Years of life lost (YLL) associated with COVID-19 deaths in Khorasan-RAZAVI province, Iran.

BACKGROUND: The number of deaths among people with coronavirus disease 2019 (COVID-19) does not show the true impact of the disease on communities. Therefore, this study aimed to calculate years of life lost (YLL) due to premature death in patients with COVID-19. METHODS: We performed a descriptive cross-sectional study based on data from one of the largest provinces of Iran, in the period 13 February 2020 to 17 May 2021. We used WHO proposed guidelines for the calculation of the burden of diseases to calculate the YLL among patients with COVID-19, taking into consideration gender in different age groups. RESULTS: Findings showed that 13 628 deaths were due to COVID-19 with associated 249 309 YLL. The study reported higher mortality among men (1222 cases) in the age group over 85 years than in women (840) of the same age group. The minimum number of YLL for men was 1749 in the 5-9 years age group and that for women was 1551 years in the 14-10 years age group. CONCLUSION: The high number of deaths due to COVID-19 has led to high YLL due to premature death. The provision of adequate health care and appropriate policies will bring about a decrease in YLL due to COVID-19.

Gender differences in premature mortality for cardiovascular disease in India, 2017-18.

BACKGROUND: The present study tries to provide a comprehensive estimate of gender differences in the years of life lost due to CVD across the major states of India during 2017-18. METHODS: The information on the CVD related data were collected from medical certification of causes of death (MCCD reports, 2018). Apart from this, information from census of India (2001, 2011), SRS (2018) were also used to estimate YLL. To understand the variation in YLL due to CVD at the state level, nine sets of covariates were chosen: share of elderly population, percentage of urban population, literacy rate, health expenditure, social sector expenditure, labour force participation, HDI Score and co-existence of other NCDs such as diabetes, & obesity. The absolute number of YLL and YLL rates were calculated. Further, Pearson's correlation had been calculated and to understand the effect of explanatory variables on YLL due to CVD, multiple linear regression analysis had been applied. RESULTS: Men have a higher burden of premature mortality in terms of Years of life lost (YLL) due to CVD than women in India, with pronounced differences at adult ages of 50-54 years and over. The age pattern of YLL rate suggests that the age group 85 + makes the highest contribution to the overall YLL rate due to CVD. YLL rate showed a J-shaped relationship with age, starting high at ages below 1 years, dropping to their lowest among children aged 1-4 years, and rising again to highest levels at 85 + years among both men and women. In all the states except Bihar men had higher estimated YLL due to CVD for all ages than women. Among men the YLL due to CVD was higher in Tamil Nadu followed by Madhya Pradesh and Chhattisgarh. On the other hand, the YLL due to CVD among men was lowest in Jharkhand followed by Assam. Similarly, among women the YLL due to CVD was highest in Tamil Nadu followed by Madhya Pradesh and Chhattisgarh. While, the YLL due to CVD among women was lowest in Jharkhand. Irrespective of gender, all factors except state health expenditure were positively linked with YLL due to CVD, i.e., as state health expenditure increases, the years of life lost (YLL) due to CVDs falls. Among all the covariates, the proportion of a state's elderly population emerges as the most significant predictor variable for YLL for CVDs (r = 0.42 for men and r = 0.50 for women). CONCLUSION: YLL due to cardiovascular disease varies among men and women across the states of India. The state-specific findings of gender differences in years of life lost due to CVD may be used to improve policies and programmes in India.

The burden of premature mortality among older adults: a population-based study in Malaysia.

