| 1. |
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| 2. |
- 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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| 3. |
- Sun, Xiaoming, et al.
(författare)
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Adjustable hardness of hydrogel for promoting vascularization and maintaining sternness of stem cells in skin flap regeneration
- 2018
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Ingår i: Applied Materials Today. - : Elsevier. - 2352-9407. ; 13, s. 54-63
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Tidskriftsartikel (refereegranskat)abstract
- The matrix mechanical stiffness of biomaterials plays an important role in the pluripotency and biological function of stem cells in the microenvironment. It is a key step to adjust the stiffness of biomaterials for inducing stem cells to promote vascularization in order to promote damaged tissue repair. In this study, we transplant adipose derived stem cells (ADSCs) within an in situ forming dextran hydrogel with controllable mechanical strength formed by cross-linking glycidyl methacrylate derivatized dextran and dithiothreitol, which can regulate the stemness and biological functions of stem cells. We show that softer dextran hydrogel can better maintain stemness markers expression of ADSCs, and significantly stimulate ADSCs to secrete angiogenic factors. The ADSCs-encapsulated hydrogel distinctly promote the skin flap survival compared to direct cell injection. Bioluminescence imaging analysis shows that in situ forming dextran hydrogel can improve cells retention, and postmortem analysis reveals that the transplanted ADSCs with hydrogel can promote vascularization. These results support the use of injectable dextran hydrogel for skin ischemia tissue regeneration. (C) 2018 Elsevier Ltd. All rights reserved.
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| 4. |
- 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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| 5. |
- 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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| 6. |
- Wang, Hongyu, et al.
(författare)
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Exploration of selective copper ion separation from wastewater via capacitive deionization with highly effective 3D carbon framework-anchored Co(PO3)2 electrode
- 2024
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Ingår i: Separation and Purification Technology. - : ELSEVIER. - 1383-5866 .- 1873-3794. ; 336
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Tidskriftsartikel (refereegranskat)abstract
- The increasing amount of heavy metal copper ions (Cu2+) in industrial emissions, poses a serious threat to human health, biological environment, and resource scarcity. Capacitive deionization (CDI) is considered as a green and efficient method for desalination. It is crucial to develop high-performance electrodes for efficient operation of CDI that go beyond conventional carbon and yield considerable environmental benefits. Here, metal organic frameworks (MOFs) derived carbon-loaded cobalt metaphosphate (NC-Co(PO3)2) was prepared by lowtemperature gas-solid phosphating for Cu2+ removal as CDI electrode for the first time. NC-Co(PO3)2 demonstrated superior electrode structure and function due to the synergistic effects of electric double layer coupling PO bonds, the binding tendency of metaphosphate groups with Cu2+, and interfacial redox reactions induced by the labile valence state of cobalt. The optimal electrosorption capacity of NC-Co(PO3)2 was 95.41 mg g-1 at 1 V in 50 mL Cu2+ solution with splendid cyclic regeneration capability. Moreover, NC-Co(PO3)2 exhibited excellent selectivity and outstanding electrosorption performance in the presence of multiple coexisting ions and this CDI system realized the purification of actual copper-containing wastewater. A series of characterizations further revealed the specific mechanism of Cu2+ in adsorption-desorption process. Our finding strongly supported NCCo(PO3)2 electrode can extend the CDI platform's capability for effectively removing and retrieving Cu2+ from wastewater.
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| 7. |
- 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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| 8. |
- Zhang, Shuyu, et al.
