Stroke in Africa: Profile, progress, prospects and priorities

Funding text 1 R.O.A. is supported by the UK Royal Society/African Academy of Sciences FLAIR Grants FLR/R1/191813 and FCG/R1/ 201034, and a GCRF Networking Grant from the UK Academy of Medical Sciences. R.O.A., M.O.O., B.O. and F.S.S. are also supported by grants U54HG007479 and U01HG010273 from the US National Institutes of Health (NIH) as part of the H3Africa Consortium. M.O.O., B.O., R.O.A. and F.S.S. are further supported by NIH grant R01NS107900. R.N.K.’s research on elderly survivors of stroke has been supported by the Medical Research Council, RCUK Newcastle Centre for Brain Ageing and Vitality (MRC G0500247), Alzheimer’s Research UK, the Dunhill Medical Trust, UK, and the Newcastle National Institute for Health Research Biomedical Research Centre in Ageing and Age-Related Diseases, Newcastle upon Tyne Hospitals National Health Service Foundation Trust. Funding text 2 funds provided by the Wellcome Trust and the NIH. The NIH-funded SIREN study is exploring the genetic architecture of stroke among Indigenous Africans. More than 4,000 case–control pairs have already been recruited to the study and several publications on stroke phenom-ics and preliminary candidate gene analyses have been generated. The SIREN study has also undertaken the first-ever GWAS to unravel the genetic architecture of stroke in Indigenous Africans and the results are eagerly awaited. Stroke neurobanking resources consisting of blood fractions, extracted DNA, neuroimages and databases of clinical information are also being built in Africa and could facilitate data science-driven trans-omics research (including epigenomics, tran-scriptomics, proteomics and metabolomics) as well as the development of precision medicine products such as Afrocentric risk calculators, polygenic risk scores, biomarkers and drug targets23–25,227,307,308. The SIREN neurobiobank comprises a group of constantly monitored ultra-low-temperature (–86 °C) freezers located in Ibadan, Nigeria, constantly powered –20 °C chest freezers located in Ibadan and other recruitment sites, barcode scanners and printers, a laboratory information management system, a secure multi-terabyte server,Stroke is a leading cause of disability, dementia, and death worldwide. Approximately 70% of deaths from stroke and 87% of stroke-related disabilities occur in low-income and middle-income countries. At the turn of the century, the most common diseases in Africa were communicable diseases, whereas non-communicable diseases, including stroke, were considered rare, particularly in sub-Saharan Africa. However, evidence indicates that today, Africa could have up to 2–3-fold greater rates of stroke incidence and higher stroke prevalence than western Europe and the USA. In Africa, data published within the past decade show that stroke has an annual incidence rate of up to 316 per 100,000, a prevalence of up to 1,460 per 100,000, and a 3-year fatality rate greater than 80%. Moreover, many Africans have a stroke within the fourth to sixth decades of life, with serious implications for the individual, their family, and society. This age profile is particularly important as strokes in younger people tend to result in a greater loss of self-worth and socioeconomic productivity than in older individuals. Emerging insights from research into stroke epidemiology, genetics, prevention, care, and outcomes offer great prospects for tackling the growing burden of stroke on the continent. In this article, we review the unique profile of stroke in Africa and summarize current knowledge on stroke epidemiology, genetics, prevention, acute care, rehabilitation, outcomes, cost of care, and awareness. We also discuss knowledge gaps, emerging priorities, and future directions of stroke medicine for the more than 1 billion people who live in Africa. © 2021, Springer Nature Limited.Newcastle National Institute for Health Research Biomedical Research Centre in Ageing and Age-Related Diseases Newcastle upon Tyne Hospitals National Health Service Foundation Trust RCUK Newcastle Centre for Brain Ageing and Vitality Royal Society/African Academy of Sciences: FCG/R1/ 201034,FLR/R1/191813 National Institutes of Health (NIH): R01NS107900 Wellcome Trust (WT) Medical Research Council (MRC): G0500247 Dunhill Medical Trust (DMT) Academy of Medical Sciences: U01HG010273,U54HG007479 Alzheimer’s Research UK (ARUK

