| 1. |
- Feigin, Valery L., et al.
(författare)
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Global, regional, and national burden of stroke and its risk factors, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019
- 2021
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Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 20:10, s. 795-820
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Tidskriftsartikel (refereegranskat)abstract
- Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12.2 million (95% UI 11.0-13.6) incident cases of stroke, 101 million (93.2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6.55 million (6.00-7.02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11.6% [10.8-12.2] of total deaths) and the third-leading cause of death and disability combined (5.7% [5.1-6.2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70.0% (67.0-73.0), prevalent strokes increased by 85.0% (83.0-88.0), deaths from stroke increased by 43.0% (31.0-55.0), and DALYs due to stroke increased by 32.0% (22.0-42.0). During the same period, age-standardised rates of stroke incidence decreased by 17.0% (15.0-18.0), mortality decreased by 36.0% (31.0-42.0), prevalence decreased by 6.0% (5.0-7.0), and DALYs decreased by 36.0% (31.0-42.0). However, among people younger than 70 years, prevalence rates increased by 22.0% (21.0-24.0) and incidence rates increased by 15.0% (12.0-18.0). In 2019, the age-standardised stroke-related mortality rate was 3.6 (3.5-3.8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3.7 (3.5-3.9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62.4% of all incident strokes in 2019 (7.63 million [6.57-8.96]), while intracerebral haemorrhage constituted 27.9% (3.41 million [2.97-3.91]) and subarachnoid haemorrhage constituted 9.7% (1.18 million [1.01-1.39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79.6 million [67.7-90.8] DALYs or 55.5% [48.2-62.0] of total stroke DALYs), high body-mass index (34.9 million [22.3-48.6] DALYs or 24.3% [15.7-33.2]), high fasting plasma glucose (28.9 million [19.8-41.5] DALYs or 20.2% [13.8-29.1]), ambient particulate matter pollution (28.7 million [23.4-33.4] DALYs or 20.1% [16.6-23.0]), and smoking (25.3 million [22.6-28.2] DALYs or 17.6% [16.4-19.0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.
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| 2. |
- 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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| 3. |
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| 4. |
- 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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| 5. |
- 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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| 6. |
- Abbafati, Cristiana, et al.
(författare)
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- 2020
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Tidskriftsartikel (refereegranskat)
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| 7. |
- Kassebaum, Nicholas J., et al.
(författare)
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Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015 : 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. 1603-1658
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Tidskriftsartikel (refereegranskat)abstract
- Background Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. Findings Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs off set by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2.9 years (95% uncertainty interval 2.9-3.0) for men and 3.5 years (3.4-3.7) for women, while HALE at age 65 years improved by 0.85 years (0.78-0.92) and 1.2 years (1.1-1.3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. Interpretation Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum.
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| 8. |
- Khalil, Ibrahim, et al.
(författare)
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Burden of Diarrhea in the Eastern Mediterranean Region, 1990-2013 : Findings from the Global Burden of Disease Study 2013
- 2016
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Ingår i: American Journal of Tropical Medicine and Hygiene. - : American Society of Tropical Medicine and Hygiene. - 1476-1645 .- 0002-9637. ; 95:6, s. 1319-1329
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Tidskriftsartikel (refereegranskat)abstract
- Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low- and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0-1) in Bahrain and Oman to 471 (95% UI = 245-763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520-989) in Syria to 40,869 (95% UI = 21,540-65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden.
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| 9. |
- Mokdad, Ali H., et al.
(författare)
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Adolescent health in the Eastern Mediterranean Region : findings from the global burden of disease 2015 study
- 2018
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Ingår i: International Journal of Public Health. - : SPRINGER BASEL AG. - 1661-8556 .- 1661-8564. ; 63, s. 79-96
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Tidskriftsartikel (refereegranskat)abstract
- The 22 countries of the East Mediterranean Region (EMR) have large populations of adolescents aged 10-24 years. These adolescents are central to assuring the health, development, and peace of this region. We described their health needs. Using data from the Global Burden of Disease Study 2015 (GBD 2015), we report the leading causes of mortality and morbidity for adolescents in the EMR from 1990 to 2015. We also report the prevalence of key health risk behaviors and determinants. Communicable diseases and the health consequences of natural disasters reduced substantially between 1990 and 2015. However, these gains have largely been offset by the health impacts of war and the emergence of non-communicable diseases (including mental health disorders), unintentional injury, and self-harm. Tobacco smoking and high body mass were common health risks amongst adolescents. Additionally, many EMR countries had high rates of adolescent pregnancy and unmet need for contraception. Even with the return of peace and security, adolescents will have a persisting poor health profile that will pose a barrier to socioeconomic growth and development of the EMR.
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| 10. |
- Moradi-Lakeh, Maziar, et al.
(författare)
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Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990-2013 : findings from the Global Burden of Disease Study 2013
- 2017
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 76, s. 1365-1373
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: We used findings from the Global Burden of Disease Study 2013 to report the burden of musculoskeletal disorders in the Eastern Mediterranean Region (EMR).METHODS: The burden of musculoskeletal disorders was calculated for the EMR's 22 countries between 1990 and 2013. A systematic analysis was performed on mortality and morbidity data to estimate prevalence, death, years of live lost, years lived with disability and disability-adjusted life years (DALYs).RESULTS: For musculoskeletal disorders, the crude DALYs rate per 100 000 increased from 1297.1 (95% uncertainty interval (UI) 924.3-1703.4) in 1990 to 1606.0 (95% UI 1141.2-2130.4) in 2013. During 1990-2013, the total DALYs of musculoskeletal disorders increased by 105.2% in the EMR compared with a 58.0% increase in the rest of the world. The burden of musculoskeletal disorders as a proportion of total DALYs increased from 2.4% (95% UI 1.7-3.0) in 1990 to 4.7% (95% UI 3.6-5.8) in 2013. The range of point prevalence (per 1000) among the EMR countries was 28.2-136.0 for low back pain, 27.3-49.7 for neck pain, 9.7-37.3 for osteoarthritis (OA), 0.6-2.2 for rheumatoid arthritis and 0.1-0.8 for gout. Low back pain and neck pain had the highest burden in EMR countries.CONCLUSIONS: This study shows a high burden of musculoskeletal disorders, with a faster increase in EMR compared with the rest of the world. The reasons for this faster increase need to be explored. Our findings call for incorporating prevention and control programmes that should include improving health data, addressing risk factors, providing evidence-based care and community programmes to increase awareness.
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| 11. |
- 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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| 12. |
- 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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| 13. |
- Ahmad, Azeem, et al.
(författare)
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A Multi-factor Approach for Flaky Test Detection and Automated Root Cause Analysis
- 2021
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Ingår i: Proceedings - Asia-Pacific Software Engineering Conference, APSEC. - : IEEE. - 1530-1362. - 9781665437844 - 9781665437851
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Konferensbidrag (refereegranskat)abstract
- Developers often spend time to determine whether test case failures are real failures or flaky. The flaky tests, also known as non-deterministic tests, switch their outcomes without any modification in the codebase, hence reducing the confidence of developers during maintenance as well as in the quality of a product. Re-running test cases to reveal flakiness is resource-consuming, unreliable and does not reveal the root causes of test flakiness. Our paper evaluates a multi-factor approach to identify flaky test executions implemented in a tool named MDF laker. The four factors are: trace-back coverage, flaky frequency, number of test smells, and test size. Based on the extracted factors, MDFlaker uses k-Nearest Neighbor (KNN) to determine whether failed test executions are flaky. We investigate MDFlaker in a case study with 2166 test executions from different open-source repositories. We evaluate the effectiveness of our flaky detection tool. We illustrate how the multi-factor approach can be used to reveal root causes for flakiness, and we conduct a qualitative comparison between MDF laker and other tools proposed in literature. Our results show that the combination of different factors can be used to identify flaky tests. Each factor has its own trade-off, e.g., trace-back leads to many true positives, while flaky frequency yields more true negatives. Therefore, specific combinations of factors enable classification for testers with limited information (e.g., not enough test history information).
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| 14. |
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| 15. |
- Ahmad, Azeem, 1984-, et al.
