bluuebunny/crossref_metadata_2025 huggingface dataset:
The affordability of a healthy and sustainable diet: an Australian case study
Authors: Goulding Tara , Lindberg Rebecca , Russell Catherine Georgina
Published: September 2020

Background/Aims

EAT–Lancet Commission’s Planetary Health Diet proposed a diet that integrates nutrition and sustainability considerations, however its affordability is unknown in many country-specific contexts, including Australia. The aim of this study is to develop a healthy and sustainable food basket modelled on the Planetary Health Diet to determine the affordability of the Planetary Health Diet basket across various socio-economic groups, and compare this affordability with a food basket modelled on the typical current diet, in an Australian setting.

Methods

An Australian-specific Planetary Health Diet basket was developed for a reference household (2 adults and 2 children) modelled on the Planetary Health Diet reference diet, and compared to a previously-developed Typical Australian Diet basket. The cost of each food basket was determined by online supermarket shopping surveys in low, medium and high socio-economic areas in each Australian state. Basket affordability was determined for the reference household by comparing the basket cost to disposable income in each socio-economic group in each state. Mann-Whitney U tests then determined if there were significant differences between the median costs and the median affordability of both baskets.

Results

The Planetary Health Diet basket was shown to be less expensive and more affordable than the Typical Australian Diet basket nationally, in all metropolitan areas, in all socio-economic groups across Australia (median cost: Planetary Health Diet = AUD$188.21, Typical Australian Diet = AUD$224.36; median affordability: Planetary Health Diet = 13%, Typical Australian Diet = 16%; p = < 0.05).

Conclusions

This study showed the Planetary Health Diet to be more affordable than the Typical Australian Diet for metropolitan-dwelling Australians.

Implications

These results can help to inform public health and food policy aimed at achieving a healthy and sustainable future for all Australians, including reductions in overweight/obesity rates and increased food security.
Signaling and other functions of lipids in autophagy: a review
Authors: Soto-Avellaneda Alejandro , Morrison Brad E.
Published: September 2020

The process of autophagy is integral to cellular function. In this process, proteins, organelles, and metabolites are engulfed in a lipid vesicle and trafficked to a lysosome for degradation. Its central role in protein and organelle homeostasis has piqued interest for autophagy dysfunction as a driver of pathology for a number of diseases including cancer, muscular disorders, neurological disorders, and non-alcoholic fatty liver disease. For much of its history, the study of autophagy has centered around proteins, however, due to advances in mass spectrometry and refined methodologies, the role of lipids in this essential cellular process has become more apparent. This review discusses the diverse endogenous lipid compounds shown to mediate autophagy. Downstream lipid signaling pathways are also reviewed in the context of autophagy regulation. Specific focus is placed upon the Mammalian Target of Rapamycin (mTOR) and Peroxisome Proliferator-Activated Receptor (PPAR) signaling pathways as integration hubs for lipid regulation of autophagy.
Significance of accurate hilar and intrapulmonary lymph node examination and prognostication in stage IA–IIA non-small cell lung cancer, a retrospective cohort study
Authors: Zhai Wenyu , Duan Fangfang , Zheng Yuzhen , Yan Qihang , Dai Shuqin , Chen Tao , Chen Jianlong , Wang Junye
Published: September 2020

Background

The examination of lymph nodes (LNs) plays an important role in the nodal staging of non-small cell lung cancer (NSCLC). For patients without LN metastasis, the main role of thorough LN examination is accurate staging, which weakens the effect of staging migration. To date, the role of hilar and intrapulmonary (N1) station LNs has not been fully appreciated. In this study, we aimed to confirm the significance of N1 LNs in long-term survival for stage IA–IIA NSCLC patients and to find the minimum number of LN to examine.

Methods

The data of patients who underwent radical lobectomy and were confirmed as having non-metastatic LNs from January 2008 to March 2018 were retrospectively screened. Pathology records were reviewed for the number of LNs examined. The Kaplan-Meier method and Cox regression model were used to identify survival and prognostic factors.

Results

The median number of resected N1 LNs was 8. The number of patients with 0–2 N1 LNs, 3–5 N1 LNs, 6–8 N1 LNs, 9–11 N1 LNs, and more than 11 N1 LNs examined was 181, 425, 477, 414, and 531, respectively. Sex (P = 0.004), age (P < 0.001), tumor size (P = 0.004), differentiation degree (P = 0.001), and number of N1 LNs examined (P = 0.008) were independent prognostic factors of overall survival. Gender (P = 0.006), age (P = 0.031), tumor size (P = 0.001), differentiation degree (P = 0.001), vascular invasion (P = 0.034), and number of N1 LNs examined (P = 0.007) were independent prognostic factors of disease-free survival. Compared with patients with 0–5 N1 LNs examined, patients with more than 5 N1 LNs examined had better OS (P = 0.015) and had better DFS (P = 0.015) if only a landmark 5-year follow-up was performed.

