Primer reporte de bacterias termo alcalófilas del manantial “Los Baños del Carmen”, Venustiano Carranza, Chiapas, México

Objective: To isolate and to characterize extremophile microoorganism from hot spring manantial “Baños del Carmen” Venustiano Carranza, Chiapas, México. Design/methodology/approach: The samples were collected in three points of the main pit of the site called "Los Baños del Carmen". Serial dilutions were made and plated in LB medium and nutrient agar. Reseed colonies were isolated with different colonial morphology to obtain axenic cultures. Micro and macroscopic morphological characterization of the isolates and a biochemical characterization with the API 20E kit were carried out. Results: Three alkaline thermophilic bacterial strains were successfully found: YEFP-C, YEPF-J, and YEPF-P. All strains were gram-negative an ability to grow at pH 8-10 and 50?C. Also, all them have a fermentative metabolism of carbohydrates and beta-galactosidase activity. Limitations on study/implications: The strategy used was limited to heterotrophic aerobic organisms; however, it is likely that there is a diversity of other types of prokaryotes and eukaryotes on the site. Findings/conclusions: There are extremophile organisms in hot spring “Los Baños del Carmen”, and this work is the first report with scientific evidence.Objetivo: Aislar y caracterizar microbiológicamente bacterias extremófilas del manantial “Baños del Carmen” Venustiano Carranza, Chiapas, México. Diseño/metodología/aproximación: Las muestras fueron recolectadas en tres puntos de la fosa principal del sitio. Se realizaron diluciones seriadas y se sembraron en medio LB y agar nutritivo. Se llevaron a cabo resiembras de colonias aisladas con diferente morfología colonial hasta obtener cultivos axénicos. Se llevó a cabo una caracterización morfológica micro y macroscópica de los aislados y una caracterización bioquímica con el kit API 20E Resultados: Tres cepas bacterianas termo alcalófilas fueron encontradas: YEFP-C, YEPF-J, y YEPF-P. Todas las cepas fueron Gram negativas y registraron crecimiento en medios con pH de 8.0 a 10.0 y 50 °C. Además, todas tienen metabolismo fermentativo de carbohidratos y actividad beta galactosidase.  Limitaciones del estudio/implicaciones: La estrategia utilizada se limitó a organismos aerobios heterotróficos; sin embargo, es probable que exista biodiversidad de otro tipo de organismos procariotes y eucariotes en el sitio. Hallazgos/conclusiones: Existe vida bacteriana extremofila en el manantial “Los Baños del Carmen”. Este es el primer reporte con evidencia científica

una mirada desde las Ciencias de la Conducta

Este libro es el resultado de los trabajos presentados en el 1er Congreso Internacional "Convivencia y bienestar con sentido humanista para una cultura de paz"

POR UNA CULTURA DE PAZ: UNA MIRADA DESDE LAS CIENCIAS DE LA CONDUCTA

En
 virtud
 de
 lo
 anterior,
 los
 estudiosos
 de
 las
 ciencias
 de
 la
 conducta
 
de
 la
 Universidad
Autónoma 
del
 Estado 
de 
México,

ante 
la
persistencia
 y 
proliferación
 de
 estos 
hechos
 en
 diversas
 partes
 del
Mundo
 y
 de
 nuestro 
país 
en 
particular, se
 convocó
 a
 los
 estudiosos
 interesados
 y
 a
 la
 sociedad
 en
 general
 a
 presentar
 trabajos
 para
 analizar,
 debatir
 y
 proponer
 estrategias
 de
 acción
 y
 dirección,
 que
 fortalezcan
 una
 convivencia y bienestar con sentido humanista para una cultura de paz. El
 presente
 texto
 es
 producto
 de 
esta convocatoria 
que
 recoge 
los
trabajos 
de 