(författare)
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An Industrial Study on the Challenges and Effects of Diversity-Based Testing in Continuous Integration
- 2023
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Ingår i: IEEE International Conference on Software Quality, Reliability and Security, QRS. - 2693-9177. - 9798350319583
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Konferensbidrag (refereegranskat)abstract
- Many test prioritisation techniques have been proposed in order to improve test effectiveness of Continuous Integration (CI) pipelines. Particularly, diversity-based testing (DBT) has shown promising and competitive results to improve test effectiveness. However, the technical and practical challenges of introducing test prioritisation in CI pipelines are rarely discussed, thus hindering the applicability and adoption of those proposed techniques. This research builds on our prior work in which we evaluated diversity-based techniques in an industrial setting. This work investigates the factors that influence the adoption of DBT both in connection to improvements in test cost-effectiveness, as well as the process and human related challenges to transfer and use DBT prioritisation in CI pipelines. We report on a case study considering the CI pipeline of Axis Communications in Sweden. We performed a thematic analysis of a focus group interview with senior practitioners at the company to identify the challenges and perceived benefits of using test prioritisation in their test process. Our thematic analysis reveals a list of ten challenges and seven perceived effects of introducing test prioritisation in CI cycles. For instance, our participants emphasized the importance of introducing comprehensible and transparent techniques that instill trust in its users. Moreover, practitioners prefer techniques compatible with their current test infrastructure (e.g., test framework and environments) in order to reduce instrumentation efforts and avoid disrupting their current setup. In conclusion, we have identified tradeoffs between different test prioritisation techniques pertaining to the technical, process and human aspects of regression testing in CI. We summarize those findings in a list of seven advantages that refer to specific stakeholder interests and describe the effects of adopting DBT in CI pipelines.
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| 16. |
- Ahmad, Azeem, 1984-
(författare)
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Contributions to Improving Feedback and Trust in Automated Testing and Continuous Integration and Delivery
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- An integrated release version (also known as a release candidate in software engineering) is produced by merging, building, and testing code on a regular basis as part of the Continuous Integration and Continuous Delivery (CI/CD) practices. Several benefits, including improved software quality and shorter release cycles, have been claimed for CI/CD. On the other hand, recent research has uncovered a plethora of problems and bad practices related to CI/CD adoption, necessitating some optimization. Some of the problems addressed in this work include the ability to respond to practitioners’ questions and obtain quick and trustworthy feedback in CI/CD. To be more specific, our effort concentrated on: 1) identifying the information needs of software practitioners engaged in CI/CD; 2) adopting test optimization approaches to obtain faster feedback that are realistic for use in CI/CD environments without introducing excessive technical requirements; 3) identifying perceived causes and automated root cause analysis of test flakiness, thereby providing developers with guidance on how to resolve test flakiness; and 4) identifying challenges in addressing information needs, providing faster and more trustworthy feedback. The findings of the research reported in this thesis are based on data from three single-case studies and three multiple-case studies. The research uses quantitative and qualitative data collected via interviews, site visits, and workshops. To perform our analyses, we used data from firms producing embedded software as well as open-source repositories. The following are major research and practical contributions. Information Needs: The initial contribution to research is a list of information needs in CI/CD. This list contains 27 frequently asked questions on continuous integration and continuous delivery by software practitioners. The identified information needs have been classified as related to testing, code & commit, confidence, bug, and artifacts. We investigated how companies deal with information needs, what tools they use to deal with them, and who is interested in them. We concluded that there is a discrepancy between the identified needs and the techniques employed to meet them. Since some information needs cannot be met by current tools, manual inspections are required, which adds time to the process. Information about code & commit, confidence level, and testing is the most frequently sought for and most important information. Evaluation of Diversity Based Techniques/Tool: The contribution is to conduct a detailed examination of diversity-based techniques using industry test cases to determine if there is a difference between diversity functions in selecting integrationlevel automated test. Additionally, how diversity-based testing compares to other optimization techniques used in industry in terms of fault detection rates, feature coverage, and execution time. This enables us to observe how coverage changes when we run fewer test cases. We concluded that some of the techniques can eliminate up to 85% of test cases (provided by the case company) while still covering all distinct features/requirements. The techniques are developed and made available as an open-source tool for further research and application. Test Flakiness Detection, Prediction & Automated Root Cause Analysis: We identified 19 factors that professionals perceive affect test flakiness. These perceived factors are divided into four categories: test code, system under test, CI/test infrastructure, and organizational. We concluded that some of the perceived factors of test flakiness in closed-source development are directly related to non-determinism, whereas other perceived factors concern different aspects e.g., lack of good properties of a test case (i.e., small, simple and robust), deviations from the established processes, etc. To see if the developers’ perceptions were in line with what they had labelled as flaky or not, we examined the test artifacts that were readily available. We verified that two of the identified perceived factors (i.e., test case size and simplicity) are indeed indicative of test flakiness. Furthermore, we proposed a light weight technique named trace-back coverage to detect flaky tests. Trace-back coverage was combined with other factors such as test smells indicating test flakiness, flakiness frequency and test case size to investigate the effect on revealing test flakiness. When all factors are taken into consideration, the precision of flaky test detection is increased from 57% (using single factor) to 86% (combination of different factors).
