infra-renal em ratos

OBJETIVO: Relacionar as alterações morfológicas renais sob microscopia de luz, de ratos submetidos à oclusão de aorta, em modelo que simule a condição clínica de reparação cirúrgica de um aneurisma de aorta abdominal. MÉTODO: Ratos Wistar (N = 60), machos pesando entre 200 e 250g, foram distribuídos em três grupos: I (simulado); II (isquemia); III (isquemia + reperfusão); e cada grupo redistribuído em dois subgrupos: A (30 min); B (60 min). Foi realizada isquemia utilizando clamp vascular (8mm) na aorta abdominal infra-renal de acordo com o grupo estudado. Ao final de cada experimento os animais foram mortos e realizada análise histológica renal cortical e medular (descritiva e morfométrica) através de metodologia convencional (parafina-hematoxilinaeosina). A análise semiquantitativa de lesão tubular e intersticial foi realizada de acordo com o índice de lesão tubular e índice de lesão intersticial. Para a análise estatística foram aplicados os seguintes testes: Mann-Whitney, Kruskal-Wallis, Comparações múltiplas (p < 0,001). RESULTADOS: Observou-se no grupo III alterações histológicas tubulares e intersticiais significantes com relação aos outros grupos (p < 0,001). CONCLUSÕES: A oclusão da aorta abdominal infra-renal em ratos está associada a lesões estruturais renais tanto tubulares quanto intersticiais principalmente na fase de reperfusão

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field