Background Diabetes, particularly type 1 diabetes, at younger ages can be a largely preventable cause of death with the correct health care and services. We aimed to evaluate diabetes mortality and trends at ages younger than 25 years globally using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.
MethodsWe used estimates of GBD 2019 to calculate international diabetes mortality at ages younger than 25 years in 1990 and 2019. Data sources for causes of death were obtained from vital registration systems, verbal autopsies, and other surveillance systems for 1990-2019. We estimated death rates for each location using the GBD Cause of Death Ensemble model. We analysed the association of age-standardised death rates per 100 000 population with the Socio-demographic Index (SDI) and a measure of universal health coverage (UHC) and described the variability within SDI quintiles. We present estimates with their 95% uncertainty intervals.
FindingsIn 2019, 16 300 (95% uncertainty interval 14 200 to 18 900) global deaths due to diabetes (type 1 and 2 combined) occurred in people younger than 25 years and 73•7% (68•3 to 77•4) were classified as due to type 1 diabetes. The age-standardised death rate was 0•50 (0•44 to 0•58) per 100 000 population, and 15 900 (97•5%) of these deaths occurred in low to high-middle SDI countries. The rate was 0•13 (0•12 to 0•14) per 100 000 population in the high SDI quintile, 0•60 (0•51 to 0•70) per 100 000 population in the low-middle SDI quintile, and 0•71 (0•60 to 0•86) per 100 000 population in the low SDI quintile. Within SDI quintiles, we observed large variability in rates across countries, in part explained by the extent of UHC (r²=0•62). From 1990 to 2019, age-standardised death rates decreased globally by 17•0% (-28•4 to -2•9) for all diabetes, and by 21•0% (-33•0 to -5•9) when considering only type 1 diabetes. However, the low SDI quintile had the lowest decline for both all diabetes (-13•6% [-28•4 to 3•4]) and for type 1 diabetes (-13•6% [-29•3 to 8•9]). Interpretation Decreasing diabetes mortality at ages younger than 25 years remains an important challenge, especially in low and low-middle SDI countries. Inadequate diagnosis and treatment of diabetes is likely to be major contributor to these early deaths, highlighting the urgent need to provide better access to insulin and basic diabetes education and care. This mortality metric, derived from readily available and frequently updated GBD data, can help to monitor preventable diabetes-related deaths over time globally, aligned with the UN's Sustainable Development Targets, and serve as an indicator of the adequacy of basic diabetes care for type 1 and type 2 diabetes across nations. Funding Bill & Melinda Gates Foundation.
Abstract:We demonstrate an all-optical wavelength converter using a ring cavity that produces conversion efficiency of more than unity within a certain bandwidth. The highly nonlinear fiber is used as the parametric amplifying medium and it is pumped by four independent pump lasers at 1427, 1443, 1461, and 1493 nm. The parametric pump is formed internally from the ring cavity through the effect of stimulated Raman scattering. The interaction between signal and parametric pump becomes intensified as they propagate along the fiber from input to the output ports. This un-depleted pump power condition enhances the process of degenerate four-wave mixing in the proposed structure. The maximum conversion efficiency is obtained at 9.5 dB and the bandwidth of positive conversion efficiency is about 20.6 nm. Output spectra of the all-optical wavelength converter with signal power at -1 dBm and its wavelength at (a) 1520 nm (blue curve) and (b) 1620 nm (red curve)
The objective of this research is to define optimum operating conditions for preparation of activated carbon from kenaf fiber which would conciliate for highest removal efficiency of manganese (II) ions along with maximum possible yield. Kenaf fiber (KF) is used to prepare activated carbon by using two step; physiochemical activation method which consisted of potassium hydroxide treatment (KOH) with carbon dioxide gasification. The effects of three preparation variables; temperature (500 to 700°C), time (1 to 3 h) and KOH impregnation ratio, IR (1-3) on the percentage yield and removal percentage of Mn (II) ions were investigated. Based on central composite design (CCD), quadratic models were developed to correlate activated carbon preparation variables with the aforementioned two responses. From the analysis of variance (ANOVA), the most influential factor on each experimental design response was identified. The optimum conditions determined were: activation temperature, activation time and impregnation ratio, IR of 574°C, 1.31 h and 3, respectively. The application of prepared activated carbon under optimum condition was further analyzed by Langmuir, Freundlich and Temkin isotherm. The values of Langmuir separation factor, R L and Freundlich exponent, 1/n were less than 1 reflecting favorable process for adsorption.
In recent years, recycled aggregates from construction and demolition waste (CDW) have been widely accepted in construction sectors as the replacement of coarse aggregate in order to minimize the excessive use of natural resources. In this paper, an experimental investigation is carried out to observe the influence of low grade steel fiber reinforcements on the stress-strain behavior of concrete made with recycled and fresh brick aggregates. In addition, compressive strength by destructive and nondestructive tests, splitting tensile strength, and Young’s modulus are determined. Hooked end steel wires with 50 mm of length and an aspect ratio of 55.6 are used as fiber reinforcements in a volume fraction of 0% (control case), 0.50%, and 1.00% in concrete mixes. The same gradation of aggregates and water-cement ratio (w/c=0.44) were used to assess the effect of steel fiber in all these concrete mixes. All tests were conducted at 7, 14, and 28 days to perceive the effect of age on different mechanical properties. The experimental results show that around 10%~15% and 40%~60% increase in 28 days compressive strength and tensile strength of steel fiber reinforced concrete, respectively, compared to those of the control case. It is observed that the effect of addition of 1% fiber on the concrete compressive strength is little compared to that of 0.5% steel fiber addition. On the other hand, strain of concrete at failure of steel fiber reinforced concrete has increased almost twice compared to the control case. A simple analytical model is also proposed to generate the ascending portions of the stress-strain curve of concrete. There exists a good correlation between the experimental results and the analytical model. A relatively ductile failure is observed for the concrete made with low grade steel fibers.
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