Conclusion

Increasing the number of N1 LN examination might improve the long-term survival of T1-2N0 NSCLC patients. These data indicate that at least 6 N1 nodes examined is an essential part in surgical and pathological management but cannot prove this. This finding should be confirmed in a large, prospective randomized clinical study.
Does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients?
Authors: Wang Wenjie , Cai Jiali , Liu Lanlan , Xu Yingpei , Liu Zhenfang , Chen Jinghua , Jiang Xiaoming , Sun Xiaohua , Ren Jianzhi
Published: September 2020

Background

While single embryo transfer (SET) is widely advocated, double embryo transfer (DET) remains preferable in clinical practice to improve IVF success rate, especially in poor prognosis patients with only poor quality embryos (PQEs) available in addition to one or no good quality embryos (GQEs). Furthermore, previous studies suggest PQE might adversely affect the implantation of a GQE when transferred together. This study aims to evaluate the effect of transferring an additional PQE with a GQE on the outcomes in poor prognosis patients.

Methods

A total of 5037 frozen-thawed blastocyst transfer (FBT) cycles between January 2012 and May 2019 were included. Propensity score matching was applied to control for potential confounders, and we used generalized estimating equations (GEE) models to identify the association between the effect of an additional PQE and the outcomes.

Results

Overall, transferring a PQE with GQE (Group GP) achieved significantly higher pregnancy rate (PR), live birth rate (LBR) and multiple pregnancy rate (MPR) than GQE only (group G). The addition of a PQE increased LBR in patients aged 35 and over and in patients who received over 3 cycles of embryo transfer (ET) (48.1% vs 27.2%, OR:2.56, 95% CI: 1.3–5.03 and 46.6% vs 35.4%, OR:1.6, 95% CI: 1.09–2.35), but not in women under 35 and in women who received less than 3 cycles of ET (48.7% vs 43.9%, OR:1.22, 95% CI: 0.93–1.59 and 48.3% vs 41.4%, OR:1.33, 95% CI: 0.96–1.85). Group GP resulted in significantly higher MPR than group G irrespective of age and the number of previous IVF cycles.

Conclusions

An additional PQE does not negatively affect the implantation potential of the co-transferred GQE. Nevertheless, the addition of a PQE contributes to both live birth and multiple birth in poor prognosis patients. Physicians should still balance the benefits and risks of DET.
Depressive disorders in Brazil: results from the Global Burden of Disease Study 2017
Authors: Bonadiman Cecília Silva Costa , Malta Deborah Carvalho , de Azeredo Passos Valéria Maria , Naghavi Mohsen , Melo Ana Paula Souto
Published: September 2020

Background

Depression is one of the major causes of disability worldwide. The objective of this study was to analyze the results of the Global Burden of Disease Study 2017 (GBD-2017) for depressive disorders in Brazil and its Federated Units (FUs) in 1990 and 2017.

Methods

We used GBD-2017 study methodology to evaluate the prevalence estimates, the disability-adjusted life-year (DALY), and the years lived with disability (YLDs) for depressive disorders, which include major depressive disorder and dysthymia. The YLD estimates and the position of these disorders in the DALY and YLD rankings were compared to those of seven other countries. The observed versus expected YLD, based on the sociodemographic index (SDI), were compared.

Results

In GBD-2017, the prevalence of depressive disorders in Brazil was 3.30% (95% uncertainty interval [UI]: 3.08 to 3.57), ranging from 3.79% (3.53 to 4.09) in Santa Catarina to 2.78% in Pará (2.56 to 3.03), with significant differences between the Federated Units. From 1990 to 2017, there was an increase in number of YLD (55.19%, 49.57 to 60.73), but a decrease in the age-standardized rates (− 9.01%, − 11.66 to − 6.31). The highest proportion of YLD was observed in the age range of 15–64 years and among females. These disorders rank 4th and 13th as leading causes of YLD and DALY, respectively, in Brazil. In the other countries evaluated, the ranking of these disorders in the YLD classification was close to Brazil’s, while in the DALY classification, there was higher variability. All countries had YLD rates similar to the overall rate. The observed/expected YLD ratio ranged from 0.81 in Pará to 1.16 in Santa Catarina. Morbidity of depressive disorders was not associated with SDI.

Conclusions

Depressive disorders have been responsible for a high disability burden since 1990, especially in adult women living in the Southern region of the country. The number of people affected by these disorders in the country tends to increase, requiring more investment in mental health aimed at advancements and quality of services. The epidemiological studies of these disorders throughout the national territory can contribute to this planning and to making the Brazilian health system more equitable.
The burden of disease among Brazilian older adults and the challenge for health policies: results of the Global Burden of Disease Study 2017
Authors: de Azeredo Passos Valéria Maria , Champs Ana Paula Silva , Teixeira Renato , Lima-Costa Maria Fernanda Furtado , Kirkwood Renata , Veras Renato , Nascimento Bruno Ramos , Nogales Ana Maria , Schmidt Maria Inês , Duncan Bruce Bartholow , Cousin Ewerton , Naghavi Mohsen , Souza Fatima Marinho
Published: September 2020

Background

Brazil is the world’s fifth most populous nation, and is currently experimenting a fast demographic aging process in a context of scarce resources and social inequalities. To understand the health profile of older adults in Brazil is fundamental for planning public policies.

Methods

The estimates were derived from data obtained through the collaboration between the Brazilian Ministry of Health and the Institute of Health Metrics and Evaluation of the University of Washington. The Brazilian Institute of Geography and Statistics provided the population estimates. Data on causes of death came from the Mortality Information System. To calculate morbidity, population-based studies on the prevalence of diseases in Brazil were comprehensively searched, in addition to information obtained from national databases such as the Hospital Information System, the Outpatient Information System, and the Injury Information System. We presented the Global Burden of Disease (GBD) 2017 estimates among Brazilian older adults (60+ years old) for life expectancy at birth (LE), healthy life expectancy (HALE), cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs), from 2000 to 2017.

