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- 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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- Stanaway, Jeffrey D., et al.
(författare)
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Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1923-1994
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Tidskriftsartikel (refereegranskat)abstract
- Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
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- Christiansen, Sigurd, et al.
(författare)
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Sea Spray Aerosol Formation : Laboratory Results on the Role of Air Entrainment, Water Temperature, and Phytoplankton Biomass
- 2019
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Ingår i: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 53:22, s. 13107-13116
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Tidskriftsartikel (refereegranskat)abstract
- Sea spray aerosol (SSA) emission is a complex process affected by various controlling factors. This work seeks to deconvolute some of this complexity in a controlled laboratory setting using a plunging jet by varying three key parameters, one at a time: (1) air entrainment rate, (2) seawater temperature, and (3) biomass of phytoplankton. The production of SSA is found to vary linearly with air entrainment rate. By normalizing the production flux to air entrainment rate, we observe nonlinear variation of the production efficiency of SSA with seawater temperature with a minimum around 6-10 degrees C. For comparison, SSA was also generated by detraining air into artificial seawater using a diffuser demonstrating that the production efficiency of SSA generated using a diffuser decreases almost linearly with increasing seawater temperature, and the production efficiency is, significantly higher than that for SSA generated using a plunging jet. Finally, by varying the amount of phytoplankton biomass we demonstrate that SSA particle production varies nonlinearly with the amount of biomass in seawater.
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- Freud, Eyal, et al.
(författare)
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Pan-Arctic aerosol number size distributions : seasonality and transport patterns
- 2017
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Ingår i: Atmospheric Chemistry And Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 17:13, s. 8101-8128
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Tidskriftsartikel (refereegranskat)abstract
- The Arctic environment has an amplified response to global climatic change. It is sensitive to human activities that mostly take place elsewhere. For this study, a multi-year set of observed aerosol number size distributions in the diameter range of 10 to 500 nm from five sites around the Arctic Ocean (Alert, Villum Research Station - Station Nord, Zeppelin, Tiksi and Barrow) was assembled and analysed. A cluster analysis of the aerosol number size distributions revealed four distinct distributions. Together with Lagrangian air parcel back-trajectories, they were used to link the observed aerosol number size distributions with a variety of transport regimes. This analysis yields insight into aerosol dynamics, transport and removal processes, on both an intra- and an inter-monthly scale. For instance, the relative occurrence of aerosol number size distributions that indicate new particle formation (NPF) event is near zero during the dark months, increases gradually to similar to 40% from spring to summer, and then collapses in autumn. Also, the likelihood of Arctic haze aerosols is minimal in summer and peaks in April at all sites. The residence time of accumulation-mode particles in the Arctic troposphere is typically long enough to allow tracking them back to their source regions. Air flow that passes at low altitude over central Siberia and western Russia is associated with relatively high concentrations of accumulation-mode particles (N-acc) at all five sites - often above 150 cm(-3). There are also indications of air descending into the Arctic boundary layer after transport from lower latitudes. The analysis of the back-trajectories together with the meteorological fields along them indicates that the main driver of the Arctic annual cycle of N-acc, on the larger scale, is when atmospheric transport covers the source regions for these particles in the 10-day period preceding the observations in the Arctic. The scavenging of these particles by precipitation is shown to be important on a regional scale and it is most active in summer. Cloud processing is an additional factor that enhances the N-acc annual cycle. There are some consistent differences between the sites that are beyond the year-to-year variability. They are the result of differences in the proximity to the aerosol source regions and to the Arctic Ocean sea-ice edge, as well as in the exposure to free-tropospheric air and in precipitation patterns - to mention a few. Hence, for most purposes, aerosol observations from a single Arctic site cannot represent the entire Arctic region. Therefore, the results presented here are a powerful observational benchmark for evaluation of detailed climate and air chemistry modelling studies of aerosols throughout the vast Arctic region.
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- Nguyen, Quynh T., et al.
(författare)
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Seasonal variation of atmospheric particle number concentrations, new particle formation and atmospheric oxidation capacity at the high Arctic site Villum Research Station, Station Nord
- 2016
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Ingår i: Atmospheric Chemistry and Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 16:17, s. 11319-11336
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Tidskriftsartikel (refereegranskat)abstract
- This work presents an analysis of the physical properties of sub-micrometer aerosol particles measured at the high Arctic site Villum Research Station, Station Nord (VRS), northeast Greenland, between July 2010 and February 2013. The study focuses on particle number concentrations, particle number size distributions and the occurrence of new particle formation (NPF) events and their seasonality in the high Arctic, where observations and characterization of such aerosol particle properties and corresponding events are rare and understanding of related processes is lacking. A clear accumulation mode was observed during the darker months from October until mid-May, which became considerably more pronounced during the prominent Arctic haze months from March to mid-May. In contrast, nucleation- and Aitken-mode particles were predominantly observed during the summer months. Analysis of wind direction and wind speed indicated possible contributions of marine sources from the easterly side of the station to the observed summertime particle number concentrations, while southwesterly to westerly winds dominated during the darker months. NPF events lasting from hours to days were mostly observed from June until August, with fewer events observed during the months with less sunlight, i.e., March, April, September and October. The results tend to indicate that ozone (O3) might be weakly anti-correlated with particle number concentrations of the nucleation-mode range (10-30ĝ€nm) in almost half of the NPF events, while no positive correlation was observed. Calculations of air mass back trajectories using the Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model for the NPF event days suggested that the onset or interruption of events could possibly be explained by changes in air mass origin. A map of event occurrence probability was computed, indicating that southerly air masses from over the Greenland Sea were more likely linked to those events.
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6. |
- Pablos, Isabel, et al.
(författare)
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Mechanistic insights into COVID-19 by global analysis of the SARS-CoV-2 3CL(pro) substrate degradome
- 2021
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Ingår i: Cell Reports. - : Cell Press. - 2211-1247. ; 37:4
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Tidskriftsartikel (refereegranskat)abstract
- The main viral protease (3CL(pro)) is indispensable for SARS-CoV-2 replication. We delineate the human protein substrate landscape of 3CL(pro) by TAILS substrate-targeted N-terminomics. We identify more than 100 substrates in human lung and kidney cells supported by analyses of SARS-CoV-2-infected cells. Enzyme kinetics and molecular docking simulations of 3CL(pro) engaging substrates reveal how noncanonical cleavage sites, which diverge from SARS-CoV, guide substrate specificity. Cleaving the interactors of essential effector proteins, effectively stranding them from their binding partners, amplifies the consequences of proteolysis. We show that 3CL(pro) targets the Hippo pathway, including inactivation of MAP4K5, and key effectors of transcription, mRNA processing, and translation. We demonstrate that Spike glycoprotein directly binds galectin-8, with galectin-8 cleavage disengaging CALCOCO2/NDP52 to decouple antiviral-autophagy. Indeed, in post-mortem COVID-19 lung samples, NDP52 rarely colocalizes with galectin-8, unlike in healthy lungs. The 3CL(pro) substrate degradome establishes a foundational substrate atlas to accelerate exploration of SARSCoV-2 pathology and drug design.
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