Sugar cane silage as compared to traditional supplemental sources of forage in the performance of high production cows

O experimento foi conduzido com o objetivo de avaliar o desempenho de animais de alta produção alimentados com rações com diferentes fontes de volumosos. Foram availados os seguintes tratamentos: cana-de-açúcar in natura (CA); silagem de cana-de-açúcar inoculada com L. buchneri (SCA); silagem de milho (SM); e mistura de cana-de-açúcar in natura e silagem de milho (CASM). O experimento foi conduzido em quadrado latino 4×4 com períodos de 21 dias, de modo que, nos sete últimos dias, realizou-se a coleta de amostras. Além da avaliação de desempenho, foram feitas análises bromatológicas dos volumosos, das rações e das sobras e análises da composição do leite e da estabilidade aeróbia dos volumosos e das rações. Observaram-se diferenças quanto ao consumo de MS, que foi maior quando os animais foram alimentados com a SCA (23,5 kg/dia) e a CASM (23,5 kg/dia). Todas as rações propiciaram aos animais elevada produção leiteira (24,4 a 25,5 kg/dia), que não diferiu entre os volumosos. A composição do leite variou somente quanto ao teor de gordura, que foi maior quando os animais foram alimentados com SM (36,1%) e CASM (34,8%). Os resultados de estabilidade aeróbia comprovaram efeito positivo da aditivação bacteriana na SCA, que apresentou a maior estabilidade entre os volumosos (13,63 horas). A ração contendo SM como fonte de volumoso apresentou a menor estabilidade, o que provavelmente explica o baixo consumo dos animais nesse tratamento. A SCA é uma alternativa tecnicamente viável à utilização da planta in natura e ambas podem proporcionar elevadas produções de leite, desde que as rações sejam corretamente balanceadas. A inoculação com L. buchneri melhorou o valor nutritivo e reduziu as perdas fermentativas.The experiment was carried out to evaluate the performance of high produce animals fed rations with different sources of forage, what resulted in the treatment: fresh sugarcane (SC), sugarcane silage inoculated with L. buchneri (SCS), corn silage (CS) and mixture of fresh sugarcane and corn silage (SCCS). The experiment was carried out in a 4×4 latin square design with periods of 21 days, and the last 7 days, of each period was used for sample collections. Besides the performance evaluation, chemical analyses of forages, rations and orts were performed and analyses of milk composition and aerobic stability of forages and rations were also made. There was differences for DM intake, which was higher for SCS (23.5 kg/day) and SCSM (23.5 kg/day). All rations provided to the animals high milk production (24.4-25.5 kg/day), which did not differ among the animals. The milk composition varied only as for fat content, which was higher in the animals fed CS (36.1%) and in the SCCS (34.8%). The aerobic stability results showed positive effect of the bacterial aditivation in SCS, which presented the highest aerobic stability among the forages (13.63 hours). The ration with CS as source of forage presented the worst stability, which could explain the lower intake by the animals in this treatment. The SCS is a technical viable alternative to the use of fresh plant and both can proportionate high milk production, as long as, the rations are properly balanced. The inoculation with L. buchneri showed capable to bring benefits for nutritional value and fermentative losses

Effect of moisture absorbents, chemical and microbial additives on the nutritional value, fermentative profile and losses of Brachiaria brizantha cv. Palisadegrass silages

Objetivou-se avaliar o valor nutritivo, o perfil fermentativo e as perdas de silagens de capim-marandu submetidas aos efeitos de absorventes de umidade e aditivos. Utilizou-se o delineamento inteiramente casualizado, em arranjo fatorial 3 × 5, com três teores de matéria seca (obtidos com adição de polpa cítrica (PCP) ou casca de soja (CSP), ambas peletizadas, em comparação à ausência de aditivos) e cinco aditivos (ausência ou presença de inoculante bacteriano, benzoato de sódio ou ácido fórmico 62% ou 44%). O arranjo resultou em 15 silagens, com 4 repetições, portanto 60 silos experimentais. Avaliaram-se o valor nutritivo, as perdas por gases e efluente e a recuperação de matéria seca (MS). A adição de polpa cítrica ou casca de soja peletizada elevou os teores de MS (29,4 e 28,9%), o que reduziu a produção de efluente (4,1 e 3,8 kg/t MV) e disponibilizou substratos fermentescíveis aos microrganismos, fato confirmado pela maior capacidade fermentativa e pela digestibilidade das silagens. Os aditivos à base de ácido fórmico foram mais efetivos em preservar carboidratos solúveis e proteína, o que culminou em maior digestibilidade. Esses aditivos também reduziram as perdas por gases e elevaram a recuperação de MS. O inoculante contendo bactérias homoláticas não diferiu desses aditivos quanto à digestibilidade das silagens e ainda reduziu as perdas por gases. Entre os aditivos, o benzoato foi o menos efetivo em alterar o padrão fermentativo das silagens de capim-marandu. O valor nutritivo e as perdas da silagem com teor de umidade original, não aditivada, podem ser considerados satisfatórios, contudo, a polpa cítrica e principalmente a casca de soja peletizadas se mostraram opção interessante e devem ser mais estudadas. O uso de aditivos contendo ácido fórmico também deve ser mais explorado com gramíneas tropicais, pois promove benefícios ao longo de todo processo fermentativo.The objective of this trial was to evaluate the nutritional value, fermentation profile and dry matter losses of Palisadegrass silages ensiled with either dried citrus pulp, soybean hulls, chemical or microbial additives. The trial was carried out in a completely randomized experimental design and in a factorial arrangement (3 × 5), with three dry matter levels (wet forage or forage ensiled with pelleted citrus pulp or pelleted soybean hulls) and five additives (without or with the presence of bacterial inoculants or the addition of: sodium benzoate, formic acid in the concentration of 62% or 44%), totalizing 15 treatments and 60 experimental silos. The variables analyzed were: nutritional value, losses due to gases and effluents, and dry matter recovery. The use of dried citrus pulp or soybean hulls at the ensiling time increased the dry matter content (29.4 and 28,9%) and decreased the effluent production (4.1 and 3.8 kg/t of fresh matter), also providing fermentable substrate to microorganisms, resulting in increased fermentation coefficient and digestibility of silages. The use of formic acid resulted in silages with higher digestibility and increased water-soluble carbohydrates and crude protein content. This additive was also effective in reducing the losses due to gases and, as a result, increased the total dry matter recovery. The treatment containing homolactic bacteria showed similar trend of increasing the digestibility and reducing the losses due to gases. The use of sodium benzoate was less effective in altering the fermentation pattern of tropical silages. The nutritional value and total dry matter losses of silages ensiled without additives can be considered satisfactory. However, wet forage ensiled with dried citrus pulp and, mainly, with soybeans hulls showed the best results. Treatments containing formic acid had a beneficial effect on the fermentation profile of tropical grass silages.FAPES

