The chemical composition and in vitro digestibility evaluation of almond tree (Prunus dulcis D. A. Webb syn. Prunus amygdalus; var. Shokoufeh) leaves versus hulls and green versus dry leaves as feed for ruminants

The current study aimed to evaluate the chemical composition and in vitro digestibility of almond tree (Prunus dulcis D. A. Webb syn. Prunus amygdalus; var. Shokoufeh) leaves versus hulls, and green versus dry leaves as feed for ruminants. The fresh green almond hulls (GAH) and leaves (GAL) were harvested and spread under a shade to dry. Dry almond leaves (DAL) were collected from under the trees where as dry almond hulls (DAH) were collected 4 weeks after harvesting the fresh samples. The chemical composition of substrates was determined using standard approaches and the metabolisable energy (ME), in vitro dry matter (DMD) and in vitro organic matter (OMD) digestibility were measured using the in vitro gas production (GP) technique. The GAL contained 81 g crude protein (CP) kg-1 DM while DAH contained 103 g CP kg-1 DM. The CP was higher (P = 0.0003) in dry (leaves and hulls) than in green (leaves and hulls) samples. The ash content ranged from 99.2 to 181.5 g kg-1 DM in DAH and DAL, respectively, (P = 0.0041). The ether extract content ranged from 27 for DAH to 65 g kg-1 for DAL (P = 0.0018). The acid detergent fibre and neutral detergent fibre content ranged from 185 to 304 and 444 to 620 g kg-1 DM (P = 0.04), for GAL and DAH, respectively. The DAH had the highest (P = 0.0001) GP24 and GP96. The DAH had the highest (P = 0.0001) potential GP (i.e., b), while the GP rate was highest for GAL and GAH (P = 0.034), ME was highest for DAH (P = 0.0001), and in vitro OMD was highest for DAH (P = 0.0001). The highest DMD (P = 0.0001) values were obtained with DAH followed by GAL, DAL and GAH, respectively. It can be concluded that almond hulls and leaves have a good nutritional potential to cover the maintenance nutrient requirements of small ruminants. Almond hulls and leaves can also be used as supplement to low quality mature pasture and/or crop residues. However, more studies are warranted to better characterize these feeds in in vivo animal feeding trials

The chemical composition and in vitro digestibility evaluation of almond tree (Prunus dulcis D. A. Webb syn. Prunus amygdalus; var. Shokoufeh) leaves versus hulls and green versus dry leaves as feed for ruminants

Almond, (Prunus dulcis D. A. Webb syn. Prunus amygdalus) is a species belonging to the Rosaceae family (Sfahlan et al. 2009). The state of California in the USA is the major producer of almond; however, its production is widely distributed (Wijerante et al. 2006) and there is increasing interest to produce almond and its by-products worldwide. Approximately 2,112,815 metric ton of almonds with shell is produced globally with Iran contributing about 110,000 metric ton (FAO 2007). Almond is a midsize tree with fruit that can grow up to ten meters tall (Chen et al. 2010). The fruit is made of hulls, shell and kernel. Drying almond hulls results in approximately (kg-1 DM) 250 g nut, 500 g hulls and 250 g shell (Aguilar et al. 1984; Fadel 1999).The current study aimed to evaluate the chemical composition and in vitro digestibility of almond tree (Prunus dulcis D. A. Webb syn. Prunus amygdalus; var. Shokoufeh) leaves versus hulls, and green versus dry leaves as feed for ruminants. The fresh green almond hulls (GAH) and leaves (GAL) were harvested and spread under a shade to dry. Dry almond leaves (DAL) were collected from under the trees where as dry almond hulls (DAH) were collected 4 weeks after harvesting the fresh samples. The chemical composition of substrates was determined using standard approaches and the metabolisable energy (ME), in vitro dry matter (DMD) and in vitro organic matter (OMD) digestibility were measured using the in vitro gas production (GP) technique. The GAL contained 81 g crude protein (CP) kg-1 DM while DAH contained 103 g CP kg-1 DM. The CP was higher (P = 0.0003) in dry (leaves and hulls) than in green (leaves and hulls) samples. The ash content ranged from 99.2 to 181.5 g kg-1 DM in DAH and DAL, respectively, (P = 0.0041). The ether extract content ranged from 27 for DAH to 65 g kg-1 for DAL (P = 0.0018). The acid detergent fibre and neutral detergent fibre content ranged from 185 to 304 and 444 to 620 g kg-1 DM (P = 0.04), for GAL and DAH, respectively. The DAH had the highest (P = 0.0001) GP24 and GP96. The DAH had the highest (P = 0.0001) potential GP (i.e., b), while the GP rate was highest for GAL and GAH (P = 0.034), ME was highest for DAH (P = 0.0001), and in vitro OMD was highest for DAH (P = 0.0001). The highest DMD (P = 0.0001) values were obtained with DAH followed by GAL, DAL and GAH, respectively. It can be concluded that almond hulls and leaves have a good nutritional potential to cover the maintenance nutrient requirements of small ruminants. Almond hulls and leaves can also be used as supplement to low quality mature pasture and/or crop residues. However, more studies are warranted to better characterize these feeds in in vivo animal feeding trials

