Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

The Investigation of Relationship between Cash Dividends and Investment Considering the Effect of Company's Life Cycle Modifier in Listed Companies in Tehran Stock Exchange

Decision making with regard to the dividend is an important topic because this is influenced by various factors such as economic factors. One of the economic factorsis the company's life cycle. According to the life-cycle theory, companies in different stages of the life cycle show specific behaviors financially and economically. It means that institutions and companies follow specific policy according to stage of their economic life. Thus, the present study investigates the relationship between cash dividends paid and investment at the company's life cycle in listed companies in Tehran Stock Exchange. Accordingly, the research hypotheses were tested using the mix data regression in Tehran stock exchange with regard to the related data from 2003 to 2012. Among all attended companies, 680 companies were selected as the statistical sample. The findings show that there is a significant direct relationship between the cash dividend and investment,but this relationship differs in various stages of the company's life cycle

The Study of Consumption Pattern of Addiction among Women Who Referred to Damage Reducing Center

Objective: Drug addiction is one of common deviations in present age, which sacrifices numerous victims in a year, and inflicting serious damages on families and society. Present study was aimed to study of consumption pattern of addiction among women who referred to damage reducing center in Kermanshah province. Methods: This research was a descriptive-analytical study. With consideration of accessing limitation, all women (n=121) who referred to the center were selected as a sample. The studied variables were addiction age, addiction reason, drug consumption pattern, marital status. Results: More than 72.6 of clients reported opium use record. Also, Crack, Lactuarium, Heroin, Norjazak and Tamjizak, Meth Amphetamine, and Hashish were more used materials, respectively. Conclusion: These statistics and digits can be applied in addiction policy settings

Isolation and Identification of Sulfur Degrading Bacteria in the Sludge from Tehran Refinery Wastewater Treatment

Identification of sulfur-degrading microorganisms is a major step in microbial desulfurization of organic compounds, especially oil. Microbial desulphurization is ecologically safe and economically justifiable; hence, the importance of knowledge on the identification, isolation, and adaptation of microorganisms from operational, economic, and environmental viewpoints. The objective of this descriptive‒applied research was to identify and isolate sulfur-degrading bacteria in the sludge from Tehran refinery wastewater treatment plant. For this purpose, 120 samples (10 samples per month over a 12‒month period) were collected from different locations and elevations of the sedimentation basin. The samples were then stirred and homogenized before they were transferred to the laboratory where they were cultured on specific and differential media to allow the microorganisms to grow. Finally, tests were performed and the following bacteria were identified in the samples: Brevundiomonas vesicularis, Acinetobacter spp, Clostridium spp, Alcaligenes spp, E.coli, Bacillus spp, Klebsiella spp, Acromobacter spp, and Desulfovibrio spp. Results indicate that all the bacteria identified in the samples used sulfur as their only source of energy. Another important contribution of this study is that Brevundiomonas vesicularis is for the first time identified in this study as a sulfur-degrading one

Modeling trend changes of mean annual exposure to PM2.5 particles in the Middle East countries via growth mixture models

Rapid economic expansion, industrialization, urbanization, and construction in the Middle East have led to an increase in ambient air pollution. This study was devoted to model the 28-year trend changes of the mean annual exposure to particulate matter with an aerodynamic diameter of less than 2.5 μm (PM2.5 particles) in the Middle East countries. Data used in the current study includes the mean annual exposure of PM2.5 air pollution (micrograms per cubic meter) for the Middle East countries during 1990 to 2017 that is compiled by the World Bank. To identify different longitudinal patterns of PM2.5, the researchers fitted growth mixture model with a different number of clusters in Mplus 7.4. The overall trend of annual exposure was rising during 1990 to 2017. Both the Bayesian information criterion and likelihood ratio test confirmed that the 2-cluster model is the best and the entropy of 0.99 confirmed a good quality in the cluster memberships. The observed pattern of exposure to PM2.5 in cluster 1, including Bahrain, Egypt, Iraq, Kuwait, Qatar, Saudi Arabia, and Yemen, was rising over time. On the other hand, countries in cluster 2, including Cyprus, Iran, Israel, Jordan, Oman, Lebanon, Syria, and Turkey, experienced a constant level of exposure to PM2.5 from 1990 to 2017. The main longitudinal patterns of PM2.5 were identified by the proposed model. Given the harmful effects of exposure to PM2.5 particles, taking into account more investigation in the future is highly suggested