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| 17. |
- Ahmad, Azeem, et al.
(författare)
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Data visualisation in continuous integration and delivery : Information needs, challenges, and recommendations
- 2022
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Ingår i: IET Software. - : WILEY. - 1751-8806 .- 1751-8814. ; 16:3, s. 331-349
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Tidskriftsartikel (refereegranskat)abstract
- Several operations, ranging from regular code updates to compiling, building, testing, and distribution to customers, are consolidated in continuous integration and delivery. Professionals seek additional information to complete the mission at hand during these tasks. Developers who devote a large amount of time and effort to finding such information may become distracted from their work. We will better understand the processes, procedures, and resources used to deliver a quality product on time by defining the types of information that software professionals seek. A deeper understanding of software practitioners information needs has many advantages, including remaining competitive, growing knowledge of issues that can stymie a timely update, and creating a visualisation tool to assist practitioners in addressing their information needs. This is an extension of a previous work done by the authors. The authors conducted a multiple-case holistic study with six different companies (38 unique participants) to identify information needs in continuous integration and delivery. This study attempts to capture the importance, frequency, required effort (e.g. sequence of actions required to collect information), current approach to handling, and associated stakeholders with respect to identified needs. 27 information needs associated with different stakeholders (i.e. developers, testers, project managers, release team, and compliance authority) were identified. The identified needs were categorised as testing, code & commit, confidence, bug, and artefacts. Apart from identifying information needs, practitioners face several challenges in developing visualisation tools. Thus, 8 challenges that were faced by the practitioners to develop/maintain visualisation tools for the software team were identified. The recommendations from practitioners who are experts in developing, maintaining, and providing visualisation services to the software team were listed.
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| 18. |
- Ahmad, Azeem, et al.
(författare)
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Empirical analysis of practitioners perceptions of test flakiness factors
- 2021
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Ingår i: Software testing, verification & reliability. - : Wiley-Blackwell. - 0960-0833 .- 1099-1689. ; 31:8
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Tidskriftsartikel (refereegranskat)abstract
- Identifying the root causes of test flakiness is one of the challenges faced by practitioners during software testing. In other words, the testing of the software is hampered by test flakiness. Since the research about test flakiness in large-scale software engineering is scarce, the need for an empirical case-study where we can build a common and grounded understanding of the problem as well as relevant remedies that can later be evaluated in a large-scale context is a necessity. This study reports the findings from a multiple-case study. The authors conducted an online survey to investigate and catalogue the root causes of test flakiness and mitigation strategies. We attempted to understand how practitioners perceive test flakiness in closed-source development, such as how they define test flakiness and what practitioners perceive can affect test flakiness. The perceptions of practitioners were compared with the available literature. We investigated whether practitioners perceptions are reflected in the test artefacts such as what is the relationship between the perceived factors and properties of test artefacts. This study reported 19 factors that are perceived by professionals to affect test flakiness. These perceived factors are categorized as test code, system under test, CI/test infrastructure, and organization-related. The authors concluded that some of the perceived factors in test flakiness in closed-source development are directly related to non-determinism, whereas other perceived factors concern different aspects, for example, lack of good properties of a test case, deviations from the established processes, and ad hoc decisions. Given a data set from investigated cases, the authors concluded that two of the perceived factors (i.e., test case size and test case simplicity) have a strong effect on test flakiness.
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| 19. |
- Ahmad, Azeem, et al.