(författare)
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Moisture Sources and Pathways of Annual Maximum Precipitation in the Lancang-Mekong River Basin
- 2024
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Ingår i: GEOPHYSICAL RESEARCH LETTERS. - 0094-8276 .- 1944-8007. ; 51:6
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Tidskriftsartikel (refereegranskat)abstract
- Recent extremely heavy precipitation has led to substantial economic losses and affected millions of residences in the Lancang-Mekong River Basin (LMRB). This study analyzed the spatial-temporal characteristics of the annual maximum precipitation (R1X) of the LMRB and identified the moisture sources and pathways conducive to R1Xs using a Lagrangian back trajectory model. Results show that India Ocean and Bay of Bengal (IO/BOB), local evapotranspiration, and West Pacific Ocean and East China (WP/EC) are the three main moisture transport pathways of the R1Xs in LMRB, contributing 68.3%, 20.4% and 11.3% of the trajectories, respectively. R1Xs in the downstream eastern area are affected by tropical cyclones bringing large amounts of moisture from the WP/EC. As tropical cyclones shifted northward under climate change impact, more extreme precipitation occurred over the LMRB due to moisture coming from WP/EC, but those from the IO/BOB had decreased because of the slowdown of flows across the Equator. Recent extremely heavy precipitation has led to more frequent floods, storm surges, and other natural hazards in the Lancang-Mekong River Basin, resulting in substantial economic losses and affecting millions of residences. This study used annual maximum precipitation to represent the extreme precipitation and analyzed its spatial-temporal characteristics and the moisture sources and pathways. Results show that the extreme precipitation of the upstream region mainly occurred in July, while that of the downstream region mainly occurred in August-September. The moisture pathways of the historical extreme precipitation were identified using a physical-based model, and are classified into three clusters using a machine-learning model. West Pacific Ocean and East China, local evapotranspiration, and Indian Ocean and Bay of Bengal (IO/BOB) are the three moisture transport pathways with contributions of 68.3%, 20.4%, and 11.3% to the total pathways. The tropical cyclones bring large amounts of moisture and mainly affect R1Xs in the downstream eastern area. Tropical cyclones shifted northward under climate change impact, and more extreme precipitation occurred over the LMRB due to moisture coming from the West Pacific Ocean and East China, but those from the IO and BOB had decreased because of the slowdown of flows across the Equator. The timing of the annual maximum precipitation of the Lancang-Mekong River Basin (LMRB) varies from July to September The extreme precipitation of the LMRB mainly received moisture from the Indian Ocean to the West Pacific Ocean Tropical cyclones will bring more extreme precipitation to the LMRB under climate change
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| 9. |
- 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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| 10. |
- 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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| 11. |
- Feigin, Valery L., et al.
(författare)
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Global, regional, and national burden of neurological disorders, 1990–2016 : a systematic analysis for the Global Burden of Disease Study 2016
- 2019
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Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 18:5, s. 459-480
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Tidskriftsartikel (refereegranskat)abstract
- Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders.Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach.Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable).Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies.Funding: Bill & Melinda Gates Foundation.
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| 12. |
- Griswold, Max G., et al.
(författare)
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Alcohol use and burden for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016
- 2018
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 392:10152, s. 1015-1035
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Tidskriftsartikel (refereegranskat)abstract
- Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.Methods: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.Findings: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2.2% (95% uncertainty interval [UI] 1.5-3.0) of age-standardised female deaths and 6.8% (5.8-8.0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3.8% (95% UI 3.2-4-3) of female deaths and 12.2% (10.8-13-6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2.3% (95% UI 2.0-2.6) and male attributable DALYs were 8.9% (7.8-9.9). The three leading causes of attributable deaths in this age group were tuberculosis (1.4% [95% UI 1. 0-1. 7] of total deaths), road injuries (1.2% [0.7-1.9]), and self-harm (1.1% [0.6-1.5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27.1% (95% UI 21.2-33.3) of total alcohol-attributable female deaths and 18.9% (15.3-22.6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0.0-0.8) standard drinks per week.Interpretation: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.
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| 13. |
- Huang, Linzhe, et al.
(författare)
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Facile synthesis of NS@UiO-66 porous carbon for efficient oxygen reduction reaction in microbial fuel cells
- 2022
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Ingår i: Journal of Power Sources. - : ELSEVIER. - 0378-7753 .- 1873-2755. ; 544
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Tidskriftsartikel (refereegranskat)abstract
- Exploiting a facile way to synthesize low-cost and high-performance oxygen reduction reaction (ORR) catalysts is a core issue in microbial fuel cells (MFCs). Hence, a facile and extensible method has been developed to prepare efficient ORR catalysts by using robust UiO-66 as a precursor, modified with melamine and trithiocyanuric via the impregnation method. Benefiting from the hierarchical structure of UiO-66, the NS@UiO-66 has excellent stability, more active sites and improved mass transfer. Significantly, the half-wave potential and the current density of the NS@UiO-66 are 0.546 V vs. RHE and 6.19 mA cm(-2) respectively, which is better than that of benchmark Pt/C in neutral conditions. Furthermore, the power density of MFCs assembled with the NS@UiO-66 catalyst is 318.6 +/- 2.15 mW m(-2). The density functional theory calculation demonstrates that the reaction barrier can be reduced effectively for accelerating the ORR process through the synergistic effect of N and S. The NS@UiO-66, as an ideal candidate to substitute for the commercial Pt/C counterpart, is expected to promote the scaling-up production and application of MFCs due to low-cost elements doping and facilely synthetic method.
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| 14. |
- Li, Kefei, et al.