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Background Osteoarthritis is the most common form of arthritis in adults, characterised by chronic pain and loss of mobility. Osteoarthritis most frequently occurs after age 40 years and prevalence increases steeply with age. WHO has designated 2021–30 the decade of healthy ageing, which highlights the need to address diseases such as osteoarthritis, which strongly affect functional ability and quality of life. Osteoarthritis can coexist with, and negatively effect, other chronic conditions. Here we estimate the burden of hand, hip, knee, and other sites of osteoarthritis across geographies, age, sex, and time, with forecasts of prevalence to 2050. Methods In this systematic analysis for the Global Burden of Disease Study, osteoarthritis prevalence in 204 countries and territories from 1990 to 2020 was estimated using data from population-based surveys from 26 countries for knee osteoarthritis, 23 countries for hip osteoarthritis, 42 countries for hand osteoarthritis, and US insurance claims for all of the osteoarthritis sites, including the other types of osteoarthritis category. The reference case definition was symptomatic, radiographically confirmed osteoarthritis. Studies using alternative definitions from the reference case definition (for example self-reported osteoarthritis) were adjusted to reference using regression models. Osteoarthritis severity distribution was obtained from a pooled meta-analysis of sources using the Western Ontario and McMaster Universities Arthritis Index. Final prevalence estimates were multiplied by disability weights to calculate years lived with disability (YLDs). Prevalence was forecast to 2050 using a mixed-effects model. Findings Globally, 595 million (95% uncertainty interval 535–656) people had osteoarthritis in 2020, equal to 7·6% (95% UI 6·8–8·4) of the global population, and an increase of 132·2% (130·3–134·1) in total cases since 1990. Compared with 2020, cases of osteoarthritis are projected to increase 74·9% (59·4–89·9) for knee, 48·6% (35·9–67·1) for hand, 78·6% (57·7–105·3) for hip, and 95·1% (68·1–135·0) for other types of osteoarthritis by 2050. The global age-standardised rate of YLDs for total osteoarthritis was 255·0 YLDs (119·7–557·2) per 100 000 in 2020, a 9·5% (8·6–10·1) increase from 1990 (233·0 YLDs per 100 000, 109·3–510·8). For adults aged 70 years and older, osteoarthritis was the seventh ranked cause of YLDs. Age-standardised prevalence in 2020 was more than 5·5% in all world regions, ranging from 5677·4 (5029·8–6318·1) per 100 000 in southeast Asia to 8632·7 (7852·0–9469·1) per 100 000 in high-income Asia Pacific. Knee was the most common site for osteoarthritis. High BMI contributed to 20·4% (95% UI –1·7 to 36·6) of osteoarthritis. Potentially modifiable risk factors for osteoarthritis such as recreational injury prevention and occupational hazards have not yet been explored in GBD modelling. Interpretation Age-standardised YLDs attributable to osteoarthritis are continuing to rise and will lead to substantial increases in case numbers because of population growth and ageing, and because there is no effective cure for osteoarthritis. The demand on health systems for care of patients with osteoarthritis, including joint replacements, which are highly effective for late stage osteoarthritis in hips and knees, will rise in all regions, but might be out of reach and lead to further health inequity for individuals and countries unable to afford them. Much more can and should be done to prevent people getting to that late stage

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries