Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

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 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

The Effect of Planting Date on Some Quantitative and Qualitative Traits of Nine Grain Sorghum (Sorghum bicolor L.) Cultivars in Yasouj Region

In order to investigate the effect of planting date on yield and yield components of grain sorghum cultivars, a factorial experiment was conducted at Research Farm of Yasouj University, in 2010, based on randomized complete blocks design and three replications. The studied factors included nine sorghum cultivars (SOR 1003, SOR 834, SOR 808, SOR 1008, SOR 1011, SOR 1009, SOR 1006, SOR 857 and SOR 838) and three planting dates (20 May and 5 and 20 June). The results showed that the interaction effects of cultivar and planting date on yield and yield components and some of the studied physiologic and morphologic traits were significant (P≤0.01). The highest yield (863 g/m2), chlorophyll content, panicle length and number of grains per panicle (2191) were obtained from the planting date of 5 June in SOR 834 cultivar. The highest number of fertile tillers (10), carotenoid and chlorophyll b was produced by SOR 1003 cultivar and planting dates of 5 June, 20 June and 20 May, respectively. The SOR 834 cultivar and planting date of 20 June produced the highest 1000-seed weight (28.55 g). According to the results, planting date of 5 June and SOR 834 sorghum cultivar is recommendable in Yasouj region and similar agro-climatic conditions

Effect of Drought Stress and Plant Density on Yield and Some Physiological Characteristics of Pinto Bean (Phaseolus vulgaris L.) in Yasouj Region

In order to investigate the effects of drought stress and plant density on yield and some physiological characteristics of pinto bean (Phaseolus vulgaris L. cv. C.O.S16), a field experiment was conducted in split plot arrangement based on randomized complete blocks design with three replications at Research Farm of Yasouj University, Yasouj, Iran, in 2010. Treatments were conventional irrigation, drought stress at growth stage and drought stress at reproductive stage as main plots and plant density at four levels (15, 25, 35 and 45 plants/m2) as subplots. In this experiment, mean grain and biological yield, chlorophyll a, chlorophyll b, proline, carotenoid and protein content were measured. Result showed that there was significant interaction between drought stress and plant density on biological yield, grain yield and harvest index. Maximum biological yield and grain yield (11235 and 3368 kg/ha, respectively) was recorded at 35 plants/m2 density in conventional irrigation treatment, which had no significant difference with 45 plants/m2 density. The highest grain yield due to drought stress in growth and reproductive stages (2520 and 2260 kg/ha, respectively) was observed at 35 plants/m2 density and the lowest yield (2066 and 1953 kg/ha, respectively) was obtained at 15 plants/m2. Drought stress at growth and reproductive stages reduced grain yield and chlorophyll a content, and increased carotenoid content, chlorophyll b, proline and protein content of seeds. In general, density of 35 plants/m2, without any drought stress, and density of 25 plants/m2 at all drought-stress levels, is recommended for pinto bean (cultivar C.O.S.16) in similar environmental conditions to this experiment

Evaluation of Some Physiological Characteristics of Spring Rapeseed Genotypes under Drought Stress

This experiment was conducted in 2010 in order to study the effect of drought stress on proline, soluble carbohydrates, relative water content, concentration of potassium and sodium of leaf, electrolytes leakage from leaves and grain yield of spring rapeseed cultivars in Research Greenhouse of Yasouj University, Yasouj, Iran. The experiment was factorial, based on completely randomized design with three replications. In this research, six genotypes of spring rapeseed (CR3189, CR3250, Kosa Kroko, Marnoo and Regent) and irrigation treatment at three levels (irrigation after 10, 40 and 70% depletion of soil moisture) were studied. Results showed that interaction of irrigation and genotype had significant effect on all traits, except potassium concentration. Comparison of average values of treatments showed that in all genotypes, the proline content, soluble carbohydrates, sodium concentration and electrolytes leakage from leaves were increased due to drought stress, but potassium concentration, relative water content and grain yield were decreased. Among the genotypes, at all three levels of irrigation, the maximum grain yield (0.86, 0.58 and 0.34 g/plant, respectively) was related to Kosa cultivar, which had less electrolyte leakage and sodium concentration, but higher proline content, potassium concentration and relative water content. Regent cultivar had the lowest potassium concentration, proline, relative water content and grain yield and also had the highest electrolytes leakage and sodium concentration. The lowest grain yield at 10% irrigation level (0.47 g/plant) was in CR3250 genotype and at 40% and 70% irrigation levels (0.33 and 0.19 g/plant, respectively) was observed in Regent genotype. Overall, based on the obtained results, Kosa and Regent cultivars were identified as tolerant and susceptible to drought stress, respectively