Results

LE at birth significantly increased from 71.3 years (95% UI to 70.9-71.8) to 75.2 years (95% UI 74.7-75.7). There was a trend of increasing HALE, from 62.2 years (95% UI 59.54-64.5) to 65.5 years (95% UI 62.6-68.0). The proportion of DALYs among older adults increased from 7.3 to 10.3%. Chronic noncommunicable diseases are the leading cause of death among middle aged and older adults, while Alzheimer’s disease is a leading cause only among older adults. Mood disorders, musculoskeletal pain, and hearing or vision losses are among the leading causes of disability.

Conclusions

The increase in LE and the decrease of the DALYs rates are probably results of the improvement of social conditions and health policies. However, the smaller increase of HALE than LE means that despite living more, people spend a substantial time of their old age with disability and illness. Preventable or potentially controllable diseases are responsible for most of the burden of disease among Brazilian older adults. Health investments are necessary to obtain longevity with quality of life in Brazil.
Monitoring the progress of health-related sustainable development goals (SDGs) in Brazilian states using the Global Burden of Disease indicators
Authors: Machado Daiane Borges , Pescarini Júlia Moreira , Ramos Dandara , Teixeira Renato , Lozano Rafael , Pereira Vinicius Oliveira de Moura , Azeredo Cimar , Paes-Sousa Rômulo , Malta Deborah Carvalho , Barreto Mauricio L.
Published: September 2020

Background

Measuring the Global Burden of Disease (GBD) has been the key to verifying the evolution of health indicators worldwide. We analyse subnational GBD data for Brazil in order to monitor the performance of the Brazilian states in the last 28 years on their progress towards meeting the health-related SDGs.

Methods

As part of the GBD study, we assessed the 41 health-related indicators from the SDGs in Brazil at the subnational level for all the 26 Brazilian states and the Federal District from 1990 to 2017. The GBD group has rescaled all worldwide indicators from 0 to 100, assuming that for each one of them, the worst value among all countries and overtime is 0, and the best is 100. They also estimate the overall health-related SDG index as a function of all previously estimated health indicators and the SDI index (Socio-Demographic Index) as a function of per capita income, average schooling in the population aged 15 years or over, and total fertility rate under the age of 25 (TFU25).

Results

From 1990 to 2017, most subnational health-related SDGs, the SDG and SDI indexes improved considerable in most Brazilian states. The observed differences in SDG indicators within Brazilian states, including HIV incidence and health worker density, increased over time. In 2017, health-related indicators that achieved good results globally included the prevalence of child wasting, NTD, household air pollution, conflict mortality, skilled birth attendance, use of modern contraceptive methods, vaccine coverage, and health worker density, but poor results were observed for child overweight and homicide rates. The high rates of overweight, alcohol consumption, and smoking prevalence found in the historically richest regions (i.e., the South and Southeast), contrast with the high rates of tuberculosis, maternal, neonatal, and under-5 mortality and WASH-related mortality found in the poorer regions (i.e., the North and Northeast).

Conclusions

The majority of Brazil’s health-related SDG indicators have substantially improved over the past 28 years. However, inequalities in health among the Brazilian states and regions remain noticeable negatively affecting the Brazilian population, which can contribute to Brazil not achieving the SDG 2030 targets.
The burden of diabetes and hyperglycemia in Brazil: a global burden of disease study 2017
Authors: Duncan Bruce Bartholow , Cousin Ewerton , Naghavi Mohsen , Afshin Ashkan , França Elisabeth Barboza , Passos Valéria Maria de Azeredo , Malta Deborah , Nascimento Bruno R. , Schmidt Maria Inês
Published: September 2020

Background

The Global Burden of Diseases (GBD) 2017 database permits an up-to-date evaluation of the frequency and burden of diabetes at the state level in Brazil and by type of diabetes. The objective of this report is to describe, using these updated GBD data, the current and projected future burden of diabetes and hyperglycemia in Brazil, as well as its variation over time and space.

Methods

We derived all estimates using the GBD 2016 and 2017 databases to characterize disease burden related to diabetes and hyperglycemia in Brazil, from 1990 to 2040, using standard GBD methodologies.

Results

The overall estimated prevalence of diabetes in Brazil in 2017 was 4.4% (95%UI 4.0–4.9%), with 4.0% of those with diabetes being identified as having type 1 disease. While the crude prevalence of type 1 disease has remained relatively stable from 1990, type 2 prevalence has increased 30% for males and 26% for females. In 2017, approximately 3.3% of all disability-adjusted life years lost were due to diabetes and 5.9% to hyperglycemia. Diabetes prevalence and mortality were highest in the Northeast region and growing fastest in the North, Northeast, and Center-West regions. Over this period, despite a slight decrease in age-standardized incidence of type 2 diabetes, crude overall burden due to hyperglycemia has increased 19%, with population aging being a main cause for this rise. Cardiovascular diseases, responsible for 38.3% of this burden in 1990, caused only 25.9% of it in 2017, with premature mortality attributed directly to diabetes causing 31.6% of the 2017 burden. Future projections suggest that the diabetes mortality burden will increase 144% by 2040, more than twice the expected increase in crude disease burden overall (54%). By 2040, diabetes is projected to be Brazil’s third leading cause of death and hyperglycemia its third leading risk factor, in terms of deaths.

