Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023

BACKGROUND: For more than three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has provided a framework to quantify health loss due to diseases, injuries, and associated risk factors. This paper presents GBD 2023 findings on disease and injury burden and risk-attributable health loss, offering a global audit of the state of world health to inform public health priorities. This work captures the evolving landscape of health metrics across age groups, sexes, and locations, while reflecting on the remaining post-COVID-19 challenges to achieving our collective global health ambitions. METHODS: The GBD 2023 combined analysis estimated years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 375 diseases and injuries, and risk-attributable burden associated with 88 modifiable risk factors. Of the more than 310 000 total data sources used for all GBD 2023 (about 30% of which were new to this estimation round), more than 120 000 sources were used for estimation of disease and injury burden and 59 000 for risk factor estimation, and included vital registration systems, surveys, disease registries, and published scientific literature. Data were analysed using previously established modelling approaches, such as disease modelling meta-regression version 2.1 (DisMod-MR 2.1) and comparative risk assessment methods. Diseases and injuries were categorised into four levels on the basis of the established GBD cause hierarchy, as were risk factors using the GBD risk hierarchy. Estimates stratified by age, sex, location, and year from 1990 to 2023 were focused on disease-specific time trends over the 2010-23 period and presented as counts (to three significant figures) and age-standardised rates per 100 000 person-years (to one decimal place). For each measure, 95% uncertainty intervals [UIs] were calculated with the 2·5th and 97·5th percentile ordered values from a 250-draw distribution. FINDINGS: Total numbers of global DALYs grew 6·1% (95% UI 4·0-8·1), from 2·64 billion (2·46-2·86) in 2010 to 2·80 billion (2·57-3·08) in 2023, but age-standardised DALY rates, which account for population growth and ageing, decreased by 12·6% (11·0-14·1), revealing large long-term health improvements. Non-communicable diseases (NCDs) contributed 1·45 billion (1·31-1·61) global DALYs in 2010, increasing to 1·80 billion (1·63-2·03) in 2023, alongside a concurrent 4·1% (1·9-6·3) reduction in age-standardised rates. Based on DALY counts, the leading level 3 NCDs in 2023 were ischaemic heart disease (193 million [176-209] DALYs), stroke (157 million [141-172]), and diabetes (90·2 million [75·2-107]), with the largest increases in age-standardised rates since 2010 occurring for anxiety disorders (62·8% [34·0-107·5]), depressive disorders (26·3% [11·6-42·9]), and diabetes (14·9% [7·5-25·6]). Remarkable health gains were made for communicable, maternal, neonatal, and nutritional (CMNN) diseases, with DALYs falling from 874 million (837-917) in 2010 to 681 million (642-736) in 2023, and a 25·8% (22·6-28·7) reduction in age-standardised DALY rates. During the COVID-19 pandemic, DALYs due to CMNN diseases rose but returned to pre-pandemic levels by 2023. From 2010 to 2023, decreases in age-standardised rates for CMNN diseases were led by rate decreases of 49·1% (32·7-61·0) for diarrhoeal diseases, 42·9% (38·0-48·0) for HIV/AIDS, and 42·2% (23·6-56·6) for tuberculosis. Neonatal disorders and lower respiratory infections remained the leading level 3 CMNN causes globally in 2023, although both showed notable rate decreases from 2010, declining by 16·5% (10·6-22·0) and 24·8% (7·4-36·7), respectively. Injury-related age-standardised DALY rates decreased by 15·6% (10·7-19·8) over the same period. Differences in burden due to NCDs, CMNN diseases, and injuries persisted across age, sex, time, and location. Based on our risk analysis, nearly 50% (1·27 billion [1·18-1·38]) of the roughly 2·80 billion total global DALYs in 2023 were attributable to the 88 risk factors analysed in GBD. Globally, the five level 3 risk factors contributing the highest proportion of risk-attributable DALYs were high systolic blood pressure (SBP), particulate matter pollution, high fasting plasma glucose (FPG), smoking, and low birthweight and short gestation-with high SBP accounting for 8·4% (6·9-10·0) of total DALYs. Of the three overarching level 1 GBD risk factor categories-behavioural, metabolic, and environmental and occupational-risk-attributable DALYs rose between 2010 and 2023 only for metabolic risks, increasing by 30·7% (24·8-37·3); however, age-standardised DALY rates attributable to metabolic risks decreased by 6·7% (2·0-11·0) over the same period. For all but three of the 25 leading level 3 risk factors, age-standardised rates dropped between 2010 and 2023-eg, declining by 54·4% (38·7-65·3) for unsafe sanitation, 50·5% (33·3-63·1) for unsafe water source, and 45·2% (25·6-72·0) for no access to handwashing facility, and by 44·9% (37·3-53·5) for child growth failure. The three leading level 3 risk factors for which age-standardised attributable DALY rates rose were high BMI (10·5% [0·1 to 20·9]), drug use (8·4% [2·6 to 15·3]), and high FPG (6·2% [-2·7 to 15·6]; non-significant). INTERPRETATION: Our findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural risk factors, juxtaposed with sizeable increases in DALYs attributable to metabolic risk factors and NCDs in growing and ageing populations. This long-observed consequence of the global epidemiological transition was only temporarily interrupted by the COVID-19 pandemic. The substantially decreasing CMNN disease burden, despite the 2008 global financial crisis and pandemic-related disruptions, is one of the greatest collective public health successes known. However, these achievements are at risk of being reversed due to major cuts to development assistance for health globally, the effects of which will hit low-income countries with high burden the hardest. Without sustained investment in evidence-based interventions and policies, progress could stall or reverse, leading to widespread human costs and geopolitical instability. Moreover, the rising NCD burden necessitates intensified efforts to mitigate exposure to leading risk factors-eg, air pollution, smoking, and metabolic risks, such as high SBP, BMI, and FPG-including policies that promote food security, healthier diets, physical activity, and equitable and expanded access to potential treatments, such as GLP-1 receptor agonists. Decisive, coordinated action is needed to address long-standing yet growing health challenges, including depressive and anxiety disorders. Yet this can be only part of the solution. Our response to the NCD syndemic-the complex interaction of multiple health risks, social determinants, and systemic challenges-will define the future landscape of global health. To ensure human wellbeing, economic stability, and social equity, global action to sustain and advance health gains must prioritise reducing disparities by addressing socioeconomic and demographic determinants, ensuring equitable health-care access, tackling malnutrition, strengthening health systems, and improving vaccination coverage. We live in times of great opportunity