BACKGROUND: The populations of many countries-including Malaysia-are rapidly growing older, causing a shift in leading causes of disease and death. In such rapidly ageing populations, it is critical to monitor trends in burden of disease and health of older adults by identifying the leading causes of premature mortality and measuring years of life lost (YLL) to these. The objective of this study, therefore, is to describe the burden (quantified by YLL) associated with major causes of premature mortality among older adults in Malaysia in 2019. METHODS: All deaths that occurred in older adults aged 60 and above in Malaysia in the year 2019 were included in this study. YLL was calculated by summing the number of deaths for the disease category at 5-year age intervals, multiplied by the remaining life expectancy for the specific age and sex group. Both life expectancy and mortality data were obtained from the Department of Statistics Malaysia. RESULTS: In 2019, older adults accounted for 67.4% of total deaths in Malaysia (117,102 out of 173,746). The total number of YLL among older adults in Malaysia in 2019 was estimated at 1.36 million YLL, accounting for 39.6% of the total YLL (3.44 million) lost to all premature deaths in that year. The major causes of premature mortality among older adults were ischaemic heart disease (29.5%) followed by cerebrovascular disease (stroke) (20.8%), lower respiratory infections (15.9%), diabetes mellitus (8.1%) and trachea, bronchus and lung cancers (5.0%). CONCLUSIONS: Non-communicable diseases (NCD) remained the largest contributor to premature mortality among older adults in Malaysia. Implementation of population-level NCD health promotion programmes, screening programmes among high-risk groups and holistic intervention programmes among populations living with NCD are critical in reducing the overall burden of premature mortality.

Disability adjusted life years associated with COVID-19 in Denmark in the first year of the pandemic.

BACKGROUND: Burden of disease studies measure the public health impact of a disease in a society. The aim of this study was to quantify the direct burden of COVID-19 in the first 12 months of the epidemic in Denmark. METHODS: We collected national surveillance data on positive individuals for SARS-CoV-2 with RT-PCR, hospitalization data, and COVID-19 mortality reported in the period between 26th of February, 2020 to 25th of February, 2021. We calculated disability adjusted life years (DALYs) based on the European Burden of Disease Network consensus COVID-19 model, which considers mild, severe, critical health states, and premature death. We conducted sensitivity analyses for two different death-registration scenarios, within 30 and 60 days after first positive test, respectively. RESULTS: We estimated that of the 211,823 individuals who tested positive to SARS-CoV-2 by RT-PCR in the one-year period, 124,163 (59%; 95% uncertainty interval (UI) 112,782-133,857) had at least mild symptoms of disease. The total estimated disease burden was 30,180 DALYs (95% UI 30,126; 30,242), corresponding to 520 DALYs/100,000. The disease burden was higher in the age groups above 70 years of age, particularly in men. Years of life lost (YLL) contributed with more than 99% of total DALYs. The results of the scenario analysis showed that defining COVID-19-related fatalities as deaths registered up to 30 days after the first positive test led to a lower YLL estimate than when using a 60-days window. CONCLUSION: COVID-19 led to a substantial public health impact in Denmark in the first full year of the epidemic. Our estimates suggest that it was the the sixth most frequent cause of YLL in Denmark in 2020. This impact will be higher when including the post-acute consequences of COVID-19 and indirect health outcomes.

Estimating the direct Covid-19 disability-adjusted life years impact on the Malta population for the first full year.

BACKGROUND: Disability-adjusted life years (DALYs) combine the impact of morbidity and mortality, allowing for comprehensive comparisons of the population. The aim was to estimate the DALYs due to Covid-19 in Malta (March 2020-21) and investigate its impact in relation to other causes of disease at a population level. METHODS: Mortality and weekly hospital admission data were used to calculate DALYs, based on the European Burden of Disease Network consensus Covid-19 model. Covid-19 infection duration of 14 days was considered. Sensitivity analyses for different morbidity scenarios, including post-acute consequences were presented. RESULTS: An estimated 70,421 people were infected (with and without symptoms) by Covid-19 in Malta (March 2020-1), out of which 1636 required hospitalisation and 331 deaths, contributing to 5478 DALYs. These DALYs positioned Covid-19 as the fourth leading cause of disease in Malta. Mortality contributed to 95% of DALYs, while post-acute consequences contributed to 60% of morbidity. CONCLUSIONS: Covid-19 over 1 year has impacted substantially the population health in Malta. Post-acute consequences are the leading morbidity factors that require urgent targeted action to ensure timely multidisciplinary care. It is recommended that DALY estimations in 2021 and beyond are calculated to assess the impact of vaccine roll-out and emergence of new variants.

Effect of long-term exposure to PM2.5 on years of life lost in a populated Middle Eastern city.

