16 research outputs found
Mechanisms of action and health benefits of probiotics: a comprehensive review
No full textProbiotics, originating at birth, play a crucial role in the development and maintenance of a healthy and disease-free environment within the gut of both humans and animals. These beneficial microorganisms from fermented, processed, and non-dairy foods provide numerous health benefits, such as stress reduction, disease prevention, immune stimulation, gut microbiota control, nutritional supplementation, diarrheal disease relief, vitamin production, weight management, and anticancer activities. With more health problems on the rise and the negative side effects of conventional medication and antibiotics prevailing, natural supplements such as probiotics are a relief. Probiotics, such as Lactobacillus, Bifidobacterium, and Saccharomyces, have been identified as safe and effective candidates for gut health applications. This review addresses the current understanding of the mechanism of action of probiotics, their functions in human health, and their therapeutic potential for various diseases. We emphasize the importance of prioritizing probiotic administration along with conventional medicinal drugs for their wide benefits and fewer side effects. Our findings aim to direct future studies on the modes of action of probiotics against emerging health challenges
Numerical Modeling of Ammonia-Fueled Protonic-Ion Conducting Electrolyte-Supported Solid Oxide Fuel Cell (H-SOFC): A Brief Review
No full textSolid oxide fuel cells with protonic ion conducting electrolytes (H-SOFCs) are recognized and anticipated as eco-friendly electrochemical devices fueled with several kinds of fuels. One distinct feature of SOFCs that makes them different from others is fuel flexibility. Ammonia is a colorless gas with a compound of nitrogen and hydrogen with a distinct strong smell at room temperature. It is easily dissolved in water and is a great absorbent. Ammonia plays a vital role as a caustic for its alkaline characteristics. Nowadays, ammonia is being used as a hydrogen carrier because it has carbon-free molecules and prosperous physical properties with transportation characteristics, distribution options, and storage capacity. Using ammonia as a fuel in H-SOFCs has the advantage of its ammonia cracking attributes and quality of being easily separated from generated steam. Moreover, toxic NOx gases are not formed in the anode while using ammonia as fuel in H-SOFCs. Recently, various numerical studies have been performed to comprehend the electrochemical and physical phenomena of H-SOFCs in order to develop a feasible and optimized design under different operating conditions rather than doing costlier experimentation. The aim of this concisely reviewed article is to present the current status of ammonia-fueled H-SOFC numerical modeling and the application of numerical modeling in ammonia-fueled H-SOFC geometrical shape optimization, which is still more desirable than traditional SOFCs
Characterising acute and chronic care needs: insights from the Global Burden of Disease Study 2019
No full textChronic care manages long-term, progressive conditions, while acute care addresses short-term conditions. Chronic conditions increasingly strain health systems, which are often unprepared for these demands. This study examines the burden of conditions requiring acute versus chronic care, including sequelae. Conditions and sequelae from the Global Burden of Diseases Study 2019 were classified into acute or chronic care categories. Data were analysed by age, sex, and socio-demographic index, presenting total numbers and contributions to burden metrics such as Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLD), and Years of Life Lost (YLL). Approximately 68% of DALYs were attributed to chronic care, while 27% were due to acute care. Chronic care needs increased with age, representing 86% of YLDs and 71% of YLLs, and accounting for 93% of YLDs from sequelae. These findings highlight that chronic care needs far exceed acute care needs globally, necessitating health systems to adapt accordingly.
© 2025. The Author(s)
Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019
No full textHealth-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. W measured the Healthcare Access and Quality (HAQ) Index overall and for select
age groups in 204 locations from 1990 to 2019. For GBD 2019, HAQ Index
construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting
the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile.