(författare)
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Identifying Randomness related Flaky Tests through Divergence and Execution Tracing
- 2022
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Ingår i: 2022 IEEE 15TH INTERNATIONAL CONFERENCE ON SOFTWARE TESTING, VERIFICATION AND VALIDATION WORKSHOPS (ICSTW 2022). - : IEEE COMPUTER SOC. - 9781665496285 ; , s. 293-300
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Konferensbidrag (refereegranskat)abstract
- Developers often spend time to determine whether test case failures are real failures or flaky. The flaky tests, known as non-deterministic tests, change their outcomes without any changes in the codebase, thus reducing the trust of developers during a software release as well as in the quality of a product. While rerunning test cases is a common approach, it is resource intensive, unreliable, and does not uncover the actual cause of test flakiness. Our paper evaluates an approach to identify randomness-related flaky. This paper used a divergence algorithm and execution tracing techniques to identify flaky tests, which resulted in the FLAKYPY prototype. In addition, this paper discusses the cases where FLAKYPY successfully identified the flaky test as well as those cases where FLAKYPY failed. The papers discuss how the reporting mechanism of FLAKYPY can help developers in identifying the root cause of randomness-related test flakiness. Thirty-two open-source projects were used in this. We concluded that FLAKYPY can detect most of the randomness-related test flakiness. In addition, the reporting mechanism of FLAKYPY reveals sufficient information about possible root causes of test flakiness.
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| 20. |
- Ahmad, Azeem, 1984-, et al.
(författare)
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Information Needs in Continuous Integration and Delivery in Large Scale Organizations : An Observational Study
- 2024
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Ingår i: Proceedings of the 39th ACM/SIGAPP Symposium on Applied Computing (SAC '24). - 9798400702433 ; , s. 1262-1271
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Konferensbidrag (refereegranskat)abstract
- Continuous integration and delivery encompass a variety of activities, including regular code changes, compilation, building, testing, and distribution to clients. In order to accomplish the assigned tasks, practitioners tend to pursue additional information. Software practitioners who allocate a significant portion of their time and energy towards seeking out required information may experience a diversion from their primary responsibilities. Identifying the specific types of information sought by software practitioners can enhance our comprehension of the processes, protocols, and resources utilized to ensure timely delivery of a high-quality product. Gaining a comprehensive understanding of the information needs of software practitioners can yield numerous benefits such as maintaining competitiveness, enhancing awareness of challenges that may impede a faster delivery, and developing a visual tool to facilitate practitioners in fulfilling their information needs. This study extends prior research by Ahmad et. al [1, 2], by using the observation and think-aloud technique to broaden upon our understanding of information needs. A multiple-case holistic study was carried out to identify information needs in continuous integration and delivery. The study involved four companies and a total of 34 unique participants. The present investigation attempts to capture the importance, frequency, and necessary effort (such as the series of steps needed to gather information) pertaining to identified needs. A total of 39 different information needs were identified across various stakeholders, including release managers, testers, project owners, release team members, and compliance authorities. The needs that were identified have been classified into five distinct categories, namely code and commit, test suite and test case, release and deployment, trends and statistics, and testing infrastructure. The present study has revealed additional 31% of information needs compared to previous work, with 77% of these needs being unique. The level of overlap between the current research and Ahmad et. al work from other researchers is 23%. The impact of utilizing diverse methodologies on the identification of information needs was also a topic of discussion.
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| 21. |
- Ahmad, Azeem, et al.
(författare)
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Limitations of the analytic hierarchy process technique with respect to geographically distributed stakeholders
- 2010
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Ingår i: Proceedings of World Academy of Science, Engineering and Technology. - : World Academy of Science. - 2010-376X .- 2070-3740. ; 70:Sept., s. 111-116
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Tidskriftsartikel (refereegranskat)abstract
- The selection of appropriate requirements for product releases can make a big difference in a product success. The selection of requirements is done by different requirements prioritization techniques. These techniques are based on pre-defined and systematic steps to calculate the requirements relative weight. Prioritization is complicated by new development settings, shifting from traditional co-located development to geographically distributed development. Stakeholders, connected to a project, are distributed all over the world. These geographically distributions of stakeholders make it hard to prioritize requirements as each stakeholder have their own perception and expectations of the requirements in a software project. This paper discusses limitations of the Analytical Hierarchy Process with respect to geographically distributed stakeholders' (GDS) prioritization of requirements. This paper also provides a solution, in the form of a modified AHP, in order to prioritize requirements for GDS. We will conduct two experiments in this paper and will analyze the results in order to discuss AHP limitations with respect to GDS. The modified AHP variant is also validated in this paper.
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| 22. |
- Ahmad, Azeem, et al.
