Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

مارکس کی معاشرتی اور معاشی جدلیات اور اقبال

Since the majority of philosophers base their theories on the idea of human well-being, human sciences did not envision an ideal state but rather a setting where concrete and useful services to human well-being were provided. Your fate is determined by God, but statistics and formulas in human scientific, social, and particularly economic fields have demonstrated how the early members of humankind appropriated human resources and exploited people like commodities. This system has continually been created in this alluring manner of government. Mother's data shows that the current economic system will inevitably fail. It doesn't matter why this system failed if it was so instinctive. Iqbal's view in this regard holds that military prowess and ultimately suffers from here. We cannot dispute its scientific supremacy notwithstanding this shortcoming

اُردو سفرنامہ کی تدریس؛ایک مطالعہ

Teaching of Urdu language and literature is difficult. For which background study is required. Apart from this, each genre of teaching has its own requirements. This is also the case with travelogues. In relation to the teaching of travelogue, it is important to determine the definition of travelogue, its evolution from era to era and technical accessories. In this research paper, the researchers have made a detailed review of the definition of Urdu travelogue, as well as its evolution so that the process of teaching of this important genre of literature become easier and more effective for teachers.

بابا گرونانک کے کلام کے اردو تراجم

Baba Guru Nanak, the pioneer of monotheism, equality and brotherhood, was born in a middle-class Hindu family of Punjab, about five centuries ago, i.e. 1526 A.D. according to Bikram, 1469 A.D. His father's name was Baba Kalyan Chand alias Mah. He was three years old. His mother's name was Tripta Bibi. People recited Guru Nanak’s poetry Jip Ji in the early morning in Sikhism. It is a word whose every syllable is a message of humanity, brotherhood, negation of caste community, as well as complete peace. Baba Guru Nanak founded Sikhism in the late fifteenth century. Baba Guru Nanak was an influential spiritual figure who taught not only spiritual but Ibid social, religious, equality, brotherly love and peace in his teachings, which is reflected in his words Jap Ji in the holy religious book of Sikhism. Many scholars have translated the Baba Guru Nanak’s poetry in Urdu. This article is about analysis of translation of Baba Guru Nanak’s Poetry

لکھے موسیٰ پڑھے خُدا کی تحقیق اُردو لغات کی روشنی میں

The proverbs in a language are the essence of a nation's intelligence and experiments of social and spiritual life. This is the reason that there is a real truth in the background of each proverb, which makes it easy to understand the meaning of the said proverb. In Urdu dictionaries, the blind copying of predecessors is very bad tradition. The words and proverbs in Old dictionaries have been repeated without any research, to the present age. For example the Urdu proverb "Lekhay Mu Sa Parhe Khud Aa" is one of these proverbs. There are mistakes in Urdu dictionaries regarding to the origin and meaning of this proverb. In this research paper the researchers have tried to determine the correct Imla, meaning and significance of this proverb.

Effects of Computer-Based Integrated Learning System on the Teaching of Mathematics at Higher secondary Level in Pakistan

The purpose of this experimental research is to determine the effectiveness of computer-based integrated learning system on the teaching of Mathematics at a higher secondary level in Pakistan. The objectives of the study were to measure the academic achievement of students in Mathematics by teaching through the traditional method, measure the academic achievement of students using the computer-based integrated learning system in Mathematics, and compare the effectiveness of computer-based integrated learning system and traditional method in term of academic achievement of the higher secondary schools’ students in Mathematics. All the Students of F.Sc Pre-Engineering in G.H.S.S of Khyber Pakhtunkhwa constituted the population of the study. One Govt. Higher Secondary School was conveniently taken from the population as a sample. Students were divided into experimental group and control group randomly containing 25 students in each group. Pretest, post-test control group design was used in this study. The pre-test score was recorded before the treatment and the post-test score after six weeks of treatment. The collected data were tabulated, analyzed, and interpreted with SPSS. For analysis of the result, a t-test was used. The study concluded from the analysis that a computer-based integrated learning system was more effective as compared to the traditional method of teaching Mathematics. The study recommended that a computer based integrated learning system should be adopted in the existing system of teaching Mathematics to increase the interest and motivation of students and decrease the anxiety of Mathematics

THE NEXUS OF CLIMATE CHANGE AND DEVELOPMENT: THE ROLE OF MEDIA IN PAKISTAN: Dr. Sher Muhammad Malik, Dr. Malik Adnan, Dr. Amjad Ali

Pakistan is facing two front challenges from climate change and development. It has the least share in production of Green House Gases (GHGs) as well as in Carbon Offset and on the other hand, it is the country which is worst affected by climate change among South Asian countries. Similarly, the cost of sustainable development hinders the growth of Gross Domestic Products (GDP). The electronic and printed media in Pakistan is more focused on the causes and impacts of climate change as well as on the progress of sustainable Development Goals (SDGs). The present study explores the diverse dimensions of the role of media in the understanding of the nexus of climate change and development to maximize the benefits for the country development particularly of GDP sector. The existing potential of Pakistani media is studied to interlink the GHGs emission and GDP, with the impacts of climate change and Carbon Offset take down by the country. In the same fashion, the relation between sustainable development and growth of GDP with inflation rate portrayed the actual struggle of the country for the SDGs progress. The paradigm shift in understanding and projecting of the nexus of climate change and development from Pakistani media will support the growth of GDP in the country

GEO-SPATIAL ANALYSIS: THE IMPACTS OF LAND POLICY ON THE DEVELOPMENT OF CHOLISTAN DESERT REGION, PAKISTAN: Dr. Sher Muhammad Malik, Dr. Amjad Ali, Dr. Fazlur-Rahman

The Cholistan desert region has the potential of agro-pastoral husbandry development with limited natural resources. The Government guided this developmental process through land allotment policy which has different implementation modality each time. The land policy has diverse impacts on the arid and semi-arid regions of the Cholistan desert. The impacts of policy on the socioeconomic conditions of the regions are associated with geo-spatial techniques. The sample settlement is geo-coded, and their responses are combined into two regions i.e. Lesser and Greater Cholistan regions. The combined responses are associated through phi coefficient and Cramér's V. The impacts of land policy in the Lesser Cholistan region are encouraging the developmental process while in Greater Cholistan, it discourages the development with poor socioeconomic conditions. The present study provide opportunity for understanding, mode of implementation and modification in land policy to achieve sustainable development