From a public health point of view, years of life lost (YLL) is a more important index than the number of deaths to evaluate the effect of risk factors. The objective of the present study was to estimate the burden of disease including years of life lost (YLL) and expected life remaining (ELR) attributed to long-term exposure to PM2.5 in Ahvaz, one of the most polluted cities of the world, during March 2014 through March 2017. AirQ + software was used for the estimation of YLL and ELR due to all natural causes of death. Hourly concentrations of PM2.5 were acquired from the Department of Environment (DoE) of Ahvaz. Several steps were performed to validate the raw air quality data. Only the monitors were included that had minimum data completeness of 75%. Two age groups were selected for this study, including 0-64 and 65 < years. The life table approach was used to estimate YLL and ELR. Annual averages of PM2.5 were 5.2-8 times higher than the air quality guideline (10 µg/m3) set by WHO for long-term exposure to PM2.5. In total, PM2.5 has caused 234,041 years of life lost due to mortality. About 84% of YLLs were attributed to people older than 65 years old. The YLLs of men were higher than those for women. The YLLs in the third year were greater than the first two years. PM2.5 has caused the average age of total population, people aged 0-64 years old, and people > 65 years old decreased by 2.5, 3, and 1.6 years, respectively. These studies indicated that people in a city that the air quality is highly affected by dust storms, industrial emissions, and urban air pollution are significantly at risk. Air pollution control strategies and actions should be designed and executed to improve the quality of ambient air.

Yeast and other lower eukaryotic organisms for studies of Vps13 proteins in health and disease.

Human Vps13 proteins are associated with several diseases, including the neurodegenerative disorder Chorea-acanthocytosis (ChAc), yet the biology of these proteins is still poorly understood. Studies in Saccharomyces cerevisiae, Dictyostelium discoideum, Tetrahymena thermophila and Drosophila melanogaster point to the involvement of Vps13 in cytoskeleton organization, vesicular trafficking, autophagy, phagocytosis, endocytosis, proteostasis, sporulation and mitochondrial functioning. Recent findings show that yeast Vps13 binds to phosphatidylinositol lipids via 4 different regions and functions at membrane contact sites, enlarging the list of Vps13 functions. This review describes the great potential of simple eukaryotes to decipher disease mechanisms in higher organisms and highlights novel insights into the pathological role of Vps13 towards ChAc.

The world-wide burden of musculoskeletal diseases: a systematic analysis of the World Health Organization Burden of Diseases Database.

BACKGROUND: Musculoskeletal (MSK) diseases are expected to have a growing impact worldwide. OBJECTIVE: To analyse the worldwide burden of MSK diseases from 2000 to 2015. METHODS: Disability-adjusted life years (DALYs), which combines the years of life lost (YLLs) and the years lived with disability (YLDs), were extracted for 183 countries from the WHO Global Health Estimates Database. We analysed the median proportion of DALYS, YLLs and YLDs for MSK diseases (ICD-10: M00-M99) among the 23 WHO categories of diseases. Mixed models were built to assess temporal changes. RESULTS: Worldwide, the total number of MSK DALYs increased significantly from 80,225,634.6 in 2000 to 107,885,832.6 in 2015 (p < 0.001), with the total number of MSK YLDs increasing from 77,377,709.4 to 103,817,908.4 (p = 0.0008) and MSK diseases being the second cause of YLDs worldwide. YLLs due to MSK diseases increased from 2,847,925.2 to 4,067,924.2 (p = 0.03). In 2015, the median proportion of DALYs attributed to MSK diseases was 6.66% (IQR: 5.30 - 7.88) in Europe versus 4.66% (3.98 - 5.59) in the Americas (p < 0.0001 vs Europe), 4.17% (3.14 - 6.25) in Asia (p < 0.0001), 4.14% (2.65 - 5.57) in Oceania (p = 0.0008) and 1.33% (1.03 - 1.92) in Africa (p < 0.0001). We observed a significant correlation (r = 0.85, p < 0.0001) between the proportion of MSK DALYs and the gross domestic product per capita for the year 2015. CONCLUSIONS: The burden of MSK diseases increased significantly between 2000 and 2015 and is high in Europe. These results are crucial to health professionals and policy makers to implement future health plan adjustments for MSK diseases.

A Quantification of the Net Consumer Surplus from Gambling Participation.

