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- Naghavi, Mohsen, et al.
(författare)
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Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
- 2015
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 385:9963, s. 117-171
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Tidskriftsartikel (refereegranskat)abstract
- Background Up-to-date evidence on levels and trends for age-sex-specifi c all-cause and cause-specifi c mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specifi c all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specifi c causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Findings Global life expectancy for both sexes increased from 65.3 years (UI 65.0-65.6) in 1990, to 71.5 years (UI 71.0-71.9) in 2013, while the number of deaths increased from 47.5 million (UI 46.8-48.2) to 54.9 million (UI 53.6-56.3) over the same interval. Global progress masked variation by age and sex: for children, average absolute diff erences between countries decreased but relative diff erences increased. For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative diff erences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10.7%, from 4.3 million deaths in 1990 to 4.8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. Interpretation For most countries, the general pattern of reductions in age-sex specifi c mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.
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- Forouzanfar, Mohammad H, et al.
(författare)
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Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013 : a systematic analysis for the Global Burden of Disease Study 2013.
- 2015
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 386:10010, s. 2287-2323
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.METHODS: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol.FINDINGS: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa.INTERPRETATION: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.FUNDING: Bill & Melinda Gates Foundation.
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- Liang, Hua, et al.
(författare)
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Recognition of maturity-onset diabetes of the young in China
- 2021
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Ingår i: Journal of Diabetes Investigation. - : Wiley. - 2040-1116 .- 2040-1124. ; 12:4, s. 501-509
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Tidskriftsartikel (refereegranskat)abstract
- Aims/Introduction: Given that mutations related to maturity-onset diabetes of the young (MODY) are rarely found in Chinese populations, we aim to characterize the mutation spectrum of MODY pedigrees. Materials and Methods: Maturity-onset diabetes of the young candidate gene- or exome-targeted capture sequencing was carried out in 76 probands from unrelated families fulfilling the clinical diagnostic criteria for MODY. MAF <0.01 in the GnomAD or ExAC database was used to filter significant variants. Sanger sequencing was then carried out to validate findings. Function prediction by SIFT, PolyPhen-2 and PROVEAN or CADD was carried out in missense mutations. Results: A total of 32 mutations in six genes were identified in 31 families, accounting for 40.79% of the potential MODY families. The MODY subtype detection rate was 18.42% for GCK, 15.79% for HNF1A, 2.63% for HNF4A, and 1.32% for KLF11, PAX4 and NEUROG3. Seven nonsense/frameshift mutations and four missense mutations with damaging prediction were newly identified novel mutations. The clinical features of MODY2, MODY3/1 and MODYX are similar to previous reports. Clinical phenotype of NEUROG3 p.Arg55Glufs*23 is characterized by hyperglycemia and mild intermittent abdominal pain. Conclusions: This study adds to the emerging pattern of MODY epidemiology that the proportion of MODY explained by known pathogenic genes is higher than that previously reported, and found NEUROG3 as a new causative gene for MODY.
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- Zhang, Guoqing, et al.
(författare)
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Extensive and drastically different alpine lake changes on Asia's high plateaus during the past four decades
- 2017
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Ingår i: Geophysical Research Letters. - 0094-8276. ; 44:1, s. 252-260
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Tidskriftsartikel (refereegranskat)abstract
- Asia's high plateaus are sensitive to climate change and have been experiencing rapid warming over the past few decades. We found 99 new lakes and extensive lake expansion on the Tibetan Plateau during the last four decades, 1970–2013, due to increased precipitation and cryospheric contributions to its water balance. This contrasts with disappearing lakes and drastic shrinkage of lake areas on the adjacent Mongolian Plateau: 208 lakes disappeared and 75% of the remaining lakes have shrunk. We detected a statistically significant coincidental timing of lake area changes in both plateaus, associated with the climate regime shift that occurred during 1997/1998. This distinct change in 1997/1998 is thought to be driven by large-scale atmospheric circulation changes in response to climate warming. Our findings reveal that these two adjacent plateaus have been changing in opposite directions in response to climate change. These findings shed light on the complex role of the regional climate and water cycles, and provide useful information for ecological and water resource planning in these fragile landscapes.
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- Belopolski, Ilya, et al.