Conclusions

The disease burden in Brazil attributable to diabetes and hyperglycemia, already large, is predicted by GBD estimates to more than double to 2040. Strong actions by the Ministry of Health are necessary to counterbalance the major deleterious effects of population aging.
Changes in malaria patterns in Brazil over 28 years (1990–2017): results from the Global Burden of Disease Study 2017
Authors: Bezerra Juliana Maria Trindade , Barbosa David Soeiro , Martins-Melo Francisco Rogerlândio , Werneck Guilherme Loureiro , Braga Érika Martins , Tauil Pedro Luiz , Carneiro Mariângela
Published: September 2020

Background

This study presents the malaria burden in Brazil from 1990 to 2017 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), by analyzing disease burden indicators in federated units of the Legal Amazon and Extra-Amazon regions, as well as describing malaria cases according toPlasmodiumspecies occurring in the country.

Methods

We used estimates from the GBD 2017 to report years of life lost due to premature death (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) for malaria in Brazil, grouped by gender, age group, and Brazilian federated unit, from 1990 to 2017. Results are presented as absolute numbers and age-standardized rates (per 100,000 inhabitants) with 95% uncertainty intervals (UI).

Results

At the national level, the age-standardized DALYs rate due to malaria decreased by 92.0%, from 42.5 DALYs per 100,000 inhabitants (95% UI 16.6–56.9) in 1990 to 3.4 DALYs per 100,000 inhabitants (95% UI 2.7–4.7) in 2017. The YLLs were the main component of the total DALYs rate for malaria in 1990 (67.3%), and the YLDs were the main component of the metric in 2017 (61.8%). In 2017, the highest sex–age DALYs rate was found among females in the “< 1-year-old” age group, with a 6.4 DALYs per 100,000 inhabitants (95% UI 1.8–14.7) and among males in the age group of “20 to 24 years old”, with a 4.7 DALYs per 100,000 inhabitants (95% UI 3.3–9.9). Within the Brazilian Amazon region, the three federated units with the highest age-standardized DALYs rates in 2017 were Acre [28.4 (95% UI 14.2–39.1)], Roraima [28.3 (95% UI 13.5–40.2)], and Rondônia [24.7 (95% UI 11.4–34.8)]. Concerning the parasite species that caused malaria, 73.5% of the total of cases registered in the period hadPlasmodium vivaxas the etiological agent.

Conclusions

The results of the GBD 2017 show that despite the considerable reduction in the DALYs rates between 1990 and 2017, malaria remains a relevant and preventable disease, which in recent years has generated more years of life lost due to disability than deaths. The states endemic for malaria in the Amazon region require constant evaluation of preventive and control measures. The present study will contribute to the direction of current health policies aimed at reducing the burden of malaria in Brazil, as knowing the geographical and temporal distribution of the risk of death and disability of this disease can facilitate the planning, implementation, and improvement of control strategies aimed at eliminating the disease.
Comparative analysis of completeness of death registration, adult mortality and life expectancy at birth in Brazil at the subnational level
Authors: Queiroz Bernardo L , Gonzaga Marcos R. , Vasconcelos Ana M. N. , Lopes Bruno T. , Abreu Daisy M. X.
Published: September 2020

Background

Estimates of completeness of death registration are crucial to produce estimates of life tables and population projections and to estimate the burden of disease. They are an important step in assessing the quality of data. In the case of subnational data analysis in Brazil, it is important to consider spatial and temporal variation in the quality of mortality data. There are two main sources of data quality evaluation in Brazil, but there are few comparative studies and how they evolve over time. The aim of the paper is to compare and discuss alternative estimates of completeness of death registration, adult mortality (45q15) and life expectancy estimates produced by the National Statistics Office (IBGE), Institute for Health Metrics and Evaluation (IHME), and estimates presented in Queiroz et al. (2017) and Schmertmann and Gonzaga (2018), for 1980 and 2010.

Methods

We provide a descriptive and comparative analysis of aforementioned estimates from four (4) sources of estimates at subnational level (26 states and one Federal District) in Brazil from two different points in time.

Results

We found significant differences in estimates that affect both levels and trends of completeness of adult mortality in Brazil and states. IHME and Queiroz et al. (2017) estimates converge by 2010, but there are large differences when compared to estimates from the National Statistics Office (IBGE). Larger differences are observed for less developed states. We have showed that the quality of mortality data in Brazil has improved steadily overtime, but with large regional variations. However, we have observed that IBGE estimates show the lowest levels of completeness for the Northern of the country compared to other estimates. Choice of methods and approaches might lead to very unexpected results.

Conclusion

We produced a detailed comparative analysis of estimates of completeness of death registration from different sources and discuss the main results and possible explanations for these differences. We have also showed that new improved methods are still needed to study adult mortality in less developed countries and at a subnational level. More comparative studies are important in order to improve quality of estimates in Brazil.
Trends in mortality due to non-communicable diseases in the Brazilian adult population: national and subnational estimates and projections for 2030
Authors: Malta Deborah Carvalho , Duncan Bruce Bartholow , Schmidt Maria Inês , Teixeira Renato , Ribeiro Antonio Luiz Pinho , Felisbino-Mendes Mariana Santos , Machado Ísis Eloah , Velasquez-Melendez Gustavo , Brant Luisa Campos Caldeira , Silva Diego Augusto Santos , Passos Valéria Maria de Azeredo , Nascimento Bruno R , Cousin Ewerton , Glenn Scott , Naghavi Mohsen
Published: September 2020

Background

Monitoring and reducing premature mortality due to non-communicable diseases (NCDs) is a global priority of Agenda 2030. This study aimed to describe the mortality trends and disability-adjusted life years (DALYs) lost due to NCDs between 1990 and 2017 for Brazil and to project those for 2030 as well as the risk factors (RFs) attributed deaths according to estimates of the Global Burden of Disease Study.

Methods

We analyzed cardiovascular diseases, chronic respiratory diseases, neoplasms, and diabetes, and compared the mortality rates in 1990 and 2017 for all of Brazil and states. The study used the definition of premature mortality (30–69 years) that is used by the World Health Organization. The number of deaths, mortality rates, DALYs, and years of life lost (YLL) were used to compare 1990 and 2017. We analyzed the YLL for NCDs attributable to RFs.

Results

There was a reduction of 35.3% from 509.1 deaths/100,000 inhabitants (1990) to 329.6 deaths/100,000 inhabitants due to NCDs in 2017. The DALY rate decreased by 33.6%, and the YLL rate decreased by 36.0%. There were reductions in NCDs rates in all 27 states. The main RFs related to premature deaths by NCDs in 2017 among women were high body mass index (BMI), dietary risks, high systolic blood pressure, and among men, dietary risks, high systolic blood pressure, tobacco, and high BMI. Trends in mortality rates due to NCDs declined during the study period; however, after 2015, the curve reversed, and rates fluctuated and tended to increase.

Conclusion

Our findings highlighted a decline in premature mortality rates from NCDs nationwide and in all states. There was a greater reduction in deaths from cardiovascular diseases, followed by respiratory diseases, and we observed a minor reduction for those from diabetes and neoplasms. The observed fluctuations in mortality rates over the last 3 years indicate that if no further action is taken, we may not achieve the NCD Sustainable Development Goals. These findings draw attention to the consequences of austerity measures in a socially unequal setting with great regional disparities in which the majority of the population is dependent on state social policies.
The burden of non-communicable diseases attributable to high BMI in Brazil, 1990–2017: findings from the Global Burden of Disease Study
Authors: Felisbino-Mendes Mariana Santos , Cousin Ewerton , Malta Deborah Carvalho , Machado Ísis Eloah , Ribeiro Antonio Luiz Pinho , Duncan Bruce Bartholow , Schmidt Maria Inês , Silva Diego Augusto Santos , Glenn Scott , Afshin Ashkan , Velasquez-Melendez Gustavo
Published: September 2020

Background

The prevalence and burden of disease resulting from obesity have increased worldwide. In Brazil, more than half of the population is now overweight. However, the impact of this growing risk factor on disease burden remains inexact. Using the 2017 Global Burden of Disease (GBD) results, this study sought to estimate mortality and disability-adjusted life years (DALYs) lost to non-communicable diseases caused by high body mass index (BMI) in both sexes and across age categories. This study also aimed to describe the prevalence of overweight and obesity throughout the states of Brazil.

Methods

Age-standardized prevalence of overweight and obesity were estimated between 1990 and 2017. A comparative risk assessment was applied to estimate DALYs and deaths for non-communicable diseases and for all causes linked to high BMI.

Results

The prevalence of overweight and obesity increased during the period of analysis. Overall, age-standardized prevalence of obesity in Brazil was higher in females (29.8%) than in males (24.6%) in 2017; however, since 1990, males have presented greater rise in obesity (244.1%) than females (165.7%). Increases in prevalence burden were greatest in states from the North and Northeast regions of Brazil. Overall, burden due to high BMI also increased from 1990 to 2017. In 2017, high BMI was responsible for 12.3% (8.8–16.1%) of all deaths and 8.4% (6.3–10.7%) of total DALYs lost to non-communicable diseases, up from 7.2% (4.1–10.8%), and 4.6% (2.4-6.0%) in 1990, respectively. Change due to risk exposure is the leading contributor to the growth of BMI burden in Brazil. In 2017, high BMI was responsible for 165,954 deaths and 5,095,125 DALYs. Cardiovascular disease and diabetes have proven to be the most prevalent causes of deaths, along with DALYs caused by high BMI, regardless of sex or state.

Conclusions

This study demonstrates increasing age-standardized prevalence of obesity in all Brazilian states. High BMI plays an important role in disease burdens in terms of cardiovascular diseases, diabetes, and all causes of mortality. Assessing levels and trends in exposures to high BMI and the resulting disease burden highlights the current priority for primary prevention and public health action initiatives focused on obesity.
Association between firearms and mortality in Brazil, 1990 to 2017: a global burden of disease Brazil study
Authors: Malta Deborah Carvalho , Soares Filho Adauto Martins , Pinto Isabella Vitral , de Souza Minayo Maria Cecília , Lima Cheila Marina , Machado Ísis Eloah , Teixeira Renato Azeredo , Neto Otaliba Libânio Morais , Ladeira Roberto Marini , Merchan-Hamann Edgar , de Souza Maria de Fatima Marinho , Vasconcelos Cíntia Honório , Vidotti Carlos Cezar Flores , Cousin Ewerton , Glenn Scott , Bisignano Catherine , Chew Adrienne , Ribeiro Antonio Luiz , Naghavi Mohsen
Published: September 2020

Background

Brazil leads the world in number of firearm deaths and ranks sixth by country in rate of firearm deaths per 100,000 people. This study aims to analyze trends in and burden of mortality by firearms, according to age and sex, for Brazil, and the association between these deaths and indicators of possession and carrying of weapons using data from the global burden of diseases, injuries, and risk factors study (GBD) 2017.

