| 1. |
- Wang, Haidong, et al.
(författare)
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Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015 : a systematic analysis for the Global Burden of Disease Study 2015
- 2016
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 388:10053, s. 1459-1544
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures.METHODS: We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography-year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).FINDINGS: Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4-61·9) in 1980 to 71·8 years (71·5-72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7-17·4), to 62·6 years (56·5-70·2). Total deaths increased by 4·1% (2·6-5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8-18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6-16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9-14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1-44·6), malaria (43·1%, 34·7-51·8), neonatal preterm birth complications (29·8%, 24·8-34·9), and maternal disorders (29·1%, 19·3-37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000-183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000-532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death.INTERPRETATION: At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems.
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| 2. |
- Sartelli, Massimo, et al.
(författare)
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Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action
- 2023
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Ingår i: WORLD JOURNAL OF EMERGENCY SURGERY. - 1749-7922. ; 18:1
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Forskningsöversikt (refereegranskat)abstract
- Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or "golden rules," for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice.
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| 3. |
- Mlecnik, B, et al.
(författare)
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Clinical Performance of the Consensus Immunoscore in Colon Cancer in the Asian Population from the Multicenter International SITC Study
- 2022
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Ingår i: Cancers. - : MDPI AG. - 2072-6694. ; 14:18
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In this study, we evaluated the prognostic value of Immunoscore in patients with stage I–III colon cancer (CC) in the Asian population. These patients were originally included in an international study led by the Society for Immunotherapy of Cancer (SITC) on 2681 patients with AJCC/UICC-TNM stages I–III CC. METHODS: CD3+ and cytotoxic CD8+ T-lymphocyte densities were quantified in the tumor and invasive margin by digital pathology. The association of Immunoscore with prognosis was evaluated for time to recurrence (TTR), disease-free survival (DFS), and overall survival (OS). RESULTS: Immunoscore stratified Asian patients (n = 423) into different risk categories and was not impacted by age. Recurrence-free rates at 3 years were 78.5%, 85.2%, and 98.3% for a Low, Intermediate, and High Immunoscore, respectively (HR[Low-vs-High] = 7.26 (95% CI 1.75−30.19); p = 0.0064). A High Immunoscore showed a significant association with prolonged TTR, OS, and DFS (p < 0.05). In Cox multivariable analysis stratified by center, Immunoscore association with TTR was independent (HR[Low-vs-Int+High] = 2.22 (95% CI 1.10–4.55) p = 0.0269) of the patient’s gender, T-stage, N-stage, sidedness, and MSI status. A significant association of a High Immunoscore with prolonged TTR was also found among MSS (HR[Low-vs-Int+High] = 4.58 (95% CI 2.27−9.23); p ≤ 0.0001), stage II (HR[Low-vs-Int+High] = 2.72 (95% CI 1.35−5.51); p = 0.0052), low-risk stage-II (HR[Low-vs-Int+High] = 2.62 (95% CI 1.21−5.68); p = 0.0146), and high-risk stage II patients (HR[Low-vs-Int+High] = 3.11 (95% CI 1.39−6.91); p = 0.0055). CONCLUSION: A High Immunoscore is significantly associated with the prolonged survival of CC patients within the Asian population.
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| 4. |
- Mlecnik, B, et al.
(författare)
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Multicenter International Study of the Consensus Immunoscore for the Prediction of Relapse and Survival in Early-Stage Colon Cancer
- 2023
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Ingår i: Cancers. - : MDPI AG. - 2072-6694. ; 15:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: The prognostic value of Immunoscore was evaluated in Stage II/III colon cancer (CC) patients, but it remains unclear in Stage I/II, and in early-stage subgroups at risk. An international Society for Immunotherapy of Cancer (SITC) study evaluated the pre-defined consensus Immunoscore in tumors from 1885 AJCC/UICC-TNM Stage I/II CC patients from Canada/USA (Cohort 1) and Europe/Asia (Cohort 2). METHODS: Digital-pathology is used to quantify the densities of CD3+ and CD8+ T-lymphocyte in the center of tumor (CT) and the invasive margin (IM). The time to recurrence (TTR) was the primary endpoint. Secondary endpoints were disease-free survival (DFS), overall survival (OS), prognosis in Stage I, Stage II, Stage II-high-risk, and microsatellite-stable (MSS) patients. RESULTS: High-Immunoscore presented with the lowest risk of recurrence in both cohorts. In Stage I/II, recurrence-free rates at 5 years were 78.4% (95%-CI, 74.4–82.6), 88.1% (95%-CI, 85.7–90.4), 93.4% (95%-CI, 91.1–95.8) in low, intermediate and high Immunoscore, respectively (HR (Hi vs. Lo) = 0.27 (95%-CI, 0.18–0.41); p < 0.0001). In Cox multivariable analysis, the association of Immunoscore to outcome was independent (TTR: HR (Hi vs. Lo) = 0.29, (95%-CI, 0.17–0.50); p < 0.0001) of the patient’s gender, T-stage, sidedness, and microsatellite instability-status (MSI). A significant association of Immunoscore with survival was found for Stage II, high-risk Stage II, T4N0 and MSS patients. The Immunoscore also showed significant association with TTR in Stage-I (HR (Hi vs. Lo) = 0.07 (95%-CI, 0.01–0.61); P = 0.016). The Immunoscore had the strongest (69.5%) contribution χ2 for influencing survival. Patients with a high Immunoscore had prolonged TTR in T4N0 tumors even for patients not receiving chemotherapy, and the Immunoscore remained the only significant parameter in multivariable analysis. CONCLUSION: In early CC, low Immunoscore reliably identifies patients at risk of relapse for whom a more intensive surveillance program or adjuvant treatment should be considered.