Gambling exposes people to risk for harm, but also has recreational benefits. The present study aimed to measure gambling harm and gambling benefits on similar scales using two novel methods adapted from the Burden of Disease approach (McCormack et al. in Psychol Med 18(4):1007-1019, 1988; Torrance et al. in Health Serv Res 7(2):118-133, 1972) to find whether gambling either adds or subtracts from quality of life. A Tasmanian population-representative survey of 5000 adults (2534 female) from random digit dialling (RDD) of landline telephones in Tasmania (50%), as well as pre-screened Tasmanian RDD mobiles (17%) and listed mobile numbers (33%), measured gambling benefits and harms amongst gamblers (59.2%) and a non-exclusive set of people who were "affected" by someone else's gambling (4.5%). The majority of gamblers indicated no change to their quality of life from gambling (82.5% or 72.6% based on direct elicitation or time trade off methods, respectively). Nevertheless, a weighted average of all the positive and negative influences on quality of life, inclusive of gamblers and affected others, revealed that the quality of life change from gambling is either a very modest + 0.05% or a more concerning - 1.9% per capita. Gambling generates only small or negative net consumer surpluses for Tasmanians.

Association between ambient temperature and chronic obstructive pulmonary disease: a population-based study of the years of life lost.

Limited evidence on the burden of chronic obstructive pulmonary disease (COPD) attributable to ambient temperature. We aim to explore the association between ambient temperature and years of life lost (YLL), and to get a more intuitive understanding of the dangers of COPD in China. Death and meteorological data of 31 Chinese provincial capital cities during 2008-2013 was analyzed in this study. Distributed Lag Non-linear Model (DLNM) was used to estimate the association between ambient temperature and mortality. The attributable fraction (AF) to cold effect ranged from 8.19 (95%CI: -8.52,19.38) to 28.98 (95%CI: -64.78,67.59), while the AF to heat effect varied from 0.02 (95%CI: -0.13,0.05) to 5.73 (95%CI: 0.31,10.22). Cold effect was higher than heat effect on COPD in women and elderly, heat effect was higher in men and younger. Low temperature can cause more serious disease burden of COPD than high temperature.

The burden of cardio-cerebrovascular disease and lung cancer attributable to PM2.5 for 2009, Guangzhou: a retrospective population-based study.

Particulate matter pollution has become a widely-concerned issue in public health and led to a substantial loss of health. The study reports relationship between particulate matter with aerodynamic diameter <2.5 µm (PM2.5) and years of life lost (YLL) in Guangzhou. A retrospective burden analysis on annual mean PM2.5 data was conducted. Data on annual mortality were collected for 2009, from the Health Department of Guangzhou. Data on particulate matter were collected for period 2006-2009. Comparative risk assessment and exposure-response function were used to estimate attributable YLL. The exposure to PM2.5 was associated with a total of 454.6 YLLs (95% uncertainty interval 449.0-460.1) per 100,000 people in 2009. This study has confirmed the substantial adverse health effects of PM2.5 exposure in population with cardio-cerebrovascular disease and lung cancer. This study highlights the need to reduce ambient particulate pollution for better environmental health and lower burden of disease.

[ICD coding of causes of death: challenges for calculating the burden of disease in Germany]. / ICD-Codierung von Todesursachen: Herausforderungen bei der Berechnung der Krankheitslast in Deutschland.

In the project BURDEN 2020 - "The burden of disease in Germany and its regions" - the years of life lost (YLL) due to premature mortality are calculated on the basis of official cause-of-death statistics. This requires the identification and redistribution of the so-called ill-defined ICD codes. "Ill-defined" means that an ICD code does not sufficiently reflect the cause of death, such that it is not informative for the calculation of the burden of disease.The first steps on the way to calculating cause-specific YLL are presented. Different frameworks of ill-defined codes are compared. The number of deaths with ill-defined codes that can be found in the German cause-of-death statistics in absolute and relative terms are analyzed, including how they are distributed by age, sex, and region.According to the WHO framework, 15.6% of the 925,200 deaths in Germany in 2015 can be identified as ill-defined. According to the framework of the Institute for Health Metrics and Evaluation (IHME) in the Global Burden of Disease Study (GBD), the proportion of ill-defined codes is 26.6%. The ICD-related distribution patterns hardly differ between WHO and IHME classifications. Considerable differences exist between the federal states, with shares of ill-defined codes between 16 and 35% (IHME framework).The cause-of-death statistics in Germany contain a considerable proportion of ill-defined codes. The differences between the federal states can only partially be explained by different electronic data processing. Due to further dissemination and improvement of electronic data collection, higher quality of cause-of-death statistics can be expected in the future.