Methods

We used GBD 2017 estimates of mortality due to physical violence and self-harm from firearms for Brazil to analyze the association between deaths by firearms and explanatory variables.

Results

Deaths from firearms increased in Brazil from 25,819 in 1990 to 48,493 in 2017. Firearm mortality rates were higher among men and in the 20–24 age group; the rate was 20 times higher than for women in the same age group. Homicide rates increased during the study period, while mortality rates for suicides and accidental deaths decreased. The group of Brazilian federation units with the highest firearm collection rate (median = 7.5) showed reductions in the rate of total violent deaths by firearms. In contrast, the group with the lowest firearm collection rate (median = 2.0) showed an increase in firearm deaths from 2000 to 2017. An increase in the rate of voluntary return of firearms was associated with a reduction in mortality rates of unintentional firearm deaths (r= −0.364,p< 0.001). An increase in socio-demographic index (SDI) was associated with a reduction in all firearm death rates (r= −0.266,p= 0.008). An increase in the composite index of firearms seized or collected was associated with a reduction in rates of deaths by firearm in the subgroup of females, children, and the elderly (r= −0.269,p= 0.005).

Conclusions

There was a change in the trend of firearms deaths after the beginning of the collection of weapons in 2004. Federation units that collected more guns have reduced rates of violent firearm deaths.
Identification of WTAP-related genes by weighted gene co-expression network analysis in ovarian cancer
Authors: Wang Jing , Xu Jing , Li Ke , Huang Yunke , Dai Yilin , Xu Congjian , Kang Yu
Published: September 2020

Background

Wilms tumor 1 associated protein (WTAP) modulates other genes via transcriptional and post-transcriptional regulation, in particular, by acting as a N6-methyladenosine writer or binding to the 3’UTR of mRNA, and promotes a variety of tumuors. However, the roles and mechanisms of WTAP in ovarian cancer are unknown.

Results

In this study, using univariate Cox analysis and online CPTA analysis, we found that WTAP was a poor prognostic factor for ovarian cancer, and its protein expression level was higher in ovarian cancer than in normal tissue. Functionally, WTAP promoted the proliferation, invasion, and migration capability of ovarian cancer, according to the results of real time cellular analysis (RTCA), EdU cell proliferation assay, transwell assay. Subsequently, we identified a module containing 133 genes that were carefully related to WTAP expression through weighted gene co-expression network analysis (WGCNA). By calculating the hazard ratios of these genes and comparing their differences in the WTAP high-expression group and the low-expression group, we observed that there was a significant positive correlation between WTAP and two poor survival-related genes, family with sequence similarity 76 member A (FAM76A) and HBS1 like translational GTPase (HBS1L), which was also verified by quantitative real-time PCR in SKOV3 and A2780 cells.

Conclusion

WTAP functions as an oncogenic factor that promotes the progression of ovarian cancer in which WTAP-HBS1L/FAM76A axis may be involved. Our study indicates the potential role of WTAP in prognostic biomarker and therapeutic target for ovarian cancer.
Ultrasound-guided peripheral vascular catheterization in pediatric patients: a narrative review
Authors: Nakayama Yoshinobu , Takeshita Jun , Nakajima Yasufumi , Shime Nobuaki
Published: September 2020

Peripheral vascular catheterization (PVC) in pediatric patients is technically challenging. Ultrasound guidance has gained the most interest in perioperative and intensive care fields because it visualizes the exact location of small target vessels and is less invasive than other techniques. There have been a growing number of studies related to ultrasound guidance for PVC with or without difficult access in pediatric patients, and most findings have demonstrated its superiority to other techniques. There are various ultrasound guidance approaches, and a comprehensive understanding of the basics, operator experience, and selection of appropriate techniques is required for the successful utilization of this technique. This narrative review summarizes the literature regarding ultrasound-guided PVC principles, approaches, and pitfalls to improve its clinical performance in pediatric settings.
Evaluation of the effect of Cooled HaEmodialysis on Cognitive function in patients suffering with end-stage KidnEy Disease (E-CHECKED): feasibility randomised control trial protocol
Authors: Dasgupta Indranil , Odudu Aghogho , Baharani Jyoti , Fergusson Niall , Griffiths Helen , Harrison John , Maruff Paul , Thomas G Neil , Woodhall Gavin , Youseff Samir , Tadros George
Published: September 2020

Background

Cognitive impairment is common in haemodialysis (HD) patients and is associated independently with depression and mortality. This association is poorly understood, and no intervention is proven to slow cognitive decline. There is evidence that cooler dialysis fluid (dialysate) may slow white matter changes in the brain, but no study has investigated the effect of cooler dialysate on cognition. This study addresses whether cooler dialysate can prevent the decline in cognition and improve quality of life (QOL) in HD patients.

