Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

FRANÇAFRIQUE : a permanência francesa na África diante dos processos descolonizatórios

Esse estudo analisa as relações entre a França e seu espaço colonial africano. O perfil e a manutenção de um relacionamento estreito a partir dos processos de descolonização constituiu o que François Verschave denominou como Françafrique. O objetivo principal é verificar a manutenção da presença francesa na África no período que sucede à descolonização do continente, mostrando que apesar das independências formais, a França permaneceu na África através de meios políticos, econômicos e militares, e que por essa razão continuou exercendo influência sobre grande parte do continente. Mais especificamente, pretende-se analisar os motivos da instalação e a da manutenção dessa política de caráter neocolonial, além de demonstrar que, apesar das mudanças formais ocorridas após o término da Guerra Fria, a política africana da França perpetuou-se sem maiores modificações em todos os governos da V República Francesa até o governo de Nicolas Sarkozy, configurando-se como uma política de Estado. Para tanto, será importante levar em conta os aspectos históricos dessa relação e os condicionantes da manutenção da presença francesa, bem como o aporte de estudiosos no assunto para, através de uma revisão bibliográfica, explicar como a Françafrique se consolidou e se perpetuou desde os anos 1960 até a atualidade.This study analyzes the relations between France and its colonial space. The profile and endurance of a close relationship since colonization process has composed what François Verschave called Françafrique. Its main goal is to verify the continuity of French presence in Africa in the period that succeeds the decolonization of the continent, showing that, although the formal independences, France has remained in Africa through political, economic and military means, and, because of that, it had continued to maintain its influence on a big portion of the continent. More specifically, this study intends to analyze the reasons of the establishment and the continuity of this policy of neocolonial character, and to demonstrate that, although all the formal changes that have taken place since the end of Cold War, the foreign French policy for Africa remained without any serious modification in all governments of the V French Republic up to Nicolas Sarkozy, configuring a State policy. Therefore, it will be important to take into consideration historical aspects of this relationship and the facts that explain this enduring French presence, as well as the specialized researchers’ works, through a bibliographic review, to explain how Françafrique consolidated itself and remained from the 1960’s to nowadays.Ce travail analyse les relations entre la France et son espace colonial. Les caractéristiques du maintient de liens étroits entre elles depuis le processus de décolonisation ont constitué ce que François Verschave a nommé la Françafrique. Le principal objectif est de montrer la continuation de la présence française en Afrique dans la période qui suit la décolonisation de ce continent, démontrant ainsi que malgré les proclamations d’indépendances la France est restée présente politiquement, économiquement et militairement, et que pour ces raisons elle a continué à exercer son influence sur une grande partie du continent. Ce travail prétend plus particulièrement analyser les raisons de la naissance et du maintient de cette politique à caractère néocolonial, ainsi que de démontrer que, malgré les changements significatifs apparus depuis la fin de la Guerre Froide, la politique de la France au sujet de l’Afrique est restée sans changements majeurs et ce quelque soit les gouvernements de la Vème République jusqu’à celui de Nicolas Sarkozy, montrant ainsi qu’il s’agit d’une politique d’État. Pour ce faire, il sera important de prendre en compte les aspects historiques de ces relations et les facteurs conditionnants le maintient de la présence française depuis le processus de décolonisation. Par le biais également de nombreux écrits de spécialistes sur le sujet, nous chercherons à expliquer comment la Françafrique a su se consolider et perpétrer depuis les années 1960 jusqu’à ce jour

FRANÇAFRIQUE : a permanência francesa na África diante dos processos descolonizatórios

Esse estudo analisa as relações entre a França e seu espaço colonial africano. O perfil e a manutenção de um relacionamento estreito a partir dos processos de descolonização constituiu o que François Verschave denominou como Françafrique. O objetivo principal é verificar a manutenção da presença francesa na África no período que sucede à descolonização do continente, mostrando que apesar das independências formais, a França permaneceu na África através de meios políticos, econômicos e militares, e que por essa razão continuou exercendo influência sobre grande parte do continente. Mais especificamente, pretende-se analisar os motivos da instalação e a da manutenção dessa política de caráter neocolonial, além de demonstrar que, apesar das mudanças formais ocorridas após o término da Guerra Fria, a política africana da França perpetuou-se sem maiores modificações em todos os governos da V República Francesa até o governo de Nicolas Sarkozy, configurando-se como uma política de Estado. Para tanto, será importante levar em conta os aspectos históricos dessa relação e os condicionantes da manutenção da presença francesa, bem como o aporte de estudiosos no assunto para, através de uma revisão bibliográfica, explicar como a Françafrique se consolidou e se perpetuou desde os anos 1960 até a atualidade.This study analyzes the relations between France and its colonial space. The profile and endurance of a close relationship since colonization process has composed what François Verschave called Françafrique. Its main goal is to verify the continuity of French presence in Africa in the period that succeeds the decolonization of the continent, showing that, although the formal independences, France has remained in Africa through political, economic and military means, and, because of that, it had continued to maintain its influence on a big portion of the continent. More specifically, this study intends to analyze the reasons of the establishment and the continuity of this policy of neocolonial character, and to demonstrate that, although all the formal changes that have taken place since the end of Cold War, the foreign French policy for Africa remained without any serious modification in all governments of the V French Republic up to Nicolas Sarkozy, configuring a State policy. Therefore, it will be important to take into consideration historical aspects of this relationship and the facts that explain this enduring French presence, as well as the specialized researchers’ works, through a bibliographic review, to explain how Françafrique consolidated itself and remained from the 1960’s to nowadays.Ce travail analyse les relations entre la France et son espace colonial. Les caractéristiques du maintient de liens étroits entre elles depuis le processus de décolonisation ont constitué ce que François Verschave a nommé la Françafrique. Le principal objectif est de montrer la continuation de la présence française en Afrique dans la période qui suit la décolonisation de ce continent, démontrant ainsi que malgré les proclamations d’indépendances la France est restée présente politiquement, économiquement et militairement, et que pour ces raisons elle a continué à exercer son influence sur une grande partie du continent. Ce travail prétend plus particulièrement analyser les raisons de la naissance et du maintient de cette politique à caractère néocolonial, ainsi que de démontrer que, malgré les changements significatifs apparus depuis la fin de la Guerre Froide, la politique de la France au sujet de l’Afrique est restée sans changements majeurs et ce quelque soit les gouvernements de la Vème République jusqu’à celui de Nicolas Sarkozy, montrant ainsi qu’il s’agit d’une politique d’État. Pour ce faire, il sera important de prendre en compte les aspects historiques de ces relations et les facteurs conditionnants le maintient de la présence française depuis le processus de décolonisation. Par le biais également de nombreux écrits de spécialistes sur le sujet, nous chercherons à expliquer comment la Françafrique a su se consolider et perpétrer depuis les années 1960 jusqu’à ce jour

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved