Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

DLC-coated CoCrMo steel for use in medical implants - wear and corrosion resistance influence of different surface finishing techniques

Cobalt-based alloys have been widely used in implant components, especially in orthopaedic implants. The biocompatibility of CoCrMo alloy is related closely to this material's excellent corrosion resistance, imparted by a thin passive chromium oxide layer with some minor contributions from Co and Mo oxides. The oxide film on CoCrMo alloy inhibits the dissolution of metal ions but is not always stable in the human body. There is a general agreement that corrosion is a serious problem for medical metallic materials. For joint replacements, they are exposed to tribological contacts and load so their performance (long-term durability) relies on both their corrosion and wear resistance. Diamond like carbon (DLC), with its extreme smoothness, hardness, low coefficient of friction, and biocompatibility is an excellent candidate to serve as a tribology-enhancing and corrosion-protective functional coating. In this study we have characterized the complex wear - corrosion resistance of the CoCrMo / DLC system. The wear-corrosion effects were investigated in a simulated body fluid under the simultaneous action of electrochemical corrosion and mechanical wear. The effects of the corrosion and wear of the CoCrMo/DLC systems are discussed

The formation and morphology of nanoparticle supracrystals

Supracrystals are highly symmetrical ordered superstructures built up from nanoparticles (NPs) via self-assembly. While the NP assembly has been intensively investigated, the formation mechanism is still not understood. To shed some light onto the formation mechanism, one of the most common supracrystal morphologies, the trigonal structures, as a model system is being used to investigate the formation process in solution. To explain the formation of the trigonal structures and determining the size of the supracrystal seeds formed in solution, the concept of substrate-affected growth is introduced. Furthermore, the influence of the NP concentration on the seed size is shown and our investigations from Ag toward Au are extended

Self – supporting Hierarchical Porous PtAg Alloy Nanotubular Aerogels as Highly Active and Durable Electrocatalysts

Developing electrocatalysts with low cost, high activity, and good durability is urgently demanded for the wide commercialization of fuel cells. By taking advantage of nanostructure engineering, we fabricated PtAg nanotubular aerogels (NTAGs) with high electrocatalytic activity and good durability via a simple galvanic replacement reaction between the in situ spontaneous gelated Ag hydrogel and the Pt precursor. The PtAg NTAGs have hierarchical porous network features with primary networks and pores from the interconnected nanotubes of the aerogel and secondary networks and pores from the inter-connected thin nanowires on the nanotube surface, and show very high porosities and large specific surface areas. Due to the unique structure, the PtAg NTAGs exhibit greatly enhanced electrocatalytic activity towards formic acid oxidation, reaching 19 times higher metal based mass current density as compared to the commercial Pt black. Furthermore, the PtAg NTAGs show outstanding structural stability and electrochemical durability during the electrocatalysis. Noble metal based NTAGs are promising candidates for applications in electrocatalysis not only for fuel cells, but also for other energy related systems

Self-Supporting Hierarchical Porous PtAg Alloy Nanotubular Aerogels as Highly Active and Durable Electrocatalysts

Developing electrocatalysts with low cost, high activity, and good durability is urgently demanded for the wide commercialization of fuel cells. By taking advantage of nanostructure engineering, we fabricated PtAg nanotubular aerogels (NTAGs) with high electrocatalytic activity and good durability via a simple galvanic replacement reaction between the in situ spontaneously gelated Ag hydrogel and the Pt precursor. The PtAg NTAGs have hierarchical porous network features with primary networks and pores from the interconnected nanotubes of the aerogel and secondary networks and pores from the interconnected thin nanowires on the nanotube surface, and they show very high porosities and large specific surface areas. Due to the unique structure, the PtAg NTAGs exhibit greatly enhanced electrocatalytic activity toward formic acid oxidation, reaching 19 times higher metal-based mass current density as compared to the commercial Pt black. Furthermore, the PtAg NTAGs show outstanding structural stability and electrochemical durability during the electrocatalysis. Noble metal-based NTAGs are promising candidates for applications in electrocatalysis not only for fuel cells, but also for other energy-related systems

Expert consensus statements for Waldeyer\u27s ring involvement in pediatric Hodgkin lymphoma: The staging, evaluation, and response criteria harmonization (SEARCH) for childhood, adolescent, and young adult Hodgkin lymphoma (CAYAHL) group.

Waldeyer\u27s ring (WR) involvement in pediatric Hodgkin lymphoma (HL) is extremely rare and criteria for determining involvement and response to treatment are unclear. The international Staging, Evaluation, and Response Criteria Harmonization for Childhood, Adolescent and Young Adult Hodgkin Lymphoma (SEARCH for CAYAHL) Group performed a systematic review of the literature in search of involvement or response criteria, or evidence to support specific criteria. Only 166 cases of HL with WR involvement were reported in the literature, 7 of which were pediatric. To date no standardized diagnostic or response assessment criteria are available. Given the paucity of evidence, using a modified Delphi survey technique, expert consensus statements were developed by the SEARCH group to allow for a more consistent definition of disease and response evaluation related to this rare site of involvement among pediatric oncologists. The available evidence and expert consensus statements are summarized

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

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