Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

BACKGROUND: Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. METHODS: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. FINDINGS: Globally, 18·7% (95% uncertainty interval 18·4–19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2–59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5–49·6) to 70·5 years (70·1–70·8) for men and from 52·9 years (51·7–54·0) to 75·6 years (75·3–75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5–51·7) for men in the Central African Republic to 87·6 years (86·9–88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3–238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6–42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2–5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. INTERPRETATION: This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing

Effects of Aloe vera (L.) Burm. f. in gingivitis: a review of clinical trials

Background and objectives: Gingivitis is the inflammation of gingiva which, unless treated, will lead to periodontitis in susceptible patients. Aloe vera (L.) Burm. f. (aloe) from the family Asphodelaceae (Liliaceae) is a perennial plant which originates from South Africa. Potentially active compounds of the leaves include vitamins, simple/complex polysaccharides, minerals, organic acids, and phenolic compounds. The aim of this study was to review the literature regarding the efficacy and safety of aloe in patients with gingivitis. Methods: Using the search formula "Gingivitis [title/abstract] AND Aloe vera/ Aloe [all fields]", electronic databases, including PubMed, Scopus, Science direct and Cochrane library were searched for clinical trials on treatments containing aloe for gingivitis and relevant articles with English full-text from 2000 until 2017 were finally included.  Results: Total of 8 clinical trials were finally included in this paper. Various preparations of aloe such as mouth rinse and dentifrice have been investigated in patients with gingivitis. Each study has measured the periodontal health via a specific index including plaque index, gingivitis index, and bleeding index, as well as the microbial count and composition of the oral cavity and biomarkers of inflammation in crevicular fluid and aloe could significantly improve the above mentioned parameters. Conclusion: It was concluded that aloe could improve periodontal health either alone or as an adjunct to scaling and root planning treatments. Some studies also proved its efficacy to be equal to other commercially available products such as chlorhexidine without having their side effects

Chemical composition and antioxidant activity of Origanum vulgare subsp. vulgare essential oil from Iran

Background and Objectives: Essential oils are very complex mixture of components and their composition may vary in different species or varieties or even within the same variety. Origanum vulgare L. subsp. vulgare is one of the most distributed subspecies within the genus Origanum and has been found to be a poor-oil, categorized in cymyl, bornane or sabinyl chemotypes with higher proportion of sesquiterpenes. In this experiment, the Iranian sample was studied for the chemical composition of the oil and evaluation of its antioxidant activity. Methods: Essential oil was obtained by hydro-distillation and analyzed by GC/MS for determination of components. Antioxidant activity was evaluated by radical scavenging ability (DPPH method) and reducing power (FRAP assay). Results: The sample belonged to “thymol” chemotype with the main components as thymol (37.13%), gama-terpinene (9.67%), carvacrol (9.57%), carvacrol methyl ether (6.88), cis-alpha-bisabolene (6.80%), eucalyptol (3.82%), p-cymene (3.58%) and elemol (2.04%). The oil of plant showed very strong antioxidant activity (IC50=2.5 µg/mL in DPPH method), which was stronger than the standard antioxidants (Vit E and BHA,

In vitro and in vivo antidiabetic activity of Tamarix stricta Boiss.: Role of autophagy

Ethnopharmacological relevance: Type 2 diabetes mellitus (DM) is a complicated metabolic disorder with no definite treatment. Different species of the genus Tamarix (tamarisk) are used by local people to treat DM. Tamarix stricta Boiss. is an endemic species to Iran with several traditional therapeutic uses in Persian Medicine. This study aimed to assess the antidiabetic activity of T. stricta. Materials and methods: Hydroethanolic extract of the plant was prepared and analyzed by High-performance liquid chromatography (HPLC). The protective effect of the extract was evaluated in streptozotocin (STZ)-induced toxicity and markers of autophagy in pancreatic RIN-5F cells. The effect of intragastric 10 or 20 mg/kg of the extract was compared with negative control (water) or positive control (metformin) treatment during four weeks of administration in high-fat diet + STZ-induced DM in Balb/c mice. Results: Results showed the presence of 8.436 mg of gallic acid in each gram of the extract. A significant cytoprotective effect was observed by T. stricta in STZ-induced toxicity in RIN-5F cells, partially due to the modulation of autophagy. Also, animals treated with the extract showed a significant improvement in glycemic and lipid profiles, liver function, and histopathologic features of pancreas and liver compared with the negative control. Conclusion: T. stricta demonstrated beneficial effects in animal model of DM; though, further studies are recommended to confirm the clinical use of this plant in DM. © 2020 Elsevier B.V