The VFH1 (YLL056C) promoter is vanillin-inducible and enables mRNA translation despite pronounced translation repression caused by severe vanillin stress in Saccharomyces cerevisiae.

Vanillin, furfural and 5-hydroxymethylfurfural (HMF) are representative fermentation inhibitors generated during the pretreatment process of lignocellulosic biomass in bioethanol production. These biomass conversion inhibitors, particularly vanillin, are known to repress translation activity in Saccharomyces cerevisiae. We have reported that the mRNAs of ADH7 and BDH2 were efficiently translated under severe vanillin stress despite marked repression of overall protein synthesis. In this study, we found that expression of VFH1 (YLL056C) was also significantly induced at the protein level by severe vanillin stress. Additionally, we demonstrated that the VFH1 promoter enabled the protein synthesis of other genes including GFP and ALD6 under severe vanillin stress. It is known that transcriptional activation of VFH1 is induced by furfural and HMF, and we verified that Vfh1 protein synthesis was also induced by furfural and HMF. The null mutant of VFH1 delayed growth in the presence of vanillin, furfural and HMF, indicating the importance of Vfh1 for sufficient tolerance against these inhibitors. The protein levels of Vfh1 induced by the inhibitors tested were markedly higher than those of Adh7 and Bdh2, suggesting the superior utility of the VFH1 promoter over the ADH7 or BDH2 promoter for breeding optimized yeast strains for bioethanol production from lignocellulosic biomass.

Cost-effectiveness of preoperative motor mapping with navigated transcranial magnetic brain stimulation in patients with high-grade glioma.

OBJECTIVE Navigated transcranial magnetic stimulation (nTMS) is used to identify the motor cortex prior to surgery. Yet, there has, until now, been no published evidence on the economic impact of nTMS. This study aims to analyze the cost-effectiveness of nTMS, evaluating the incremental costs of nTMS motor mapping per additional quality-adjusted life year (QALY). By doing so, this study also provides a model allowing for future analysis of general cost-effectiveness of new neuro-oncological treatment options. METHODS The authors used a microsimulation model based on their cohort population sampled for 1000 patients over the time horizon of 2 years. A health care provider perspective was used to assemble direct costs of total treatment. Transition probabilities and health utilities were based on published literature. Effects were stated in QALYs and established for health state subgroups. RESULTS In all scenarios, preoperative mapping was considered cost-effective with a willingness-to-pay threshold < 3*per capita GDP (gross domestic product). The incremental cost-effectiveness ratio (ICER) of nTMS versus no nTMS was 45,086 Euros/QALY. Sensitivity analyses showed robust results with a high impact of total treatment costs and utility of progression-free survival. Comparing the incremental costs caused by nTMS implementation only, the ICER decreased to 1967 Euros/QALY. CONCLUSIONS Motor mapping prior to surgery provides a cost-effective tool to improve the clinical outcome and overall survival of high-grade glioma patients in a resource-limited setting. Moreover, the model used in this study can be used in the future to analyze new treatment options in neuro-oncology in terms of their general cost-effectiveness.

COVID-19 burden in Iran: disability-adjusted life years analysis from hospital data, 2020-2021.

