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 life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015

Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61.7 years (95% uncertainty interval 61.4-61.9) in 1980 to 71.8 years (71.5-72.2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11.3 years (3.7-17.4), to 62.6 years (56.5-70.2). Total deaths increased by 4.1% (2.6-5.6) from 2005 to 2015, rising to 55.8 million (54.9 million to 56.6 million) in 2015, but age-standardised death rates fell by 17.0% (15.8-18.1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14.1% (12.6-16.0) to 39.8 million (39.2 million to 40.5 million) in 2015, whereas age-standardised rates decreased by 13.1% (11.9-14.3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42.1%, 39.1-44.6), malaria (43.1%, 34.7-51.8), neonatal preterm birth complications (29.8%, 24.8-34.9), and maternal disorders (29.1%, 19.3-37.1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Copyright (C) The Author(s). Published by Elsevier Ltd.Peer reviewe

Assessing Tourism Potential In Bhaktapur Durbar Square, Nepal

<p>Tourism is one of the most promising driver and contributor of the world economy having significant role in sustainable development, economic upliftment and social benefits. It has the potential to contribute towards environmental protection and poverty reduction. Prior to investment in tourism, concerned authorities must know the condition of respective tourist resources, their attractiveness and levels of touristic demand. Very few studies in Nepal have made an effort to quantify the tourism potential in cultural, historical and religious sites such as Bhaktapur Durbar Square. With an objective to assess the tourism potential of Bhaktapur Durbar Square using Weighted Sum Method, this study was carried out from start of June to the end of July in 2013. For this purpose, questionnaire survey with tourists, private businesses and public sector institutions; focus group discussion and key informant interview with tourism enterpreneur and local government officer was carried out. The tourism potential was found to be high with a strength of exceptionally rich cultural, historical and religious heritage, favourable geographical situation, positive image of local Newari food products and friendly and welcoming local people. The areas of weaknesses were lack of tourism infrastructures and services, lack of tourist information and weak management of tourist area. Hence, to utilise the tourism potential of Bhaktapur Durbar Square to the fullest for the economic upliftment of its inhabitants, promotional activities such as tourism fairs, festivals, cultural dances and events should be conducted at regular intervals with prompt security services.</p> <p>International Journal of Environment, Volume-2, Issue-1, Sep-Nov 2013, Pages 250-261</p> <p>DOI: <a href="http://dx.doi.org/10.3126/ije.v2i1.9225">http://dx.doi.org/10.3126/ije.v2i1.9225</a></p

Recent warming and its risk assessment on ecological and societal implications in Nepal

A predominantly mountainous country Nepal has a complex climatic pattern that varies from tropical in the south (Terai region) to arctic in the north (Himalayas). The gradual rise in temperature in the mountainous region has attracted great interest among the scientific community in general over recent years. However, recent warming in Nepal’s east-west and south-north temperature gradients and its implications for ecology and society based on facts and figures are still lacking. In this context, temperature data (1970–2016) of 76 meteorological stations from the Terai region to the Mountains were used in this study to analyze the annual and seasonal warming trends in the different physiographic regions of Nepal. We performed a hybrid analytical approach i.e. integrated statistical and theoretical tools to detect the warming trend and its ecological and societal implications across the country. The Eastern part of the country was found to be more warming than the Central and Western parts, showing an increased climatic sensitivity across the Khumbu (Mt. Everest region). The increasing trends of temperature have been found in all physiographic regions along an altitude gradient, i.e. Terai, Siwaliks, Lower Hills, and Upper Hills observed 0.15, 0.26, 0.68, and 0.57 °C per decade, respectively. Higher warming trend in Lower Hills than the Upper Hills showed that higher elevations experienced lesser degrees of warming trends than the lower elevations in the mountainous regions. Further, a higher warming trend was observed in the winter season than the other seasons in all regions except for Terai. Based on the warming trends in different physiographic regions, we also found a similar pattern of ecological impacts, where a higher warming region also experienced higher ecological impacts such as changes in water resources, phenology, etc. Lower Hills, Upper Hills, and Mountains experienced higher adverse impacts than the Terai and Siwaliks in the current global warming scenarios

