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

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

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

Efecto de la metionina protegida en el crecimiento de astas y evaluación del semen de ciervo rojo (Cervus elaphus) en el trópico

El Ciervo Rojo es una especie con potencial de desarrollo en las granjas intensivas, que se ha ganado la preferencia de los criadores por su temperamento apacible y hábitos gregarios; además de cumplir exigencias actuales de un producto cárnico alto en proteína y bajo en grasa, energía y colesterol. Es importante desarrollar investigaciones en condiciones del trópico y con un enfoque sustentable El objetivo de la presente investigación fue evaluar el efecto de la metionina protegida (RPMet) en la ganancia de peso y crecimiento de astas de ciervo rojo. Además, se evaluaron las características del semen de ciervos rojos adultos en el trópico. Para realizar el primer objetivo los animales estaban en crecimiento. Se evaluaron tres niveles de RPMet: 2.5, 3.5, 4.5 g/d por animal. También, se realizaron análisis bioquímicos de sangre al inicio y final del estudio. Las variables fueron analizadas en un diseño completamente al azar con cuatro repeticiones. Para la comparación de medias se utilizo contrastes ortogonales. El crecimiento en longitud y grosor de las astas fue favorecido por la suplementación de RPMet (p≤0.07). Además, el efecto linear fue significante en los niveles de RPMet en ganancia de peso, crecimiento de la roseta y TGP. Todas las características del semen de los ciervos fueron similares a las obtenidas en la época de celo de animales de clima templado. Es probable que la fuente de proteína en el suplemento y la buena calidad de la pradera aportaran un adecuado suministro de metionina de origen microbiano en duodeno. Se sugiere que niveles altos de metionina deben ser evaluados con la finalidad de encontrar una mejor respuesta.__________The red deer has potential development under intensive system because its temperament and gregarious habits. Venison is recognized to be high in protein and low in fat, energy and cholesterol. Is important to develop research under tropical conditions in agree of a sustainable ecological system. The present study was designed to evaluate the effect of the rumen-protected Met on weight gain and growth of the antlers of red deer. Besides, the semen traits of deer males were evaluated under tropical condition. For first objective all animals were in growing stage. Three levels of RPMet were evaluated: 2.5, 3.5, 4.5 g/d by animal. Also, blood biochemical analysis was applied at beginning and end of study. The variables were analyzed under randomized completely design with four replicates. Orthogonal contrast was used in means comparisons. The growth in length and thickness of the antlers was favoured by the supplementation of methionine (p≤0.07). Moreover, only linear effect of RPMet was significant on weight gain, bony coronet and PGT. All semen traits in males were similar to the obtained in mating season under tempered climate. It is probable that the protein source in the supplement and the quality of the pasture would are contributing to supply adequate amounts of microbial methionine in duodenum. It is suggested that high level of RPMet must be evaluated in order of find better response.Tesis ( Doctorado en Ciencias, especialista en Ganadería).- Colegio de Postgraduados, 2008.CONACY

Comportamiento productivo y composición de la canal de la gallina de Guinea (Numida meleagris)

This study aimed to evaluate productive indicators of growth, carcass aspects and the proximal composition of the meat of the Guinea Fowl (GF) reared under tropical conditions in Mexico. It was carried out from July 2016 to May 2017. The productive behavior (PB) of 100 keets in 14 weeks was evaluated and for the trait of the carcass (TC) samples of 5 males and 5 females were analyzed. It was evaluated in PB, Weight gain (WG), feed consumption (FC) and feed conversion (FCO) and in TC, carcass yield (CY), water retention capacity (WRC), pH and color. Descriptive statistics were performed and a generalized linear model (GLM) was used to detect differences between sex, using the SAS statistical package (Ver. 9.4). The final average weight was 1161.56 ± 94.82 g with a WG of 10.98 ± 0.95 g/bird, FC of 62.04 ± 2.48 g and an FCO of 5.65 ± 0.57 g. Males were superior (79.3%) in the CY, without statistical differences (P> 0.05). The WRC and the pH were very similar. GF production is an alternative meat supply being a source of animal proteinEste estudio tuvo como objetivo evaluar indicadores productivos del crecimiento, rasgos de la canal y la composición proximal de carne de la Gallina de Guinea (GG) criada bajo condiciones tropicales de México. Se realizó de julio 2016 a mayo 2017. Se evaluó el comportamiento productivo (CP) de 100 keets en 14 semanas y para los rasgos de la canal (RC) se analizaron muestras de 5 machos y 5 hembras. Se evaluó en CP, la Ganancia de peso (GPE), consumo de alimento (CAL) y conversión alimenticia (ECA) y en RC, rendimiento de la canal (RCA), capacidad de retención de agua (CRA), pH y color. Se realizó estadística descriptiva y para detectar diferencias entre sexo se usó un modelo lineal generalizado (GLM), usando el paquete estadístico SAS (Ver. 9.4). El peso final promedio fue de 1161.56 ± 94.82 g con una GPE de 10.98 ± 0.95 g/ave, CAL de 62.04 ± 2.48 g y una ECA de 5.65 ± 0.57 g. Los machos fueron superiores (79.3%) en la RCA, sin diferencias estadísticas (P>0.05). La CRA y el pH fueron muy similares. La producción de GG es una alternativa de suministro de carne siendo una fuente de proteína de origen anima

EFECTO DE DOS NIVELES DE FORRAJE ARBÓREO TEPOZÃN (Buddleia cordata) EN EL COMPORTAMIENTO PRODUCTIVO Y MICROBIOLÓGICO RUMINAL EN CABRAS

Se evaluó el efecto de la inclusión (0, 15 y 30 %) de forraje arbóreo de Buddleida cordata (Tepozán) en el comportamiento productivo y los microorganismos del rumen en cabras. Se distribuyeron al azar 30 cabras criollas con un peso vivo promedio de 14 kg en tres tratamientos y fueron alojadas en corrales individuales durante 45 días. Se midió ganancia diaria de peso (GDP), consumo de materia seca (CMS), pH ruminal, concentración de bacterias totales, celulolíticas y protozoarios a los, 30 y 45 días del periodo experimental. El diseño experimental fue completamente al azar con mediciones repetidas a través del tiempo, analizando los datos de GDP, CMS y pH ruminal con PROC MIXED. El número de bacterias fue estadísticamente analizado por intervalos de confianza. No hubo diferencias entre tratamientos (p>0.05) por la inclusión de B. cordata en la dieta sobre la GDP, CMS, pH ruminal, concentración de bacterias totales, celulolíticas y protozoarios. No se presentaron diferencia entre periodos (p>0.05) en ninguna variable. Se concluye  que el henificado de B. cordata muestra potencial para ser incluido en la dieta de cabras hasta un máximo de 30%, sin afectar negativamente las variables productivas ni a los microorganismos del rumen.

Aprovechamiento de fauna silvestre para autoconsumo en ?reas naturales protegidas : estrategias de uso y conservaci?n de la biodiversidad para comunidades rurales de la Selva Lacandona, Chiapas, M?xico

CATIE (Centro Agronomico Tropical de Investigaci?n y Ense?anza