Remediation of soil contaminated with toxic organic compounds using microorganisms

Microorganisms, especially genetically modified microorganisms have continued to attract attention as a safer and environmentally friendly alternative in the bioremediation of contaminated environments such as soil and water bodies. Soil pollution by organic compounds such as pesticides, industrial and agricultural solvents, dyes, pigments, additives etc. is on the increase worldwide as a result of industrialization and agricultural modernization. Toxicity from these and other related pollutants have constituted a major challenge to humans as well as the environment. Therefore, it is important to apply effective remediation measures to reduce the levels of these toxicants so as to minimize the risk of bioaccumulation in agricultural food products. Bioremediation using biological materials viz; whole cells, cell extracts, isolated enzymes etc. is one of the most effective and environmentally friendly approaches currently in use. This paper therefore, reviews the current microbial remediation strategies of soil contaminated with various organic pollutants.Keywords: Bioremediation, Microorganisms, Pollutants, Soil, Organi

CONHECIMENTO DOS SERVIÇOS DE SAÚDE PREVENTIVA ENTRE O PESSOAL ACADÉMICO NA UNIVERSIDADE DE MAIDUGURI, ESTADO DE BORNO, NIGÉRIA

This study was conducted to assess knowledge of preventive healthcare services among academic staff in University of Maiduguri, Borno State, Nigeria. Two hypotheses guided the study. Descriptive survey research design was used for the study; simple random sampling technique was also used for the study. A sample of 200 academic staff was drawn from seven faculties in the university. Data were collected using self-structured questionnaire with two sections, demographic data and knowledge of preventive healthcare services. Data were analysed using descriptive statistics of frequency counts and percentage while inferential statistics of one sample t-test and independent t- test was used to test hypotheses at 0.05 significance level. The result showed among others that there is no significance difference in knowledge preventive healthcare services and there is no significant difference in gender knowledge of preventive healthcare services. It was recommended among others that re-visitation of preventive health programmes which have direct impact among staff should be made periodically in other to emphasize the importance of preventive healthcare services in control preventable diseases.Este estudo foi realizado para avaliar o conhecimento dos serviços de saúde preventiva entre o pessoal académico da Universidade de Maiduguri, Estado de Borno, Nigéria. Duas hipóteses orientaram o estudo. Foi utilizado para o estudo um desenho descritivo do estudo; foi também utilizada para o estudo uma técnica simples de amostragem aleatória. Uma amostra de 200 docentes foi retirada de sete faculdades da universidade. Os dados foram recolhidos utilizando um questionário auto estruturado com duas secções, dados demográficos e conhecimento dos serviços de saúde preventiva. Os dados foram analisados utilizando estatísticas descritivas de contagem de frequências e percentagem, enquanto as estatísticas inferenciais de um teste t de amostra e teste t independente foram utilizadas para testar hipóteses ao nível de significância de 0,05. O resultado mostrou, entre outros, que não há diferença significativa no conhecimento dos serviços de saúde preventiva e que não há diferença significativa no conhecimento dos serviços de saúde preventiva em termos de género. Foi recomendado, entre outros, que a revisitação dos programas de saúde preventiva que têm impacto direto entre o pessoal deveria ser feita periodicamente noutros para enfatizar a importância dos serviços de saúde preventiva no controlo de doenças evitáveis

Comparative Pre- and Post-treatment Effects of Nigella Sativa Oil on Lipid Profile and Antioxidant Enzymes in a Rat Model of Diabetes Mellitus

Background: Lipid profile dysregulation and oxidative stress are important risk factors for cardiovascular disease in diabetic individuals. Nigella Sativa (NS) oil has been reported to have a favorable effect on triglycerides (TG) in rat models of diabetes mellitus. There is a dearth of information available about preventive or corrective use to manage and ameliorate diabetes. Aim: This study sought to ascertain the comparative pre and post-treatment effects of the oil on TG, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein, and key antioxidant enzymes levels in diabetic rats. Methods: Thirty (30) Wistar rats were divided into 6 groups of 5 rats each as follows: Group I rats took normal chow ad libitum and served as Control. Group II rats were induced with diabetes using streptozocin (50 mg/Kg BW). Group III and IV rats were pre-administered with 0.5 and 1 ml of the oil, respectively, before induction, whereas Group V and VI rats were treated with 0.5 and 1 ml of the oil after induction. The listed parameters were assessed in the plasma at the end of the study. Results: Diabetes induction caused a significant increase in the TG level. There was no significant change in the oxidative stress parameters. Only post-administration caused a significant reduction in TG level, whereas both pre and post-administrations caused a significant improvement in HDL levels. Both pre- and post-administrations caused an increase in superoxide dismutase and catalase levels when causing a significant reduction in malondialdehyde level. Conclusion: Post-induction treatment may be more effective in the correction of lipid dysregulation and oxidative stress in diabetes. Keywords: Antioxidant enzymes, atherogenic index, diabetes, lipid profile, Nigella sativ