Antibacterial Activity of Honey on Cariogenic Bacteria

Objective: Honey has antibacterial activity. The aim of this study was to evaluate the antibacterial activity of honey on Streptococcus mutans and Lactobacillus.Materials and Methods: In this in vitro study, solutions containing 0%, 5%, 10%, 20%, 50% and100%(w/v) of natural Hamadan honey were prepared. Each blood (nutrient) agar plate was then filled with dilutions of the honey. The strains of bacteria were inoculated in blood agar for 24 hours at 37oC and were adjusted according to the McFarland scale (10×10 cfumcl -1). All assays were repeated 10 times for each of the honey concentrations. Data were analyzed by non parametric Chi-Square test. Statistical significance was set at α=0.05.Results: Significant antibacterial activity was detected for honey on Streptococcus mutans in concentrations more than 20% and on Lactobacillus in 100% concentration (P<0.05).Conclusion: It seems that antibacterial activity of honey could be used for prevention and reduction of dental caries

Prevalence of the Most Common Virulence-Associated Genes among Brucella Melitensis Isolates from Human Blood Cultures in Hamadan Province, West of Iran

Brucellosis is a widespread zoonotic disease causing considerable economic and public health problems. Despite animal vaccination, brucellosis remains endemic in some areas such as Iran, especially in the western Iranian province of Hamadan. We sought to detect some of the most common virulence-associated genes in Brucella isolated from human blood cultures to determine the prevalence of some virulence genes among Brucella isolates. Fifty-seven isolates were studied from patients with a clinical diagnosis of brucellosis who referred to the Infectious Diseases Ward of Sina Hospital in Hamadan Province, Iran, between April 2013 and July 2014. Blood samples were collected for the diagnosis of brucellosis using the BACTEC blood culture system. All of these isolates were confirmed by the bcsp31 Brucella-specific gene. We detected 11 virulence-associated genes of Brucella, namely cβg, virB, znuA, ure, bvfA, omp25, omp31, wbkA, mviN, manA, and manB, which are important for the pathogenesis of this bacterium in the intracellular environment by multiplex PCR. Totally, 149 patients with a clinical diagnosis of brucellosis were enrolled in this study. Fifty-seven (38.3%) patients had positive blood cultures. On biochemical and molecular testing, all of the isolates were Brucella melitensis. Ten of the virulence genes were detected among all of the 57 isolates, but the bvf gene was detected in 53 (93%) isolates. The high prevalence of virulence-associated genes among the Brucella isolates detected in Hamadan Province, Iran, underscores the pathogenicity of this bacterium in this region

Association between the clinical severity of oral lichen planus and anti-TPO level in thyroid patients

Abstract This study considered a possible relationship between the severity of oral lichen planus (OLP), serum anti-TPO autoantibodies (TPOAb) titer and thyroid disease in OLP patients. Forty-six OLP patients with positive TPOAb results (> 35 IU/ml) who had also been diagnosed with thyroid disease were included in the study group. The control group consisted of 46OLP patients with no thyroid disease. The study and control groups (92) were divided to two subgroups of erosive OLP (EOLP) and non-erosive OLP (NEOLP). Serum TPOAb levels and IL-8 (to measure OLP severity) were evaluated using the independent t-test, chi-square and conditional logistic regression analysis (α = 0.05). A significant positive correlation was found between serum IL-8 and TPOAb levels in the study group (r = 0.783; p = 0.001). The positive blood levels of TPOAb were significantly associated with an increased risk of EOLP (OR = 4.02 at 95%CI; 1.21–13.4; p = 0.023). It is possible to used positive serum TPOAb levels in patients with OLP as in indicator of possible undetected thyroid disorders in those patients. Because erosive OLP has been associated with TPOAb in thyroid patients, it may be useful to determine TPOAb levels of such patients to diagnose a possible undetected thyroid disorders and follow-up for malignancy