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- 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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| 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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| 7. |
- Borg, Mattias, et al.
(författare)
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Influence of doping on the electronic transport in GaSb/InAs(Sb) nanowire tunnel devices
- 2012
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Ingår i: Applied Physics Letters. - : AIP Publishing. - 0003-6951 .- 1077-3118. ; 101:4
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Tidskriftsartikel (refereegranskat)abstract
- The effect of various doping profiles on the electronic transport in GaSb/InAs(Sb) nanowire tunnel diodes is investigated. Zn-doping of the GaSb segment increases both the peak current density and the current level in reverse bias. Top-gated diodes exhibit peak current modulation with a threshold voltage which can be controlled by Zn-doping the InAs(Sb) segment. By intentionally n-doping the InAs(Sb) segment degenerate doping on both sides of the heterojunction can be achieved, as well as tunnel diodes with peak current of 420 kA/cm(2) at V-DS = 0.16V and a record-high current density of 3.6 MA/cm(2) at V-DS = -0.5V. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4739082]
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- Dey, Anil, et al.
(författare)
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15 nm diameter InAs nanowire MOSFETs
- 2011
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Ingår i: [Host publication title missing]. - 1548-3770. ; , s. 21-22
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Konferensbidrag (refereegranskat)abstract
- InAs is an attractive channel material for III–V nanowire MOSFETs and early prototype high performance nanowire transistors have been demonstrated1. As the gate length is reduced, the nanowire diameter must be scaled quite aggressively in order to suppress short-channel effects2. However, a reduction in transconductance (gm) and drive current (ION) could be expected due to increased surface scattering for thin wires. We present data for the device properties of thin InAs nanowires, with diameters in the 15 nm range, and investigate possible improvements of the performance focusing on transistor applications. In order to boost ION, the source and drain resistance need to be reduced. Several doping sources were therefore evaluated in the study, among them selenium (Se), tin (Sn) and sulphur (S) to form n-i-n structures. We report very high current densities, up to 33 MA/cm2, comparable to modern HEMTs3, and a normalized transconductance of 1.8 S/mm for a nanowire with an intrinsic segment of nominally 150 nm and a diameter of 15 nm.
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| 9. |
- Dey, Anil, et al.
(författare)
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Combining axial and radial nanowire heterostructures: Radial Esaki diodes and tunnel field-effect transistors
- 2013
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Ingår i: Nano Letters. - : American Chemical Society (ACS). - 1530-6992 .- 1530-6984. ; 13:12, s. 5919-5924
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Tidskriftsartikel (refereegranskat)abstract
- The ever-growing demand on high-performance electronics has generated transistors with very impressive figures of merit. The continued scaling of the supply voltage of field-effect transistors, such as tunnel field-effect transistors (TFETs), requires the implementation of advanced transistor architectures including FinFETs and nanowire devices. Moreover, integration of novel materials with high electron mobilities, such as III-V semiconductors and graphene, are also being considered to further enhance the device properties. In nanowire devices, boosting the drive current at a fixed supply voltage or maintaining a constant drive current at a reduced supply voltage may be achieved by increasing the cross-sectional area of a device, however at the cost of deteriorated electrostatics. A gate-all-around nanowire device architecture is the most favorable electrostatic configuration to suppress short channel effects, however, the arrangement of arrays of parallel vertical nanowires to address the drive current predicament will require additional chip area. The use of a core-shell nanowire with a radial heterojunction in a transistor architecture provides an attractive means to address the drive current issue without compromising neither chip area nor device electrostatics. In addition to design advantages of a radial transistor architecture, we in this work illustrate the benefit in terms of drive current per unit chip area and compare the experimental data for axial GaSb/InAs Esaki diodes and TFETs to their radial counterparts and normalize the electrical data to the largest cross-sectional area of the nanowire, i.e. the occupied chip area, assuming a vertical device geometry. Our data on lateral devices show that radial Esaki diodes deliver almost 7 times higher peak current, Jpeak = 2310 kA/cm2, than the maximum peak current of axial GaSb/InAs(Sb) Esaki diodes per unit chip area. The radial TFETs also deliver high peak current densities Jpeak = 1210 kA/cm2 while their axial counterparts at most carry Jpeak = 77 kA/cm2, normalized to the largest cross-sectional area of the nanowire.
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