Effect of Nitroxin Bio-Fertilizer Application Accompanied with Nitrogen on Canola (Brassica napus) Yield Quantity and Quality

In order to investigate the effect of chemical and biological nitrogen fertilizer on canola, a field experiment was conducted as a split plot based on a randomized complete block design with three replications at the research station of the Faculty of Agriculture, Yasouj University, located in Deshtrum region, in 2019. The main factor consisted of nitrogen fertilizer (zero, 25, 50, 75, 100 and 125 kg/ha of pure nitrogen from urea source) and the secondary factor consisted of nitroxin biofertilizer contained Azotobacter and Azospirillium bacteria (use and non-use). The results showed that nitrogen fertilizer and nitroxin had a significant effect on all investigated traits. Nitrogen fertilizer significantly increased plant height, number of lateral branches, chlorophyll index and oil yield. The highest grain (8790.60 kg/ha) and biological (23910.93 kg/ha) yield were obtained in 125 kg/ha of nitrogen and the use of nitroxin. With the consumption of 125 kg/ha of nitrogen and nitroxin, the lowest percentage of seed oil, and contrastingly the highest percentage of seed protein (36.65%) was obtained. In general, combined application of biofertilizer with chemical nitrogen increased grain, biological and oil yield. Nitroxin bio-fertilizer could reduce the consumption of chemical nitrogen fertilizer. The results showed that there was no significant difference between the application of 50 kg/ha of nitrogen + bacteria and the application of higher levels of nitrogen (75, 100 and 125 kg/ha) alone in most of the investigated traits

Hypertension and Pre-Hypertension Among Iranian Adults Population: a Meta-Analysis of Prevalence, Awareness, Treatment, and Control

Purpose of Review: This meta-analysis and systematic review was conducted to evaluate hypertension and prehypertension prevalence, awareness, treatment, and control in Iranian adults population. Recent Findings: In this study, six international and national databases were searched from inception until August 30, 2018. Forty-eight studies performed on 417,392 participants were included in the meta-analysis. Based on the results of random effect method (95 CI), the overall prevalence of pre-hypertension, hypertension, awareness, treatment, and control were 31.6 (95 CI 24.9, 38.3; I2 = 99.7), 20.4 (95 CI 16.5, 24.4; I2 = 99.9), 49.3 (95 CI 44.8, 53.8; I2 = 98.5), 44.8 (95 CI 28.3, 61.2; I2 = 99.9), 37.4 (95 CI 29.0, 45.8; I2 = 99.3), respectively. Summary: Considering the increasing prevalence of pre-hypertension, hypertension, as well as more than half of the participants were unaware of their disease and were not treated, the results of the present study can help policy-makers to increase hypertension awareness, control, and treatment, especially in high-risk individuals. © 2019, Springer Science+Business Media, LLC, part of Springer Nature

Global prevalence of depression among breast cancer patients: a systematic review and meta-analysis

Purpose: Depression in patients with breast cancer imposes huge costs to patients, families, and healthcare systems. The present study aimed at evaluating the global prevalence depression among patients with breast cancer. Methods: In this meta-analysis, three electronic databases (PubMed, Web of Science, and Scopus) were searched from 1 January, 2000 until 30 March, 2019. The Hoy tool was used to evaluate the quality of the articles included in the meta-analysis. The search, screening, quality evaluation, and data extraction were carried out by two of the researchers. Results: Of 47,424 studies, 72 studies performed in 30 countries entered the final stage of analysis. The global prevalence of depression was 32.2. Specifically, the prevalence of depression was highest in the Eastern Mediterranean region and twice as high in middle-income countries as compared to developed countries. Conclusions: Regarding the high prevalence of depression in patients with breast cancer, it is vital to carry out screening within standard time periods and offer the necessary emotional support. © 2019, Springer Science+Business Media, LLC, part of Springer Nature