| 1. |
- Lozano, Rafael, et al.
(författare)
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Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
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Tidskriftsartikel (refereegranskat)abstract
- Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
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| 2. |
- Murray, Christopher J. L., et al.
(författare)
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Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1995-2051
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Tidskriftsartikel (refereegranskat)abstract
- Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation.
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| 3. |
- 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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| 4. |
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| 5. |
- Akram, Usman, 1984-
(författare)
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Closing nutrient cycles
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Adequate and balanced crop nutrition – with nitrogen (N), phosphorus (P), and potassium (K) – is vital for sustainable crop production. Inadequate and imbalanced crop nutrition contributes to the crop yield gaps – a difference in actual and potential crop yield. Yield gap is one of the many causes of insufficient food production, thus aggravating hunger and malnourishment across the globe. On the other hand, an oversupply of nutrients is highly unsustainable, in terms of both resource conservation and global environmental health. A decreasing excreta recycling in crop production is one of the many reasons for nutrient imbalances in agriculture. Previous studies show that increasing agricultural specialization leads to spatial separation of crop and animal production. Increasing distance between excreta production and crop needs is one of the leading factors that cause reduced excreta recycling. Studies focusing on excreta recycling show that a substantial barrier to a more efficient excreta nutrient reuse is the expensive transportation of bulky volumes of excreta over long distances. In order to overcome that barrier, more detailed spatial estimates of distances between excreta production and crop nutrient needs, and the associated costs for complete excreta transport in an entire country are needed. Hence, the overall aim of this thesis was to quantify the amount of nutrients in the excreta resources compared to the crop nutrient needs at multiple scales (global, national, subnational, and local), and to analyze the need for excreta transports, total distances and costs, to meet the crop nutrient needs in a country.On the global scale, annual (2000-2016) excreta supply (livestock and human) could provide at least 48% of N, 57% of P, and 81% of K crop needs. Although excreta supply was not enough to cover the annual crop nutrient needs at the global scale, at least 29 countries for N, 41 for P, and 71 for K had an excreta nutrient surplus. When including the annual use of synthetic fertilizers, at least 42 additional countries had a N surplus, with the equivalent figures for P being 17 countries, whereas 8 additional countries attained a K surplus. At the same time, when accounting for the use of synthetic fertilizers, each year, at least 57 countries had an N deficit, 70 a P deficit, and 51 countries a K deficit, in total equivalent to 14% of global N and 16% of each P and K crop needs. The total surplus in other countries during the period was always higher than the deficit in the countries with net nutrient deficits, except for P for some years. Unfortunately, both the deficits of the deficit countries and surpluses of the surplus countries were increasing substantially during the 17 years. Such global divergence in nutrient deficits and surpluses have clear implications for global food security and environmental health.A district-scale investigation of Pakistan showed that the country had a national deficit of 0.62 million tons of P and 0.59 million tons of K, but an oversupply of N. The spatial separation was not significant at this resolution; only 6% of the excreta N supply needed to be transported between districts. Recycling all excreta, within and between districts, could cut the use of synthetic N to 43% of its current use and eliminate the need for synthetic K, but there would be an additional need of 0.28 million tons of synthetic P to meet the crop nutrient needs in the entire country. The need for synthetic fertilizers to supplement the recycled excreta nutrients would cost USD 2.77 billion. However, it might not be prohibitively expensive to correct for P deficiencies because of the savings on the costs of synthetic N, and K. Excreta recycling could promote balanced crop nutrition at the national scale in Pakistan, which in turn could eliminate the nutrient-related crop yield gaps in the country.The municipal-scale investigation using Swedish data showed that the country had a national oversupply of 110,000 tons of N, 6,000 tons of P, and 76,000 tons of K. Excreta could provide up to 75% of N and 81% of P, and more than 100% of the K crop needs in the country. The spatial separation was pronounced at the municipal scale in the country. Just 40% of the municipalities produced over 50% of the excreta N and P. Nutrient balance calculations showed that excreta recycling within municipalities could provide 63% of the P crop needs. Another 18% of the P crop needs must be transported from surplus municipalities to deficit municipalities. Nationally, an optimized reallocation of surplus excreta P towards the P deficit municipalities would cost USD 192 million for a total of 24,079 km truck transports. The cost was 3.7 