| 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. |
- 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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| 3. |
- Ali, Muhammad Amjad, et al.
(författare)
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Transcription factors WRKY11 and WRKY17 are involved in abiotic stress responses in Arabidopsis
- 2018
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Ingår i: Journal of plant physiology (Print). - : Elsevier. - 0176-1617 .- 1618-1328. ; 226, s. 12-21
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Tidskriftsartikel (refereegranskat)abstract
- Plant WRKY transcription factors play a vital role in abiotic stress tolerance and regulation of plant defense responses. This study examined AtWRKY11 and AtWRKY17 expression under ABA, salt, and osmotic stress at different developmental stages in Arabidopsis. We used reverse transcriptase PCR, quantitative real-time PCR, and promoter:GUS lines to analyze expression. Both genes were upregulated in response to abiotic stress. Next, we applied the same stressors to seedlings of T-DNA insertion wrky11 and 17 knock-out mutants (single and double). Under stress, the mutants exhibited slower germination and compromised root growth compared with the wild type. In most cases, double-mutant seedlings were more affected than single mutants. These results suggest that wrky11 and wrky17 are not strictly limited to plant defense responses but are also involved in conferring stress tolerance.
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| 4. |
- Farooq, Muhammad, et al.
(författare)
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Thermodynamic Performance Analysis of Hydrofluoroolefins (HFO) Refrigerants in Commercial Air-Conditioning Systems for Sustainable Environment
- 2020
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Ingår i: Processes. - : MDPI. - 2227-9717. ; 8:2
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Tidskriftsartikel (refereegranskat)abstract
- Global warming is one of most severe environmental concerns that our planet is facing today. One of its causes is the previous generation of refrigerants that, upon release, remain in the atmosphere for longer periods and contribute towards global warming. This issue could potentially be solved by replacing the previous generation's high global warming potential (GWP) refrigerants with environmentally friendly refrigerants. This scenario requires an analysis of new refrigerants for a comparison of the thermodynamic properties of the previously used refrigerants. In the present research, a numerical study was conducted to analyze the thermodynamic performance of specifically low GWP hydrofluoroolefens (HFO) refrigerants for an actual vapor compression refrigeration cycle (VCRC) with a constant degree of 3 K superheat. The output parameters included the refrigeration effect, compressor work input, the coefficient of performance (COP), and the volumetric refrigeration capacity (VRC), all of which were calculated by varying the condenser pressure from 6 to 12 bars and vapor pressure from 0.7 to 1.9 bars. Results showed that R1234ze(Z) clearly possessed the desired thermodynamic performance. The drop in refrigeration effect for R1234ze(Z) was merely 14.6% less than that of R134a at a 12 bar condenser pressure; this was minimum drop among candidate refrigerants. The drop in the COP was the minimum for R1234ze(Z)-5.1% less than that of R134a at a 9 bar condenser pressure and 4.7% less than that of R134a at a 1.9 bar evaporator pressure, whereas the COP values of the other refrigerants dropped more drastically at higher condenser pressures. R1234ze(Z) possessed favorable thermodynamic characteristics, with a GWP of 7, and it can serve as an alternative refrigerant for refrigeration systems for a sustainable environment.
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| 5. |
- Irshad, Azeem, et al.
(författare)
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A secure and provable multi-server authenticated key agreement for TMIS based on Amin et al. scheme
- 2017
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Ingår i: Multimedia tools and applications. - : Springer. - 1380-7501 .- 1573-7721. ; 76:15, s. 16463-16489
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Tidskriftsartikel (refereegranskat)abstract
- The security for Telecare Medicine Information Systems (TMIS) has been crucial for reliable dispensing of the medical services to patients at distant locations. Security and privacy element needs to be there for any physician or caregiver to make certain an appropriate diagnosis, medical treatment or any other exchange of critical information. In this connection, many relevant TMIS-based authentication schemes have been presented, however various forms of attacks and inefficiencies render these schemes inapplicable for a practical scenario. Lately, Amin et al. proposed a scheme based on a multi-server authentication for TMIS. However, the Amin et al., scheme has been found vulnerable to user and server impersonation attacks. We have proposed an improved model with higher performance and efficiency, as evident from the forthcoming sections. Besides, the scheme has been backed up by formal security analysis using BAN logic to ensure the resilience of the proposed scheme.
