Biosorption characteristics of Cadmium from environment by one-year old seedlings of Acer velutinum

Background and Aims: Heavy metals are elements with high atomic weight and could be harmful for living organisms at higher concentrations. Cadmium is among these metals and may result in various health problems forhuman. The ability of Acer Velutinum in bioremediation of cadmium was considered in the present study.Materials and Methods: One-year old seedlings of Acer Velutinum were provided from Department of Natural Resources making arrangements well in advance. Cadmium chloride solutions were prepared with different concentrations of 0, 10, 20 and 40 mg/L and consequently were added into the soil. The seedlings were planted inpots and their aerial organs (stems and leaves) as well as their roots were separated three month after. The results were then analyzed using Danken and ANOVA tests.Results: The maximum amount of cadmium accumulation in aerial organs, root and soil was 9.67, 60.61 and 12.44 mg/kg, respectively. Similarly, the respective lowest level of cadmium accumulation in aerial organs, root and soil was 6.05, 2.3 and 0.1mg/kg. The least amount of aerial organs (4.45 g) and root (1.25 g) dry weights wereoccurred at 40 mg Ca/L, and the most values of respectively 9.02 and 3.95 g was observed at pristine control pot.Conclusion: Acer Velutinum species is considered as appropriate for bioremediation of soils contaminated by cadmium.Keywords: Cadmium, Adsorption, Heavy metals, Phytoremediation, Acer Velutinu

Contaminación por mercurio en árboles de carpes (Carpinus betulus) en espacios verdes en el área del parque industrial (Irán)

The heavy metal mercury among other toxic metals can accumulate in plant organs in large quantities toxic to humans. Carpinus betulus is a most species from Caspian hyrcanian Mixed Forests, in this research it was studied that how much mercury absorbed from the environment . Twenty five  trees were randomly selected, and the distances between trees (Hornbeam) were 10 to 15 meters in industrial park in North of Iran . From each tree selected, 15  grams leaves and 15 grams root were harvested with horticultural scissors and 15 g of soil from 30 cm depth. Four stations were selected near  steel factory. A control station, located 2 km from the steel factory was selected and three stations were located near the steel factory. Samples of leaves, soil and roots are prepared after encoding, placed in paper envelopes and transferred to the lab. The amount of mercury in plant samples was prepared by dry digestion with atomic absorption spectroscopy. To compare the effect of mercury concentration on leaf and stem and root, Tukey's test was used. The average concentration of mercury in soil is 0.96 mg / kg, root 0.551 mg / kg, leaf 0.28 mg / kg. With increasing mercury, observed in the amount of leaf chlorophyll content is decreased. According to conducted investigations in study the Carpinus betulus tree can be concluded that the accumulation amount of heavy metal, mercury, and hornbeam is suitable for absorbing the contamination of mercury of soil pollutionEl mercurio es un metal tóxico que puede acumularse en los órganos de las plantas en grandes cantidades ocasionando toxicidad a los humanos. Carpinus betulus es una especies de los bosques mixtos hircanos del Caspio. En esta investigación, se estudió la cantidad de mercurio que pueden absorber los árboles de carpes del ambiente. Veinticinco árboles fueron seleccionados al azar, las distancias entre árboles fueron de 10 a 15 m en un parque industrial en el norte de Irán. De cada árbol seleccionado, se cosecharon 15 g de hojas y 15 g de raíz con tijeras hortícolas, y 15 g de tierra a partir de 30 cm de profundidad. Se seleccionaron cuatro estaciones cerca de la fábrica de acero. Se seleccionó una estación de control ubicada a 2 km de la fábrica de acero y se ubicaron tres estaciones cerca de la fábrica de acero. Las muestras de hojas, tierra y raíces se prepararon y codificaron, se colocan en sobres de papel y se transfirieron al laboratorio. La cantidad de mercurio en las muestras de plantas se preparó mediante digestión en seco con espectroscopía de absorción atómica. Para comparar el efecto de la concentración de mercurio en la hoja y la raíz, se utilizó la prueba de Tukey. La concentración promedio de mercurio en el suelo fue de 0.96 mg/kg, en la raíz 0.551 mg/kg y en la hoja 0.28 mg/kg. Se observó que con el aumento de mercurio la cantidad de clorofila en la hoja disminuye. Se puede concluir que la cantidad de acumulación de metales mercurio en el árbol Carpinus betulus es adecuada para absorber la contaminación del mercurio de la contaminación del suelo

Zinc absorption in two-year old Poplar seedlings (Populus deltoids) in the environment

Background and Aims: Phytoremediation is the use of green plants to reduce contaminant levels such as heavy metals in the environment. Some plants can uptake and store (accumulate) environmental contaminants within their tissue and organs. Due to their sustainability in the environment, heavy metals are of particular significance. This study was, therefore, conducted to evaluate the phytoremediation potential of zinc by Populus deltoids.Materials and Methods: Biennial seedlings of populous deltoids were provided from plantations with arrangements made well in advance with the directors of the Department of Natural Resources. Zinc chloride solutions (0, 10, 20 and 40 mg /L) were prepared, added into the soil and the seedlings were thereafter placed in pots. The seedlings were grown for three months exposing to various zinc concentrations. Seedlings aerial organs (stems and leaves) and roots as well as the soil were sampled and analyzed using atomic absorption spectrometry. Analysis of variance (ANOVA) followed by Duncan’s multiple comparisons (P < 0.05) was performed to test the significance of treatment effects.Results: The highest level of Zn in aerial organs, root and the soil structure of Populous deltoids was 142.86, 85.94, 12.002 mg/kg, respectively. Similarly, the corresponding lowest level of Zn was 44.61, 21.20, and 0.124 mg/kg. The high-zinc (40 mg/L) treated plants showed the lowest levels of 4.14 and 1.03 g/L in aerial organs and root dry weights, respectively. The maximum values of 20.61 and 3.066 were also respectively determined at control experiments.Conclusions: The results suggest that Populous deltoids is an appropriate alternative for phytoremediation of zincpolluted soils