BACKGROUND: The burden of disease based on disability-adjusted life years (DALYs) is one of the internationally accepted metrics for assessing the impact of a disease or injury on population health. This study aimed to provide evidence of the burden of COVID-19 on health in Iran based on hospital-level data from the Iran Health Insurance Organization (IHIO), which covers almost half of the country's population. METHODS: The data of all IHIO enrollees who were referred to hospitals across the country from the beginning of the COVID-19 pandemic (February 2020) to December 30, 2021, with assigned diagnosis codes of COVID-19, were extracted from the hospital information processing system. The DALYs due to COVID-19 were estimated using the standard approach of the World Health Organization and the European Burden of Disease Network guideline. RESULTS: In the years 2020 and 2021, among a population of about 42 million people, 1,040,367 individuals were admitted to the hospital due to COVID-19 infection, of whom 73% were hospitalized (760,963 patients). The total estimated DALYs for these two years were 665,823 and 928,393, respectively (1,603 and 2,234 per 100,000 population). 99.7% of DALYs were attributed to years of life lost due to premature death (YLLs). The share of the disease burden in the age groups of under 20 years, 20-49 years, 50-80 years, and over 80 years was 6.6%, 26.4%, 58.4%, and 8.6%, respectively. CONCLUSIONS: Based on the hospital-level data estimates, COVID-19 has had a significant burden on health in Iran. COVID-19 was identified as the fifth leading cause of disease burden in Iran during the study period, ranking after cardiovascular diseases, psychological disorders, neoplasms, and musculoskeletal disorders. Additionally, COVID-19 was the third major cause of death, following cardiovascular diseases and neoplasms. Policymaking and the implementation of comprehensive programs to enhance the response of the health system and society to outbreaks of emerging and re-emerging infectious diseases are of utmost importance.

Health impact assessment of increasing public transport and cycling use in Barcelona: a morbidity and burden of disease approach.

OBJECTIVE: Quantify the health impacts on morbidity of reduced car trips and increased public transport and cycling trips. METHODS: A health impact assessment study of morbidity outcomes related to replacing car trips in Barcelona metropolitan (3,231,458 inhabitants). Through 8 different transport scenarios, the number of cases of disease or injuries related to physical activity, particulate matter air pollution <2.5 µm (PM2.5) and traffic incidents in travelers was estimated. We also estimate PM2.5 exposure and cases of disease in the general population. RESULTS: A 40% reduction in long-duration car trips substituted by public transport and cycling trips resulted in annual reductions of 127 cases of diabetes, 44 of cardiovascular diseases, 30 of dementia, 16 minor injuries, 0.14 major injuries, 11 of breast cancer and 3 of colon-cancer, amounting to a total reduction of 302 Disability Adjusted Life Years per year in travelers. The reduction in PM2.5 exposure in the general population resulted in annual reductions of 7 cases of low birth weight, 6 of preterm birth, 1 of cardiovascular disease and 1 of lower respiratory tract infection. CONCLUSIONS: Transport policies to reduce car trips could produce important health benefits in terms of reduced morbidity, particularly for those who take up active transportation.

Mortality risk and years of life lost for people with reduced renal function detected from regular health checkup: A matched cohort study.

With the increasing threat of metabolic syndromes, a focus on maintaining kidney health from early- to mid-adulthood is necessary. This study elucidates mortality risk and years of life lost (YLLs) due to abnormal renal function. This was a retrospective, matched cohort study from health checkup data from 2000 to 2015. We identified 12,774 participants with abnormal renal function (eGFR < 60 mL/min/1.73 m2) and used propensity score matching to identify 25,548 participants with normal renal function (eGFR ≥ 60). YLLs were estimated using the life expectancy differences between the abnormal and matched normal cohorts. Cox models were used to estimate the adjusted mortality risk. The estimated life expectancy of participants with proteinuria and eGFR < 60 was 26.24 years, with a 95 % confidence interval of (23.96, 29.36), 17.62 (16.37, 18.78), and 11.70 (11.02, 12.46) for age groups of 30 - 54, 55 - 64, and 65 - 79 years, respectively. The estimated YLLs of participants with proteinuria and eGFR < 60, as compared with the matched normal cohort, were 17.86 (13.41, 20.36), 12.55 (11.41, 13.78), and 8.31 (7.47, 9.13) years for the three age groups, respectively. The Cox model estimates of mortality hazard ratios of participants having proteinuria and eGFR < 60 against matched referents were 5.29 (3.97, 7.05), 3.99 (3.34, 4.75), and 3.05 (2.62, 3.55) for the three age groups, respectively. Abnormal renal function shortens life expectancy, particularly in patients with proteinuria and in younger adults. Active health management of renal function can reduce the disease burden.

Years of Life Lost due to Suicide in Southern Iran 2011-18: A Population-Based Study.