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| 6. |
- Lakhan, Abdullah, et al.
(författare)
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Dynamic application partitioning and task-scheduling secure schemes for biosensor healthcare workload in mobile edge cloud
- 2021
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Ingår i: Electronics. - 2079-9292. ; 10:22, s. 1-30
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Tidskriftsartikel (refereegranskat)abstract
- Currently, the use of biosensor-enabled mobile healthcare workflow applications in mobile edge-cloud-enabled systems is increasing progressively. These applications are heavyweight and divided between a thin client mobile device and a thick server edge cloud for execution. Application partitioning is a mechanism in which applications are divided based on resource and energy parameters. However, existing application-partitioning schemes widely ignore security aspects for healthcare applications. This study devises a dynamic application-partitioning workload task-scheduling-secure (DAPWTS) algorithm framework that consists of different schemes, such as min-cut algorithm, searching node, energy-enabled scheduling, failure scheduling, and security schemes. The goal is to minimize the energy consumption of nodes and divide the application between local nodes and edge nodes by applying the secure min-cut algorithm. Furthermore, the study devises the secure-min-cut algorithm, which aims to migrate data between nodes in a secure form during application partitioning in the system. After partitioning the applications, the node-search algorithm searches optimally to run applications under their deadlines. The energy and failure schemes maintain the energy consumption of the nodes and the failure of the system. Simulation results show that DAPWTS outperforms existing baseline approaches by 30% in terms of energy consumption, deadline, and failure of applications in the system.
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| 7. |
- Lakhan, Abdullah, et al.
(författare)
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Dynamic application partitioning and task-scheduling secure schemes for biosensor healthcare workload in mobile edge cloud
- 2021
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Ingår i: Electronics. - : MDPI AG. - 2079-9292. ; 10:22, s. 1-30
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Tidskriftsartikel (refereegranskat)abstract
- Currently, the use of biosensor-enabled mobile healthcare workflow applications in mobile edge-cloud-enabled systems is increasing progressively. These applications are heavyweight and divided between a thin client mobile device and a thick server edge cloud for execution. Application partitioning is a mechanism in which applications are divided based on resource and energy parameters. However, existing application-partitioning schemes widely ignore security aspects for healthcare applications. This study devises a dynamic application-partitioning workload task-scheduling-secure (DAPWTS) algorithm framework that consists of different schemes, such as min-cut algorithm, searching node, energy-enabled scheduling, failure scheduling, and security schemes. The goal is to minimize the energy consumption of nodes and divide the application between local nodes and edge nodes by applying the secure min-cut algorithm. Furthermore, the study devises the secure-min-cut algorithm, which aims to migrate data between nodesin a secure form during application partitioning in the system. After partitioning the applications, the node-search algorithm searches optimally to run applications under their deadlines. The energy and failure schemes maintain the energy consumption of the nodes and the failure of the system. Simulation results show that DAPWTS outperforms existing baseline approaches by 30% in terms of energy consumption, deadline, and failure of applications in the system.