Selection of potential plantations for Buxus hyrcana Pojark using GIS near coastline of Caspian Sea in North of Iran

795-800Expansion of forests and forest species is impossible without considering the relevant standards and criteria. Therefore, plant species suited with and adaptable to natural conditions of any area should be used. In this paper, Lille Basin was selected using multi-criteria evaluation method (MCE) as a study area as it was suitable in zoning and evaluating ecological capability for Buxus hyrcana Pojark plantations, and the ecosystem did not fall out of the classification. For this purpose, GIS and AHP models were used. Eight selection criteria were: Elevation, soil type, canopy cover, wind direction, temperature, humidity, rainfall levels, and the gradient. Weights of the criteria were: 0.384, 0.2081, 0.1438, 0.0977, 0.658, 0.0444, 0.0353, and 0.0209, respectively. On this basis, elevation and gradient had the highest and the lowest values. The results suggested that Buxus hyrcana Pojark showed sensitivity to variations of the criteria and their distribution is directly correlated to ecological factors particularly climatic and physiographic ones. The layer of important zones and reserves of this species highly overlap the final layer resulting from MCE. Evaluation criteria and sub-criteria and their weights with an acceptable accuracy was 0.0467 (<0.1) that exhibited usefulness of GIS in site selection, composition and overlaying various criteria of this research

Sprayable antibacterial Persian gum-silver nanoparticle dressing for wound healing acceleration

Wound infection is considered a significant challenge in skin injuries. Sprayable antibacterial wound dressings are interesting alternatives to their traditional counterparts because of their facile preparation, ease-of-use, and the possibility of topical delivery of antibacterial materials. Herein, novel sprayable antibacterial dressings are formulated and reported. The dressings were developed by in-situ formation of Ag-nanoparticles (Ag-NPs) using Persian gum (PG) as a carbohydrate polymer. Several tests were conducted to investigate the effect of polymer concentration on the sprayablity, biocompatibility, and antibacterial activity of the dressings (PG/Ag-NPs). Results showed that formulations up to 2 wt.% PG/Ag-NPs could be sprayed properly and form intact films. Antibacterial evaluations also showed biocidal activity of 1% PG/Ag-NPs against Pseudomonas aeruginosa and Staphylococcus aureus. Cytotoxicity and in vivo full-thickness wound healing evaluation confirmed that 1% PG/ Ag-NPs spray was safe and improved wound healing process. All the results confirmed the high potential of formulated sprayable dressings for wound repair.Peer reviewe

Major and minor criteria for gastric dystemperaments in Persian Medicine: Sari gastric dystemperament criteria-I (SGDC-I)

&#60;div class="msocomtxt" id="com1" language="JavaScript" onmouseout="msoCommentHide('com1')" onmouseover="msoCommentShow('anchor1','com1')"&#62;Background: Gastric disorders are one of the most common human ailments, which impose a huge economic burden on countries. In Persian Medicine (PM), it is possible to predict the susceptibility to gastric diseases with diagnosis of gastric Mizajes (temperaments) and dystemperaments. The semiology of gastric dystemperaments has been investigated in PM textbooks, although the value of each sign and symptom is not mentioned. Consequently, this research is designed to determine the major and minor criteria for classifying gastric dystemperaments on the basis of valid manuscripts and with the help of PM specialists in the present era. Methods: This was a consensus-based study consisting of four phases. In the first phase, reference PM textbooks were studied. Symptoms and signs of gastric dystemperaments were collected and listed in four groups. In the second phase, semi-structured interviews with a sample of PM experts were carried out. Phase three included a focused group discussion with experts. Eventually, findings were integrated from the three study phases in a two-day meeting in Sari City. Results: Selected criteria included eight major and eight minor criteria for hot-cold dystemperament, as well as six major and eight minor criteria for wet-dry gastric dystemperament. Conclusion: Modern lifestyles and the interfering factors are responsible for some changes in diagnostic signs and symptoms according to PM. This was the first step to coordinate PM diagnostic criteria for gastric dystemperaments. Further studies are recommended to reach a unique protocol in the field of PM diagnostics. The next step includes design and validation of national diagnostic tools. &#160

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. Methods: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Findings: Global DALYs increased from 2·63 billion (95% UI 2·44–2·85) in 2010 to 2·88 billion (2·64–3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7–17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8–6·3) in 2020 and 7·2% (4·7–10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0–234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7–198·3]), neonatal disorders (186·3 million [162·3–214·9]), and stroke (160·4 million [148·0–171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3–51·7) and for diarrhoeal diseases decreased by 47·0% (39·9–52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54–1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5–9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0–19·8]), depressive disorders (16·4% [11·9–21·3]), and diabetes (14·0% [10·0–17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7–27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6–63·6) in 2010 to 62·2 years (59·4–64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6–2·9) between 2019 and 2021. Interpretation: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Funding: Bill &amp; Melinda Gates Foundation