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Sökning: WFRF:(Milam R.)

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1.
  • Fullman, N., et al. (författare)
  • Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016
  • 2018
  • Ingår i: Lancet. - : Elsevier BV. - 0140-6736. ; 391:10136, s. 2236-2271
  • Tidskriftsartikel (refereegranskat)abstract
    • Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97.1 (95% UI 95.8-98.1) in Iceland, followed by 96.6 (94.9-97.9) in Norway and 96.1 (94.5-97.3) in the Netherlands, to values as low as 18.6 (13.1-24.4) in the Central African Republic, 19.0 (14.3-23.7) in Somalia, and 23.4 (20.2-26.8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91.5 (89.1-936) in Beijing to 48.0 (43.4-53.2) in Tibet (a 43.5-point difference), while India saw a 30.8-point disparity, from 64.8 (59.6-68.8) in Goa to 34.0 (30.3-38.1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4.8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20.9-point to 17.0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17.2-point to 20.4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view and subsequent provision of quality health care for all populations. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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3.
  • Meech, K. J., et al. (författare)
  • EPOXI: Comet 103P/Hartley 2 Observations from a Worldwide Campaign
  • 2011
  • Ingår i: Astrophysical Journal Letters. - London : IOP. - 2041-8213 .- 2041-8205. ; 734:L1, s. 1-9
  • Tidskriftsartikel (refereegranskat)abstract
    • Earth- and space-based observations provide synergistic information for space mission encounters by providing data over longer timescales, at different wavelengths and using techniques that are impossible with an in situ flyby. We report here such observations in support of the EPOXI spacecraft flyby of comet 103P/Hartley 2. The nucleus is small and dark, and exhibited a very rapidly changing rotation period. Prior to the onset of activity, the period was ~16.4?hr. Starting in 2010 August the period changed from 16.6?hr to near 19?hr in December. With respect to dust composition, most volatiles and carbon and nitrogen isotope ratios, the comet is similar to other Jupiter-family comets. What is unusual is the dominance of CO 2 -driven activity near perihelion, which likely persists out to aphelion. Near perihelion the comet nucleus was surrounded by a large halo of water-ice grains that contributed significantly to the total water production.
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4.
  • Leisawitz, David, et al. (författare)
  • Origins Space Telescope: Baseline mission concept
  • 2021
  • Ingår i: Journal of Astronomical Telescopes, Instruments, and Systems. - 2329-4221 .- 2329-4124. ; 7:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The Origins Space Telescope will trace the history of our origins from the time dust and heavy elements permanently altered the cosmic landscape to present-day life. How did galaxies evolve from the earliest galactic systems to those found in the Universe today? How do habitable planets form? How common are life-bearing worlds? To answer these alluring questions, Origins will operate at mid-and far-infrared (IR) wavelengths and offer powerful spectroscopic instruments and sensitivity three orders of magnitude better than that of the Herschel Space Observatory, the largest telescope flown in space to date. We describe the baseline concept for Origins recommended to the 2020 US Decadal Survey in Astronomy and Astrophysics. The baseline design includes a 5.9-m diameter telescope cryocooled to 4.5 K and equipped with three scientific instruments. A mid-infrared instrument (Mid-Infrared Spectrometer and Camera Transit spectrometer) will measure the spectra of transiting exoplanets in the 2.8 to 20 μm wavelength range and offer unprecedented spectrophotometric precision, enabling definitive exoplanet biosignature detections. The far-IR imager polarimeter will be able to survey thousands of square degrees with broadband imaging at 50 and 250 μm. The Origins Survey Spectrometer will cover wavelengths from 25 to 588 μm, making wide-area and deep spectroscopic surveys with spectral resolving power R ∼ 300, and pointed observations at R ∼ 40,000 and 300,000 with selectable instrument modes. Origins was designed to minimize complexity. The architecture is similar to that of the Spitzer Space Telescope and requires very few deployments after launch, while the cryothermal system design leverages James Webb Space Telescope technology and experience. A combination of current-state-of-the-art cryocoolers and next-generation detector technology will enable Origins' natural background-limited sensitivity.
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5.