(författare)
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Software professionals' information needs in continuous integration and delivery
- 2021
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Ingår i: SAC '21: Proceedings of the 36th Annual ACM Symposium on Applied ComputingMarch 2021. - New York, NY, USA : ACM. ; , s. 1513-1520
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Continuous integration and delivery consolidate several activities, ranging from frequent code changes to compiling, building, testing, and deployment to customers. During these activities, software professionals seek additional information to perform the task at hand. Developers that spend a considerable amount of time and effort to identify such information can be distracted from doing productive work. By identifying the types of information that software professionals seek, we can better understand the processes, practices, and tools that are required to develop a quality product on time. A better understanding of the information needs of software practitioners has several benefits, such as staying competitive, increasing awareness of the issues that can hinder a timely release, and building a visualization tool that can help practitioners to address their information needs. We conducted a multiple-case holistic study with 5 different companies (34 unique participants) to identify information needs in continuous integration and delivery. This study attempts to capture the importance, frequency, required effort (e.g., sequence of actions required to collect information), current approach to handling, and associated stakeholders with respect to identified needs. We identified 27 information needs associated with different stakeholders (i.e., developers, testers, project managers, release team, and compliance authority). The identified needs were categorized as testing, code & commit, confidence, bug, and artifacts. We discussed whether the information needs were aligned with the tools used to address them.
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| 23. |
- Ahmad, Azeem, 1984-, et al.
(författare)
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The Comparative Evaluation of Test Prioritization Approaches in an Industrial Study
- 2023
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Ingår i: Proc. - IEEE Int. Conf. Softw. Qual., Reliab., Secur. Companion, QRS-C. - : Institute of Electrical and Electronics Engineers Inc.. - 9798350359398 ; , s. 35-44
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Konferensbidrag (refereegranskat)abstract
- Many test prioritisation techniques have been proposed in order to improve test effectiveness of Continuous Integration (CI) pipelines. Particularly, diversity-based testing (DBT) has shown promising and competitive results to improve test effectiveness. We report on a case study considering the CI pipeline of Axis Communications in Sweden. We compared three different prioritisation approaches (i.e., diversity, failure history and time) in terms of their impact on coverage, failure detection rates and reduction on test execution time. Our results reveal that DBT is the best candidate to provide feature coverage, whereas failure rate prioritisation yields better failure coverage. Time-based prioritisation is not a reliable approach to provide cost-effective testing. Moreover, DBT would allow stakeholders to receive quick feedback on many combinations of integrated features to verify their code changes. Our participants report that developers are mainly interested in: (i) receiving quick feedback on a high combination of integrated features to verify their code changes, and (ii) associate their test suites to confidence scores representing the risk of missing failures given that fewer tests are executed.
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| 24. |
- Ahmad, Azeem, 1984-, et al.
(författare)
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The Perceived Effects of Introducing Coaching on the Development of Student's Soft Skills Managing Software Quality
- 2021
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Ingår i: Proceedings of 4th Software Engineering Education Workshop (SEED 2021) co-located with APSEC 2021, 06-Dec, 2021, Taipei, Taiwan. - : CEUR-WS. ; , s. 22-29
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Konferensbidrag (refereegranskat)abstract
- Technical abilities (also known as hard skills) are just as crucial as soft skills (such as communication, cooperation, teamwork, etc.) in attaining professional success. Therefore it is important to pay much attention to soft skills when developing the curriculum of engineering educations. Many elements can have a direct or indirect impact on students’ soft skills, including course topic, course module (i.e., laboratories, seminars, etc.), the medium of instruction, and learning activities. Many academics have investigated the development of soft skills in a variety of disciplines, including engineering, science, and business. The purpose of this study is to assess the perceived impact of coaching on the development of soft skills in MS and BS engineering students. During four planned sessions over a six-month period, MS students acted as coachers, while BS students received coaching from MS students. After each coaching session, all students were asked to complete a survey to evaluate their perception for how their soft skills had developed. The results of the perceived effects of introducing coaching activities are presented in this article. This article is a first step, in the series of our investigation, in identifying the students’ perceptions about the development of soft skills. According to the survey, the MS engineering students who were the coachers had perceived to improve most of their soft skills. However, in the perception of BS students, their soft skills did not improve as compared to MS students, prompting us to conduct additional research in the future to discover what hampered the growth of BS students’ soft skills as well as how MS students’ soft skills were enhanced.
