1. |
- Lozano, Rafael, et al.
(författare)
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Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
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Tidskriftsartikel (refereegranskat)abstract
- Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
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2. |
- Murray, Christopher J. L., et al.
(författare)
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Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1995-2051
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Tidskriftsartikel (refereegranskat)abstract
- Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation.
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3. |
- Stanaway, Jeffrey D., et al.
(författare)
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Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1923-1994
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Tidskriftsartikel (refereegranskat)abstract
- Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
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4. |
- Agah, Shahram, et al.
(författare)
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Systematic review with meta-analysis: Effects of probiotic supplementation on symptoms in functional dyspepsia
- 2020
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Ingår i: Journal of Functional Foods. - : Elsevier BV. - 1756-4646. ; 68
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Forskningsöversikt (refereegranskat)abstract
- The pathophysiology of functional dyspepsia (FD) remains poorly understood, but alterations of the small intestinal microbiome have been observed. The place of probiotics in treatment is uncertain. We performed a systematic review and meta-analysis of the currently available randomized, controlled trials (RCTs) to evaluate the potential beneficial effects and risks of probiotics in FD. Pubmed, EMBASE, Scopus, Web of Science and the Cochrane Controlled Trials Register were searched (up to May 2019) for RCTs evaluating the effects of probiotic supplementation compared to placebo in adults with FD. Two reviewers independently assessed eligibility, trial quality and extracted information from identified articles. To compare the effects of probiotics with placebo, risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random effects models. Six trials, including 422 participants were included but only three RCTs could be included in the meta-analysis. Lactobacillus strains showed potential positive effects in terms of improving upper gastrointestinal (GI) symptoms in patients with FD. Probiotic supplementation tended to improve global dyspepsia score (n = 3 RCTs, risk ratio [RR]: 1.35, 95% CI 0.99 to 1.84; P = 0.061) and bacterial composition in the GI tract. Probiotics were well tolerated without any serious adverse events. While the available data suggest that supplementation with probiotics may improve GI symptoms in patients with FD, the evidence is insufficient to draw clear conclusions regarding efficacy. Thus, high-quality RCTs are needed to establish the beneficial effects of probiotic supplementation on FD outcomes.
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5. |
- Akbari, Ali, et al.
(författare)
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Free and hydrogel encapsulated exosome-based therapies in regenerative medicine.
- 2020
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Ingår i: Life sciences. - : Elsevier BV. - 1879-0631 .- 0024-3205. ; 249
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Tidskriftsartikel (refereegranskat)abstract
- Over the last few decades, mesenchymal stem cells-derived exosomes (MSCs-Ex) have attracted a lot of attention as a therapeutic tool in regenerative medicine. Exosomes are extracellular vehicles (EVs) that play important roles in cell-cell communication through various processes such as stress response, senescence, angiogenesis, and cell differentiation. Success in the field of regenerative medicine sparked exploration of the potential use of exosomes as key therapeutic effectors of MSCs to promote tissue regeneration. Various approaches including direct injection, intravenous injection, intraperitoneal injection, oral administration, and hydrogel-based encapsulation have been exploited to deliver exosomes to target tissues in different disease models. Despite significant advances in exosome therapy, it is unclear which approach is more effective for administering exosomes. Herein, we critically review the emerging progress in the applications of exosomes in the form of free or association with hydrogels as therapeutic agents for applications in regenerative medicine.
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6. |
- Akbari, Keramatollah, 1961-, et al.
(författare)
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Influence of indoor air conditions on radon concentration in a detached house
- 2013
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Ingår i: Journal of Environmental Radioactivity. - Elsevier : Elsevier BV. - 0265-931X .- 1879-1700. ; 116, s. 166-173
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Tidskriftsartikel (refereegranskat)abstract
- Radon is released from soil and building materials and can accumulate in residential buildings. Breathing radon and radon progeny for extended periods hazardous to health and can lead to lung cancer. Indoor air conditions and ventilation systems strongly influence indoor radon concentrations. This paper focuses on effects of air change rate, indoor temperature and relative humidity on indoor radon concentrations in a one family detached house in Stockholm, Sweden.In this study a heat recovery ventilation system unit was used to control the ventilation rate and a continuous radon monitor (CRM) was used to measure radon levels. FLUENT, a computational fluid dynamics (CFD) software package was used to simulate radon entry into the building and air change rate, indoor temperature and relative humidity effects using a numerical approach.The results from analytical solution, measurements and numerical simulations showed that air change rate, indoor temperature and moisture had significant effects on indoor radon concentration. Increasing air change rate reduces radon level and for a specific air change rate (in this work Ach = 0.5) there was a range of temperature and relative humidity that minimized radon levels. In this case study minimum radon levels were obtained at temperatures between 20 and 22 °C and a relative humidity of 50-60%
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7. |
- Akbari, Maryam, et al.
(författare)
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An Ultra-compact Pure Magnetic Arbiter PUF with High Reliability and Low Power Consumption
- 2023
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Ingår i: IEEE transactions on nanotechnology. - Piscataway, NJ : Institute of Electrical and Electronics Engineers (IEEE). - 1536-125X .- 1941-0085. ; 22, s. 449-456
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Tidskriftsartikel (refereegranskat)abstract
- Due to the rugged environmental factors in IoT applications and constrained on-chip resources, PUF, as a critical hardware primitive, is a promising solution for key storage, authentication, and ID generation. The existing CMOS-based Arbiter PUFs mainly suffer from low reliability and vulnerability against modeling attacks. In this paper, the proposed PUF utilizes mCell devices, a class of Magnetoresistive devices employing only Magnetic Tunnel Junction (MTJ) devices, as a building block. Also, a novel nonvolatile latch is proposed to act as an arbiter and generates the responses by comparing the current values instead of delays which leads to increased the reliability by subtracting the constant variation rates of MTJs under environmental variation without adding hardware overhead. The characteristics of MTJ like nonvolatility, stochastic switching, chaotic magnetization, low power consumption, and low occupied area have made the proposed PUF to a low power, highly reliable, high randomness and ultra-compact pure magnetic arbiter PUF. The Monte Carlo HSPICE simulation results reveal that the uniformity, uniqueness, bit-aliasing, power consumption, and area of the proposed PUF are 49.24 %, 49.87 %, 48.64 %, 10.771 μW and 0.106 μm2, respectively. In addition, the average BER across a wide temperature range (-50∘ C 150∘ C) and voltage range (0.05 V-0.1 V) is 0.08 % and 0.18 %, respectively. © IEEE
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8. |
- Akbari, Maryam, et al.
(författare)
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Pure Magnetic Memory-Based PUFs : A Secure and Lightweight Solution for IoT Devices
- 2023
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Ingår i: Iranian Journal of Electrical and Electronic Engineering. - Tehran : Iran University of Science and Technology. - 2383-3890 .- 1735-2827. ; 19:4
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Tidskriftsartikel (refereegranskat)abstract
- In light of the growing prevalence of Internet of Things (IoT) devices, it has become essential to incorporate cryptographic protection techniques for high-security applications. Since IoT devices are resource-constraints in terms of power and area, finding cost-effective ways to enhance their security is necessary. Physical unclonable function (PUF) is considered a trusted hardware security mechanism that generates true and intrinsic randomness by extracting the inherent process variations of circuits. In this paper, a novel pure magnetic memory-based PUF is presented. The fundamental building blocks of the proposed PUF design are magnetic devices, the so-called mCells. These magnetoresistive devices exclusively utilize Magnetic Tunnel Junction (MTJ) components. Using purely MTJ in the main memory and sense amplifier in the proposed PUF leads to high randomness, high reliability, low power, and ultra-compact occupation area. The Monte Carlo HSPICE simulation results demonstrate that the proposed PUF achieves a uniqueness of 49.89%, uniformity of 50.02 %, power consumption of 1.43 µW, and an area occupation of 0.01 µm2 per bit. © 2023, Iran University of Science and Technology. All rights reserved.
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9. |
- Ghajarnia, Navid, et al.
(författare)
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Evaluating the Evolution of ECMWF Precipitation Products Using Observational Data for Iran : From ERA40 to ERA5
- 2022
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Ingår i: Earth and Space Science. - : American Geophysical Union (AGU). - 2333-5084. ; 9:10
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Tidskriftsartikel (refereegranskat)abstract
- European Center for Medium-Range Weather Forecasts Reanalysis (ERA), one of the most widely used precipitation products, has evolved from ERA-40 to ERA-20CM, ERA-20C, ERA-Interim, and ERA5. Studies evaluating the performance of individual ERA products cannot adequately assess the evolution of the products. We compared the performance of all ERA precipitation products at daily, monthly, and annual data (1980-2018) using more than 2100 Iran precipitation gauges. Results indicated that ERA-40 performed worst, followed by ERA-20CM, which showed only minor improvements over ERA-40. ERA-20C considerably outperformed its predecessors, benefiting from the assimilation of observational data. Although several previous studies have reported full superiority of ERA5 over ERA-Interim, our results revealed several shortcomings in ERA5 compared with the ERA-Interim estimates. Both ERA-Interim and ERA5 performed best overall, with ERA-Interim showing better statistical and categorical skill scores, and ERA5 performing better in estimating extreme precipitations. These results suggest that the accuracy of ERA precipitation products has improved from ERA-40 to ERA-Interim, but not consistently from ERA-Interim to ERA5. This study employed a grid-grid comparison approach by first creating a gridded reference data set through the spatial aggregation of point source observations, however, the results from a point-grid approach showed no change in the overall ranking of products (despite the slight changes in the error index values). These findings are useful for model development at a global scale and for hydrological applications in Iran.
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10. |
- Javanbakht, Mehran, et al.
(författare)
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On-line clean-up and determination of tramadol in human plasma and urine samples using molecularly imprinted monolithic column coupling with HPLC
- 2012
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Ingår i: Journal of chromatography. B. - : Elsevier BV. - 1570-0232 .- 1873-376X. ; 911:12, s. 49-54
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Tidskriftsartikel (refereegranskat)abstract
- The applicability of an on-line solid phase extraction method using molecularly imprinted monolithic column was developed for the assay of tramadol (TRD) in urine and plasma samples. The monolithic column was prepared by using TRD as the template, methacrylic acid (MAA) as the functional monomer, ethylene glycol dimethacrylate (EGDMA) as the cross-linker and chloroform as the porogen with in situ molecular imprinting polymerization technique. Various parameters affecting the extraction efficiency of the monolithic column were evaluated. Chromatographic analysis of TRD after on-line clean-up of samples was performed by reversed-phase HPLC on an ACE column with ultraviolet detection at 218 nm. The present work was successfully applied for automated simple analysis of TRD in urine and plasma samples with high recoveries between 90.5–93.1% and 93.3–96.0%, respectively. The results revealed that in concentration up to 500 ng/mL of dextromethorphan (DEX), timolol (TMO) and O-desmethyltramadol (M1), the recoveries were not reduced more than 4.3% and 4.0% for plasma and urine samples, respectively. The limit of detection (S/N = 3) and limit of quantification (S/N = 10) for TRD in urine samples were 0.03 ng/mL and 0.10 ng/mL, and in plasma samples were 0.3 and 1.0 ng/mL, respectively. Inter-column precision of the assays (n = 3) for urine and plasma samples at the 100 ng/mL TRD level were 4.0% and 4.2%, respectively.
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