  • Leisawitz, David, et al. (författare)
  • The origins space telescope
  • 2019
  • Ingår i: Proceedings of SPIE - The International Society for Optical Engineering. - : SPIE. - 0277-786X .- 1996-756X. ; 11115
  • Konferensbidrag (refereegranskat)abstract
    • The Origins Space Telescope will trace the history of our origins from the time dust and heavy elements permanently altered the cosmic landscape to present-day life. How did galaxies evolve from the earliest galactic systems to those found in the universe today? How do habitable planets form? How common are life-bearing worlds? To answer these alluring questions, Origins will operate at mid-and far-infrared wavelengths and offer powerful spectroscopic instruments and sensitivity three orders of magnitude better than that of Herschel, the largest telescope flown in space to date. After a 3 1/2 year study, the Origins Science and Technology Definition Team will recommend to the Decadal Survey a concept for Origins with a 5.9-m diameter telescope cryocooled to 4.5 K and equipped with three scientific instruments. A mid-infrared instrument (MISC-T) will measure the spectra of transiting exoplanets in the 2.8-20 μm wavelength range and offer unprecedented sensitivity, enabling definitive biosignature detections. The Far-IR Imager Polarimeter (FIP) will be able to survey thousands of square degrees with broadband imaging at 50 and 250 μm. The Origins Survey Spectrometer (OSS) will cover wavelengths from 25-588 μm, make wide-area and deep spectroscopic surveys with spectral resolving power R ∼ 300, and pointed observations at R ∼ 40,000 and 300,000 with selectable instrument modes. Origins was designed to minimize complexity. The telescope has a Spitzer-like architecture and requires very few deployments after launch. The cryo-thermal system design leverages JWST technology and experience. A combination of current-state-of-the-art cryocoolers and next-generation detector technology will enable Origins' natural backgroundlimited sensitivity.
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6.
  • Biver, N., et al. (författare)
  • Coma composition of comet 67P/Churyumov-Gerasimenko from radio-wave spectroscopy
  • 2023
  • Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 672
  • Tidskriftsartikel (refereegranskat)abstract
    • We present the results of a molecular survey of comet 67P/Churyumov-Gerasimenko undertaken with the Institut de RadioAstronomie Millimétrique (IRAM) 30-m radio telescope in November–December 2021, when it had its most favourable apparition in decades. Observations at IRAM 30-m during the 12–16 November period covered 8 GHz bandwidth at 3 mm, 16 GHz at 2 mm, and 60 GHz in the 1 mm window domain. These were completed by snapshots at 1 mm on 12–13 December and a short observation of the H2O line at 557 GHz with the Odin sub-millimetre observatory on 17.0 November 2021, and with 18-cm observations of OH with the Nançay radio telescope. Less sensitive observations obtained at a previous perihelion passage on 18–22 September 2015 with IRAM and 9–12 November 2015 with Odin are also presented. The gas outflow velocity, outgassing pattern, and temperature have been accurately constrained by the observations. They are perfectly consistent with those measured in situ with the Rosetta/MIRO sub-millimetre instrument in 2015. In particular, the asymmetry of the line is well represented by a jet concentrating three-quarters of the outgassing in about π steradians. We derived abundances relative to water for seven molecules and significant upper limits for approximately five others. The retrieved abundances were compared to those measured in situ at the previous perihelion with Rosetta. While those of HCN, CH3OH, and HNCO are comparable, 67P is found to be depleted in H2S and relatively normal in CS (H2S/CS ≈ 3) in strong contradiction with the Rosetta/ROSINA mass spectrometer measurement of the H2S/CS2 (≈100) abundance ratio. While the formaldehyde total abundance found with IRAM 30-m when assuming it to be mostly produced by a distributed source (Haser parent scale length ≈8000 km) is similar to the one derived by Rosetta/ROSINA, we find that the formaldehyde coming from the nucleus is one order of magnitude less abundant than measured in situ by Rosetta/ROSINA. 
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7.
  • De Nutte, R., et al. (författare)
  • Nucleosynthesis in AGB Stars Traced by Oxygen Isotopic Ratios
  • 2015
  • Ingår i: Conference on Why Galaxies Care About AGB Stars III: A Closer Look in Space and Time, Vienna, 28- July - 1 Aug. 2014: (Astronomical Society of the Pacific Conference Series). - : ASTRONOMICAL SOC PACIFIC. - 9781583818794 ; 497, s. 289-294, s. 289-294
  • Konferensbidrag (refereegranskat)abstract
    • Isotopic ratios are by far the best diagnostic tracers of the stellar origin of elements, as they are very sensitive to the precise conditions in the nuclear burning regions. They allow us to give direct constraints on stellar evolution models and on the progenitor mass. However, up to now different isotopic ratios have been well constrained for only a handful of Asymptotic Giant Branch (AGB) stars. We present new data on isotopologue lines of a well-selected sample of AGB stars, covering the three spectral classes of C-, S- and M-type stars. We report on the first efforts made in determining accurate isotopologue fractions, focusing on oxygen isotopes which are a crucial tracer of the poorly constrained extra mixing processes in stellar atmospheres.
