| 1. |
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| 2. |
- Abbafati, Cristiana, et al.
(författare)
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- 2020
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Tidskriftsartikel (refereegranskat)
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| 3. |
- 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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| 4. |
- 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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| 5. |
- 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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| 6. |
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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. |
- 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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| 9. |
- 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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| 10. |
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| 11. |
- Biasin, Elisa, et al.
(författare)
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Femtosecond X-Ray Scattering Study of Ultrafast Photoinduced Structural Dynamics in Solvated[Co(terpy)2]2$
- 2016
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Ingår i: Physical Review Letters. - : American Physical Society (APS). - 1079-7114 .- 0031-9007. ; 117:1
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Tidskriftsartikel (refereegranskat)abstract
- We study the structural dynamics of photoexcited [Co(terpy)2]2+ in an aqueous solution with ultrafast x-ray diffuse scattering experiments conducted at the Linac Coherent Light Source. Through direct comparisons with density functional theory calculations, our analysis shows that the photoexcitation event leads to elongation of the Co-N bonds, followed by coherent Co-N bond length oscillations arising from the impulsive excitation of a vibrational mode dominated by the symmetrical stretch of all six Co-N bonds. This mode has a period of 0.33 ps and decays on a subpicosecond time scale. We find that the equilibrium bond-elongated structure of the high spin state is established on a single-picosecond time scale and that this state has a lifetime of ∼7 ps.
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| 12. |
- Coates, Matthew M., et al.
(författare)
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A comparison of all-cause and cause-specific mortality by household socioeconomic status across seven INDEPTH network health and demographic surveillance systems in sub-Saharan Africa
- 2019
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Ingår i: Global Health Action. - : Taylor & Francis Group. - 1654-9716 .- 1654-9880. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Understanding socioeconomic disparities in all-cause and cause-specific mortality can help inform prevention and treatment strategies.Objectives: To quantify cause-specific mortality rates by socioeconomic status across seven health and demographic surveillance systems (HDSS) in five countries (Ethiopia, Kenya, Malawi, Mozambique, and Nigeria) in the INDEPTH Network in sub-Saharan Africa.Methods: We linked demographic residence data with household survey data containing living standards and education information we used to create a poverty index. Person-years lived and deaths between 2003 and 2016 (periods varied by HDSS) were stratified in each HDSS by age, sex, year, and number of deprivations on the poverty index (0-8). Causes of death were assigned to each death using the InterVA-4 model based on responses to verbal autopsy questionnaires. We estimated rate ratios between socioeconomic groups (2-4 and 5-8 deprivations on our poverty index compared to 0-2 deprivations) for specific causes of death and calculated life expectancy for the deprivation groups.Results: Our pooled data contained almost 3.5 million person-years of observation and 25,038 deaths. All-cause mortality rates were higher among people in households with 5-8 deprivations on our poverty index compared to 0-2 deprivations, controlling for age, sex, and year (rate ratios ranged 1.42 to 2.06 across HDSS sites). The poorest group had consistently higher death rates in communicable, maternal, neonatal, and nutritional conditions (rate ratios ranged 1.34-4.05) and for non-communicable diseases in several sites (1.14-1.93). The disparities in mortality between 5-8 deprivation groups and 0-2 deprivation groups led to lower life expectancy in the higher-deprivation groups by six years in all sites and more than 10 years in five sites.Conclusions: We show large disparities in mortality on the basis of socioeconomic status across seven HDSS in sub-Saharan Africa due to disparities in communicable disease mortality and from non-communicable diseases in some sites. Life expectancy gaps between socioeconomic groups within sites were similar to the gaps between high-income and lower-middle-income countries. Prevention and treatment efforts can benefit from understanding subpopulations facing higher mortality from specific conditions.
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| 13. |
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| 14. |
- Ahmed, JH, et al.