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| 8. |
- Nawaz, Imran
(författare)
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Employing epigenetic marks to detect cancer : studies on nasopharyngeal carcinoma and lung cancer
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Tumor suppressor genes (TSGs) or oncogenes aberrantly methylated in transcription control regions during early carcinogenesis are potential tools for early detection of cancer. We have identified suitable genes and explored assays based on their methylation status aiming for early detection of cancer: nasopharyngeal carcinoma (NPC) and non-small cell lung cancer (NSCLC). We established and developed further the “multiplex methylation specific-PCR (MMSP)” assay designed to detect the tumor-specific methylation status of several NPC-related genes (paper I). It provided information about the methylation status of multiple genes simultaneously in a single PCR with small amounts of tumor DNA derived from nasopharyngeal swabs. It was shown to be applicable with DNA from as few as 10 cells. The detection rate of NPC from nasopharyngeal swabs was 98%. The false positive rate was zero. We employed the MMSP assay on NPC tumors from two other regions (Morocco and Italy) and compared our results with those on Chinese NPC patients from paper I (paper II). We also did a pilot study using sera from Italian and Chinese NPC. We updated the panel of MMSP markers and modified the assay to improve its applicability to NPC from different geographical locations. We could detect at least any one methylation marker gene in 97% of the EBNA1 positive samples with a specificity of 94%, while the results on sera were less informative than using swabs. We used an established NotI microarray method to identify gene losses (by deletion or methylation) in chromosome 3 of NPC tumors (paper III), This chromosome is known to contain TSGs involved in many cancer types. Ten candidate TSGs were found. Among them, the CpG rich area in the promoter region of Integrin α9 (ITGA9) was confirmed to be hypermethylated in NPC by bisulfite cloned sequencing, bisulfite pyrosequencing and methylation specific PCR. ITGA9 was downregulated in NPC clinical samples and 5-aza-2′-deoxycytidine restored the expression of ITGA9 in NPC derived cell lines. The functional role of ITGA9 downregulation in NPC should be explored further. We developed an MMSP assay for analysis of the methylation status of multiple potential TSGs in NSCLC samples (paper IV). Thirty-eight potential TSGs were selected, based on literature search, genome-wide CpG methylation and expression microarrays performed on NSCLC tissues and matched control tissues. After evaluation by methylation specific PCR (MSP) six of these genes were selected for inclusion into the MMSP assay. Subsequently, 70 NSCLC DNA samples with matched controls and 24 non-cancerous DNA samples were screened with this assay. With a cut off of methylation of at least any two of these marker genes 87% of the cancer samples were detected with a specificity of 94%. Early stage I or II NSCLC showed a 100% specificity and 86% sensitivity.
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| 9. |
- Nawaz, Imran, et al.
(författare)
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Integrin α9 gene promoter is hypermethylated and downregulated in nasopharyngeal carcinoma
- 2015
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Ingår i: Oncotarget. - Albany, NY, United States : Impact Journals LLC. - 1949-2553. ; 6:31, s. 31493-31507
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Tidskriftsartikel (refereegranskat)abstract
- Epigenetic silencing of tumor suppressor genes (TSGs) by promoter methylation can be an early event in the multi-step process of carcinogenesis. Human chromosome 3 contains clusters of TSGs involved in many cancer types including nasopharyngeal carcinoma (NPC), the most common cancer in Southern China. Among ten candidate TSGs identified in chromosome 3 using NotI microarray, ITGA9 and WNT7A could be validated. 5-aza-2 deoxycytidine treatment restored the expression of ITGA9 and WNT7A in two NPC cell lines. Immunostaining showed strong expression of these genes in the membrane and cytoplasm of adjacent control nasopharyngeal epithelium cells, while they were weakly expressed in NPC tumor cells. The ITGA9 promoter showed marked differentially methylation between tumor and control tissue, whereas no differentially methylation could be detected for the WNT7A promoter. The expression level of ITGA9 in NPC tumors was downregulated 4.9-fold, compared to the expression in control. ITGA9 methylation was detected by methylation specific PCR (MSP) in 56% of EBV positive NPC-cases with 100% specificity. Taken together, this suggests that ITGA9 might be a TSG in NPC that is involved in tumor cell biology. The possibility of using ITGA9 methylation as a marker for early detection of NPC should further be explored.
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| 10. |
- Wang, Haidong, et al.
(författare)
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Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015 : the Global Burden of Disease Study 2015.
- 2016
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Ingår i: The lancet. HIV. - : Elsevier. - 2352-3018. ; 3:8, s. e361-e387
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015.METHODS: For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification.FINDINGS: Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95% uncertainty interval [UI] 3·1-3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5-2·8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38·8 million (95% UI 37·6-40·4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths (95% UI 1·7-1·9 million) in 2005, to 1·2 million deaths (1·1-1·3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections.INTERPRETATION: Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030.
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