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8.
  • De Nutte, R., et al. (författare)
  • Nucleosynthesis in AGB stars traced by oxygen isotopic ratios I. Determining the stellar initial mass by means of the O-17/O-18 ratio
  • 2017
  • Ingår i: Astronomy and Astrophysics. - : EDP SCIENCES S A. - 0004-6361 .- 1432-0746. ; 600
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims. We seek to investigate the O-17/O-18 ratio for a sample of AGB stars containing M-, S-, and C-type stars. These ratios are evaluated in relation to fundamental stellar evolution parameters: the stellar initial mass and pulsation period.Methods. Circumstellar (CO)-C-13-O-16, (CO)-C-12-O-17, and (CO)-C-12-O-18 line observations were obtained for a sample of nine stars with various single-dish long-wavelength facilities. Line intensity ratios are shown to relate directly to the surface O-17/O-18 abundance ratio.Results. Stellar evolution models predict the O-17/O-18 ratio to be a sensitive function of initial mass and to remain constant throughout the entire TP-AGB phase for stars initially less massive than 5 M-circle dot. This makes the measured ratio a probe of the initial stellar mass.Conclusions. Observed O-17/O-18 ratios are found to be well in the range predicted by stellar evolution models that do not consider convective overshooting. From this, accurate initial mass estimates are calculated for seven sources. For the remaining two sources, there are two mass solutions, although there is a larger probability that the low-mass solution is correct. Finally, we present hints at a possible separation between M/S- and C-type stars when comparing the O-17/O-18 ratio to the stellar pulsation period.
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9.
  • Leisawitz, David, et al. (författare)
  • The Origins Space Telescope: Mission concept overview
  • 2018
  • Ingår i: Proceedings of SPIE - The International Society for Optical Engineering. - : SPIE. - 0277-786X .- 1996-756X. ; 10698
  • Konferensbidrag (refereegranskat)abstract
    • Downloading of the abstract is permitted for personal use only. The Origins Space Telescope (OST) will trace the history of our origins from the time dust and heavy elements permanently altered the cosmic landscape to present-day life. How did the universe evolve in response to its changing ingredients? How common are life-bearing planets? To accomplish its scientific objectives, OST will operate at mid- and far-infrared wavelengths and offer superlative sensitivity and new spectroscopic capabilities. The OST study team will present a scientifically compelling, executable mission concept to the 2020 Decadal Survey in Astrophysics. To understand the concept solution space, our team studied two alternative mission concepts. We report on the study approach and describe both of these concepts, give the rationale for major design decisions, and briefly describe the mission-enabling technology.
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10.
  • Lo Faro, Valeria, Postdoc, et al. (författare)
  • Novel ancestry-specific primary open-angle glaucoma loci and shared biology with vascular mechanisms and cell proliferation
  • 2024
  • Ingår i: Cell Reports Medicine. - : Elsevier. - 2666-3791. ; 5:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Primary open -angle glaucoma (POAG), a leading cause of irreversible blindness globally, shows disparity in prevalence and manifestations across ancestries. We perform meta -analysis across 15 biobanks (of the Global Biobank Meta -analysis Initiative) (n = 1,487,441: cases = 26,848) and merge with previous multiancestry studies, with the combined dataset representing the largest and most diverse POAG study to date (n = 1,478,037: cases = 46,325) and identify 17 novel significant loci, 5 of which were ancestry specific. Gene -enrichment and transcriptome-wide association analyses implicate vascular and cancer genes, a fifth of which are primary ciliary related. We perform an extensive statistical analysis of SIX6 and CDKN2B-AS1 loci in human GTEx data and across large electronic health records showing interaction between SIX6 gene and causal variants in the chr9p21.3 locus, with expression effect on CDKN2A/B. Our results suggest that some POAG risk variants may be ancestry specific, sex specific, or both, and support the contribution of genes involved in programmed cell death in POAG pathogenesis.
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