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

Background: Disorders 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. Methods: We 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. Findings: Globally, 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. Interpretation: As 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. Funding: Bill & Melinda Gates Foundation

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

Container-breeding mosquitoes and predator community dynamics along an urban-forest gradient: The effects of habitat type and isolation

Environmental disturbances such as deforestation, urbanization or pollution have been widely acknowledged to play a keyrole in the emergence of many infectious diseases, including mosquito-borne viruses. However, we have little understanding ofhow habitat isolation affects the communities containing disease vectors. Here, we test the effects of habitat type and isolationon the colonization rates, species richness and abundances of mosquitoes and their aquatic predators in water-filled containers innorthwestern Thailand. For eight weeks water-filled containers were monitored in areas containing forest, urban and agriculturalhabitats and mixtures of these three. Mosquito larvae of the genera Aedes and Culex appeared to be differentially affected by thepresence of the dominant predator; Toxorhynchites splendens (Culicidae). Therefore, a predation experiment was conducted todetermine predator response to prey density and its relative effects on different mosquito prey populations. Colonization rates,species richness and abundances of mosquito predators were strongly related to forest habitat and to the distance from otheraquatic habitats. Areas with more tree cover had higher predator species richness and abundance in containers. Containers thatwere close to surface water were more rapidly colonized than those further away. In all habitat types, including urban areas,when predators were present, the number of mosquito larvae was much lower. Containers in urban areas closer to water-bodies,or with more canopy cover, had higher predator colonization rates and species richness. T. splendens (Culicidae) preyed onthe larvae of two mosquito genera at different rates, which appeared to be related to prey behaviour. This study shows thatanthropogenic landscape modification has an important effect on the natural biological control of mosquitoes. Vector controlprogrammes and urban planning should attempt to integrate ecological theory when developing strategies to reduce mosquitopopulations. This would result in management strategies that are beneficial for both public health and biodiversity

Canine lacrimal and third eyelid superficial glands’ macroscopic and morphometric characteristics Aspectos macroscópicos e morfométricos das glândulas lacrimal e superficial da terceira pálpebra de cães (Canis familiares; LINNAEUS, 1758)

The lacrimal and third eyelid superficial glands produce the aqueous component of the preocular tear film. In this research, morphologic and morphometric assessments of the parenchyma and stroma of both lacrimal glands of healthy adult mongrel dogs were performed. Both lacrimal and third eyelid glands of fourteen dogs were collected, summing fifty-six samples. The macroscopic and morphometric data were statistically analyzed, according to the glandular type (lacrimal and third eyelid superficial glands) and sexual dimorphism (male or female). The lacrimal glands were significantly larger and longer than the superficial glands of the third eyelid. Expressive morphometric differences of interlobular duct, lymphocytic infiltration, interlobular vessels and secretory parenchyma between the two glandular types were encountered. The lacrimal glands from the male subjects were significantly larger than those from female ones, as well as the superficial glands of the third eyelid were thicker. The higher lymphocyte infiltration and poorer secretor parenchyma in female dogs may be one of the reasons for the higher incidence of keratoconjunctiviti sicca (KCS) in such canine population.<br>As glândulas lacrimal e superficial da terceira pálpebra atuam produzindo o componente aquoso do filme lacrimal. Nesta pesquisa, estudaram-se aspectos morfológicos e morfométricos do parênquima e do estroma de ambas as glândulas em cães mestiços, hígidos, adultos (machos ou fêmeas). As glândulas lacrimal e superficial da terceira pálpebra de 14 cães foram colhidas, totalizando 56 amostras. Foram estudadas, à estatística, as variáveis macroscópicas e morfométricas, comparando-as quanto ao tipo glandular (lacrimal e superficial da terceira pálpebra) e quanto ao dimorfismo sexual (macho e fêmea). Às glândulas lacrimais foram significativamente maiores comparativamente as superficiais da terceira pálpebra. Foram evidenciados diferenças morfométricas expressivas quanto aos vasos e ductos interlobulares, ducto interlobular, infiltração linfocitária e parênquima secretório entre os dois tipos glandulares. As glândulas lacrimais dos machos foram significativamente maiores comparativamente às fêmeas, assim como as glândulas superficiais da terceira pálpebra apresentaram-se mais espessas. A maior infiltração linfocitária e a menor proporção de parênquima secretor nas fêmeas poderá ser uma das razões para uma maior incidência de ceratoconjuntivite seca (CCS) em fêmeas na população canina

Long-term demographic balance in the Broadstone stream insect community

Population models based on Lotka–Volterra-type differential equations with logistic prey were made for a simple stream community including two stonefly prey Leuctra nigra Olivier and Nemurella pictetii Klàpalek, and two predators, the caddisfly Plectrocnemia conspersa (Curtis) and the alderfly Sialis fuliginosa Pictet. In order to assess the importance of predation in this system, we constructed both an explicit four-species model and a simplified model with two functional groups which was more amenable to analytical treatment. The models were parameterized using new data on adult emergence and recruitment combined with previously published data on larval densities and prey uptake. The models were falsified if parameterizations led either to negative prey carrying capacities or to unstable dynamics. Both the functional group and four-species models predict asymptotically stable interactions, with feasible carrying capacities. The models are consistent in predicting that the observed prey are in excess of 70% of their carrying capacities. The four-species model indicates that predation impact is not evenly shared between the two prey, with L. nigra being depressed further from its carrying capacity than N. pictetii. Sensitivity analysis shows that the results of the full four-species model remain very robust to realistic levels of stochastic variation in the input data. The four-species model is used to predict the outcome of an ongoing large-scale field experiment involving the transfer of all S. fuliginosa eggs from one stretch of the stream to another. Although the equilibrial prey populations are barely affected by the manipulation, the model predicts marked transient prey-release and prey-depression of L. nigra in the predator addition and removal areas, respectively