(författare)
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Observation of a linked-loop quantum state in a topological magnet
- 2022
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 604:7907, s. 647-652
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Tidskriftsartikel (refereegranskat)abstract
- Quantum phases can be classified by topological invariants, which take on discrete values capturing global information about the quantum state1–13. Over the past decades, these invariants have come to play a central role in describing matter, providing the foundation for understanding superfluids5, magnets6,7, the quantum Hall effect3,8, topological insulators9,10, Weyl semimetals11–13 and other phenomena. Here we report an unusual linking-number (knot theory) invariant associated with loops of electronic band crossings in a mirror-symmetric ferromagnet14–20. Using state-of-the-art spectroscopic methods, we directly observe three intertwined degeneracy loops in the material’s three-torus, T3, bulk Brillouin zone. We find that each loop links each other loop twice. Through systematic spectroscopic investigation of this linked-loop quantum state, we explicitly draw its link diagram and conclude, in analogy with knot theory, that it exhibits the linking number (2, 2, 2), providing a direct determination of the invariant structure from the experimental data. We further predict and observe, on the surface of our samples, Seifert boundary states protected by the bulk linked loops, suggestive of a remarkable Seifert bulk–boundary correspondence. Our observation of a quantum loop link motivates the application of knot theory to the exploration of magnetic and superconducting quantum matter.
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- Chang, Guoqing, et al.
(författare)
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Topological quantum properties of chiral crystals
- 2018
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Ingår i: Nature Materials. - : NATURE PUBLISHING GROUP. - 1476-1122 .- 1476-4660. ; 17:11, s. 978-
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Tidskriftsartikel (refereegranskat)abstract
- Chiral crystals are materials with a lattice structure that has a well-defined handedness due to the lack of inversion, mirror or other roto-inversion symmetries. Although it has been shown that the presence of crystalline symmetries can protect topological band crossings, the topological electronic properties of chiral crystals remain largely uncharacterized. Here we show that Kramers-Weyl fermions are a universal topological electronic property of all non-magnetic chiral crystals with spin-orbit coupling and are guaranteed by structural chirality, lattice translation and time-reversal symmetry. Unlike conventional Weyl fermions, they appear at time-reversal-invariant momenta. We identify representative chiral materials in 33 of the 65 chiral space groups in which Kramers-Weyl fermions are relevant to the low-energy physics. We determine that all point-like nodal degeneracies in non-magnetic chiral crystals with relevant spin-orbit coupling carry non-trivial Chern numbers. Kramers-Weyl materials can exhibit a monopole-like electron spin texture and topologically non-trivial bulk Fermi surfaces over an unusually large energy window.
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- Chang, Guoqing, et al.
(författare)
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Unconventional Chiral Fermions and Large Topological Fermi Arcs in RhSi
- 2017
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Ingår i: Physical Review Letters. - : American Physical Society. - 0031-9007 .- 1079-7114. ; 119:20
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Tidskriftsartikel (refereegranskat)abstract
- The theoretical proposal of chiral fermions in topological semimetals has led to a significant effort towards their experimental realization. In particular, the Fermi surfaces of chiral semimetals carry quantized Chern numbers, making them an attractive platform for the observation of exotic transport and optical phenomena. While the simplest example of a chiral fermion in condensed matter is a conventional vertical bar C vertical bar = 1 Weyl fermion, recent theoretical works have proposed a number of unconventional chiral fermions beyond the standard model which are protected by unique combinations of topology and crystalline symmetries. However, materials candidates for experimentally probing the transport and response signatures of these unconventional fermions have thus far remained elusive. In this Letter, we propose the RhSi family in space group No. 198 as the ideal platform for the experimental examination of unconventional chiral fermions. We find that RhSi is a filling-enforced semimetal that features near its Fermi surface a chiral double sixfold-degenerate spin-1 Weyl node at R and a previously uncharacterized fourfold-degenerate chiral fermion at Gamma. Each unconventional fermion displays Chern number +/- 4 at the Fermi level. We also show that RhSi displays the largest possible momentum separation of compensative chiral fermions, the largest proposed topologically nontrivial energy window, and the longest possible Fermi arcs on its surface. We conclude by proposing signatures of an exotic bulk photogalvanic response in RhSi.
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- Cheng, Jie, et al.
(författare)
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Guanidimidazole-quanternized and cross-linked alkaline polymer electrolyte membrane for fuel cell application
- 2016
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Ingår i: Journal of Membrane Science. - : Elsevier BV. - 0376-7388 .- 1873-3123. ; 501, s. 100-108
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Tidskriftsartikel (refereegranskat)abstract
- A modified imidazole, namely guanidimidazole (GIm) was designed and synthesized as a novel quaternizing- and cross-linking agent for alkaline polymer electrolyte membrane fabrication. The resulting membrane was more alkali tolerant and swelling resistant than that quaternized purely by 1-methylimidazole owing to the enhanced resonance and cross-linking ability of GIm, the former confirmed by a LUMO (lowest unoccupied molecular orbital) energy calculation. The membrane also showed good ionic conductivity, mechanical strength and thermal stability. A H2/O2 fuel cell using the synthesized membrane showed a peak power density of 39 mW cm−2 at 50 °C. This work preliminarily demonstrates the beneficial effect of imidazole modification by both experimental and computational investigation; it provides a new cation design strategy that may potentially achieve simultaneous improvement of alkali-stability and swelling resistance of alkaline electrolyte membranes.
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