(författare)
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Long-term field exposure of structural concretes in marine environment: state-of-the-art review by RILEM TC 289-DCM
- 2022
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Ingår i: Materials and Structures/Materiaux et Constructions. - : Springer Science and Business Media LLC. - 1359-5997. ; 55:7
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Tidskriftsartikel (refereegranskat)abstract
- This paper reviews the technical aspects related to the long-term field exposure practice in marine environments, based on the return of experiences of major marine exposure sites in world-wide scope. The long-term exposure practice helps both the research on durability mechanisms of structural concretes under real environments and the calibration of durability models to support the life-cycle management of concrete structures. The presentation of the field exposure data can be categorized into the information relevant to exposure sites, the data related to the exposed materials and specimens, the information of environmental actions, and the data related to the performance of materials. A standardized presentation of these data can help the efficiency of data sharing and exploitation. The exploitation of exposure data employs various models to represent the chloride ingress and the induced corrosion risk of the embedded steel bars. There are needs for models addressing the strong environment-material interactions, and simple yet reliable durability indicators for engineering use. The design and operation of exposure stations need the careful choice of exposure sites and specimens, the appropriate scheme for monitoring and inspection of exposed specimens, the systematic recording and management of exposure data, and the regular maintenance of exposure facilities. The support of exposure data for life-cycle management is demonstrated through the durability planning of a real project case. The good practice of long-term field exposure is summarized in the end.
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| 15. |
- Li, Kefei, et al.
(författare)
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RILEM recommendation from TC 289-DCM: guideline for designing and operating long-term marine exposure sites
- 2024
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Ingår i: Materials and Structures/Materiaux et Constructions. - 1359-5997. ; 57:3
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Tidskriftsartikel (refereegranskat)abstract
- This guideline prescribes the technical requirements for the design and operation of long-term exposure sites in marine environments. The technical content includes the design of exposure site, the monitoring of environmental conditions, the monitoring of exposed specimens, the data management and the maintenance of exposure facilities. The design of exposure site covers the choice of exposure sites, the exposure infrastructure and facilities, exposure specimens and their placing and protection. Then, the guideline defines the environmental factors to be monitored and the corresponding monitoring methods. For the exposed specimens, the guideline specifies the target performance to monitor, the sampling, the testing and the reporting of exposure results. The data management deals with such aspects as the data storage, data transmission and the data sharing. At the end, the guideline gives the principles for the maintenance of the exposure facilities. This guideline summarizes the best practice of long-term exposure in marine environments, and it is expected to support the normalization of exposure practice and to generate more added values from this practice.
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| 16. |
- 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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| 17. |
- 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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| 18. |
- 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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| 19. |
- Ning, Zhongrui, et al.
(författare)
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Wetter trend in source region of Yangtze River by runoff simulating based on Grid-RCCC-WBM
- 2024
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Ingår i: Journal of Hydrology. - 0022-1694. ; 631
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Tidskriftsartikel (refereegranskat)abstract
- Exploring the future hydroclimatic conditions of source region of Yangtze River (SRYaR), an alpine affected by climate change significantly, is essential for basin water resources management and development ss global climate change intensifies and the process of climate warming and humidification in Northwest China. This study proposed a practical framework for assessing water resource response to the context of climate changes in alpine catchments from the respective of both runoff and hydroclimatic conditions. Utilizing Grid-RCCC-WBM driven by corrected climatic forcing from the global climate models, this study estimate the prospective overall warmer and wetter pattern in the source region of Yangtze River. The key results indicated that: (1) Under all future scenarios, both temperature and precipitation within the catchment exhibit a significant upward trend. Projections from multi-model ensembles (MME) suggest that during the mid-term period (2041–2060, MT), temperatures are expected to rise by [0.74 °C, 3.08 °C] compared to the baseline period (1995–2014), with precipitation changes ranging from [4.8%, 21.4%]. (2) Future runoff within the catchment exhibits a consistent increase, with a linear trend rate of 1.1 mm/decade. runoff changes in MT compared to the baseline period vary from [−5.1%, 33.7%]. Runoff decreases in the northern part of the catchment, while notable increases occur in the southeastern and western regions. (3) In the future, the ratio of catchment evaporation capacity to precipitation decreases in comparison to the baseline period with an augmentation in soil moisture, enhancing its capacity for water retention and reducing the conversion of precipitation to evaporation, resulting a wetting trend of the catchment. (4) The future snowpack in the catchment continues to decrease, with a significant reduction in both the proportion of snowfall relative to total precipitation and the proportion of snowmelt runoff relative to total runoff, the risk of water resources crisis in the watershed is escalating.
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| 20. |
- O’Reilly, Catherine M., et al.