(författare)
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Vitamin D Status and Association of VDR Genetic Polymorphism to Risk of Breast Cancer in Ethiopia
- 2019
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Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 11:2
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Tidskriftsartikel (refereegranskat)abstract
- Emerging evidence associates vitamin D deficiency and vitamin D receptor (VDR) genetic variations with risk for breast cancer. This study investigated the prevalence of vitamin D deficiency and its association with tumor characteristics and the implications of VDR genetic variations for risk of breast cancer in Ethiopia. This unmatched case–control study involved 392 female breast cancer patients and 193 controls. The plasma 25-hydroxyvitamin D (25(OH)D3) level was quantified in chemotherapy-naïve (N = 112) and tamoxifen-treated patients (N = 89). Genotyping for the VDR common variant alleles rs7975232 (ApaI), rs2228570 (FokI), and rs731236 (TaqI) was done. Eighty-six percent of the patients were vitamin D deficient (<50 nmol/L). Chemotherapy-naïve breast cancer patients had a higher prevalence of vitamin D deficiency (91.9% vs. 78.3%) compared to the tamoxifen-treated group (p < 0.001). The prevalence of severe vitamin D deficiency (<25 nmol/L) was significantly higher in chemotherapy-naïve (41.1%) than tamoxifen-treated (11.2%) patients. Vitamin D deficiency was not significantly associated with tumor characteristics or VDR genotype. The rs2228570 GG genotype was associated with increased risk of breast cancer (OR = 1.44, 95% confidence interval = 1.01−2.06). Our result indicates that rs2228570 might be a moderate risk factor for breast cancer development in the Ethiopian population. The high prevalence of severe vitamin D deficiency in treatment-naïve breast cancer patients indicates the need for nutritional supplementation of vitamin D at the time of chemotherapy initiation.
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| 15. |
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| 16. |
- Assefa, Getachew, et al.
(författare)
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Environmental assessment of building properties — Where natural and social sciences meet : the case of EcoEffect
- 2007
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Ingår i: Building and Environment. - : Elsevier BV. - 0360-1323 .- 1873-684X. ; 42:3, s. 1458-1464
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Tidskriftsartikel (refereegranskat)abstract
- The EcoEffect method of assessing external and internal impacts of building properties is briefly described. The external impacts of manufacturing and transport of the building materials, the generation of power and heat consumed during the operation phase are assessed using life-cycle methodology. Emissions and waste; natural resource depletion and toxic substances in building materials are accounted for. Here methodologies from natural sciences are employed. The internal impacts involve the assessment of the risk for discomfort and ill-being due to features and properties of both the indoor environment and outdoor environment within the boundary of the building properties. This risk is calculated based on data and information from questionnaires; measurements and inspection where methodologies mainly from social sciences are used. Life-cycle costs covering investment and utilities costs as well as maintenance costs summed up over the lifetime of the building are also calculated.The result presentation offers extensive layers of diagrams and data tables ranging from an aggregated diagram of environmental efficiency to quantitative indicators of different aspects and factors. Environmental efficiency provides a relative measure of the internal quality of a building property in relation to its external impact vis-à-vis its performance relative to other building properties.
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| 17. |
- Assefa, T. A., et al.
(författare)
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The fluctuation–dissipation measurement instrument at the Linac Coherent Light Source
- 2022
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Ingår i: Review of Scientific Instruments. - : AIP Publishing. - 1089-7623 .- 0034-6748. ; 93
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Tidskriftsartikel (refereegranskat)abstract
- The development of new modes at x-ray free electron lasers has inspired novel methods for studying fluctuations at different energies and timescales. For closely spaced x-ray pulses that can be varied on ultrafast time scales, we have constructed a pair of advanced instruments to conduct studies targeting quantum materials. We first describe a prototype instrument built to test the proof-of-principle of resonant magnetic scattering using ultrafast pulse pairs. This is followed by a description of a new endstation, the so-called fluctuation–dissipation measurement instrument, which was used to carry out studies with a fast area detector. In addition, we describe various types of diagnostics for single-shot contrast measurements, which can be used to normalize data on a pulse-by-pulse basis and calibrate pulse amplitude ratios, both of which are important for the study of fluctuations in materials. Furthermore, we present some new results using the instrument that demonstrates access to higher momentum resolution.
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| 18. |
- Eriksson, Ola, et al.
(författare)
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Municipal Solid Waste Management from a Systems Perspective
- 2005
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Ingår i: Journal of Cleaner Production. - : Elsevier BV. - 0959-6526 .- 1879-1786. ; 13:3, s. 241-252
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Tidskriftsartikel (refereegranskat)abstract
- Different waste treatment options for municipal solid waste have been studied in a systems analysis. Different combinations of incineration, materials recycling of separated plastic and cardboard containers, and biological treatment (anaerobic digestion and composting) of biodegradable waste, were studied and compared to landfilling. The evaluation covered use of energy resources, environmental impact and financial and environmental costs. In the study, a calculation model ( ) based on methodology from life cycle assessment (LCA) was used. Case studies were performed in three Swedish municipalities: Uppsala, Stockholm, and Älvdalen. The study shows that reduced landfilling in favour of increased recycling of energy and materials lead to lower environmental impact, lower consumption of energy resources, and lower economic costs. Landfilling of energy-rich waste should be avoided as far as possible, partly because of the negative environmental impacts from landfilling, but mainly because of the low recovery of resources when landfilling. Differences between materials recycling, nutrient recycling and incineration are small but in general recycling of plastic is somewhat better than incineration and biological treatment somewhat worse. When planning waste management, it is important to know that the choice of waste treatment method affects processes outside the waste management system, such as generation of district heating, electricity, vehicle fuel, plastic, cardboard, and fertiliser.
