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- 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. |
- Ahmed, Kamran, et al.
(författare)
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Development of a standardised training curriculum for robotic surgery: a consensus statement from an international multidisciplinary group of experts
- 2015
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Ingår i: BJU International. - : Wiley. - 1464-4096 .- 1464-410X. ; 116:1, s. 93-101
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To explore the views of experts about the development and validation of a robotic surgery training curriculum, and how this should be implemented. Materials and methods: An international expert panel was invited to a structured session for discussion. The study was of a mixed design, including qualitative and quantitative components based on focus group interviews during the European Association of Urology (EAU) Robotic Urology Section (ERUS) (2012), EAU (2013) and ERUS (2013) meetings. After introduction to the aims, principles and current status of the curriculum development, group responses were elicited. After content analysis of recorded interviews generated themes were discussed at the second meeting, where consensus was achieved on each theme. This discussion also underwent content analysis, and was used to draft a curriculum proposal. At the third meeting, a quantitative questionnaire about this curriculum was disseminated to attendees to assess the level of agreement with the key points. Results: In all, 150 min (19 pages) of the focus group discussion was transcribed (21 316 words). Themes were agreed by two raters (median agreement kappa 0.89) and they included: need for a training curriculum (inter-rater agreement kappa 0.85); identification of learning needs (kappa 0.83); development of the curriculum contents (kappa 0.81); an overview of available curricula (kappa 0.79); settings for robotic surgery training ((kappa 0.89); assessment and training of trainers (kappa 0.92); requirements for certification and patient safety (kappa 0.83); and need for a universally standardised curriculum (kappa 0.78). A training curriculum was proposed based on the above discussions. Conclusion: This group proposes a multi-step curriculum for robotic training. Studies are in process to validate the effectiveness of the curriculum and to assess transfer of skills to the operating room.
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| 7. |
- Alakangas, Lena, et al.
(författare)
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StopOx : Utilization Of Industrial Residuals For Prevention Of Sulfide Oxidation In Mine Waste
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This report is the outcome of the SIP STRIM projectStopOx-Utilization of industrial residuals for prevention of sulfide oxidation in mine waste implemented at Applied geochemistry, Luleå University of Technology running from 2015 to 2018. Boliden Mineral has been partner and co-funder of the project. Other partners in the project were Cementa, Dragon Mining, MEROX, Nordkalk, and SP Processum. The overall aim of the project was to develop prevention technologies to reduce the sulfide oxidation in mine waste, during and after operation, and thereby reduce the generation of acid mine drainage. The StopOx project has been focusing on sulfidic mine waste from the Boliden area which were disposed of and are causing acid mine drainage or have the potential. Industrial residues/products were supplied by BillerudKorsnäs, Cementa, MEROX, and Nordkalk. The report consists of chapters based on three subprojects.Chapter 1. IntroductionChapter 2. Inhibition technology with aim to minimize waste rock oxidation during operations by using residues from other industries (passivation of sulfidic surfaces by the formation of secondary minerals)Chapter 3. The suitability of green liquor dregs as substitutes for or additives to till in a sealing layer as part of a cover systemChapter 4. Weathering of waste rock under changing chemical conditionsThe research described in chapters 2 and 3 was performed by Ph.D. students and will continue until 2021, while the subproject in chapter 2 ended in 2018.
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| 8. |
- Amofah, Lea Rastas, et al.
(författare)
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Extraction of arsenic from soils contaminated with wood preservation chemicals
- 2010
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Ingår i: Soil & sediment contamination. - : Informa UK Limited. - 1532-0383 .- 1549-7887. ; 19:2, s. 142-159
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Tidskriftsartikel (refereegranskat)abstract
- Three soil samples contaminated by chromated zinc arsenate (CZA) or chromated copper arsenate (CCA) were investigated in a laboratory scale to study As mobilization and to identify a chemical agent that could be used in soil washing to extract arsenic. Besides high As extraction, the cost, occupational health issues and technical aspects were considered when selecting the chemical. Arsenic is strongly bound to CZA/CCA soils; only ∼50% of the tot-As was removed from water-washed soils. High Fe or Al mobilization is not necessarily indicative of high As removal from CZA/CCA soils. A high Cu/As-ratio and a large amount of soluble Ca in the soil hampered As extraction. The high ratio can be an indication of stable Cu-arsenates in soil. Calcium can react with the extraction agent or with As during extraction. Sodium hydroxide, dithionite with citrate (and oxalate) (dithionite solutions), and oxalate with citrate were the most efficient chemicals for removing As from the soils. The disadvantages of using these strong chemicals are: a high cost (oxalate with citrate); damage to equipment (dithionite solutions); an adverse impact on occupational health (dithionite solutions); or a deterioration in soil quality after extraction (NaOH and dithionite solutons). Phosphate, solutions based on NH2OH·HCl, or citrate were not efficient in mobilizing As from the soils.