(författare)
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Rapid and highly variable warming of lake surface waters around the globe
- 2015
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Ingår i: Geophysical Research Letters. - 0094-8276 .- 1944-8007. ; 42:24
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Tidskriftsartikel (refereegranskat)abstract
- In this first worldwide synthesis of in situ and satellite-derived lake data, we find that lake summer surface water temperatures rose rapidly (global mean = 0.34°C decade−1) between 1985 and 2009. Our analyses show that surface water warming rates are dependent on combinations of climate and local characteristics, rather than just lake location, leading to the counterintuitive result that regional consistency in lake warming is the exception, rather than the rule. The most rapidly warming lakes are widely geographically distributed, and their warming is associated with interactions among different climatic factors—from seasonally ice-covered lakes in areas where temperature and solar radiation are increasing while cloud cover is diminishing (0.72°C decade−1) to ice-free lakes experiencing increases in air temperature and solar radiation (0.53°C decade−1). The pervasive and rapid warming observed here signals the urgent need to incorporate climate impacts into vulnerability assessments and adaptation efforts for lakes.
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| 21. |
- Pan, Song, et al.
(författare)
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Design and experimental study of a novel air conditioning system using evaporative condenser at a subway station in Beijing, China
- 2018
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Ingår i: Sustainable cities and society. - : Elsevier BV. - 2210-6707. ; 43, s. 550-562
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Tidskriftsartikel (refereegranskat)abstract
- Air conditioning system (AC) contributes significantly to the energy consumption of underground metros. In China, most metro stations are designed with water-cooling centralized air conditioning (WC-AC) system, it has been found that several serious problems are brought by this conventional system, such as large space occupying, water leaking, cooling tower noise and low system efficiency. In order to solve these problems, a novel energy-efficient AC system incorporating an independent evaporative condenser (EC) has been proposed and installed at Futong metro station in Beijing, China. A series of pilot measurements were conducted to analyze the cooling performance and energy consumption of this novel EC-AC system. During the testing period, the average refrigeration efficiency of COP, SCOP and ACOP in A and B side is up to 3.8/3.9, 3.4/3.4 and 2.5/2.3. At the same time, some operation problems such as unbalanced working condition have been identified during measurement. The research indicates that such EC-AC system could be a feasible solution to enhance the energy efficiency and reduce the operational costs and carbon emission in metro stations.
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| 22. |
- Vos, Theo, et al.
(författare)
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Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries 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. - 1474-547X .- 0140-6736. ; 386:9995, s. 743-800
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Tidskriftsartikel (refereegranskat)abstract
- Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2.4 billion and 1.6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537.6 million in 1990 to 764.8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114.87 per 1000 people to 110.31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21.1% in 1990 to 31.2% in 2013. Interpretation Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries.
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| 23. |
- Wang, Hongyu, et al.
(författare)
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Co/Fe co-doped ZIF-8 derived hierarchically porous composites as high-performance electrode materials for Cu2+ions capacitive deionization
- 2023
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Ingår i: Chemical Engineering Journal. - : ELSEVIER SCIENCE SA. - 1385-8947 .- 1873-3212. ; 460
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Tidskriftsartikel (refereegranskat)abstract
- Due to a threat to human life from heavy metal ions pollution, unprecedented interest has been gained in the development of water purification technologies. Here, we explore another new approach to exploit a prospective carbon material for removing copper ions from aqueous solution based on rapid and easy capacitive deionization (CDI). Reasonable carbon materials modification with ideal composition and improved morphological structure is essential to additionally optimize the capabilities of CDI. We prepared a nitrogen-rich hierarchically porous carbon composites (CoFe-NC) with uniform cobalt (Co) and iron (Fe) doped metal in carbon skeleton by a simple impregnation and pyrolysis method, derived from zeolitic imidazolate framework-8, to use as highly effective CDI electrode for copper ions removal. The addition of Fe can facilitate the uniform dispersion of metals, and enable the formation of a stable carbon cage after pyrolysis. It can sufficiently expose active sites of the electrode materials and promote interfacial charge transfer, thus improving CDI electrosorption efficiency. CoFe-NC composites electrode can achieve outstanding deionization capacity (91.31 mg g-1) in 25 mg L-1 CuSO4 solu-tion. The carbon cage structure of CoFe-NC not only prevents aggregation of metals and avoids destruction of rich multistage pore system by pyrolysis, but also induces a faster ions transport rate. In addition, density functional theory calculations demonstrated that the co-doping of Co and Fe can remarkably increase the adsorption en-ergies of Cu2+ ions, leading to excellent selectivity, which indicates that CoFe-NC composites can be a desired CDI electrode material.
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| 24. |
- 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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| 25. |
- 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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