In vitro wound healing activity of luteolin

Background and objectives: Luteolin (3′,4′,5,7-tetrahydroxy flavone) is one of the most common flavones, which is naturally found in several edible plants and traditional medicine. It is known as a non-toxic compound with anti-inflammatory, antinociceptive, anticarcinogenic, antimutagenic, and antiangiogenic properties. Luteolin has antiproliferative activity against different human hormone dependent cancer cells e.g. breast, prostate, and thyroid. Due to its bacteriostatic properties  and strong antioxidant potential, luteolin is valuable in the management of diverse diseases including peptic ulcers. There are some evidences on wound healing effect of luteolin on diabetic rats and in this work, an in vitro model of wound healing was used to study the wound healing effect of luteolin. Methods: Different concentrations of luteolin were applied in MTT and scratch assay on 3T3 fibroblast cells. FBS-free medium was used as the negative control. Cell proliferation and migration during scratch contraction was calculated. Annexin V and cell cycle analyses were performed to study the effect of luteolin on cell proliferation. Result: The results showed that, scratch contraction was observed significantly (

The role of glycogen synthase kinase 3 beta in multiple sclerosis

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) that leads to progressive neurological disability due to axonal deterioration. Although MS presents profound heterogeneity in the clinical course, its underlying central mechanism is active demyelination and neurodegeneration associated with inflammation. Multiple autoimmune and neuroinflammatory pathways are involved in the demyelination pro-cess of MS. Analysis of MS lesions has shown that inflammatory genes are upregulated. Glycogen synthase kinase3 (GSK-3) is part of the mitogen-activated protein kinase (MAPK) family and has important roles in many signaling cascades. GSK-3 is a highly conserved serine/threonine protein kinase expressed in both the central and the peripheral nervous systems. GSK-3 modulates several biological processes through phosphorylation of pro-tein kinases, including cell signaling, neuronal growth, apoptosis and production of pro-inflammatory cytokines and interleukins, allowing adaptive changes in events such as cellular proliferation, migration, inflammation, and immunity. GSK-3 occurs in mammals in two isoforms GSK-3 alpha and GSK-313, both of which are common in the brain, although GSK-3 alpha is found particularly in the cerebral cortex, cerebellum, striated hippocampus and Purkinje cells, while GSK-313 is found in all brain regions. In patients with chronic progressive MS, expression of GSK-313 is elevated in several brain regions such as the corpus callosum and cerebral cortex. GSK-313 inhibition may play a role in glial cell activation, reducing pathological pain induced by nerve injury by formalin injection. According to the role of GSK-313 in pathological conditions, the aim of this article is review of the role of GSK-313 in multiple sclerosis and inflammation of neurons

Targeting inflammation by flavonoids: Novel therapeutic strategy for metabolic disorders

A balanced metabolic profile is essential for normal human physiological activities. Disproportions in nutrition give rise to imbalances in metabolism that are associated with aberrant immune function and an elevated risk for inflammatory-associated disorders. Inflammation is a complex process, and numerous mediators affect inflammation-mediated disorders. The available clinical modalities do not effectively address the underlying diseases but rather relieve the symptoms. Therefore, novel targeted agents have the potential to normalize the metabolic system and, thus, provide meaningful therapy to the underlying disorder. In this connection, polyphenols, the well-known and extensively studied phytochemical moieties, were evaluated for their effective role in the restoration of metabolism via various mechanistic signaling pathways. The various flavonoids that we observed in this comprehensive review interfere with the metabolic events that induce inflammation. The mechanisms via which the polyphenols, in particular flavonoids, act provide a promising treatment option for inflammatory disorders. However, detailed clinical studies of such molecules are required to decide their clinical fate