Water quality and hydrochemical assessments of thermal springs, Gandaki Province, Nepal

Thermal springs are the sites where the water temperature lies above ambient temperature. They are widely used for power generation, hot water spas, balneotherapy, agriculture, laundering, and aquaculture. In Nepal, many thermal springs are reported but scientific understanding on water quality and hydrogeochemistry of the springs is very limited. In this study, a total of 28 physico-chemical parameters were measured in water samples collected from 12 thermal springs from Gandaki Province, Nepal. Correlation matrix and multivariate statistical analysis such as principal component analysis (PCA) and cluster analysis were used to understand the water quality and hydrogeochemistry of the hot water springs. The pH, temperature, electrical conductivity, total dissolved solids, and turbidity in the hot water springs ranged from 7.3 to 8.8, 31.6–64.3 °C, 206–16270 μS/cm, 115–6637 mg/L, and 0.21–63.7 NTU; respectively. The dominance order of major anions and cations were: Cl− > HCO3− > SO42− > NO3− > F− and Na+ > Ca2+ > K+ > Mg2+; respectively. Comparison of the water quality parameters with the WHO and National Water Quality Standards suggested that the majority of the parameters were within the safe limit. Out of 9 heavy metals and trace elements analyzed Zn2+, Ni2+, Cr3+, Cd+2, Hg (total), and Pb2+ were found below the safe limit but Fe (total), As (total) and Cu (total) were found higher than the WHO safe limit in total of 3, 5 and 1 sampling sites; respectively. The water quality index (WQI), sodium absorption ratio (SAR), and magnesium hazard (MH) ratio in the hot water springs ranged from 40.9 to 573, 2.2–49.3, 7.1–70.8; respectively. The result of PCA analysis showed that four principal components are required to explain hydrogeochemistry. Cluster analysis suggested that the sampling sites can be grouped into three distinct clusters based on total dissolved solids. Interestingly, the classification of hydrochemical facies using a Piper diagram suggested that 7 out of 12 thermal springs have Na–Cl type water. Finally, a perspective on the suitability of the hot springs for hot water spas and balneotherapy and policy recommendation is provided

Determinants of Herpetofaunal Diversity in a Threatened Wetland Ecosystem: A Case Study of the Ramaroshan Wetland Complex, Western Nepal

Wetlands are among the highly threatened ecosystems due to anthropogenic activities. The Ramaroshan Wetland Complex (RWC) of Achham District, Nepal is one of the high-altitude wetlands facing human induced degradation and loss. Herpetofauna are key bio-indicators of environmental health and habitat quality and are useful to assess habitat conditions of such threatened ecosystems. This study quantified the land use and land cover (LULC) change in the RWC and documented the diversity and distribution pattern of herpetofauna. The LULC in the area (13.94 Km2) was analyzed for 1989, 2000, 2010 and 2021 by supervised classification of remote sensing images. Surveys were conducted along 25 transects, each of 200 m in length and environmental variables were recorded for every observation of herpetofauna. The LULC analysis revealed an overall loss of 16% of the total water body between 1989 (0.25 Km2) and 2021 (0.21 Km2). Eleven species of herpetofauna (five amphibians and six reptiles) within five families and two orders (i.e., Anura and Squamata), were recorded with low diversity (H’ = 1.88312) and evenness (E = 0.3642) indices. The herpetofauna had a hump-shaped distribution along the elevation gradient with the highest richness and abundance at 2300 m asl. Amphibian abundance decreased with increasing distance to nearest water sources, whereas reptile abundance increased. Amphibians were more abundant in agricultural field and marsh land, whereas reptile abundance was higher around human settlements. Results indicate that the wetland area in the RWC is declining at an alarming rate and, in turn, might account for the low diversity and abundance of the herpetofauna

Integrated Geoelectrical and Geological Investigation of a Quaternary Paleo-Depositional Environment in the Haripur Basin, Northern Pakistan: Implications for Groundwater System

