71 research outputs found

    Procena potencijalnog rizika po zdravlje ljudi usled prisustva teŔkih metala u zemljiŔtu centralne zone Beograda

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    An investigation of the soil quality in the centre of Belgrade was performed to define how seriously the soil is polluted. On the basis of the heavy metal content (Zn, Cd, Pb, Co, Ni, Cu, Cr and Mn), the potential health risk assessment calculated for a lifetime of exposure (ingestion and inhalation), based on the USEPA model, was determined as the cumulative carcinogenic and non-carcinogenic risk for children and adults. The study proved that soil contamination in Belgrade is not insignificant; risk assessment indicated that the carcinogenic risk is completely insignificant but the cumulative non-carcinogenic risk tends to became significant, mainly for children, since it approaches unacceptable values. There is no particularly dangerous single heavy metal, but their cumulative effect, expressed as Child Soil Ingestion Hazardous Index, is for concern.Ispitivanje zemljiÅ”ta centralne zone Beograda rađeno je sa ciljem da se odredi nivo njegove zagađenosti teÅ”kim metalima. Polazeći od sadržaja teÅ”kih metala (Zn, Cd, Pb, Co, Ni, Cu, Cr i Mn) procenjen je kumulativni potencijalni kancerogeni i nekancerogeni zdravstveni rizik (za ingestiju i inhalaciju) za životni vek čoveka, dece i odraslih, polazeći od modela koji je razvila američka agencija za zaÅ”titu životne sredine. Istraživanja pokazuju da zagađenje zemljiÅ”ta u Beogradu nije zanemarljivo iako procena kancerogenog rizika ukazuje da je on zanemarljiv, ali da nekancerogeni rizik postaje značajan, posebno u slučaju dece. Za sada ne postoji određeni teÅ”ki metal koji se može identifikovati kao opasan, ali kumulativni efekat svih ispitivanih metala iskazan kroz ingestioni hazardni indeks za decu postaje zabrinjavajući poÅ”to se približava vrednostima koje se smatraju nepovoljnim

    The importance of alternative host plants as reservoirs of the cotton leaf hopper, Amrasca devastans, and its natural enemies

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    Many agricultural pests can be harboured by alternative host plants but these can also harbour the pestsā€™ natural enemies. We evaluated the capacity of non-cotton plant species (both naturally growing and cultivated) to function as alternative hosts for the cotton leaf hopper Amrasca devastans (Homoptera: Ciccadellidae) and its natural enemies. Forty-eight species harboured A. devastans. Twenty-four species were true breeding hosts, bearing both nymphal and adult A. devastans, the rest were incidental hosts. The crop Ricinus communis and the vegetables Abelmoschus esculentus and Solanum melongena had the highest potential for harbouring A. devastans and carrying it over into the seedling cotton crop. Natural enemies found on true alternative host plants were spiders, predatory insects (Chrysoperla carnea, Coccinellids, Orius spp. and Geocoris spp.) and two species of egg parasitoids (Arescon enocki and Anagrus sp.). Predators were found on 23 species of alternative host plants, especially R. communis. Parasitoids emerged from one crop species (R. communis) and three vegetable species; with 39 % of A. devastans parasitised. We conclude that the presence of alternative host plants provides both advantages and disadvantages to the cotton agro-ecosystem because they are a source of both natural enemy and pest species. To reduce damage by A. devastans, we recommend that weeds that harbour the pest should be removed, that cotton cultivation with R. communis, A. esculentus, and S. melongena should be avoided, that pesticides should be applied sparingly to cultivate alternative host plants and that cotton crops should be sown earlier

    Drivers of tropical forest loss between 2008 and 2019

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    During December 2020, a crowdsourcing campaign to understand what has been driving tropical forest loss during the past decade was undertaken. For 2 weeks, 58 participants from several countries reviewed almost 115ā€‰K unique locations in the tropics, identifying drivers of forest loss (derived from the Global Forest Watch map) between 2008 and 2019. Previous studies have produced global maps of drivers of forest loss, but the current campaign increased the resolution and the sample size across the tropics to provide a more accurate mapping of crucial factors leading to forest loss. The data were collected using the Geo-Wiki platform (www.geo-wiki.org) where the participants were asked to select the predominant and secondary forest loss drivers amongst a list of potential factors indicating evidence of visible human impact such as roads, trails, or buildings. The data described here are openly available and can be employed to produce updated maps of tropical drivers of forest loss, which in turn can be used to support policy makers in their decision-making and inform the public

    Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019 : a systematic analysis for the Global Burden of Disease Study 2020, Release 1

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    Background Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. Methods For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dosespecific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in countryreported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. Findings By 2019, global coverage of third-dose DTP (DTP3; 81.6% [95% uncertainty interval 80.4-82 .7]) more than doubled from levels estimated in 1980 (39.9% [37.5-42.1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38.5% [35.4-41.3] in 1980 to 83.6% [82.3-84.8] in 2019). Third- dose polio vaccine (Pol3) coverage also increased, from 42.6% (41.4-44.1) in 1980 to 79.8% (78.4-81.1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56.8 million (52.6-60. 9) to 14.5 million (13.4-15.9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. Interpretation After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

    Hearing loss prevalence and years lived with disability, 1990ā€“2019: findings from the Global Burden of Disease Study 2019

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    Background Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. Findings An estimated 1Ā·57 billion (95% uncertainty interval 1Ā·51ā€“1Ā·64) people globally had hearing loss in 2019, accounting for one in five people (20Ā·3% [19Ā·5ā€“21Ā·1]). Of these, 403Ā·3 million (357Ā·3ā€“449Ā·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430Ā·4 million (381Ā·7ā€“479Ā·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127Ā·1 million people [112Ā·3ā€“142Ā·6]). Of all people with a hearing impairment, 62Ā·1% (60Ā·2ā€“63Ā·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65Ā·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2Ā·45 billion (2Ā·35ā€“2Ā·56) people will have hearing loss, a 56Ā·1% (47Ā·3ā€“65Ā·2) increase from 2019, despite stable age-standardised prevalence. Interpretation As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings

    Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

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    Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0Ā·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1Ā·0). Findings: In 2019, there were 36Ā·8 million (95% uncertainty interval [UI] 35Ā·1ā€“38Ā·9) people living with HIV worldwide. There were 0Ā·84 males (95% UI 0Ā·78ā€“0Ā·91) per female living with HIV in 2019, 0Ā·99 male infections (0Ā·91ā€“1Ā·10) for every female infection, and 1Ā·02 male deaths (0Ā·95ā€“1Ā·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28Ā·52% decrease in incident cases, 95% UI 19Ā·58ā€“35Ā·43, and a 39Ā·66% decrease in deaths, 36Ā·49ā€“42Ā·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0Ā·05 (95% UI 0Ā·05ā€“0Ā·06) and the global incidence-to-mortality ratio was 1Ā·94 (1Ā·76ā€“2Ā·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH

    Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

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    Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10ā€“14 and 50ā€“54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2Ā·72 (95% uncertainty interval [UI] 2Ā·66ā€“2Ā·79) in 2000 to 2Ā·31 (2Ā·17ā€“2Ā·46) in 2019. Global annual livebirths increased from 134Ā·5 million (131Ā·5ā€“137Ā·8) in 2000 to a peak of 139Ā·6 million (133Ā·0ā€“146Ā·9) in 2016. Global livebirths then declined to 135Ā·3 million (127Ā·2ā€“144Ā·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2Ā·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27Ā·1% (95% UI 26Ā·4ā€“27Ā·8) of global livebirths. Global life expectancy at birth increased from 67Ā·2 years (95% UI 66Ā·8ā€“67Ā·6) in 2000 to 73Ā·5 years (72Ā·8ā€“74Ā·3) in 2019. The total number of deaths increased from 50Ā·7 million (49Ā·5ā€“51Ā·9) in 2000 to 56Ā·5 million (53Ā·7ā€“59Ā·2) in 2019. Under-5 deaths declined from 9Ā·6 million (9Ā·1ā€“10Ā·3) in 2000 to 5Ā·0 million (4Ā·3ā€“6Ā·0) in 2019. Global population increased by 25Ā·7%, from 6Ā·2 billion (6Ā·0ā€“6Ā·3) in 2000 to 7Ā·7 billion (7Ā·5ā€“8Ā·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58Ā·6 years (56Ā·1ā€“60Ā·8) in 2000 to 63Ā·5 years (60Ā·8ā€“66Ā·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019

    Global disparities in surgeonsā€™ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

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    : The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSSĀ® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 Ā± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 Ā± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 Ā± 4.9 and 7.8 Ā± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 Ā± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity &gt; 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI
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