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| 5. |
- Alabas, Mohammed A Almajeed A, et al.
(författare)
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Investigation of the Effect of Downstream Slope and Rockfill Materials on Flow Regimes over Gabion Stepped Weirs
- 2023
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Ingår i: Polish Journal of Environmental Studies. - : HARD. - 1230-1485 .- 2083-5906. ; 32:4, s. 3481-3490
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Tidskriftsartikel (refereegranskat)abstract
- It is important to determine the limits of flow regimes in the design of stepped weirs because of the hydraulic performance of each regime. The present study investigates the effect of downstream slope and rock fill materials on flow regimes in gabion stepped weirs. Nine physical models of gabion weirs were used in the experiments. The models’ downstream slopes ranged from 1:05 to 1:4 V:H. In addition, two types of rockfill materials: crushed stone of 0.42 porosity and rounded gravel of 0.38 porosity were used to study the effect of rockfill materials on flow regimes. The nominal size of the crushed stone was (37.5 mm - 13.2 mm) D50 = 23 mm and the nominal size of the rounded gravel was (26.5 mm - 13.2 mm) D50 = 16 mm. Each model has been tested with ten runs for discharge per unit width ranging (from 0.006 to 0.105 m3/sec. m) to cover all flow conditions and flow regimes. The onset of each flow regime for all physical models has been observed. The experimental data of the gabion stepped weirs have been used to develop equations to estimate the onset of each flow regime. The coefficient of correlation (R) of the developed equations ranged between 0.95 to 0.97. The results indicated on the steeper downstream slope models (1:0.5, 1:0.83), there is interference between the nappe and transition flow regimes. The nappe flow regime has not appeared on all steps at the same time. Moreover, the shape and size of the rockfill materials have an insignificant effect on flow regimes, especially at a high flow rate.
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| 6. |
- Kobo, Ofer, et al.
(författare)
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Impact of Multisite artery disease on Clinical Outcomes After Percutaneous Coronary Intervention : An Analysis from the e-Ultimaster Registry
- 2023
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Ingår i: European Heart Journal - Quality of Care and Clinical Outcomes. - : Oxford University Press. - 2058-5225 .- 2058-1742. ; 9:4, s. 417-426
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Multisite artery disease is considered a 'malignant' type of atherosclerotic disease associated with an increased cardiovascular risk, but the impact of multisite artery disease on clinical outcomes after percutaneous coronary intervention (PCI) is unknown.METHODS: Patients enrolled in the large, prospective e-Ultimaster study were grouped into 1) those without known prior vascular disease; 2) those with known single-territory vascular disease 3) those with known 2-3 territories (i.e, coronary, cerebrovascular, or peripheral) vascular disease (multisite artery disease). The primary outcome was coronary target lesion failure (TLF) defined as the composite of cardiac death, target vessel-related myocardial infarction, and clinically driven target lesion revascularization at 1-year. Inverse propensity score weighted (IPSW) analysis was performed to address differences in baseline patient and lesion characteristics.RESULTS: Of the 37,198 patients included in the study, 62.3% had no prior known vascular disease, 32.6% had single-territory vascular disease, and 5.1% multisite artery disease. Patients with known vascular disease were older and were more likely to be men and to have more co-morbidities. After IPSW, the TLF rate incrementally increased with the number of diseased vascular beds (3.16%, 4.44% and 6.42% for no, single- and multisite artery disease, p<0.01 for all comparisons). This was also true for all cause death (2.22%, 3.28% and 5.29%, p<0.01 for all comparisons) and cardiac mortality (1.26%, 1.91% and 3.62%, p≤0.01 for all comparisons).CONCLUSIONS: Patients with previously known vascular disease experienced an increased risk for adverse cardiovascular events and mortality post percutaneous coronary intervention. This risk is highest among patients with multisite artery disease.
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| 7. |
- Ostonen, I., et al.