los
 interesados 
en 
la
 temática,

 de
 diferentes 
países
(España,
Argentina,
Cuba,
Brasil,
Costa
 Rica
 y
 México)
 retomando
 con
 ello
 sus
 experiencias
 relativas
 al
 estudio,
 análisis,
 comprensión
 e
 instrumentación
 de
 la
 cultura
 de
 paz
 en
 los
 distintos
 ámbitos
 institucionales
 en
 los
 que
 participan:
 educativo,
 salud,
 penitenciario,
 social,
laboral,
familia,
alimentario,
psicológico,
por 
mencionar 
algunos.
 El
 presente
 libro,
 propicia
 un
 espacio
 de
 reflexión,
 diálogo
 y
 posicionamiento
 de
 las 
ciencias 
de 
la 
conducta
 para 
la 
apropiación,
análisis,
debate
 y 
propuestas 
que
 fortalezcan 
una
 cultura
 de 
paz
 a
través
 de 
la
 convivencia 
y
 el 
bienestar
 social 
con
 sentido 
humanista.
El
 sistema 
económico
 neoliberal
 y 
el 
proceso
 de 
globalización 
han
 contribuido
al
 logro
 de
 avances
 significativos
 en
 la
 ciencia
 y
 la
 tecnología,
 pero
 también
 han
 propiciado
 la
 polarización
 de
 las
 sociedades
 lo
 que
 ha
 impactado
 de
 manera
 negativa
 a
 la
 sociedad
 en
 su
 conjunto,
 pero
 en
 mayor
 medida
 a
 los grupos
 vulnerables. Dicha
 polarización
 ha
 traído
 consigo
 un
 desarrollo
 desigual
 del
 mundo
 que
 se
 expresa
 de
 diferentes
 maneras
 tanto
 en
 países
 desarrollados
 como
 en
 los
 llamados
 del
 tercer
 mundo,
 en
 donde
 no
 están
 satisfechas
 las
 necesidades
 humanas 
elementales
 de
 todos 
los
sectores 
de 
la 
población,
siempre 
falta 
algo. 
Si 
a
 esto 
le
 sumamos 
los
conflictos
 internacionales por
 diferentes
 motivos
 que
 enfrentan
 algunas
 naciones,
 una
 insuficiente
 cobertura
 educativa
 y
 de
 salud,

 desempleo
 y
 pobreza 
extrema,
 entre 
otras
 cosas; 
estamos
 frente
 a
retos 
de
 gran
 envergadura
 para
 los
 gobiernos,
 para
 los
 estudiosos
 y
 para
 la
 sociedad
 civil
 en
 general. Uno 
de 
los
 intentos
 para
 frenar 
y prevenir 
la
 agudización
 de 
estas 
problemáticas
 es
 la
 cultura 
de 
paz,
cuyo
 estudio
y propuestas 
han 
ido 
avanzando 
en 
diferentes
 sentidos 
y 
de 
manera 
favorable,
el 
tema 
está 
presente 
en 
diferentes 
Organismos
 Internacionales
 como
 la
 ONU,
 la
 UNESCO,
 la
 OCDE,
 El
 Banco
 Mundial,
 entre
 otros.
 Pero
 falta 
mucho 
por 
hacer.Universidad Autónoma del Estado de Méxic