Prevalence of Anterior Cruciate Ligament Injury among Amateur Footballers in Enugu, South‑East Nigeria: The Need for Injury Prevention Programs

Background: Anterior cruciate ligament (ACL) injury is debilitating to any footballer. The injury is sustained in different ways during sportingevents. There is need for injury prevention programs among the growing population of amateur footballers. Aim: This study was carried out to determine the prevalence of ACL injury among Amateur footballers in Enugu, South‑East Nigeria. Methodology: An observational study involving 825 of the registered amateur footballers in Enugu Metropolis. Oral interview and adapted knee pain evaluation form were used to screen for knee injuries and followed by Lachman and Pivot shift test to confirm ACL injury. Results: The mean age of the participants was 22.7 ± 3.1. The prevalence of ACL injury was 3.6% among the study population (8% for females and 3.5% for males), 56.6% among the participants with a history of knee injuries. Nearly 37.3% of the injuries occurred as a result of torsion/twist, which is a noncontact mechanism, 3.3% due to overuse, 13.3% due to contact/person, and 10.0% due to contact/friction. 70.0% of the injuries occurred during a training session, while 30.0% occurred during competition. Furthermore, 50.0% of athletes sought medical attention from traditional bone setters, 6.7% from physiotherapists, 10.0% from medical doctors, while 30.0% had self‑medication. Conclusion: The prevalence of ACL injury among amateur footballers in Enugu, South‑east Nigeria, falls within that obtained among athletes worldwide, with most of the injuries occurring from noncontact mechanisms during a training session. The prevalence is more in females than males. Keywords: Amateur footballers, anterior cruciate ligament injury, injury prevention, Nigeri

HABCSm: A Hamming Based t-way Strategy based on Hybrid Artificial Bee Colony for Variable Strength Test Sets Generation

Search-based software engineering that involves the deployment of meta-heuristics in applicable software processes has been gaining wide attention. Recently, researchers have been advocating the adoption of meta-heuristic algorithms for t-way testing strategies (where t points the interaction strength among parameters). Although helpful, no single meta-heuristic based t-way strategy can claim dominance over its counterparts. For this reason, the hybridization of meta-heuristic algorithms can help to ascertain the search capabilities of each by compensating for the limitations of one algorithm with the strength of others. Consequently, a new meta-heuristic based t-way strategy called Hybrid Artificial Bee Colony (HABCSm) strategy, based on merging the advantages of the Artificial Bee Colony (ABC) algorithm with the advantages of a Particle Swarm Optimization (PSO) algorithm is proposed in this paper. HABCSm is the first t-way strategy to adopt Hybrid Artificial Bee Colony (HABC) algorithm with Hamming distance as its core method for generating a final test set and the first to adopt the Hamming distance as the final selection criterion for enhancing the exploration of new solutions. The experimental results demonstrate that HABCSm provides superior competitive performance over its counterparts. Therefore, this finding contributes to the field of software testing by minimizing the number of test cases required for test execution

In vitro and in vivo anti-diabetic and anti-oxidant activities of methanolic leaf extracts of Ocimum canum

Background: Diabetes is a metabolic disorder with a highly complex, multifaceted and intricate etiologies and thus may require management options that proffers multimodal mechanism of action. This present study evaluated the antidiabetic and antioxidant potential of the methanolic extract/fractions of leaves of Ocimum canum. Methods: The antidiabetic potential was evaluated and using STZ-induced diabetic Wistar rat model (in vivo) and inhibition of α-amylase and α-glucosidase activity (in vitro).  Antioxidant activity was assessed in vitro by free radical scavenging and reducing power assays and in vivo via monitoring SOD and CAT activities; GSH and MDA levels. Results: The total phenolic content (221.0±3.0 mg catechol/g of sample) and tannins (146.0±4.0 mg tannic acid/g of sample) of the crude extract; and flavonoid of the aqueous-methanol fraction (216.0.0±1.0 mg of rutin/g of sample) were found to be significantly higher relative to others. The crude extract and the aqueous-methanol fraction exhibited a significantly (p<0.05) higher percentage reduction in fasting blood glucose and a concomitant increase in serum insulin level relative to the diabetic control group. The highest radical scavenging activity and reducing power were observed in the aqueous-methanol fraction. The aqueous-methanol solvent fraction also significantly reversed the alterations in oxidative stress markers occasioned by the diabetic condition. Conclusion: In conclusion, the result of the present study has demonstrated evidently that extracts of Ocimum canum leaves ameliorates hyperglycemia and the associated oxidative stress in STZ-induced rats

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere

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

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation