Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods: We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings: Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation: Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding: Bill & Melinda Gates Foundation

Qualidade tecnológica da pluma do algodoeiro herbáceo cultivado com biossólidos.

Made available in DSpace on 2011-07-20T01:01:13Z (GMT). No. of bitstreams: 1 v10n3a08.pdf: 194820 bytes, checksum: f69bc836fbbbdefadf635bd12cc92818 (MD5) Previous issue date: 2007-02-23200

High-spin states in \chem{^{44}Ca}

High-spin states of the $^{44}$Ca nucleus populated in the 68 MeV $^{18}$O + $^{30}$Si reaction have been studied in a $\gamma$-$\gamma$-recoil coincidence experiment. The level scheme of $^{44}$Ca has been extended up to 12.2 MeV. In particular, the negative-parity band has been identified with the highest $I = 13^-$ level at 10.6 MeV. This state is interpreted as the band-terminating state for the ($d_{3/2}^ {-1} f_{7/2}^5$) configuration

Avaliação da debulha mecânica em sementes de milho Evaluation of mechanical thrashing processing in corn seeds

No estado da Paraíba, as perdas de sementes e grãos de milho (Zea mays L.) provocadas principalmente pela colheita, debulha mecânica, beneficiamento e processos subseqüentes, são da ordem de 20%, acarretando prejuízos econômicos ao estado. Assim, estudaram-se as danificações decorrentes da debulha mecânica e da passagem das sementes de milho, variedades Cruzeta e Sertanejo, pelas diferentes etapas do beneficiamento. Para avaliar os danos provocados às sementes, utilizou-se uma debulhadora estacionária trabalhando a rotações de 520, 600 e 700 rpm, obtidas pela variação da aceleração do motor do trator ao qual a debulhadora se achava acoplada, como também das etapas promovidas pela UBS. Os danos foram avaliados visualmente e analisados em um delineamento estatístico inteiramente casualizado, com os tratamentos distribuídos em esquema fatorial. A variedade Cruzeta foi mais resistente aos impactos provocados pela debulha e pelo beneficiamento; o efeito do impacto na qualidade das sementes torna-se mais evidente com a elevação da velocidade do cilindro debulhador; a rotação de 600 rpm mostrou-se a mais indicada para a debulha do milho Cruzeta e Sertanejo.<br>In the State of Paraiba, the loss of seeds and grains of corn (Zea mays L.) caused, mainly by harvesting, mechanical thrashing and subsequent processes is about 20% resulting in economic loss to the state. In this context, the effect of mechanical damages during the thrashing and passage of corn seeds varieties -Cruzeta- and -Sertanejo- were studied, in the different stages of processing. To evaluate the damages caused to the seeds, a stationary thrasher was used working at 520, 600 and 700 rpm, obtained by the acceleration variation of the tractor to which the thrasher was attached. The damages were visually appraised and analysed in a completely randomized statistical design with the treatments distributed in a factorial scheme. -Cruzeta- variety was more resistant to the impacts caused by the thrashing and processing; the impacts on the seed quality became more evident with the elevation of speed of the thrashing cylinder; the 600 rpm rotation proved to be better for the thashing of Cruzeta and Sertanejo corn