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| 25. |
- Azeem, Muhammad, et al.
(författare)
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Combined Economic Emission Dispatch in Presence of Renewable Energy Resources Using CISSA in a Smart Grid Environment
- 2023
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Ingår i: Electronics. - : MDPI. - 2079-9292. ; 12:3
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Tidskriftsartikel (refereegranskat)abstract
- The geographically spatial and controlled distribution of fossil fuel resources, catastrophic global warming, and depletion of fossil fuel resources have forced us to integrate zero- or low-emissions energy resources, such as wind and solar, in the generation mix. These renewable energy resources are unexhausted, available around the globe, and free of cost. The advancement in wind and solar technologies has caused an appreciable decrease in installed the and global levelized costs of electricity via these sources. Therefore, the penetration of renewable energy resources in the generation mix can provide a promising solution to the above-mentioned problems. The aim of simultaneously reducing fuel consumption in terms of “Fuel Cost” and “Emission” in thermal power plants is called a combined economic emission dispatch problem. It is a combinatorial and multi-objective optimization problem. The solution of this problem is to allocate the load demand and losses on the committed units in such way that the overall costs of the generation and emission of thermal units are reduced, while the legal bounds (constraints) are met. It is a highly non-linear and complex optimization problem. The valve-point loading effect makes this problem non-convex. The addition of renewable energy resources (RERs) adds more complexities to this problem because they are intermittent. In this work, chaotic salp swarm algorithms (CISSA) are used to solve the combined economic emission dispatch problem. Chaos is used as an alternative to randomization for the tuning of the control variable to improve the trait of obtaining global extrema. Different test cases having different combinations of thermal, solar, and wind units are solved using the proposed algorithm. The results show the superiority of this study in comparison to the existent research results in terms of the cost of generation and emissions.
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| 26. |
- de Oliveira Neto, Francisco Gomes, et al.
(författare)
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Improving continuous integration with similarity-based test case selection
- 2018
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Ingår i: Proceedings of the 13th International Workshop on Automation of Software Test. - New York : ACM Digital Library. - 0270-5257. - 9781450357432 ; , s. 39-45
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Konferensbidrag (refereegranskat)abstract
- Automated testing is an essential component of Continuous Integration (CI) and Delivery (CD), such as scheduling automated test sessions on overnight builds. That allows stakeholders to execute entire test suites and achieve exhaustive test coverage, since running all tests is often infeasible during work hours, i.e., in parallel to development activities. On the other hand, developers also need test feedback from CI servers when pushing changes, even if not all test cases are executed. In this paper we evaluate similarity-based test case selection (SBTCS) on integration-level tests executed on continuous integration pipelines of two companies. We select test cases that maximise diversity of test coverage and reduce feedback time to developers. Our results confirm existing evidence that SBTCS is a strong candidate for test optimisation, by reducing feedback time (up to 92% faster in our case studies) while achieving full test coverage using only information from test artefacts themselves.
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| 27. |
- 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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| 28. |
- Kumar, Sunjeet, et al.
(författare)
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Chemical Composition of Fresh Leaves Headspace Aroma and Essential Oils of Four Coriander Cultivars
- 2022
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Ingår i: Frontiers in Plant Science. - : Frontiers Media SA. - 1664-462X. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Aroma is one of the key food characteristics determining consumers' perception and acceptability of products. Coriandrum sativum L. is an aromatic herb commonly used as a food additive and taste enhancer. Besides the culinary applications, coriander is also used in traditional medicine, cosmetics, and the food industry. In this study, we aimed to determine aroma composition of fresh chopped leaves and essential oils extracted from the leaves of four coriander cultivars. The essential oils were extracted from the fresh leaves using steam distillation and volatile aroma components were collected from the headspace by solid phase micro extraction technique. Analyses were carried out by gas chromatography-mass spectrometry. Free radical scavenging activity of essential oils was determined by using 2,2-diphenyl-1-picrylhydrazyl assay. The essential oils were also investigated for their anti-microbial potential. The aroma of freshly chopped coriander leaves was characterized by thirteen compounds, including six aldehydes, four alcohols, one ester and one hydrocarbon. The essential oils were comprised of twenty-seven compounds, where (E)-2-decenal, decanal, (E)-2-dodecenal and (E)-2-tetradecenal were the main components in all cultivars. Free radical scavenging activity of the essential oil samples was in the range of 6-15%. The essential oils of Desi and Hybrid cultivars exhibited least minimum inhibitory concentration (MIC) against all tested bacterial strains. Fresh green leaves of the Desi and Peshawari cultivars were found to be the richest in six carbon chain length alcohols and acetates, which are important constituents of the aroma giving a characteristic odor referred to as the "green note." The Hybrid cultivar showed the highest free radical scavenging activity, bearing the highest amount of antioxidants. The study revealed that the fresh leaves HS aroma of Desi and Hybrid cultivars were different, however, their essential oils possessed almost similar chemistry and anti-bacterial activity.