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| 19. |
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| 20. |
- Eriksson, Ola, et al.
(författare)
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ORWARE : a simulation tool for waste management
- 2002
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Ingår i: Resources, Conservation and Recycling. - 0921-3449 .- 1879-0658. ; 36:4, s. 287-307
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Tidskriftsartikel (refereegranskat)abstract
- A simulation model, ORWARE (ORganic WAste REsearch) is described. The model is mainly used as a tool for researchers in environmental systems analysis of waste management. It is a computer-based model for calculation of substance flows, environmental impacts, and costs of waste management. The model covers, despite the name, both organic and inorganic fractions in municipal waste. The model consists of a number of separate submodels, which describes a process in a real waste management system. The submodels may be combined to design a complete waste management system. Based on principles from life cycle assessment the model also comprises compensatory processes for conventional production of e.g. electricity, district heating and fertiliser. The compensatory system is included in order to fulfil the functional units, i.e. benefits from the waste management that are kept constant in the evaluation of different scenarios. ORWARE generates data on emissions, which are aggregated into different environmental impact categories, e.g. the greenhouse effect, acidification and eutrophication. Throughout the model all physical flows are described by the same variable vector, consisting of up to 50 substances. The extensive vector facilitates a thorough analysis of the results, but involves some difficulties in acquiring relevant data. Scientists have used ORWARE for 8 years in different case studies for model testing and practical application in the society. The aims have e.g. been to evaluate waste management plans and to optimise energy recovery from waste.
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| 21. |
- Frostell, Björn M., et al.
(författare)
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Modeling both direct and indirect environmental load of purchase decisions : a web-based tool addressing household metabolism
- 2015
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Ingår i: Environmental Modelling & Software. - : Elsevier BV. - 1364-8152 .- 1873-6726. ; 71, s. 138-147
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Tidskriftsartikel (refereegranskat)abstract
- Consumer awareness is continuously increasing towards pro-environmental behavior. Thus, we developed a web-based environmental feedback tool EcoRunner, which is designed for Swedish households aiming at increasing the awareness in a more pro-environmental direction. The conceptual model of EcoRunner has been developed based on top-down and bottom-up approaches connecting economic activities within a household to environmental pressures (both direct and indirect). In addition, the development of the tool includes a multi-level model aiming at better tailor-made advice to consumers. In this paper, we examine the EcoRunner tool with average single Swedish household expenditures as well as explore options for reductions and systems effects. Analysis shows that food and non-alcoholic beverages, fuel for personal transport (e.g. car) and air transports have significant environmental pressures. In addition, this study suggests that EcoRunner could be used in education systems as an environmental feedback tool to enlighten consumers motivation and change consumption patterns.
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| 22. |
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| 23. |
- Geberhiwot, T, et al.
(författare)
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Laminin-8 (alpha4beta1gamma1) is synthesized by lymphoid cells, promotes lymphocyte migration and costimulates T cell proliferation
- 2001
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Ingår i: Journal of cell science. - : The Company of Biologists. - 0021-9533 .- 1477-9137. ; 114:2Pt 2, s. 423-433
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Tidskriftsartikel (refereegranskat)abstract
- Laminins are a growing family of large heterotrimeric proteins with cell adhesive and signalling functions. They are major components of basement membranes and are found in many organs, including the vasculature and other compartments of bone marrow, thymus, lymph nodes and spleen. However, expression, recognition and use of laminin isoforms by lymphoid cells are poorly understood. In the present study, lymphoid T cells (Jurkat) were found to synthesize laminin alpha4, beta1 and gamma1 mRNAs and polypeptides and to assemble the chains into laminin-8. Lymphoblastoid B (NAD-20) cells, lymphoid NK (NKL) cells and blood lymphocytes also contained laminin-8 and, after cell permeabilization, practically all blood lymphocytes reacted with mAbs to laminin beta1 and gamma1 chains. Following stimulation, blood lymphocytes secreted laminin-8, and this laminin isoform, but not laminin-10/11(alpha5beta1gamma1/alpha5beta2gamma1), promoted chemokine-induced migration of the cells. In an activation-dependent manner, purified blood CD4 T cells adhered to immobilized laminin-8 and laminin-10/11 by using alpha6beta1 integrin, but minimally to laminin-1 (alpha1beta1gamma1). Accordingly, laminin-8 and laminin-10/11, but not laminin-1, strongly costimulated proliferation of the T cells via the same integrin. Thus, lymphoid cells are able to synthesize and secrete complete laminin molecules. In addition, synthesis of laminin-8 and recognition of laminin-8 and -10/11 by lymphocytes indicate relevance of these laminin isoforms in lymphocyte physiology.