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.</p

A century of trends in adult human height

Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5-22.7) and 16.5 cm (13.3-19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8-144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol�which is a marker of cardiovascular risk�changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95 credible interval 3.7 million�4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world. © 2020, The Author(s), under exclusive licence to Springer Nature Limited

Density functional theory investigation of the binding interactions between phosphoryl, carbonyl, imino, and thiocarbonyl ligands and the pentaaqua nickel(II) complex: Coordination affinity and associated parameters

Density Functional Theory (UB3LYP/6-311++G(d,p)) calculations of the affinity of the pentaaqua nickel(II) complex for a set of phosphoryl [O\uef\ua3P(H)(CH3)(PhR)], imino [HN\uef\ua3C(CH 3)(PhR)], thiocarbonyl [S\uef\ua3C(CH3)(PhR)] and carbonyl [O\uef\ua3C(CH3)(PhR)] ligands were performed, where R\uef\ua3NH2, OCH3, OH, CH3, H, Cl, CN, and NO2 is a substituent at the para-position of a phenyl ring.The affinity of the pentaaqua nickel(II) complex for these ligands was analized and quantified in terms of interaction enthalpy (\u394H), Gibbs free energy (\u394G298), geometric and electronic parameters of the resultant octahedral complexes. The \u394H and \u394G298 results show that the ligand coordination strength increases in the following order: carbonyl < thiocarbonyl < imino < phosphoryl. This coordination strength order is also observed in the analysis of the metal-ligand distances and charges on the ligand atom that interacts with the Ni(II) cation. The electronic character of the substituent R is the main parameter that affects the strength of the metal-ligand coordination. Ligands containing electron-donating groups (NH 2, OCH3, OH) have more exothermic \u394H and \u394G298 than ligands with electron-withdrawing groups (Cl, CN, NO2). The metal-ligand interaction decomposed by means of the energy decomposition analysis (EDA) method shows that the electronic character of the ligand modulates all the components of the metal-ligand interaction. The absolute softness of the free ligands is correlated with the covalent contribution to the instantaneous interaction energy calculated using the EDA method. \ua9 2013 Wiley Periodicals, Inc. The interactions between metal cations and biomolecules are extensively studied in bioinorganic and coordination chemistry. Transition metal ions are present in many enzymes, metalloproteins, peptide hormones, and nucleic acids and are fundamental for their biological functions. In this work, the affinity of the pentaaqua nickel(II) complex toward a set of para-substituted ligands is evaluated. The electronic nature of the ligand modulates the magnitude of the electrostatic, covalent, and repulsion components of the interaction. \ua9 2013 Wiley Periodicals, Inc.Peer reviewed: YesNRC publication: Ye

Potencial genético de progênies de feijão-caupi segregantes quanto ao tipo da inflorescência

O objetivo deste trabalho foi avaliar o potencial genético produtivo de progênies de feijão-caupi (Vigna unguiculata) segregantes quanto ao tipo da inflorescência. Foram avaliadas 68 progênies F4 obtidas dos retrocruzamentos: (TV x 5058-09C x Cacheado-roxo) x TV x 5058-09C e (AU94-MOB-816 x Cacheado-roxo) x AU94-MOB-816, com os genitores. Dois experimentos foram conduzidos no delineamento de blocos ao acaso, tendo-se avaliado 17 progênies, com quatro repetições, em parcelas subdivididas quanto à inflorescência: simples e composta. A análise estatística foi realizada por modelos mistos via procedimento REML/BLUP. As estimativas das variâncias genéticas foram significativas para todos os caracteres estudados. Os caracteres comprimento do pedúnculo, número médio de vagens por pedúnculo e floração inicial apresentaram alta variabilidade e expressão do componente genético para a inflorescência composta. As progênies de inflorescência simples apresentam potencial genético produtivo similar às progênies de inflorescência composta. As progênies resultantes do retrocruzamento (AU94-MOB-816 x Cacheado-roxo) x AU94-MOB-816 são promissoras como estratégia para aumentar os níveis atuais de produtividade do feijão-caupi