Methods

This is a multi-site prospective randomised, double-blinded feasibility trial. Setting: Four HD units in the UK. Participants and interventions: Ninety HD patients randomised (1:1) to standard care (dialysate temperature 36.5 °C) or intervention (dialysate temperature 35 °C) for 12 months. Primary outcome measure: Change in cognition using the Montreal Cognitive Assessment (MoCA). Secondary outcome measures: Recruitment and attrition rates, reasons for non-recruitment, frequency of intradialytic hypotension, depressive symptom scores, patient and carers burden, a detailed computerised cognitive test and QOL assessments. Analysis: mixed method approach, utilising measurement of cognition, questionnaires, physiological measurements and semi-structured interviews.

Discussion

The results of this feasibility trial will inform the design of a future adequately powered substantive trial investigating the effect of dialysate cooling on prevention and/or slowing in cognitive decline in patients undergoing haemodialysis using a computerised battery of neuro-cognitive tests. The main hypothesis that would be tested in this future trial is that patients treated with regular conventional haemodialysis will have a lesser decline in cognitive function and a better quality of life over 1 year by using cooler dialysis fluid at 35 °C, versus a standard dialysis fluid temperature of 36.5 °C. This also should reflect in improvements in their abilities for activities of daily living and therefore reduce carers’ burden. If successful, the treatment could be universally applied at no extra cost.

Trial registration

ClinicalTrials.gov NCT03645733. Registered retrospectively on 24 August 2018.
Diagnostic accuracy of the Finnish Diabetes Risk Score for the prediction of undiagnosed type 2 diabetes, prediabetes, and metabolic syndrome in the Lebanese University
Authors: Abdallah Maher , Sharbaji Safa , Sharbaji Marwa , Daher Zeina , Faour Tarek , Mansour Zeinab , Hneino Mohammad
Published: September 2020

Background

Risk scores were mainly proved to predict undiagnosed type 2 diabetes mellitus (UT2DM) in a non-invasive manner and to guide earlier clinical treatment. The objective of the present study was to assess the performance of the Finnish Diabetes Risk Score (FINDRISC) for detecting three outcomes: UT2DM, prediabetes, and the metabolic syndrome (MS).

Methods

This was a prospective, cross-sectional study during which employees aged between 30 and 64, with no known diabetes and working within the faculties of the Lebanese University (LU) were conveniently recruited. Participants completed the FINDRISC questionnaire and their glucose levels were examined using both fasting blood glucose (FBG) and oral glucose tolerance tests (OGTT). Furthermore, they underwent lipid profile tests with anthropometry.

Results

Of 713 subjects, 397 subjects (55.2% female; 44.8% male) completed the blood tests and thus were considered as the sample population. 7.6% had UT2DM, 22.9% prediabetes and 35.8% had MS, where men had higher prevalence than women for these 3 outcomes (P = 0.001, P = 0.003 and P = 0.001) respectively. The AUROC value with 95% Confidence Interval (CI) for detecting UT2DM was 0.795 (0.822 in men and 0.725 in women), 0.621(0.648 in men and 0.59 in women) for prediabetes and 0.710 (0.734 in men and 0.705 in women) for MS. The correspondent optimal cut-off point for UT2DM was 11.5 (sensitivity = 83.3% and specificity = 61.3%), 9.5 for prediabetes (sensitivity = 73.6% and specificity = 43.1%) and 10.5 (sensitivity = 69.7%; specificity = 56.5%) for MS.

Conclusion

The FINDRISC can be considered a simple, quick, inexpensive, and non-invasive instrument to use in a Lebanese community of working people who are unaware of their health status and who usually report being extremely busy because of their daily hectic work for the screening of UT2DM and MS. However, it poorly screens for prediabetes in this context.
Designing refugees’ camps: temporary emergency solutions, or contemporary paradigms of incomplete urban citizenship? Insights from Al Za’atari
Authors: Aburamadan Rania , Trillo Claudia , Makore Busisiwe Chikomborero Ncube
Published: September 2020

Millions of people have been forcibly displaced around the world at an alarming rate. In 2018, approximately 70.8 million people (UNHCR 2018) were living in refugee camps. These camps are the most immediate response to the emergency. However, they have become more than a simple temporary solution, with refugees spending significantly longer than they should. Motivated largely by an economic rationale, the camps are often produced rapidly, cheaply and effectively to accommodate the largest possible number of shelters in the shortest time. The aim of this paper is to explore whether the concept of permanence should be embedded in the spatial configuration of a refugees’ camp, or whether the concept of transient and temporary community would better reflect the aspirations of the users. The Al Za’atari camp has been selected as a case study to explore the nexus between spatial configuration and social aspirations of the refugees’ community. Indeed, the findings revealed that the spatial configuration of the Al Za’atari camp reflects social fabric, habits and organization of the refugees’ community. This has occurred to the point that the camp has taken on the appearance of a sort of informal city. This study therefore suggests recommendations to support the design of spatial and architectural solutions that better meet the actual needs of the final users largely disregarded in the current emergency approach.
Correction to: Understanding university English instructors’ assessment training needs in the Chinese context
Authors: Gan Ling , Lam Ricky
Published: September 2020

An amendment to this paper has been published and can be accessed via the original article.
Benign mesenteric lipomatous tumor in a child: a case report and literature review
Authors: Hashizume Naoki , Aiko Takato , Fukahori Suguru , Ishii Shinji , Saikusa Nobuyuki , Koga Yoshinori , Higashidate Naruki , Sakamoto Saki , Tsuruhisa Shiori , Nakahara Hirotomo , Muta Hiroko , Miyoshi Hiroaki , Naito Yoshiki , Yamamoto Hidetaka , Oda Yoshinao , Tanaka Yoshiaki , Yagi Minoru
Published: September 2020

Background

Lipomatous tumors are the most common type of soft-tissue tumors. Benign lipomatous tumors are lipomas and lipoblastoma. We herein report a case of benign mesenteric lipomatous tumor and the largest collection of known benign mesenteric lipomatous tumors in children in the literature.