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| 9. |
- Amofah, Lea Rastas, et al.
(författare)
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The influence of temperature, pH/molarity and extractant on the removal of arsenic, chromium and zinc from contaminated soil
- 2011
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Ingår i: Journal of Soils and Sediments. - : Springer Science and Business Media LLC. - 1439-0108 .- 1614-7480. ; 11:8, s. 1334-1344
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Normal soil washing leave high residual pollutant content in soil. The remediation could be improved by targeting the extraction to coarser fractions. Further, a low/high extraction pH and higher temperature enhance the pollutant removal, but these measures are costly. In this study, the utility of NaOH, oxalate-citrate (OC) and dithionite-citrate-oxalate (DCO) solutions for extracting of arsenic, chromium and zinc from contaminated soil were assessed and compared. In addition the effects of NaOH concentration and temperature on NaOH extractions, and those of temperature and pH on OC and DCO extractions, were evaluated. Materials and methods: A two-level, full-factorial design with a centre point was implemented. Two factors, concentration and temperature,were evaluated in NaOH extractions, and pH and temperature for OC and DCO solutions. In all cases, the extraction temperature was 20°C, 30°C and 40°C. The studied NaOH concentrations were 0.05, 0.075 and 0.1 M. The pH in OC solutions was 3, 5 and 7, and in DCO solutions, 4.7, 6.3 and 6.7. Water-washed and medium coarse soil fraction of arsenic, chromium and zinc contaminated soil was agitated for 15 min with the extraction solution. Results and discussion: In NaOH extractions, the temperature and (less strongly) NaOH concentration significantly affected As and Cr mobilisation, but only the latter affected Zn mobilisation. Both pH and temperature significantly (and similarly) influenced As and Cr mobilisation in OC extractions, while only the pH influenced Zn mobilisation. In contrast, the extraction temperature (but not pH) influenced As, Cr and Zn mobilisation in DCO extractions. Conclusions: For all extractants, mobilisation was most efficient at elevated temperature (40°C). None of the extractants reduced the soil's As content to below the Swedish EPA's guideline value. Use of DCO is not recommended because dithionite has a short lifetime and residual arsenic contents in DCO-extracted soil are relatively high. Instead, sequential extraction with NaOH followed by OC solutions (affording significant reductions in As, Cr and Zn levels in the soil with short extraction times) at 40°C is recommended.
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| 10. |
- Dublet-Adli, Gabrielle, et al.
(författare)
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A trade-off in activated biochar capping of complex sediment contamination: reduced PAH transport at the cost of potential As mobilisation
- 2024
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Ingår i: Journal of Soils and Sediments. - : Springer Nature. - 1439-0108 .- 1614-7480. ; 24:1, s. 497-508
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The effect of thin-layer capping with activated biochar on sediment-to-water flux was investigated. For the first time, the diffusion of both polycyclic aromatic hydrocarbons (PAHs) and arsenic (As) were studied simultaneously. The fate of As was investigated, under successive dysoxic and oxic conditions, in order to assess and discuss potential trade-off effects when using biochar as an active sorbent for capping of multi-contaminated sediments.Methods: Sediments from the Bureå bay (Sweden), contaminated with PAH and metal elements including As and Hg, were capped with activated biochar and/or bentonite in simple microcosm test systems in the laboratory. The contaminant transport from sediment through the capping to water body was studied by sampling metals in the water phase above the cap over time, or PAH in a heptane layer over water, at regular time intervals.Results: Consistently with the limited previous studies, reductions were observed (e.g., 60–65% for 15-PAH, 100% for chrysene) in sediment-to-water PAH fluxes upon biochar-based thin-layer capping. However, the most important novel finding revealed ambiguous effects of biochar capping on redox-sensitive elements, in particular As. Under the microcosm conditions of the experiment, where pH was affected by the capping material, biochar treatments favoured As mobility under oxic conditions, directly and/or via effects on Fe speciation. While capping limited the diffusion of As under dysoxic conditions, this also favoured greater As mobility under oxic water conditions compared to no capping.Conclusion: Design and monitoring of capping of PAH contaminated sediments should account for potential negative effects on co-occurring contaminants.
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