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

Digging for gold in good : sustainability opportunity recognition for entrepreneurs

We propose a systematic importance-performance analysis to identify unexplored opportunities for entrepreneurs. The sustainable context is used to determine competitive areas that need to be improved. After identifying the areas that require improvement, opportunities with a high chance of success are determined. We summarize results of this approach to dairy farming context in The Netherlands. Importance-performance analysis is applied using a sustainability business model for entrepreneurs. Importance-performance analysis can also be used by other stakeholders in the entrepreneurship ecosystem, including venture capitalists, advisors and policy-makers

Opportunity Recognition for Entrepreneurs Based on a Business Model for Sustainability : A Systematic Approach and Its Application in the Dutch Dairy Farming Sector

In this article, a systematic approach is suggested to identify unexplored opportunities and recommend a business model for sustainability for startups. Considering a particular sector, following the proposed approach, an entrepreneur should first determine the importance of the different areas which could be improved in that sector. Then the current performance of these areas is also evaluated. Subsequently, by an importance-performance analysis, an entrepreneur can obtain information on areas that can be improved but that are currently underperforming. These are the areas that can be considered as opportunities with high success rate by the entrepreneurs for being survival. The proposed approach is applied to the case of dairy farming in The Netherlands. Data is collected from a sample of top experts in this field and analyzed using best-worst method and importance-performance analysis. We found that, of the technological, social, and organizational areas in Dutch dairy farming, the social area is the one area where the performance does not reflect its importance. Following the business model for sustainability, the entrepreneurs are advised to adopt archetypes that are suitable for the social area

Relationship between Self-concept and Attitude towards the Others

Attitude has been the focal point of studies for social psychologists for many years. A proper understanding of this concept can be helpful in many fields such as management and communication. One's attitude toward different issues stems from his relation with the issues. Thus, one's attitude towards himself is deeply rooted in his relationship with himself. Starting a new relationship brings about complexities to the process of the relationship. Negative attitude towards oneself and others causes serious problems in various organizations. On the other hand, positive attitude seems to be beneficial to the improvement of the organizational relationships. The object of this study is to elaborate the concept of the attitude as well as test the following hypothesis: "there is a significant relationship between one's attitude towards himself and towards the others ".The results confirm the hypothesis

Role of knowledge management processes within different stages of technological innovation : evidence from biotechnology SMEs

Managing technological innovations in the knowledge-intensive and dynamic biotechnology industry involves the effective application of knowledge. Knowledge management has been shown to improve technological innovation capabilities, thus indirectly contributing to sustainable competitive advantage. This paper views knowledge management from a process capabilities perspective and aims to understand its role within the technological innovation process in biotechnology sector in the Netherlands. Through a qualitative and exploratory research design including 15 biotechnology case interviews, three general roles of knowledge management processes were identified: a key role, a supporting role, and a complementary role. The roles depend on the innovation phase. Four propositions are introduced and shed more light on the role of each individual knowledge management process with respect to the different innovation phases. Understanding how these processes work throughout the innovation process will provide insight for organisations on how to use knowledge management effectively to improve the innovation process performance

University Relationship Management

\u3cp\u3eIn recent decades, to gain a competitive advantage, firms have improved their relationships with universities as the main generators of science and technology in modern societies. There are various goals and drivers that inspire firms to engage in such relationships. These goals and drivers, along with several facilitators, in turn indicate the existence of different types of relationships between firms and universities, which are characterized by different elements, like trust, commitment, and communication. It is very important for firms to manage the level of different elements in these relationships for different types of interactions, in what we call university relationship management (URM). The main purpose of this paper is to propose a generic framework for URM, to discuss the most important antecedents and consequences of URM, and to provide conclusions and avenues for future research.\u3c/p\u3

The Amount of Alcohol Consumption and Its Quantitative Risk Assessment through Wastewater-Based Epidemiology: a Case Study in Kermanshah City

Background and Aim: Monitoring alcohol consumption in population is very important for planning public health and evaluation of the efficiency of intervention strategies. The aim of this study was to use wastewater-based epidemiology (WBE) to estimate alcohol consumption in a Kermanshah City and calculate risk assessment using the margin of exposure (MOE) approach. Materials and Methods: Raw composite wastewater samples (5 hours) were collected form the entrance of Kermanshah wastewater plant over a 30 days’ period. Ethyl sulfate metabolite was used to measure the alcohol content of the samples, which is excreted in the urine after consuming alcohol by humans and enters into the wastewater collection network. After centrifugation and filtration, the samples were directly injected into the liquid chromatography with tandem mass spectrometry LC-MS/MS for analysis. After calculation of alcohol consumption rate with back-calculation method, the results were used for risk assessment by MOE. Results: In general, the average amount of alcohol consumption during sampling in the society was 0.332 ml per person of equal age and over 15 years of age (adult) per day, which was equal to 0.121 liters of pure alcohol per person per year. We found no significant difference in the amount of alcohol consumption between the weekend and working days of the week, and also between  sampling days in Ramadan and ordinary  days. In 90% of the samples taken, the risk associated with alcohol consumption was higher than MOE=100 and only in 3 samples the MOE value was in the "risk" category. Conclusion: The results of this study showed that wastewater-based epidemiology can provide appropriate timely and transisional  information on alcohol use and its associated exposure risks in the community. Also, the amount of alcohol consumption in the population in our study was much lower than those in the European and American countries