(författare)
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Specific root length as an indicator of environmental change
- 2007
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Ingår i: Plant Biosystems. - : Informa UK Limited. - 1126-3504 .- 1724-5575. ; 141:3, s. 426-442
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Tidskriftsartikel (refereegranskat)abstract
- Specific root length (SRL, m g(-1)) is probably the most frequently measured morphological parameter of fine roots. It is believed to characterize economic aspects of the root system and to be indicative of environmental changes. The main objectives of this paper were to review and summarize the published SRL data for different tree species throughout Europe and to assess SRL under varying environmental conditions. Meta-analysis was used to summarize the response of SRL to the following manipulated environmental conditions: fertilization, irrigation, elevated temperature, elevated CO(2), Al-stress, reduced light, heavy metal stress and physical disturbance of soil. SRL was found to be strongly dependent on the fine root classes, i.e. on the ectomycorrhizal short roots (ECM), and on the roots < 0.5 mm, < 1 mm, < 2 mm and 1-2 mm in diameter SRL was largest for ECM and decreased with increasing diameter. Changes in soil factors influenced most strongly the SRL of ECM and roots < 0.5 mm. The variation in the SRL components, root diameter and root tissue density, and their impact on the SRL value were computed. Meta-analyses showed that SRL decreased significantly under fertilization and Al-stress; it responded negatively to reduced light, elevated temperature and CO(2). We suggest that SRL can be used successfully as an indicator of nutrient availability to trees in experimental conditions.
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| 8. |
- Altaee, Mohammed J., et al.
(författare)
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Evaluation of Existing Bond-Slip Relations for CFRP-Steel Joints and New Model for Linear and Nonlinear Adhesives
- 2022
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Ingår i: Advances in Civil Engineering / Hindawi. - : Hindawi Publishing Corporation. - 1687-8086 .- 1687-8094. ; 2022
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Tidskriftsartikel (refereegranskat)abstract
- Existing bond-slip (τ-s) relations for fibre-reinforced polymer (FRP)-steel joints employ different shapes and mathematical expressions, inferring that their predictions of failure load and mode, and other interface properties, might be inconsistent or inaccurate. In this study, predictions of four widely used τ-s relations are evaluated using a large experimental database of 78 double-lap FRP-steel specimens. To facilitate the evaluation process, a robust finite element (FE) model is developed for each test, implementing data from either of the existing τ-s relations to define the FRP-steel interface. Comparisons between test and FE results indicated that the existing τ-s models were unable of predicting the ultimate load (Pu) and effective bond length (Leff) of FRP-steel joints, or the relation between Pu and bond length and that between Leff and FRP modulus (Ef). A new τ-s model is developed based on an inverse FE simulation, comparison with experimental results, and regression analysis. It considers the effects of Ef, the type of FRP reinforcement (sheet or plate), and applies to both linear and nonlinear adhesives. The model predictions were validated by comparing with results from small bond tests and large FRP-strengthened steel beams tested under bending, yielding excellent results for Pu, failure mode, and all other interfacial properties.
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| 9. |
- Chabuk, Ali, et al.
(författare)
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Creating the Distribution Map of Groundwater for Drinking Uses Using Physio-Chemical Variables; Case Study: Al-Hilla City, Iraq
- 2022
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Ingår i: Water, Air and Soil Pollution. - : Springer. - 0049-6979 .- 1573-2932. ; 233:6
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Tidskriftsartikel (refereegranskat)abstract
- Surface water and groundwater are significant for population and other activities due to the decreasing surface water flow toward Iraq. Therefore, there is a need to analyze groundwater’s quality and classification and its applicability as an alternative in various human activities in the study area. This study utilized the groundwater quality index model for drinking uses (GW.Q.I.) and entered the resulting values in the GIS environment. This model was applied to 56 wells in Al-Hillah city by measuring twelve variables in each well. The measured variables were calcium (Ca), magnesium (Mg), sodium (Na), chloride (Cl), sulfate (SO4), bicarbonate (HCO3), total hardness (TH), total dissolved solids (TDS), nitrate (NO3), and electric conductivity (EC). The prediction map of GW.Q.I. was produced in the GIS. Then, the distributing map was divided into six categories based on the suitability of groundwater for drinking uses. The areas’ values of six categories with their ratings were about 5 km2 (excellent), 122 km2 (good), 610 km2 (poor), 63 km2 (very poor), 36 km2 (contaminated), and 24 km2 (very contaminated). For the entire study area, the average value of the GW.Q.I. was 177, classified as poor for drinking uses.
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| 10. |
- Chabuk, Ali, et al.
(författare)
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Estimating of gases emission from waste sites to generate electrical energy as a case study at Al-Hillah City in Iraq
- 2023
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Methane (CH4) is a greenhouse gas resulting from human activities, especially landflls, and it hasmany potential environmental issues, such as its major role in global warming. On the other hand,methane can be converted to liquid fuel or electricity using chemical conversion or gas turbinegenerators. Therefore, reusing such gases could be of great environmental and economic beneft. Inthis context, this study aims to estimate the emissions of methane gas from the landflls in Al-HillahCity, Iraq, from 2023 to 2070 and the producible electric energy from this amount. The estimatingprocess was carried out using the Land GEM model and compared with traditional models. Theobtained results demonstrated that the total estimated landfll methane emissions for 48 years are875,217 tons, and the average annual methane emission is 18,234 tons based on a yearly wasteaccumulation rate of 1,046,413 tons and a total waste amount of 50,227,808 tons. The anticipatedloads of methane gas can be utilized to generate about 287,442 MW/year of electricity from 2023to 2070. In conclusion, the results obtained from this study could be evidence of the potentialenvironmental and economic benefts of harvesting and reusing methane gas from landflls.
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