5to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

El V Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2019, realizado del 6 al 8 de febrero de 2019 y organizado por la Universidad Politécnica Salesiana, ofreció a la comunidad académica nacional e internacional una plataforma de comunicación unificada, dirigida a cubrir los problemas teóricos y prácticos de mayor impacto en la sociedad moderna desde la ingeniería. En esta edición, dedicada a los 25 años de vida de la UPS, los ejes temáticos estuvieron relacionados con la aplicación de la ciencia, el desarrollo tecnológico y la innovación en cinco pilares fundamentales de nuestra sociedad: la industria, la movilidad, la sostenibilidad ambiental, la información y las telecomunicaciones. El comité científico estuvo conformado formado por 48 investigadores procedentes de diez países: España, Reino Unido, Italia, Bélgica, México, Venezuela, Colombia, Brasil, Estados Unidos y Ecuador. Fueron recibidas un centenar de contribuciones, de las cuales 39 fueron aprobadas en forma de ponencias y 15 en formato poster. Estas contribuciones fueron presentadas de forma oral ante toda la comunidad académica que se dio cita en el Congreso, quienes desde el aula magna, el auditorio y la sala de usos múltiples de la Universidad Politécnica Salesiana, cumplieron respetuosamente la responsabilidad de representar a toda la sociedad en la revisión, aceptación y validación del conocimiento nuevo que fue presentado en cada exposición por los investigadores. Paralelo a las sesiones técnicas, el Congreso contó con espacios de presentación de posters científicos y cinco workshops en temáticas de vanguardia que cautivaron la atención de nuestros docentes y estudiantes. También en el marco del evento se impartieron un total de ocho conferencias magistrales en temas tan actuales como la gestión del conocimiento en la universidad-ecosistema, los retos y oportunidades de la industria 4.0, los avances de la investigación básica y aplicada en mecatrónica para el estudio de robots de nueva generación, la optimización en ingeniería con técnicas multi-objetivo, el desarrollo de las redes avanzadas en Latinoamérica y los mundos, la contaminación del aire debido al tránsito vehicular, el radón y los riesgos que representa este gas radiactivo para la salud humana, entre otros

Resignificando la educación: 12 reflexiones pedagógicas sobre la escuela

208 páginasEste libro reúne 12 artículos de maestros y maestras de la ciudad que reflexionan sobre el rol de la Escuela en la actualidad. Sin duda, la pandemia es un hecho que atraviesa varias de estas páginas, pues esta coyuntura ha hecho que estudiantes, docentes y familias resignifiquen su papel en la educación. Pero este libro no se agota allí, en tanto aparecen iniciativas como las redes de maestros y maestras en torno a la paz, la interculturalidad, así como nuevas miradas sobre la inclusión educativa y la evaluación que aportan al diálogo pedagógico. De esta manera, el Instituto para la Investigación Educativa y el Desarrollo Pedagógico (IDEP) busca que docentes y directivos de las instituciones educativas aporten a la transformación educativa desde sus saberes y experiencias.I. La Escuela en Casa. Página 17: Transitando por la Escuela: realidades y posibilidades. Página 29: Relación Familia- Escuela, Educación Asistida y Ambientes de Aprendizaje en Casa. Página 43: Percepciones de familias sobre su participación en la Escuela. Articulando voces de madres, padres y acudientes de estudiantes en Jardín y Transición. II. Nuevas miradas de la evaluación Página 71: Del pensamiento a la acción: la evaluación en el preescolar. Página 87: La evaluación durante el confinamiento educativo: evidencias investigativas de una crisis en sus prácticas y usos. III. Redes de paz, reconciliación y ciudadanía. Página 103: La Red Elegguá: Abriendo caminos para la tolerancia y la interculturalidad. Página 113: Pedagogías colectivas para la Paz- Tejido de esperanzas de maestras y maestros de la Red Chisua. IV. Inclusión educativa. Página 131: Experiencias de apropiación: Narrativas de maestras desde la inclusión. Página 149: El rol del docente de apoyo frente al reto de una educación inclusiva de calidad para la atención a la población estudiantil con discapacidad. Página 161: La oferta bilingüe-bicultural a nivel distrital, una apuesta en la educación de la persona sorda. V. Estudiantes y maestros en cambio. Página 177: El maestro investigador en el aula y su caracterización pedagógica. Página 195: Los Procesos de Lectura y Escritura Creativa en niños, niñas y adolescentes. Análisis de una experiencia

Universidad y sociedad: comunicación e integración en empresas e instituciones públicas y organizaciones no lucrativas: innovación y progreso

Depto. de Teorías y Análisis de la ComunicaciónFac. de Ciencias de la InformaciónFALSEsubmitte