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| 24. |
- Ghasemian, Bahareh, et al.
(författare)
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Application of a Novel Hybrid Machine Learning Algorithm in Shallow Landslide Susceptibility Mapping in a Mountainous Area
- 2022
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Ingår i: Frontiers in Environmental Science. - : Frontiers Media S.A.. - 2296-665X. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Landslides can be a major challenge in mountainous areas that are influenced by climate and landscape changes. In this study, we propose a hybrid machine learning model based on a rotation forest (RoF) meta classifier and a random forest (RF) decision tree classifier called RoFRF for landslide prediction in a mountainous area near Kamyaran city, Kurdistan Province, Iran. We used 118 landslide locations and 25 conditioning factors from which their predictive usefulness was measured using the chi-square technique in a 10-fold cross-validation analysis. We used the sensitivity, specificity, accuracy, F1-measure, Kappa, and area under the receiver operating characteristic curve (AUC) to validate the performance of the proposed model compared to the Artificial Neural Network (ANN), Logistic Model Tree (LMT), Best First Tree (BFT), and RF models. The validation results demonstrated that the landslide susceptibility map produced by the hybrid model had the highest goodness-of-fit (AUC = 0.953) and higher prediction accuracy (AUC = 0.919) compared to the benchmark models. The hybrid RoFRF model proposed in this study can be used as a robust predictive model for landslide susceptibility mapping in the mountainous regions around the world.
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| 25. |
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| 26. |
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| 27. |
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| 28. |
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| 29. |
- Setegn, Shimelis Gebriye, et al.
(författare)
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Impact of climate change on the hydroclimatology of Lake Tana Basin, Ethiopia
- 2011
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Ingår i: Water resources research. - 0043-1397 .- 1944-7973. ; 47:4
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Tidskriftsartikel (refereegranskat)abstract
- Climate change has the potential to reduce water resource availability in the Nile Basin countries in the forthcoming decades. We investigated the sensitivity of water resources to climate change in the Lake Tana Basin, Ethiopia, using outputs from global climate models (GCMs). First, we compiled projected changes in monthly precipitation and temperature in the basin from 15 GCMs. Although the GCMs uniformly suggest increases in temperature, the rainfall projections are not consistent. Second, we investigated how changes in daily temperature and precipitation might translate into changes in streamflow and other hydrological components. For this, we generated daily climate projections by modifying the historical data sets to represent the changes in the GCM climatologies and calculated hydrological changes using the Soil and Water Assessment Tool (SWAT). The SWAT model itself was calibrated and validated using the flows from four tributaries of Lake Tana. For the Special Report on Emissions Scenarios A2 scenario, four of the nine GCMs investigated showed statistically significant declines in annual streamflow for the 2080-2100 period. We interpret our results to mean that anthropogenic climate changes may indeed alter the water balance in the Lake Tana Basin during the next century but that the direction of change cannot be determined with confidence using the current generation of GCMs.
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| 30. |
- Setegn, Shimelis Gebriye, et al.
(författare)
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Modeling of Sediment Yield From Anjeni-Gauged Watershed, Ethiopia Using SWAT Model
- 2010
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Ingår i: Journal of the American Water Resources Association. - : Wiley. - 1093-474X .- 1752-1688. ; 46:3, s. 514-526
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Tidskriftsartikel (refereegranskat)abstract
- The Soil and Water Assessment Tool (SWAT) was tested for prediction of sediment yield in Anjeni-gauged watershed, Ethiopia. Soil erosion and land degradation is a major problem on the Ethiopian highlands. The objectives of this study were to evaluate the performance and applicability of SWAT model in predicting monthly sediment yield and assess the impacts of subbasin delineation and slope discretization on the prediction of sediment yield. Ten years monthly meteorological, flow and sediment data were used for model calibration and validation. The annual average measured sediment yield was 24.6 tonnes/ha. The annual average simulated sediment yield was 27.8 and 29.5 tones/ha for calibration and validation periods, respectively. The study found that the observed values showed good agreement with the simulated sediment yield with Nash-Sutcliffe efficiency (NSE) = 0.81, percent bias (PBIAS) = 28%, RMSE-observations standard deviation ratio (RSR) = 0.23, and coefficient of determination (R superset of) = 0.86 for calibration and NSE = 0.79, PBIAS = 30%, RSR = 0.29, and R superset of = 0.84 for validation periods. The model can be used for further analysis of different management scenarios that could help different stakeholders to plan and implement appropriate soil and water conservation strategies.