times more than the total NPK fertilizer value transported, and that met the crop nutrient needs. It was concluded that Sweden could potentially reduce its dependence on synthetic fertilizers, but to cover the costs of an improved excreta reuse would require valuing the additional benefits of recycling.An investigation was also done to understand the effect of the input data resolution on the results (transport needs and distances) from a model to optimize excreta redistribution. The results showed that the need for excreta transports, distances, and spatial patterns of the excreta transports changed. Increasing resolution of the spatial data, from political boundaries in Sweden and Pakistan to 0.083 decimal grids (approximately 10 km by 10 km at the equator), showed that transport needs for excreta-N increased by 12% in Pakistan, and the transport needs for excreta-P increased by 14% in Sweden. The effect of the increased resolution on transport analysis showed inconsistency in terms of the excreta total nutrient transportation distance; the average distance decreased by 67% (to 44 km) in Pakistan but increased by 1 km in Sweden. A further increase in the data resolution to 5 km by 5 km grids for Sweden showed that the average transportation distance decreased by 9 km. In both countries, increasing input data resolution resulted in a more favorable cost to fertilizer value ratios. In Pakistan, the cost of transport was only 13% of the NPK fertilizer value transported at a higher resolution. In Sweden, the costs decreased from 3.7 (at the political resolution) to slightly higher than three times of the fertilizer value transported in excreta at the higher data resolution.This Ph.D. thesis shows that we could potentially reduce the total use of synthetic fertilizers in the world and still reduce the yield gaps if we can create a more efficient recycling of nutrients both within and between countries, and a more demand adapted use of synthetic fertilizers.
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| 6. |
- Akram, Usman, 1984-, et al.
(författare)
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Closing Pakistan’s yield gaps through nutrient recycling
- 2018
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Ingår i: Frontiers in Sustainable Food Systems. - : Frontiers Media S.A.. - 2571-581X. ; , s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- Achieving food security will require closing yield gaps in many regions, including Pakistan. Although fertilizer subsidies have facilitated increased nitrogen (N) application rates, many staple crop yields have yet to reach their maximum potential. Considering that current animal manure and human excreta (bio-supply) recycling rates are low, there is substantial potential to increase the reuse of nutrients in bio-supply. We quantified 2010 crop N, phosphorus (P), and potassium (K) needs along with bio-supply nutrient availability for Pakistani districts, and compared these values to synthetic fertilizer use and costs. We found that synthetic fertilizer use combined with low bio-supply recycling resulted in a substantial gap between nutrient supply and P and K crop needs, which would cost 3 billion USD to fill with synthetic fertilizers. If all bio-supply was recycled, it could eliminate K synthetic fertilizer needs and decrease N synthetic fertilizer needs to 43% of what was purchased in 2010. Under a full recycling scenario, farmers would still require an additional 0.28 million tons of synthetic P fertilizers, costing 2.77 billion USD. However, it may not be prohibitively expensive to correct P deficiencies. Pakistan already spends this amount of money on fertilizers. If funds used for synthetic N were reallocated to synthetic P purchases in a full bio-supply recycling scenario, crop needs could be met. Most recycling could happen within districts, with only 6% of bio-supply requiring between-district transport when optimized to meet national N crop needs. Increased recycling in Pakistan could be a viable way to decrease yield gaps.
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| 7. |
- Akram, Usman, et al.
(författare)
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Enhancing nutrient recycling from excreta to meet crop nutrient needs in Sweden - a spatial analysis
- 2019
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Ingår i: Scientific Reports. - : NATURE PUBLISHING GROUP. - 2045-2322. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Increased recycling of nutrient-rich organic waste to meet crop nutrient needs is an essential component of a more sustainable food system. However, agricultural specialization continues to pose a significant challenge to balancing crop nutrient needs and the nutrient supply from animal manure and human excreta locally. For Sweden, this study found that recycling all excreta (in 2007) could meet up to 75% of crop nitrogen and 81% of phosphorus needs, but that this would exceed crop potassium needs by 51%. Recycling excreta within municipalities could meet 63% of crop P nutrient needs, but large regional differences and imbalances need to be corrected to avoid over or under fertilizing. Over 50% of the total nitrogen and phosphorus in excreta is contained in just 40% of municipalities, and those have a surplus of excreta nutrients compared to crop needs. Reallocation of surpluses (nationally optimized for phosphorus) towards deficit municipalities, would cost 192 million USD (for 24 079 km of truck travel). This is 3.7 times more than the total NPK fertilizer value being transported. These results indicate that Sweden could reduce its dependence on synthetic fertilizers through investments in excreta recycling, but this would likely require valuing also other recycling benefits.