Case presentation

A 3-year-old girl presented with repeated dull abdominal pain and left abdominal mass swelling. On a physical examination, the child had a soft, moderately distended left abdomen that was not tender when palpated. Computed tomography and magnetic resonance imaging demonstrated a large fatty mass within the mesentery, measuring approximately 8 × 6 cm. The mass extended from the right upper quadrant to the lower pole of the kidneys. Laparotomy with resection of the mesenteric tumor was performed under general anesthesia. A well-capsuled tumor was a soft, yellow mass and found loosely attached to the mesenterium of the ileum. A histopathological examination demonstrated the lobular proliferation of mature adipocytes. Atypical lipoblasts were not seen. These features are compatible with benign lipomatous tumor, such as lipoma or lipoblastoma with maturation.

Conclusion

In conclusion, benign mesenteric lipomatous tumors tend to be large in size over 10 cm in longitudinal length. However, resection is well tolerated in the vast majority of cases with benign post-operative courses.
Malnutrition and poverty in India: does the use of public distribution system matter?
Authors: Panda Basant Kumar , Mohanty Sanjay K. , Nayak Itishree , Shastri Vishal Dev , Subramanian S. V.
Published: September 2020

Background

Large scale public investment in Public Distribution System (PDS) have aimed to reduce poverty and malnutrition in India. The PDS is the largest ever welfare programme which provides subsidised food grain to the poor households. This study attempt to examine the extent of stunting and underweight among the children from poor and non-poor households by use of public distribution system (PDS) in India.

Methods

Data from the National Family and Health Survey-4 (NFHS-4), was used for the analysis. A composite variable based on asset deprivation and possession of welfare card provided under PDS (BPL card), was computed for all households and categorised into four mutually exclusive groups, namely real poor, excluded poor, privileged non-poor and non-poor. Real poor are those economically poor and have a welfare card, excluded poor are those economically poor and do not have welfare card, privileged poor are those economically non-poor but have welfare card, and non-poor are those who are not economically poor and do not have welfare card. Estimates of stunting and underweight were provided by these four categories. Descriptive statistics and logistic regression were used for the analysis.

Results

About half of the children from each real poor and excluded poor, two-fifths among privileged non-poor and less than one-third among non-poor households were stunted in India. Controlling for socio-economic and demographic covariates, the adjusted odds ratio of being stunted among real poor was 1.42 [95% CI: 1.38, 1.46], 1.43 [95% CI: 1.39, 1.47], among excluded poor and 1.15 [95% CI: 1.12, 1.18], among privileged non-poor. The pattern was similar for underweight and held true in most of the states of India.

Conclusions

Undernutrition among children from poor households those excluded from PDS is highest, and it warrants inclusion in PDS. Improving the quality of food grains and widening food basket in PDS is recommended for reduction in level of malnutrition in India.
Predictive equations for evaluation for resting energy expenditure in Brazilian patients with type 2 diabetes: what can we use?
Authors: Grassi Thaiciane , Boeno Francesco Pinto , de Freitas Mauren Minuzzo , de Paula Tatiana Pedroso , Viana Luciana Vercoza , de Oliveira Alvaro Reischak , Steemburgo Thais
Published: September 2020

Background

Evaluation of the resting energy expenditure (REE) is essential to ensure an appropriate dietary prescription for patients with type 2 diabetes. The aim of this record was to evaluate the accuracy of predictive equations for REE estimation in patients with type 2 diabetes, considering indirect calorimetry (IC) as the reference method.

Methods

A cross-sectional study was performed in outpatients with type 2 diabetes. Clinical, body composition by electrical bioimpedance and laboratory variables were evaluated. The REE was measured by IC (QUARK RMR, Cosmed, Rome, Italy) and estimated by eleven predictive equations. Data were analyzed using Bland–Altman plots, paired t-tests, and Pearson’s correlation coefficients.

Results

Sixty-two patients were evaluated [50% female; mean age 63.1 ± 5.2 years; diabetes duration of 11 (1–36) years, and mean A1C of 7.6 ± 1.2%]. There was a wide variation in the accuracy of REE values predicted by equations when compared to IC REE measurement. In all patients, Ikeda and Mifflin St-Jeor equations were that most underestimated REE. And, the equations that overestimated the REE were proposed by Dietary Reference Intakes and Huang. The most accurate equations were FAO/WHO/UNO in women (− 1.8% difference) and Oxford in men (− 1.3% difference).

Conclusion

In patients with type 2 diabetes, in the absence of IC, FAO/WHO/UNO and Oxford equations provide the best REE prediction in comparison to measured REE for women and men, respectively.