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| 31. |
- Setegn, Shimelis Gebriye, et al.
(författare)
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Spatial delineation of soil erosion vulnerability in the Lake Tana Basin, Ethiopia
- 2009
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Ingår i: Hydrological Processes. - : Wiley. - 0885-6087 .- 1099-1085. ; 23:26, s. 3738-3750
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Tidskriftsartikel (refereegranskat)abstract
- The main objective of this study was to identify the most vulnerable areas to soil erosion in the Lake Tana Basin, Blue Nile, Ethiopia using the Soil and Water Assessment Tool (SWAT), a physically based distributed hydrological model, and a Geographic Information System based decision support system that uses multi-criteria evaluation (NICE). The SWAT model was used to estimate the sediment yield within each sub-basin and identify the most sediment contributing areas in the basin. Using the NICE analysis, an attempt was made to combine a set of factors (land use, soil, slope and river layers) to make a decision according to the stated objective. On the basis of simulated SWAT, sediment yields greater than 30 tons/ha for each of the sub-basin area, 18.4% of the watershed was determined to be high erosion potential area. The NICE results indicated that 12-30.5% of the watershed is high erosion potential area. Both approaches show comparable watershed area with high soil erosion susceptibility. The output of this research can aid policy and decision makers in determining the soil erosion 'hot spots' and the relevant soil and water conservation measures. (C) Copyright 2009 John Wiley & Sons, Ltd.
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| 32. |
- Setegn, Shimelis Gebriye, et al.
(författare)
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SWAT model application and prediction uncertainty analysis in the Lake Tana Basin, Ethiopia
- 2010
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Ingår i: Hydrological Processes. - : Wiley. - 0885-6087 .- 1099-1085. ; 24:3, s. 357-367
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Tidskriftsartikel (refereegranskat)abstract
- Lake Tana Basin is of significant importance to Ethiopia concerning water resources aspects and the ecological balance of the area. Many years of mismanagement, wetland losses due to urban encroachment and population growth, and droughts are causing its rapid deterioration. The main objective of this study was to assess the performance and applicability of the soil water assessment tool (SWAT) model for prediction of streamflow in the Lake Tana Basin, so that the influence of topography, land use, soil and climatic condition on the hydrology of Lake Tana Basin can be well examined. The physically based SWAT model was calibrated and validated for four tributaries of Lake Tana. Sequential uncertainty fitting (SUFI-2), parameter solution (ParaSol) and generalized likelihood uncertainty estimation (GLUE) calibration and uncertainty analysis methods were compared and used for the set-up of the SWAT model. The model evaluation statistics for streamflows prediction shows that there is a good agreement between the measured and simulated flows that was verified by coefficients of determination and Nash Sutcliffe efficiency greater than 0.5. The hydrological water balance analysis of the basin indicated that baseflow is an important component of the total discharge within the study area that contributes more than the surface runoff. More than 60% of losses in the watershed are through evapotranspiration. Copyright (C) 2009 John Wiley & Sons, Ltd.
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| 33. |
- Shahabi, Himan, et al.
(författare)
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Flood Detection and Susceptibility Mapping Using Sentinel-1 Remote Sensing Data and a Machine Learning Approach : Hybrid Intelligence of Bagging Ensemble Based on K-Nearest Neighbor Classifier
- 2020
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Ingår i: Remote Sensing. - Switzerland : MDPI. - 2072-4292. ; 12:2, s. 1-30
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Tidskriftsartikel (refereegranskat)abstract
- Mapping flood-prone areas is a key activity in flood disaster management. In this paper, we propose a new flood susceptibility mapping technique. We employ new ensemble models based on bagging as a meta-classifier and K-Nearest Neighbor (KNN) coarse, cosine, cubic, and weighted base classifiers to spatially forecast flooding in the Haraz watershed in northern Iran. We identified flood-prone areas using data from Sentinel-1 sensor. We then selected 10 conditioning factors to spatially predict floods and assess their predictive power using the Relief Attribute Evaluation (RFAE) method. Model validation was performed using two statistical error indices and the area under the curve (AUC). Our results show that the Bagging–Cubic–KNN ensemble model outperformed other ensemble models. It decreased the overfitting and variance problems in the training dataset and enhanced the prediction accuracy of the Cubic–KNN model (AUC=0.660). We therefore recommend that the Bagging–Cubic–KNN model be more widely applied for the sustainable management of flood-prone areas.