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

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

Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2\ub75th percentile and 100 as the 97\ub75th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59\ub74 (IQR 35\ub74–67\ub73), ranging from a low of 11\ub76 (95% uncertainty interval 9\ub76–14\ub70) to a high of 84\ub79 (83\ub71–86\ub77). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030

Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

How long one lives, how many years of life are spent in good and poor health, and how the population's state of health and leading causes of disability change over time all have implications for policy, planning, and provision of services. We comparatively assessed the patterns and trends of healthy life expectancy (HALE), which quantifies the number of years of life expected to be lived in good health, and the complementary measure of disability-adjusted life-years (DALYs), a composite measure of disease burden capturing both premature mortality and prevalence and severity of ill health, for 359 diseases and injuries for 195 countries and territories over the past 28 years. Methods We used data for age-specific mortality rates, years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to calculate HALE and DALYs from 1990 to 2017. We calculated HALE using age-specific mortality rates and YLDs per capita for each location, age, sex, and year. We calculated DALYs for 359 causes as the sum of YLLs and YLDs. We assessed how observed HALE and DALYs differed by country and sex from expected trends based on Socio-demographic Index (SDI). We also analysed HALE by decomposing years of life gained into years spent in good health and in poor health, between 1990 and 2017, and extra years lived by females compared with males. Findings Globally, from 1990 to 2017, life expectancy at birth increased by 7·4 years (95% uncertainty interval 7·1-7·8), from 65·6 years (65·3-65·8) in 1990 to 73·0 years (72·7-73·3) in 2017. The increase in years of life varied from 5·1 years (5·0-5·3) in high SDI countries to 12·0 years (11·3-12·8) in low SDI countries. Of the additional years of life expected at birth, 26·3% (20·1-33·1) were expected to be spent in poor health in high SDI countries compared with 11·7% (8·8-15·1) in low-middle SDI countries. HALE at birth increased by 6·3 years (5·9-6·7), from 57·0 years (54·6-59·1) in 1990 to 63·3 years (60·5-65·7) in 2017. The increase varied from 3·8 years (3·4-4·1) in high SDI countries to 10·5 years (9·8-11·2) in low SDI countries. Even larger variations in HALE than these were observed between countries, ranging from 1·0 year (0·4-1·7) in Saint Vincent and the Grenadines (62·4 years [59·9-64·7] in 1990 to 63·5 years [60·9-65·8] in 2017) to 23·7 years (21·9-25·6) in Eritrea (30·7 years [28·9-32·2] in 1990 to 54·4 years [51·5-57·1] in 2017). In most countries, the increase in HALE was smaller than the increase in overall life expectancy, indicating more years lived in poor health. In 180 of 195 countries and territories, females were expected to live longer than males in 2017, with extra years lived varying from 1·4 years (0·6-2·3) in Algeria to 11·9 years (10·9-12·9) in Ukraine. Of the extra years gained, the proportion spent in poor health varied largely across countries, with less than 20% of additional years spent in poor health in Bosnia and Herzegovina, Burundi, and Slovakia, whereas in Bahrain all the extra years were spent in poor health. In 2017, the highest estimate of HALE at birth was in Singapore for both females (75·8 years [72·4-78·7]) and males (72·6 years [69·8-75·0]) and the lowest estimates were in Central African Republic (47·0 years [43·7-50·2] for females and 42·8 years [40·1-45·6] for males). Globally, in 2017, the five leading causes of DALYs were neonatal disorders, ischaemic heart disease, stroke, lower respiratory infections, and chronic obstructive pulmonary disease. Between 1990 and 2017, age-standardised DALY rates decreased by 41·3% (38·8-43·5) for communicable diseases and by 49·8% (47·9-51·6) for neonatal disorders. For non-communicable diseases, global DALYs increased by 40·1% (36·8-43·0), although age-standardised DALY rates decreased by 18·1% (16·0-20·2)