Thermal And Morphological Characterization Of Basalt Continuous Fibers [caracterização Térmica E Morfológica De Fibras Contínuas De Basalto]

The basalts are abundant volcanic rocks formed from extensive wastes. The technology of continuous wiring produces basalt filaments in micrometric amorphous long fibers. In this work are presented results of the thermal and morphologic characterization of micrometric basalt fibers. These fibers showed excellent thermal stability, resulting in low weight change (less than 1 wt. %) up to 1000 °C, under heating in inert or oxidant atmosphere. On the other hand, partial crystallization of basalt fibers occurred at ∼ 800 °C, resulting in diffraction peaks in the X-ray patterns, characteristic of silicates and aluminosilicates as the anorthite from the plagioclase class. The morphology of fibers after heating at 1000 °C was changed due to the fusion and crystallization of the present phases.53326212217Potsch, C., (1954) Mineralogia e Geologia, Ed, , Livraria Francisco Alves, Rio de JaneiroJung, T., Subramanian, R.V., (1993) Scripta Met. Mater, 28, p. 527Militký, J., Kovacic, V., Rubnerová, J., (2002) Eng. Fract. Mech, 69, p. 1025J. Bernard, G. Berthier, H. Furtak, M. Opozda, Processo de obtenção de fibras minerais, dispositivo de fibração e fibras de basalto, PI9104665, Saint-Gobain, (1990)Medvedyev, O.O., Tsubulya, Y.L., (2004) Proc. 49th Int. Symp. Exhib. Mater. Proc, , Techn, SAMPE, Long Beach, CA, USAN. N. Morozov, V. S. Bakunov, E. N. Morozov, L. G. Aslanova, P. A. Granovskii, V. V. Prokshin, A. A., Zemlyanitsyn, Glass and Ceramics 58 (2001) 100Toropina, L.V., Vasyuk, G.G., Fedorova, O.F., Kornyushina, V.L., Dyaglev, V.M., Rassadin, Y.M., (1994) Fiber Chem, 26, p. 414Toropina, L.V., Vasyuk, G.G., Kornyushina, V.L., Dyaglev, V.M., Rassadin, Y.M., Makarushina, M.A., (1995) Fiber Chem, 27, p. 67Szabó, J.S., Czigány, T., (2003) Polymer Testing, 22, p. 711Liu, Q., Shaw, M.T., Parnas, R.S., McDonnell, A., (2006) Polymer Composites, 27 (1), p. 41Sergeev, V.P., Chuvashov, Y.N., Galushchak, O.V., Pervak, I.G., Fatikova, N.S., Powder Met (1994) Metal Ceram, 33, p. 555Czigány, T., Poloskei, K., Karger-Kocsis, J., (2005) J. Mater. Sci, 40, p. 5609M. A. Schiavon, L. C. de Souza, L. C. Pardini, I. V. P. Yoshida, Anais XVI Cong. Bras. Enge. Ci. Mater., Porto Alegre, RS (2004) 857Sim, J., Park, C., Young Moon, D., (2005) Composites: Part B, 36, p. 504P. I. Bashtannik, A. I. Kabak, Y. Y. Yakovchuk, Mechanics of Composite Mater. 39, 1 (2003) 85. (Rec. 28/10/2006, Ac. 16/03/2007