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| 34. |
- Vanko, Gyoergy, et al.
(författare)
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Detailed Characterization of a Nanosecond-Lived Excited State: X-ray and Theoretical Investigation of the Quintet State in Photoexcited [Fe(terpy)(2)](2+)
- 2015
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Ingår i: Journal of Physical Chemistry C. - : American Chemical Society (ACS). - 1932-7447 .- 1932-7455. ; 119:11, s. 5888-5902
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Tidskriftsartikel (refereegranskat)abstract
- Theoretical predictions show that depending on the populations of the Fe 3d(xy), 3d(xz), and 3d(yz) orbitals two possible quintet states can exist for the high-spin state of the photoswitchable model system [Fe(terpy)(2)](2+). The differences in the structure and molecular properties of these B-5(2) and E-5 quintets are very small and pose a substantial challenge for experiments to resolve them. Yet for a better understanding of the physics of this system, which can lead to the design of novel molecules with enhanced photoswitching performance, it is vital to determine which high-spin state is reached in the transitions that follow the light excitation. The quintet state can be prepared with a short laser pulse and can be studied with cutting-edge time-resolved X-ray techniques. Here we report on the application of an extended set of X-ray spectroscopy and scattering techniques applied to investigate the quintet state of [Fe(terpy)(2)](2+) 80 ps after light excitation. High-quality X-ray absorption, nonresonant emission, and resonant emission spectra as well as X-ray diffuse scattering data clearly reflect the formation of the high-spin state of the [Fe(terpy)(2)](2+) molecule; moreover, extended X-ray absorption fine structure spectroscopy resolves the Fe-ligand bond-length variations with unprecedented bond-length accuracy in time-resolved experiments. With ab initio calculations we determine why, in contrast to most related systems, one configurational mode is insufficient for the description of the low-spin (LS)-high-spin (HS) transition. We identify the electronic structure origin of the differences between the two possible quintet modes, and finally, we unambiguously identify the formed quintet state as 5E, in agreement with our theoretical expectations.
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| 35. |
- Vester, Peter, et al.
(författare)
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Tracking structural solvent reorganization and recombination dynamics following e-photoabstraction from aqueous I-with femtosecond x-ray spectroscopy and scattering
- 2022
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Ingår i: Journal of Chemical Physics. - : AIP Publishing. - 0021-9606 .- 1089-7690. ; 157:22
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Tidskriftsartikel (refereegranskat)abstract
- We present a sub-picosecond resolved investigation of the structural solvent reorganization and geminate recombination dynamics following 400 nm two-photon excitation and photodetachment of a valence p electron from the aqueous atomic solute, I-(aq). The measurements utilized time-resolved X-ray Absorption Near Edge Structure (TR-XANES) spectroscopy and X-ray Solution Scattering (TR-XSS) at the Linac Coherent Light Source x-ray free electron laser in a laser pump/x-ray probe experiment. The XANES measurements around the L1-edge of the generated nascent iodine atoms (I0) yield an average electron ejection distance from the iodine parent of 7.4 ± 1.5 Å with an excitation yield of about 1/3 of the 0.1M NaI aqueous solution. The kinetic traces of the XANES measurement are in agreement with a purely diffusion-driven geminate iodine-electron recombination model without the need for a long-lived (I0:e-) contact pair. Nonequilibrium classical molecular dynamics simulations indicate a delayed response of the caging H2O solvent shell and this is supported by the structural analysis of the XSS data: We identify a two-step process exhibiting a 0.1 ps delayed solvent shell reorganization time within the tight H-bond network and a 0.3 ps time constant for the mean iodine-oxygen distance changes. The results indicate that most of the reorganization can be explained classically by a transition from a hydrophilic cavity with a well-ordered first solvation shell (hydrogens pointing toward I-) to an expanded cavity around I0 with a more random orientation of the H2O molecules in a broadened first solvation shell.
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