The deposition in Haripur basin not only provides a contemporary insight into old fluvial depositional sequences of the Himalayan foreland but also sheds light on the important continental depositions in a monsoon controlled foreland system. The present study emphasizes the evaluation of the paleo-depositional architecture for sustainable groundwater availability by utilizing a total of four field-based geological observations, eleven boreholes, and fifty-nine vertical electrical sounding (VES) datasets. The acquired surface geological data well correlate with resistivity and borehole data. The derived results of the lithostratigraphic cross-sections and spatial distribution maps reveal three-sided closure depositional. These depositional directions indicate thick successions of coarser sediments near the foothills and interbedded mixture of coarser and finer sediments toward the central and southern parts of the basin. The former conditions provide maximum groundwater yielding capacity for sustainable groundwater supply in the north-eastern and north-western parts of the basin. On the contrary, in the central and southern parts of the basin, the groundwater yielding capacities have drastically decreased due to deposition of finer sediments

Possible high risk of transmission of the Nipah virus in South and South East Asia: a review

Abstract Nipah virus (NiV) is a zoonotic, single-stranded RNA virus from the family Paramyxoviridae, genus Henipavirus. NiV is a biosafety-level-4 pathogen that is mostly spread by Pteropus species, which serve as its natural reservoir host. NiV is one of the major public health challenges in South and South East Asia. However, few molecular studies have been conducted to characterise NiV in a specific region. The main objective of this review is to understand the epidemiology, pathogenesis, molecular surveillance, transmission dynamics, genetic diversity, reservoir host, clinical characteristics, and phylogenetics of NiV. South and South East Asian nations have experienced NiV outbreaks. Phylogenetic analysis confirmed that two primary clades of NiV are in circulation. In humans, NiV causes severe respiratory illness and/or deadly encephalitis. NiV is mainly diagnosed by ELISA along with PCR. Therefore, we recommend that the governments of the region support the One Health approach to reducing the risk of zoonotic disease transmission in their respective countries

Pinus roxburghii stand dynamics at a heavily impacted site in Nepal: Research through an educational fieldweek

The fieldweek associated with the 4th Asian Dendrochronological Association Conference was an excellent opportunity for education, networking, and research. The participants and group leaders worked together for five days in an area that was new to some of the group leaders and new to some of the participants which enabled us to learn about forest ecology around Kathmandu and Nagarkot, Nepal. The fieldweek was an excellent networking opportunity and the group leaders and participants bonded which strengthened international research in dendrochronology and continues to foster new research collaborations. All of the group leaders and participants had the opportunity to learn about tree-ring formation in Pinus roxburghii at 1500 masl elevation, to explore its wood anatomy, and to examine specific research questions in our field area. In the end we developed a better understanding of the stand-age structure of a stand of trees in Nagarkot, explored the erosion history from exposed roots, and investigated tree health issues on closely related sites. We found that P. roxburghii poses some dating issues with false and micro rings at this elevation, but we were still able to develop a tree-ring chronology from this species and make preliminary assessments of stand dynamics and health

Pinus roxburghii stand dynamics at a heavily impacted site in Nepal: Research through an educational fieldweek

The fieldweek associated with the 4th Asian Dendrochronological Association Conference was an excellent opportunity for education, networking, and research. The participants and group leaders worked together for five days in an area that was new to some of the group leaders and new to some of the participants which enabled us to learn about forest ecology around Kathmandu and Nagarkot, Nepal. The fieldweek was an excellent networking opportunity and the group leaders and participants bonded which strengthened international research in dendrochronology and continues to foster new research collaborations. All of the group leaders and participants had the opportunity to learn about tree-ring formation in Pinus roxburghii at 1500 masl elevation, to explore its wood anatomy, and to examine specific research questions in our field area. In the end we developed a better understanding of the stand-age structure of a stand of trees in Nagarkot, explored the erosion history from exposed roots, and investigated tree health issues on closely related sites. We found that P. roxburghii poses some dating issues with false and micro rings at this elevation, but we were still able to develop a tree-ring chronology from this species and make preliminary assessments of stand dynamics and health. (C) 2016 Elsevier GmbH. All rights reserved