Eucalyptus Kraft Pulp Fibers As An Alternative Reinforcement Of Silicone Composites: I. Characterization And Chemical Modification Of Eucalyptus Fibers With Organosilane Coupling Agent

In this study, bleached Eucalyptus fibers obtained by a Kraft pulping process were characterized prior to and after chemical modification with a silane coupling agent, vinyltriethoxysilane, for use as an alternative additive in composites based on silicone. The presence of a silane coating on the fiber surface was observed by infrared, energy dispersive, and X-ray photoelectron spectroscopies. The morphology of the fibers was investigated by field emission scanning electron microscopy. The untreated fibers were ribbon-shaped and had a rough surface, due to the presence of fibrils. The coating reaction conducted in ethanol gave rise to loose fibrils and a more rough surface compared with those of untreated fibers. A smoother surface was observed when fibers were modified in tetrahydrofuran. The surface topography of the fibers was also examined by atomic force microscopy. © 2002 Wiley Periodicals, Inc. J. Appl. Polym. Sci.851225732579Zechendorf, B., (1999) Trends Biotechnol, 17, p. 219Belgacem, N.M., Gandini, A., (1998) Polym Int, 47, p. 267Amash, A., Zugenmaier, P., (2000) Polymer, 41, p. 1589Rana, A.K., Mandal, A., Mitra, B.C., Jacabson, R., Rowell, R., Banerjee, A.N., (1998) J Appl Polym Sci, 69, p. 329Bledzki, A.K., Gassan, J., (1999) Prog Polym Sci, 24, p. 221Gatenholm, P., Betilsson, H., Mathiasson, A., (1993) J Appl Polym Sci, 49, p. 197Trejo-O'Reilly, J.A., Cavaille, J.Y., Gandini, A., (1997) Cellulose, 4, p. 305Botaro, V.R., Gandini, A., (1998) Cellulose, 5, p. 65Tai, W.C., Quarles, S.L., Rials, T.G., (1993) Cellulosics: Chemical, Biochemical and Material Aspects, , Kenedy, J.F.Phillips, G.O.Willians, P.A., Eds., Ellis Horwood: New York, Chapter 74Hornsby, P.R., Hinrichsen, E., Tarverdi, K., (1997) J Mater Sci, 32, p. 1009Matias, M.C., De la Orden, M.V., Sanchez, J.M., Urreaga, C.G., (2000) J Appl Polym Sci, 75, p. 256Valadez-Gonzalez, A., Cervantes-Uc, J.M., Olayo, R., Herrera-Franco, P.J., (1999) Composites: Part B, 30, p. 321Hon, D.S., Shiraishi, N., (1991) Wood and Cellulosic Chemistry, , Marcel Dekker: New York, Chapter 8Rao, C.N.R., (1963) Chemical Applications of Infrared Spectroscopy, , Academic: New York, Chapter VIIISefain, M.Z., Nagieb, Z.A., El-Wakil, N.A., Noum, M.M., (1991) Thermochim Acta, 191, p. 21Cordero, T., Rodriguez-Maroto, J.M., Rodriguez-Mirasol, J., Rodriguez, J.J., (1990) Thermochim Acta, 164, p. 135Statheropoulos, M., Liodakis, S., Tzamtzi, N., Papa, A., Kyriakou, S., (1997) J Anal Appl Pyrolysis, 43, p. 115Daniel, J.R., (1989) Encyclopedia of Polymer Science and Engineering, 3, p. 90. , Mark, H.F.Bikales, N.M.Overberger, C.G.Menges, G., Eds.John Wiley & Sons: New YorkDoris, G.M., Gray, D.G., (1978) Cell Chem Technol, 12, p. 721Koubaa, A., Riedl, B., Koran, Z., (1996) J Appl Polym Sci, 6, p. 545Bulchholz, V., Adler, P., Backer, M., Holle, W., Simon, A., Wegner, G., (1997) Langmuir, 13, p. 320

Investigation On Kinetics Of Thermal Decomposition In Polysiloxane Networks Used As Precursors Of Silicon Oxycarbide Glasses

In this study, polysiloxane networks prepared by hydrosilylation or hydrolysis/condensation reactions were considered to be potential precursors for Si-C-O systems. Different precursors had different pyrolytic properties, which was essentially due to their molecular architecture. The kinetics parameters, such as the activation energy, E (kJ/mol) involved in the polymer-to-ceramic conversion, were investigated by thermogravimetry using a multiple heating rate kinetic method. The relationships between the molecular architecture and the precursor composition were compared to that of a linear poly(dimethylsiloxane) precursor. Solid-state 29Si nuclear magnetic resonance, infrared spectroscopies, density measurements, and X-ray diffraction measurements were made on the final samples. These products were typically amorphous, with a molecular structure formed by a random distribution of different silicon sites and variable amounts of free carbon residue. © 2002 Elsevier Science B.V. All rights reserved.3041-392100Riedel, R., (1996) Materials Science and Technology. A Comprehensive Treatment, 17, p. 1. , R.W. Cahn, P. Haasen, E.J. Kramer (Eds.), VCH, WeinheimBill, J., Aldinger, F., (1999) Precursor-Derived Ceramics: Synthesis, Structures, and High Temperature Mechanical Properties, p. 33. , J. Bill, F. Wakai, F. Aldinger (Eds.), Wiley-VCH, WeinheimGreil, P., (1995) J. Am. Ceram. Soc., 78, p. 835Renlund, G.M., Prochaska, S., Doremus, R.H., (1991) J. Mater. Res., 6, p. 2723Rouxel, T., Massouras, G., Sorarù, G.D., (1999) J. Sol-Gel Sci. Tech., 14, p. 87Kalfat, R., Babonneau, F., Gharbi, N., Zarouk, H., (1996) J. Mater. Chem., 6, p. 1673Liu, Q., Shi, W., Babonneau, F., Interrante, L.V., (1997) Chem. Mater., 9, p. 2434Radovanovic, E., Gozzi, M.F., Gonçalves, M.C., Yoshida, I.V.P., (1999) J. Non-Cryst. Solids, 248, p. 37Pantano, C.G., Singh, A.K., Zhang, H., (1999) J. Sol-Gel Sci. Tech., 14, p. 7Gozzi, M.F., Gonçalves, M.C., Yoshida, I.V.P., (1999) J. Mater. Sci., 34, p. 155Gozzi, M.F., Yoshida, I.V.P., (1997) Eur. Polym. J., 33, p. 1301Schiavon, M.A., Pardini, L.C., Yoshida, I.V.P., (2001) Key Eng. Mater., 189, p. 48Redondo, S.U.A., Radovanovic, E., Torriani, I.L., Yoshida, I.V.P., (2001) Polymer, 42, p. 1319Ozawa, T., (1965) Bull. Chem. Soc. Jpn., 38, p. 1881Thomas, T.H., Kendrick, T.C., (1969) J. Polym. Sci.: Part A-2, 7, p. 537Campostrini, R., D'Andrea, G., Carturan, G., Ceccato, R., Sorarù, G.D., (1996) J. Mater. Chem., 6, p. 585Çolak, N., Akgün, A., (1999) Polym. Plast. Technol. Eng., 38, p. 647Tutas, M., Saglam, M., Yüksel, M., Güler, Ç., (1987) Termochim. Acta, 111, p. 121Li, D., Hwang, S.-T., (1992) J. Appl. Polym. Sci., 44, p. 1979Michalczyk, M.J., Farneth, W.E., Vega, A.J., (1993) Chem. Mater., 5, p. 1687(1973) Powder Diffraction File Search Manual, , Joint Committee on Powder Diffraction Standarts, SwarthmoreHurwits, F.I., Meador, M.A.B., (1999) J. Sol-Gel Sci. Tech., 14, p. 75Camino, G., Lomakin, S.M., Lazzari, M., (2001) Polymer, 42, p. 2395Ikeda, M., Nakamura, T., Nagase, Y., Ikeda, K., Sekine, Y., (1981) J. Polym. Sci.: Polym. Chem. Ed., 19, p. 259

An experimental and first-principles study of the effect of B/N doping in TiO2 thin films for visible light photo-catalysis

Thin films of TiO2 and boron-nitrogen (B/N) co-doped TiO 2 on glass substrates have been prepared by a simple sol-gel dip coating route. Titanium (IV) isopropoxide, boric acid and urea have been used as titanium, boron and nitrogen sources, respectively. The films were characterized by X-ray diffraction, X-ray photo-electron spectroscopy, scanning electron microscopy, Raman spectroscopy and UV-vis spectroscopy. The TiO 2 thin films with co-doping of different B/N atomic ratios (0.27-20.89) showed better photo-catalytic degradation ability of methylene blue compared to that of bare-TiO2 under visible light. The TiO 2 film doped with the highest atomic concentration of N showed repeatedly the best photo-catalytic performance. The high activity of co-doped TiO2 thin films toward organic degradation can be related to the stronger absorption observed in the UV-vis region, red shift in adsorption edges and surface acidity induced by B/N doping. Furthermore, several atomic models for B/N doping have been used to investigate the effect of doping on electronic structure and density of states of TiO2 through ab-initio density functional theory calculations. The computational study suggested a significant narrowing of the band gap due to the formation of midgap states and the shift of Fermi-level for the interstitial N model supporting the experimental results. © 2013 Elsevier B.V