BACKGROUND: Suicide is a major public health concern with diversity in epidemiological aspects and applied methods. In this study, we estimate years of life lost (YLLs) related to completed suicidal in the Fars province, southern Iran. METHODS: Our study included data of all mortality events during 2011-2018 from Fars Suicide Surveillance System (FSSS). The validity of qualitative and quantitative variables was assessed through contrasting data between different sources and phone call justification. Case-fatality rates, age-specific and gender-specific mortality rates, ASR (age standardized rate), and YLLs through WHO's 2015 "YLL template" were calculated. RESULTS: During the study period, 2384 mortalities with a mean age of 32.73±15.65 had been registered. Most of them were males (male: 70.05% vs. female: 29.95%; male-female ratio: 2.33), hanging was the most frequent method (29.94%), and an increasing pattern in successful suicidal attempts was observed. The total YLLs were calculated to be 58669 years (14.71 per 1000 persons). Regardless of year or gender, suicide had the largest YLLs amongst those aged 15-29 years. CONCLUSION: Regarding the increasing trend in YLLs and observing the highest rate of successful suicidal attempts amongst active and productive members of community, a comprehensive inter organizational reaction is demanded.

Analysis of the Global Disease Burden of Down Syndrome Using YLDs, YLLs, and DALYs Based on the Global Burden of Disease 2019 Data.

Purpose: This study aimed to determine Down syndrome (DS) burden using years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life years (DALYs), and the trends in these parameters. Methods: We obtained the annual YLDs, YLLs, DALYs, and age-standardized rates (ASRs) of DS from 2010 to 2019 using the Global Health Data Exchange tool. The estimated annual percentage changes (EAPCs) in ASR were used to quantify and evaluate DS burden trends. Gaussian-process regression and Pearson's correlation coefficient were used to assess the relationship between DS burden and socio-demographic index (SDI). Results: Global DALYs decreased by 2.68% from 2010 to 2019 but the ASR was stable, which was mostly explained by the stability in the ASR for YLLs. The ASR of YLDs showed an increasing trend (EAPC = 1.07, 95% CI = 0.45 to 1.69). There was notable regional imbalance, with most of the DALYs or ASRs in areas with relatively low SDI. The DALY rates of DS were mostly from the YLLs of children younger than 1 year. Lower SDI areas tended to have higher DS burdens (ρ = -0.3, p < 0.001). Conclusion: This systematic analysis of the global disease burden of DS from 2010 to 2019 revealed that although the global DS DALY and YLL rate is stable, the YLD rate is increasing. And the DS burden varies significantly differences among regions or countries. The present results suggest that future strategies should focus on DS-related deaths in children younger than 1 year and the DS burden in low-SDI regions or countries, since this may be effective in further reducing DS burden.

Value of a national burden-of-disease study: a comparison of estimates between the Australian Burden of Disease Study 2015 and the Global Burden of Disease Study 2017.

BACKGROUND: Estimates of burden of disease are important for monitoring population health, informing policy and service planning. Burden estimates for the same population can be reported differently by national studies [e.g. the Australian Burden of Disease Study (ABDS) and the Global Burden of Disease Study (GBDS)]. METHODS: Australian ABDS 2015 and GBDS 2017 burden estimates and methods for 2015 were compared. Years of life lost (YLL), years lived with disability (YLD) and disability-adjusted life years (DALY) measures were compared for overall burden and 'top 50' causes. Disease-category definitions (based on ICD-10), redistribution algorithms, data sources, disability weights, modelling methods and assumptions were reviewed. RESULTS: GBDS 2017 estimated higher totals than ABDS 2015 for YLL, YLD and DALY for Australia. YLL differences were mainly driven by differences in the allocation of deaths to disease categories and the redistribution of implausible causes of death. For YLD, the main drivers were data sources, severity distributions and modelling strategies. Most top-50 diseases for DALY had a similar YLL:YLD composition reported. CONCLUSIONS: Differences in the ABDS and GBDS estimates reflect the different purposes of local and international studies and differences in data and modelling strategies. The GBDS uses all available evidence and is useful for international comparisons. National studies such as the ABDS have the flexibility to meet local needs and often the advantage of access to unpublished data. It is important that all data sources, inputs and models be assessed for quality and appropriateness. As studies evolve, differences should be accounted for through increased transparency of data and methods.