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| 8. |
- Akram, Usman, et al.
(författare)
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Optimizing Nutrient Recycling From Excreta in Sweden and Pakistan : Higher Spatial Resolution Makes Transportation More Attractive
- 2019
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Ingår i: Frontiers in Sustainable Food Systems. - : Frontiers Media SA. - 2571-581X. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Recycling essential plant nutrients like nitrogen (N), phosphorus (P), and potassium (K) from organic waste such as human and animal excreta will be an essential part of sustainable food systems and a circular economy. However, transportation is often cited as a major barrier to increased recycling as organic waste is heavy and bulky, and distances between areas of abundant waste may be far from areas with a need for fertilizers. We investigated the effect of increased input data spatial resolution to an optimization model on the weight, distance, and spatial patterns of transport. The model was run in Sweden and in Pakistan to examine cost-effectiveness of transporting excess excreta to areas of crop need after local recycling. Increasing the resolution of input data from political boundaries (municipalities and districts) to 0.083 decimal grids increased the amount of N requiring transport by 12% in Pakistan and increased P requiring transport by 14% in Sweden. The average distance decreased by 67% (to 44 km) in Pakistan but increased by 1 km in Sweden. Further increasing the resolution to 5 km grids in Sweden decreased the average transportation distance by 9 km (down to 123 km). In both countries, increasing resolution also decreased the number of long-distance heavy transports, and as such costs did not increase as much as total distance and weight transported. Ultimately, transportation in Pakistan seemed financially beneficial: the cost of transport only represented 13% of the NPK fertilizer value transported, and total recycling could even cover 78% of additional fertilizer purchases required. In Sweden, the cost of transporting excreta did not seem cost effective without valuing other potential benefits of increased recycling: costs were three times higher than the fertilizer value transported in excreta at the 5 km resolution. In summary, increasing input data resolution created a more realistic picture of recycling needs. This also highlighted more favorable cost to fertilizer value ratios which could make it easier to move forward with industry and government partners to facilitate productive recycling. Our analysis shows that in both countries increased recycling can result in better spatial nutrient balances.
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| 9. |
- 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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| 10. |
- Malik, Shairyar, et al.
(författare)
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An Improved Skin Lesion Boundary Estimation for Enhanced-Intensity Images Using Hybrid Metaheuristics
- 2023
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Ingår i: Diagnostics. - : MDPI. - 2075-4418. ; 13:7, s. 1285-1285
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Tidskriftsartikel (refereegranskat)abstract
- The demand for the accurate and timely identification of melanoma as a major skin cancer type is increasing daily. Due to the advent of modern tools and computer vision techniques, it has become easier to perform analysis. Skin cancer classification and segmentation techniques require clear lesions segregated from the background for efficient results. Many studies resolve the matter partly. However, there exists plenty of room for new research in this field. Recently, many algorithms have been presented to preprocess skin lesions, aiding the segmentation algorithms to generate efficient outcomes. Nature-inspired algorithms and metaheuristics help to estimate the optimal parameter set in the search space. This research article proposes a hybrid metaheuristic preprocessor, BA-ABC, to improve the quality of images by enhancing their contrast and preserving the brightness. The statistical transformation function, which helps to improve the contrast, is based on a parameter set estimated through the proposed hybrid metaheuristic model for every image in the dataset. For experimentation purposes, we have utilised three publicly available datasets, ISIC-2016, 2017 and 2018. The efficacy of the presented model is validated through some state-of-the-art segmentation algorithms. The visual outcomes of the boundary estimation algorithms and performance matrix validate that the proposed model performs well. The proposed model improves the dice coefficient to 94.6% in the results.
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| 11. |
- Abbafati, Cristiana, et al.
(författare)
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- 2020
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Tidskriftsartikel (refereegranskat)
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