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| 29. |
- Micah, Angela E., et al.
(författare)
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Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050
- 2021
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 398:10308, s. 1317-1343
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Forskningsöversikt (refereegranskat)abstract
- Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached $8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this, $13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and $1.4 billion was repurposed from existing health projects. $3.1 billion (22.4%) of the funds focused on country-level coordination and $2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34.3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.
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| 30. |
- Mokdad, Ali H., et al.
(författare)
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Diabetes mellitus and chronic kidney disease in the Eastern Mediterranean Region : findings from the Global Burden of Disease 2015 study
- 2018
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Ingår i: International Journal of Public Health. - : SPRINGER BASEL AG. - 1661-8556 .- 1661-8564. ; 63, s. 177-186
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Tidskriftsartikel (refereegranskat)abstract
- We used findings from the Global Burden of Disease 2015 study to update our previous publication on the burden of diabetes and chronic kidney disease due to diabetes (CKD-DM) during 1990-2015. We extracted GBD 2015 estimates for prevalence, mortality, and disability-adjusted life years (DALYs) of diabetes (including burden of low vision due to diabetes, neuropathy, and amputations and CKD-DM for 22 countries of the EMR from the GBD visualization tools. In 2015, 135,230 (95% UI 123,034-148,184) individuals died from diabetes and 16,470 (95% UI 13,977-18,961) from CKD-DM, 216 and 179% increases, respectively, compared to 1990. The total number of people with diabetes was 42.3 million (95% UI 38.6-46.4 million) in 2015. DALY rates of diabetes in 2015 were significantly higher than the expected rates based on Socio-demographic Index (SDI). Our study showed a large and increasing burden of diabetes in the region. There is an urgency in dealing with diabetes and its consequences, and these efforts should be at the forefront of health prevention and promotion.
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| 31. |
- Qadri, Syed Furqan, et al.
(författare)
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CT-based automatic spine segmentation using patch-based deep learning
- 2023
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Ingår i: International Journal of Intelligent Systems. - : Hindawi Publishing Corporation. - 0884-8173 .- 1098-111X. ; 2023
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Tidskriftsartikel (refereegranskat)abstract
- CT vertebral segmentation plays an essential role in various clinical applications, such as computer-assisted surgical interventions, assessment of spinal abnormalities, and vertebral compression fractures. Automatic CT vertebral segmentation is challenging due to the overlapping shadows of thoracoabdominal structures such as the lungs, bony structures such as the ribs, and other issues such as ambiguous object borders, complicated spine architecture, patient variability, and fluctuations in image contrast. Deep learning is an emerging technique for disease diagnosis in the medical field. This study proposes a patch-based deep learning approach to extract the discriminative features from unlabeled data using a stacked sparse autoencoder (SSAE). 2D slices from a CT volume are divided into overlapping patches fed into the model for training. A random under sampling (RUS)-module is applied to balance the training data by selecting a subset of the majority class. SSAE uses pixel intensities alone to learn high-level features to recognize distinctive features from image patches. Each image is subjected to a sliding window operation to express image patches using autoencoder high-level features, which are then fed into a sigmoid layer to classify whether each patch is a vertebra or not. We validate our approach on three diverse publicly available datasets: VerSe, CSI-Seg, and the Lumbar CT dataset. Our proposed method outperformed other models after configuration optimization by achieving 89.9% in precision, 90.2% in recall, 98.9% in accuracy, 90.4% in F-score, 82.6% in intersection over union (IoU), and 90.2% in Dice coefficient (DC). The results of this study demonstrate that our model's performance consistency using a variety of validation strategies is flexible, fast, and generalizable, making it suited for clinical application.
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| 32. |
- 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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