Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Optimization approach for MoS2-water ethylene glycol mixture nanofluid flow in a wavy enclosure

The mixed convective heat transfer in a two-dimensional enclosure containing ethylene glycol-water mixture-based MoS2 nanofluid in the presence of magnetic field and thermal radiation is evaluated, adopting Galerkin standard finite element method. The Boussinesq approximation is applied to simulate natural convection. The partial differential governing equations with the appropriate boundary conditions are numerically handled using FlexPDE software. In order to validate the implemented numerical method, results were compared against outcomes obtained from the previous studies. Afterward, the influences of key indicators such as Hartmann number (Ha), Radiation parameter (Rd), Volume fraction (φ), and Shape factor of nanoparticles (Sf) on the profiles of local Nusselt number, temperature, and velocity are discussed. Furthermore, the streamlines and isothermal lines for the various values of considered control factors are demonstrated to assess a nanofluid hydrothermal behavior. Finally, the Taguchi method is undertaken to achieve the optimum condition, in which the mean Nusselt number is maximum. The obtained results reveal that in the existence of thermal radiation, augmenting Ha from 0 to 60 leads to an increment in the Nuave up to about 17%. Based on the analysis of variance (ANOVA), the nanoparticles’ volume fraction is the most influential factor affecting the average total Nusselt among the investigated control parameters, with a contribution of 56.9%

Challenges experienced by nurses in the implementation of a healthcare reform plan in Iran

Introduction: The Healthcare Reform Plan is counted as a plan for improving healthcare services in Iran. Undoubtedly pros and cons can be seen either in plan or implementation. This study was conducted to describe nurses’ challenges in implementing healthcare reform in Iran. Methods: A qualitative method centered upon conventional content analysis was applied. We used purposive sampling and data saturation was obtained by 30 participants. Data were analyzed using MAXQDA software. Results: Challenges experienced by nurses in the implementation of this reform include; unsuitable infrastructure, unfavorable vision, a complicated challenge, the necessity of monitoring, control plan outcomes, the impact on nurses, people’s misconceptions and solutions. Conclusions: The Healthcare Reform Plan in Iran is a solution to establish equality in the health system, however, to eliminate these challenges, revision and appropriate foundation of infrastructures is called for

Socioeconomic disparities in using rehabilitation services among Iranian adults with disabilities: a decomposition analysis

Abstract Background Persons with disabilities (PWD) generally experience various barriers in using health care compared to the general population, and these problems are more worsened for those with disabilities in lower socioeconomic status. The study aimed to estimate socioeconomic inequality in using rehabilitation services (URS) in adults with disabilities in Iran. Methods This cross-sectional study was conducted at a national level in Iran. 786 PWD (aged 18 years and older) participated in the study between September and December 2020. Socioeconomic-related inequality in URS was estimated by the Concentration Index (C). The C was decomposed to identify factors explaining the variability within the socioeconomic inequality in URS. Results In the present study 8.10% (N = 61) of the study population used rehabilitation services during the past three months. In this study, the value of the C was estimated 0.25 (p-value = 0.025) that shows URS was unequally distributed, and concentrated among the higher SES groups. The results of decomposition analysis indicated that the wealth index was the largest contributor (94.22%) to the observed socioeconomic inequalities in URS among PWD. Following the wealth index, Age and marital status were the major contributors to the unequal distribution of URS among the study population. Conclusions Our findings revealed that socioeconomic inequality in using rehabilitation services was concentrated among well-off PWD. Accordingly, rehabilitation financing through appropriate mechanisms for individuals with low SES is suggested

A Survey on Mental Health Status of Adult Population Aged 15 and above in the Province of Bushehr, Iran

Introduction: This research aims to determine the mental health status of population aged 15 and over in the province of Bushehr in 2015. Methods: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Bushehr province in Iran. Through systematic random cluster sampling, 1200 individuals were selected from the residents of urban and rural areas of Bushehr, Deilam and Borazjan. The 28-item version of the General Health Questionnaire was applied as the screening tool. Data were analyzed using SPSS, version 18.0 for windows. Results: The results of this study showed that using the traditional scoring method, 23.4% of the subjects (29% of females and 14.7% of males) were suspected of mental disorders. The prevalence of suspected psychiatric disorders in rural areas (24.5%) was more than the prevalence of these disorders in urban areas (22.8%). The prevalence of suspected anxiety and the somatization of symptoms was higher than the prevalence of social dysfunction and depression, and the prevalence of these components was higher in women than men. The findings of this study also showed that the prevalence of suspected cases of mental disorders increased significantly with age. The prevalence of suspected cases of these disorders was higher among females, the age group of 65 and older, people living in rural areas, divorced and widowed, students and primary and secondary education than other groups. Conclusion: The results of this study show that more than one fourth of the sample were suspected of mental disorders, and the prevalence of these disorders has increased from 21.3% in 1999 to 23.4% in 2015. Therefore, it seems necessary for the provincial public health authorities to take the needed steps for providing requirements encompassing prevention and promotion of mental health in this are

Incidence of rhabdomyolysis occurrence in psychoactive substances intoxication: a systematic review and meta-analysis

Abstract Rhabdomyolysis is a potentially life-threatening condition induced by diverse mechanisms including drugs and toxins. We aimed to investigate the incidence of rhabdomyolysis occurrence in intoxicated patients with psychoactive substances. In this review, three databases (PubMed, Scopus, Web of Science) and search engine (Google Scholar) were searched by various keywords. After the screening of retrieved documents, related data of included studies were extracted and analyzed with weighted mean difference (WMD) in random effect model. The highest incidence of rhabdomyolysis was observed in intoxication with heroin (57.2 [95% CI 22.6–91.8]), amphetamines (30.5 [95% CI 22.6–38.5]), and cocaine (26.6 [95% CI 11.1–42.1]). The pooled effect size for blood urea nitrogen (WMD = 8.78, p = 0.002), creatinine (WMD = 0.44, p < 0.001), and creatinine phosphokinase (WMD = 2590.9, p < 0.001) was high in patients with rhabdomyolysis compared to patients without rhabdomyolysis. Our results showed a high incidence of rhabdomyolysis induced by psychoactive substance intoxication in ICU patients when compared to total wards. Also, the incidence of rhabdomyolysis occurrence was high in ICU patients with heroin and amphetamine intoxication. Therefore, clinicians should anticipate this complication, monitor for rhabdomyolysis, and institute appropriate treatment protocols early in the patient’s clinical course