Interpretation Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in
the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young
Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study
No full textOBJECTIVES: Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. DESIGN: A multicentre, international, collaborative cohort study. SETTING: 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. PARTICIPANTS: Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. MAIN OUTCOME MEASURE: All-cause mortality at 30 days and 90 days. RESULTS: 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). CONCLUSIONS: The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally
Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic
No full textChildhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality
Characterising acute and chronic care needs: insights from the Global Burden of Disease Study 2019
No full textChronic care manages long-term, progressive conditions, while acute care addresses short-term conditions. Chronic conditions increasingly strain health systems, which are often unprepared for these demands. This study examines the burden of conditions requiring acute versus chronic care, including sequelae. Conditions and sequelae from the Global Burden of Diseases Study 2019 were classified into acute or chronic care categories. Data were analysed by age, sex, and socio-demographic index, presenting total numbers and contributions to burden metrics such as Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLD), and Years of Life Lost (YLL). Approximately 68% of DALYs were attributed to chronic care, while 27% were due to acute care. Chronic care needs increased with age, representing 86% of YLDs and 71% of YLLs, and accounting for 93% of YLDs from sequelae. These findings highlight that chronic care needs far exceed acute care needs globally, necessitating health systems to adapt accordingly
Global burden of lower respiratory infections and aetiologies, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023
No full textBackground: Lower respiratory infections (LRIs) remain the world’s leading infectious cause of death. This analysis
from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 provides global, regional, and
national estimates of LRI incidence, mortality, and disability-adjusted life-years (DALYs), with attribution to
26 pathogens, including 11 newly modelled pathogens, across 204 countries and territories from 1990 to 2023. With
new data and revised modelling techniques, these estimates serve as an update and expansion to GBD 2021. Through
these estimates, we also aimed to assess progress towards the 2025 Global Action Plan for the Prevention and
Control of Pneumonia and Diarrhoea (GAPPD) target for pneumonia mortality in children younger than 5 years.
Methods: Mortality from LRIs, defined as physician-diagnosed pneumonia or bronchiolitis, was estimated using
the Cause of Death Ensemble model with data from vital registration, verbal autopsy, surveillance, and minimally
invasive tissue sampling. The Bayesian meta-regression tool DisMod-MR 2.1 was used to model overall morbidity
due to LRIs. DALYs were calculated as the sum of years of life lost (YLLs) and years lived with disability (YLDs) for
all locations, years, age groups, and sexes. We modelled pathogen-specific case-fatality ratios (CFRs) for each age
group and location using splined binomial regression to create internally consistent estimates of incidence and
mortality proportions attributable to viral, fungal, parasitic, and bacterial pathogens. Progress was assessed
towards the GAPPD target of less than three deaths from pneumonia per 1000 livebirths, which is roughly
equivalent to a mortality rate of less than 60 deaths per 100 000 children younger than 5 years.
Findings: In 2023, LRIs were responsible for 2·50 million (95% uncertainty interval [UI] 2·24–2·81) deaths and
98·7 million (87·7–112) DALYs, with children younger than 5 years and adults aged 70 years and older carrying the
highest burden. LRI mortality in children younger than 5 years fell by 33·4% (10·4–47·4) since 2010, with a global
mortality rate of 94·8 (75·6–116·4) per 100000 person-years in 2023. Among adults aged 70 years and older, the burden
remained substantial with only marginal declines since 2010. A mortality rate of less than 60 deaths per 100000 for
children younger than 5 years was met by 129 of the 204 modelled countries in 2023. At a super-regional level, subSaharan Africa had an aggregate mortality rate in children younger than 5 years (hereafter referred to as under-5
mortality rate) furthest from the GAPPD target. Streptococcus pneumoniae continued to account for the largest number
of LRI deaths globally (634000 [95% UI 565000–721000] deaths or 25·3% [24·5–26·1] of all LRI deaths), followed by
Staphylococcus aureus (271000 [243000–298000] deaths or 10·9% [10·3–11·3]), and Klebsiella pneumoniae (228000
[204000–261000] deaths or 9·1% [8·8–9·5]). Among pathogens newly modelled in this study, non-tuberculous
mycobacteria (responsible for 177000 [95% UI 155000–201000] deaths) and Aspergillus spp (responsible for 67800
[59900–75900] deaths) emerged as important contributors. Altogether, the 11 newly modelled pathogens accounted for
approximately 22% of LRI deaths.
Interpretation: This comprehensive analysis underscores both the gains achieved through vaccination and the
challenges that remain in controlling the LRI burden globally. Furthermore, it demonstrates persistent disparities
in disease burden, with the highest mortality rates concentrated in countries in sub-Saharan Africa. Globally, as
well as in these high-burden locations, the under-5 LRI mortality rate remains well above the GAPPD target.
Progress towards this target requires equitable access to vaccines and preventive therapies—including newer
interventions such as respiratory syncytial virus monoclonal antibodies—and health systems capable of early
diagnosis and treatment. Expanding surveillance of emerging pathogens, strengthening adult immunisation
programmes, and combating vaccine hesitancy are also crucial. As the global population ages, the dual challenge
of sustaining gains in child survival while addressing the rising vulnerability in older adults will shape future
pneumonia control strategies
Global, regional, and national trends in routine childhood vaccination coverage from 1980 to 2023 with forecasts to 2030: a systematic analysis for the Global Burden of Disease Study 2023
No full textBackground: Since its inception in 1974, the Essential Programme on Immunization (EPI) has achieved remarkable success, averting the deaths of an estimated 154 million children worldwide through routine childhood vaccination. However, more recent decades have seen persistent coverage inequities and stagnating progress, which have been further amplified by the COVID-19 pandemic. In 2019, WHO set ambitious goals for improving vaccine coverage globally through the Immunization Agenda 2030 (IA2030). Now halfway through the decade, understanding past and recent coverage trends can help inform and reorient strategies for approaching these aims in the next 5 years. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2023, this study provides updated global, regional, and national estimates of routine childhood vaccine coverage from 1980 to 2023 for 204 countries and territories for 11 vaccine-dose combinations recommended by WHO for all children globally. Employing advanced modelling techniques, this analysis accounts for data biases and heterogeneity and integrates new methodologies to model vaccine scale-up and COVID-19 pandemic-related disruptions. To contextualise historic coverage trends and gains still needed to achieve the IA2030 coverage targets, we supplement these results with several secondary analyses: (1) we assess the effect of the COVID-19 pandemic on vaccine coverage; (2) we forecast coverage of select life-course vaccines up to 2030; and (3) we analyse progress needed to reduce the number of zero-dose children by half between 2023 and 2030. Findings: Overall, global coverage for the original EPI vaccines against diphtheria, tetanus, and pertussis (first dose [DTP1] and third dose [DTP3]), measles (MCV1), polio (Pol3), and tuberculosis (BCG) nearly doubled from 1980 to 2023. However, this long-term trend masks recent challenges. Coverage gains slowed between 2010 and 2019 in many countries and territories, including declines in 21 of 36 high-income countries and territories for at least one of these vaccine doses (excluding BCG, which has been removed from routine immunisation schedules in some countries and territories). The COVID-19 pandemic exacerbated these challenges, with global rates for these vaccines declining sharply since 2020, and still not returning to pre-COVID-19 pandemic levels as of 2023. Coverage for newer vaccines developed and introduced in more recent years, such as immunisations against pneumococcal disease (PCV3) and rotavirus (complete series; RotaC) and a second dose of the measles vaccine (MCV2), saw continued increases globally during the COVID-19 pandemic due to ongoing introductions and scale-ups, but at slower rates than expected in the absence of the pandemic. Forecasts to 2030 for DTP3, PCV3, and MCV2 suggest that only DTP3 would reach the IA2030 target of 90% global coverage, and only under an optimistic scenario. The number of zero-dose children, proxied as children younger than 1 year who do not receive DTP1, decreased by 74·9% (95% uncertainty interval 72·1-77·3) globally between 1980 and 2019, with most of those declines reached during the 1980s and the 2000s. After 2019, counts of zero-dose children rose to a COVID 19-era peak of 18·6 million (17·6-20·0) in 2021. Most zero-dose children remain concentrated in conflict-affected regions and those with various constraints on resources available to put towards vaccination services, particularly sub-Saharan Africa. As of 2023, more than 50% of the 15·7 million (14·6-17·0) global zero-dose children resided in just eight countries (Nigeria, India, Democratic Republic of the Congo, Ethiopia, Somalia, Sudan, Indonesia, and Brazil), emphasising persistent inequities. Interpretation: Our estimates of current vaccine coverage and forecasts to 2030 suggest that achieving IA2030 targets, such as halving zero-dose children compared with 2019 levels and reaching 90% global coverage for life-course vaccines DTP3, PCV3, and MCV2, will require accelerated progress. Substantial increases in coverage are necessary in many countries and territories, with those in sub-Saharan Africa and south Asia facing the greatest challenges. Recent declines will need to be reversed to restore previous coverage levels in Latin America and the Caribbean, especially for DTP1, DTP3, and Pol3. These findings underscore the crucial need for targeted, equitable immunisation strategies. Strengthening primary health-care systems, addressing vaccine misinformation and hesitancy, and adapting to local contexts are essential to advancing coverage. COVID-19 pandemic recovery efforts, such as WHO's Big Catch-Up, as well as efforts to bolster routine services must prioritise reaching marginalised populations and target subnational geographies to regain lost ground and achieve global immunisation goals. Funding: The Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance
Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019
No full textGlobally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10-24 years during the past three decades
