Five insights from the Global Burden of Disease Study 2019

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3.5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.Peer reviewe

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Lead exposure in an urban community: Investigation of risk factors and assessment of the impact of lead abatement measures

Introduction: A battery recycling plant located in an urbanized area contaminated the environment with lead oxides. The Secretary of Environment of the State of Sao Paulo demanded an evaluation of lead exposure among the population in the vicinity of the plant. Objectives: To assess the lead exposure of children, to propose control measures and evaluate the impact of these measures. Methods: Cross-sectional study of all children 10 mu g/dL were: to live in unpaved areas, parent working in the plant, distance from the plant, to play on the ground, pica, and to drink locally produced milk. After control measures were implemented (closing the plant, soil removal, dust vacuum-cleaning in the households, etc.), a reduction of 46% in BLL was observed considering the 241 reevaluated children with levels > 10 mu g/dL. Conclusions: This study showed that combined abatement measures were effective in reducing BLL in children living close to a contaminating source. These results informed the decision-making process regarding management of contaminated areas in Brazil. (c) 2006 Elsevier Inc. All rights reserved.103333834

Estudo da incidência de coledocolitíase em pacientes com colecistite calculosa aguda e crônica submetidos à colecistectomia vídeolaparoscópica

OBJETIVO: Avaliar a incidência da coledocolitiase em pacientes submetidos à colecistectomia laparoscópica, portadores de colecistopatia calculosa aguda e crônica. O presente estudo, também, analisa se a era laparoscópica modificou a incidência e a história natural da litíase da via biliar quando compara os dados da literatura com os índices do Grupo estudado. MÉTODO: O estudo foi realizado em um Grupo de 946 pacientes, distribuídos em Grupo A de 214 pacientes de 1991-1995 e Grupo B de 732 pacientes de 1999-2007 colecistectomizados pelo método laparoscópico. O critério diagnóstico de coledocolitíase foi estabelecido por colangiofluoroscopia de rotina em todas as operações. RESULTADOS: A incidência total de coledocolitiase no Grupo A de 9,8% e no B de 5,8% não mostram diferença estatística significativa entre si e com a literatura mundial (p=0,08).Nos pacientes operados por colecistite aguda também não se observou diferença estatística entre o grupo A e B na incidência de litíase da via biliar( p=0,8). A análise dos dados nos pacientes operados por colecistite crônica revela uma taxa de coledocolitíase menor no Grupo B de 3,7% com significância estatística do que no A de 8,4% p=0,03. CONCLUSÃO: O presente estudo revela uma diminuição expressiva na incidência de coledocolitiase no Grupo B em relação ao A e a literatura mundial quando a indicação cirúrgica ocorre na fase não complicada da doença litiásica biliar. O estudo também demonstra um aumento significativo na indicação da colecistectomia laparoscópica eletiva mais precoce no Grupo B como já observado em diversas publicações da literatura médica