Desenvolvimento de um picossatélite educacional - CapSat

Após o início da exploração espacial, durante a guerra fria, muitossatélites foram desenvolvidos e atualmente encontram-se em órbita.No entanto, esses equipamentos são caros de serem produzidos eo acesso a essa tecnologia é restrito basicamente a pesquisadoresde agências espaciais. Para tornar isso mais acessível, surgiu umaalternativa para o desenvolvimento de um satélite de baixo custoe dimensões reduzidas, são picossatélites. Baseado nesse conceito,esse projeto desenvolveu um picossatélite com dimensões de umalata de refrigerante de 330ml, modalidade conhecida como cansat.O objetivo principal é o uso desse cansat para demonstrar conceitose técnicas vistas apenas em teoria em unidades curricularescomo redes de computadores, física, geografia, sistemas embarcados,processamento de imagens, entre outras. Além de possibilitar aosdiscentes um contato com equipamentos e tecnologias que dificilmenteterão acesso durante o curso. Assim, esse trabalho apresentao desenvolvimento do cansat educacional, chamado CapSat

Desenvolvimento de foguetes de baixa altitude para auxiliar no ensino

Durante a Guerra Fria (pós Segunda Guerra Mundial - 1947 a 1991)ficou evidente o interesse das grandes potências mundiais na exploraçãoespacial. Desde então muitas pesquisas e agências espaciaisforam criadas com o objetivo de realizar essa exploração. No entanto,essas pesquisas ficaram restritas apenas aos países e instituiçõesque possuíam grande capacidade financeira e tecnológica. Naquelaépoca existia, e ainda hoje existe, pouca pesquisa para desenvolverfoguetes de baixa altitude, sem despender grande volume financeiro.Assim, este trabalho apresenta o desenvolvimento de um foguete debaixa altitude, criado para incentivar e demonstrar para estudantesdo ensino fundamental que o lançamento de foguetes não precisaficar restrito apenas à grandes empresas e agências espaciais, quemesmo em cidades pequenas, eles podem presenciar e experimentarum lançamento de foguete, claro, dada as devidas proporções

Cuidados pessoais para se evitar o contágio por COVID-19: os riscos nas cidades pequenas

A COVID-19 é uma doença infecciosa causada por um tipo de vírus potencialmente causador de óbitos e que provocou uma pandemia desde o ano de 2020. Diante disso, o objetivo deste trabalho é diagnosticar os cuidados pessoais da população de grandes e pequenas cidades do estado do Paraná para evitar contágio com o novo coronavírus. Foi aplicado um questionário on-line com 33 questões e analisadas 1.122 respostas dos habitantes de três grandes centros urbanos (Curitiba, Londrina, Maringá) comparados a três pequenos municípios (Matinhos, Palotina, Jandaia do Sul). Comparando os resultados de grandes e pequenas cidades, observou-se que moradores de cidades grandes apresentaram uma porcentagem significativa maior de pessoas que não saem de casa, que sempre retiram os sapatos ao chegar em casa, que sempre higienizam itens pessoais, que higienizam compras e que sempre carregam consigo álcool em gel, sendo que para as cidades pequenas não houve dados significativos com relação a esses cuidados. Estes resultados sugerem que as pessoas que vivem em cidades grandes parecem ter hábitos mais restritivos quanto ao cuidado e prevenção ao COVID-19. Por estes motivos, considera-se que os habitantes das cidades pequenas correm mais riscos que moradores de grandes centros urbanos. Este estudo pode ser considerado um alerta aos moradores e aos tomadores de decisões de cidades menores para incentivar e divulgar a importância das formas de cuidados ao contágio pelo novo coronavírus

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

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 2·5th percentile and 100 as the 97·5th 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

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings: Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs 1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Interpretation: Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

The Global Burden of Diseases, Injuries and Risk Factors 2017 includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. METHODS: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting