| 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. |
- 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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| 3. |
- 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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| 4. |
- Roselli, Carolina, et al.
(författare)
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Multi-ethnic genome-wide association study for atrial fibrillation
- 2018
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 50:9, s. 1225-1233
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Tidskriftsartikel (refereegranskat)abstract
- Atrial fibrillation (AF) affects more than 33 million individuals worldwide(1) and has a complex heritability(2). We conducted the largest meta-analysis of genome-wide association studies (GWAS) for AF to date, consisting of more than half a million individuals, including 65,446 with AF. In total, we identified 97 loci significantly associated with AF, including 67 that were novel in a combined-ancestry analysis, and 3 that were novel in a European-specific analysis. We sought to identify AF-associated genes at the GWAS loci by performing RNA-sequencing and expression quantitative trait locus analyses in 101 left atrial samples, the most relevant tissue for AF. We also performed transcriptome-wide analyses that identified 57 AF-associated genes, 42 of which overlap with GWAS loci. The identified loci implicate genes enriched within cardiac developmental, electrophysiological, contractile and structural pathways. These results extend our understanding of the biological pathways underlying AF and may facilitate the development of therapeutics for AF.
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| 5. |
- Baharin, S. A. S., et al.
(författare)
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Wavelet Analysis of the Onset of VHF and Microwave Radiation Emitted by Lightning
- 2018
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Ingår i: 2018 INTERNATIONAL CONFERENCE ON ELECTRICAL ENGINEERING AND COMPUTER SCIENCE (ICECOS). - : IEEE. - 9781538657218 ; , s. 297-300
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Konferensbidrag (refereegranskat)abstract
- Lightning flash is an electrical discharge in air (dielectric breakdown) which emits electromagnetic (FM) fields across very wide spectra from a few Hertz up to visible wavelength. Electrical breakdown process is an important event that initiates lightning. For electrical breakdown process to occur, it must fulfill two conditions which are at least has one free electron and the electric field region is more than 3 MV/m. This process starts with electron avalanche in millimeter scale then grows into streamer in centimeter scale. Lastly, from streamer it will grow into leader in meter scale. It has already established that streamer emits intensely at Very High Frequency (VHF) band as it's already proven both theoretically and experimentally. A study by Cooray, theoretically proved that emission of electron avalanche peaks at microwave band. Air-gap parallel plate antenna which could operate at 1 GHz with remote sensing is designed and simulated to measure the microwave radiation emitted by lightning. Both temporal and wavelet analyses are used to compare the onset of microwave radiation and VHF radiation in both time and frequency domains to determine electron avalanche appears at which electromagnetic band.
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| 6. |
- Ong, J. Y., et al.
(författare)
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Performance Analysis of Stacked Capacitive Antenna for Lightning Remote Sensing
- 2018
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Ingår i: 2018 INTERNATIONAL CONFERENCE ON ELECTRICAL ENGINEERING AND COMPUTER SCIENCE (ICECOS). - : IEEE. - 9781538657218 ; , s. 305-308
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Konferensbidrag (refereegranskat)abstract
- Antennas are the important elements in the lightning detection system. To improve performance of the lightning detection system, it is so necessary to improve the efficiency of the antennas. There are two types of antennas used in the system which are capacitive antenna for electric field sensing and loop antenna for magnetic field sensing Pi. Both of these antennas arc big in size and causing inconvenient during set up. Thus, small and portable antennas are designed. It is so important to remain or improve the sensitivity of the antennas even though it is small in size. Stacking method is used in capacitive antenna by increase copper plate layer in between the parallel plate antenna. After prototype the multi stacked capacitive antenna, performance analysis is carried out. Performances of the antennas are compared using CST simulation and hardware set up. Multi-stacked capacitive antenna is compared with the single plate antenna and found that the performance of the antenna increases as the stacked number increases.
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| 7. |
- Sabri, M. H. M., et al.
(författare)
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VHF Emissions Prior to the Onset of Initial Electric Field Changes of Intracloud Flashes
- 2018
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Ingår i: 2018 INTERNATIONAL CONFERENCE ON ELECTRICAL ENGINEERING AND COMPUTER SCIENCE (ICECOS). - : IEEE. - 9781538657218 ; , s. 301-304
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Konferensbidrag (refereegranskat)abstract
- We present the observation of VHF impulses electric (E) field emissions found in two normal intracloud (IC) flashes accompanied by initial electric field changes (LECs) in a tropical thunderstorm. The data was collected on November 23rd, 2017 (within reversal distance) to our lightning sensor in Malacca, Malaysia. The durations from the onset of IECs to the first initial breakdown (IB) pulse are range between 0.68 and 0.69 ms and the magnitudes of IECs are range between 0.18 and 0.50 V/m. Besides that, before the onset of LECs there is small pulses was detected for IC flash (Nov_67) same with the VHF impulse for both IC flash. It was detected earlier before the onset of IEC by 12.69 and 251.60 mu s for the VHF impulse.
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| 8. |
- Seah, B. Y., et al.
(författare)
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The Performance Evaluation of Capacitive Antenna with Various Structures and Permittivity Values
- 2018
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Ingår i: 2018 INTERNATIONAL CONFERENCE ON ELECTRICAL ENGINEERING AND COMPUTER SCIENCE (ICECOS). - : IEEE. - 9781538657218 ; , s. 457-460
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Konferensbidrag (refereegranskat)abstract
- This paper evaluates the capacitive antenna performance as a lightning sensor. The performance is evaluated by looking at two aspects, antenna structures and the background permittivity value of the antenna. Two experiments were carried out, Experiment A using two different structure antennas, one with its Bayonet Neill-Concelman (BNC) connector's core direct touching the top plate (DBNC) while the other was connected via single core wires (WBNC), capturing the electric field (E-field) generated by the small spark at a distance of 1 meter away from both antennas. Furthermore, both capacitive antennas with top plates directly soldered to their BNC cores were used to study their performance with and without being covered by plastic (dielectric constant of 2.25) during Experiment B. The result from Experiment A showed that WBNC has different onset polarity and significant decreased in amplitude of the signals captured compared to DBNC (mean ratio is 1.095 with range between 0.5838 and 4.528). Meanwhile, Experiment B shows that a comparable average ratio of 0.7835 and 0.7447 during the measurement where antenna A(wc) with and without the presence of plastic cover respectively.
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| 9. |
- Sabri, M. H. M., et al.
(författare)
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Initial electric field changes of lightning flashes in tropical thunderstorms and their relationship to the lightning initiation mechanism
- 2019
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Ingår i: Atmospheric research. - : ELSEVIER SCIENCE INC. - 0169-8095 .- 1873-2895. ; 226, s. 138-151
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Tidskriftsartikel (refereegranskat)abstract
- In this paper, the key finding is that all the examined first classic Initial Breakdown (IB) pulses in tropical flashes within the reversal distance were found to be initiated by a clearly detectable Initial E-field Change or IEC (45 -CG, 32 normal IC, and 3 IC initiated by +NBE). The durations of IECs for both -CG and IC flashes in tropical storms were longer than in Florida storms. On the other hand, for the magnitudes of the E-change, the values were smaller compared to Florida storms with averages of 0.30 V/m compared to 1.65 V/m for -CG flashes, and -0.81 V/m compared to -6.30 V/m for IC flashes. The IEC process of lightning flashes in tropical regions took longer to increase the local electric field in order to produce the first IB pulse because of the smaller magnitude of E-change. On the other hand, in Florida storms, the IEC process took a shorter time to increase the local electric field to produce the first IB pulse because of the larger magnitude of E-change. We found that very high frequency (VHF) pulses for tropical thunderstorms started sometime prior to the onset of the IECs. They started between 12.69 and 251.60 mu s before the initiation of the IEC for two normal IC flashes. The first two VHF pulses were detected alone without narrow IB pulses (fast antenna and slow antenna records) or any pulses from the B-field and dE/dt records. Furthermore, the VHF pulses for three IC flashes initiated by + NBEs were also detected before the onset of the IEC. The IEC started immediately after the detection of the + NBE. It is clear that the IEC is initiated by VHF pulses. It can be suggested that lightning is initiated by Fast Positive Breakdowns or FPBs (which emit strong VHF pulses and large + NBEs) and is followed by several negative breakdowns (weak VHF pulses and/or weak NBE-type pulses) before the IEC started. For the case of normal IC flashes, several weaker VHF pulses (mean values of 41.97 mV and 46.4 mV compared to the amplitudes of the VHF pulses of + NBEs of around 800 mV) were detected before the onset of the IEC. As FPBs can occur with a wide range of VHF strengths and E-change amplitudes, it can be suggested these weak VHF pulses accompanied by narrow IB pulses or weak NBE-type pulses detected before the onset of IEC are actually FPBs followed by negative breakdowns or several attempted FPBs.
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| 10. |
- Seah, B. Y., et al.
(författare)
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Narrow Bipolar Events within Reversal Distance and Associated UHF-VHF Emissions
- 2019
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Ingår i: 2019 3RD INTERNATIONAL CONFERENCE ON ELECTRICAL ENGINEERING AND COMPUTER SCIENCE (ICECOS 2019). - : IEEE. - 9781728147147 ; , s. 132-136
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Konferensbidrag (refereegranskat)abstract
- This paper investigates the characteristics of the ultra-high frequency (UHF) and Very High Frequency (VHF) emissions that associate with negative narrow bipolar events (NBEs) which occurred within reversal distance, drev of the base station. The UHF emissions were captured by using a parallel plates antenna with its center frequency at 0.97 GHz and 20 MHz bandwidth. There are thirteen samples whereby their VHF and FF signals were leaded by their corresponding UHF about (102.25 +/- 125.48) ns and (692.13 +/- 382.36) ns respectively. All the UHF were found to behave like continuous bursting while some of the VHF consisted of certain periods within its burst train whereby there was no any sign of pulse during that period.
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