| 1. |
- Abbafati, Cristiana, et al.
(författare)
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- 2020
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Tidskriftsartikel (refereegranskat)
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| 2. |
- Brandenburg, Axel, et al.
(författare)
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Compensating Faraday Depolarization by Magnetic Helicity in the Solar Corona
- 2017
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Ingår i: Astrophysical Journal Letters. - : IOP PUBLISHING LTD. - 2041-8205 .- 2041-8213. ; 845:2
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Tidskriftsartikel (refereegranskat)abstract
- A turbulent dynamo in spherical geometry with an outer corona is simulated to study the sign of magnetic helicity in the outer parts. In agreement with earlier studies, the sign in the outer corona is found to be opposite to that inside the dynamo. Line-of-sight observations of polarized emission are synthesized to explore the feasibility of using the local reduction of Faraday depolarization to infer the sign of helicity of magnetic fields in the solar corona. This approach was previously identified as an observational diagnostic in the context of galactic magnetic fields. Based on our simulations, we show that this method can be successful in the solar context if sufficient statistics are gathered by using averages over ring segments in the corona separately for the regions north and south of the solar equator.
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| 3. |
- Brandenburg, Axel, et al.
(författare)
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Mean-field and direct numerical simulations of magnetic flux concentrations from vertical field
- 2014
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 562
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Tidskriftsartikel (refereegranskat)abstract
- Context. Strongly stratified hydromagnetic turbulence has previously been found to produce magnetic flux concentrations if the domain is large enough compared with the size of turbulent eddies. Mean-field simulations (MFS) using parameterizations of the Reynolds and Maxwell stresses show a large-scale negative effective magnetic pressure instability and have been able to reproduce many aspects of direct numerical simulations (DNS) regarding growth rate, shape of the resulting magnetic structures, and their height as a function of magnetic field strength. Unlike the case of an imposed horizontal field, for a vertical one, magnetic flux concentrations of equipartition strength with the turbulence can be reached, resulting in magnetic spots that are reminiscent of sunspots. Aims. We determine under what conditions magnetic flux concentrations with vertical field occur and what their internal structure is. Methods. We use a combination of MFS, DNS, and implicit large-eddy simulations (ILES) to characterize the resulting magnetic flux concentrations in forced isothermal turbulence with an imposed vertical magnetic field. Results. Using DNS, we confirm earlier results that in the kinematic stage of the large-scale instability the horizontal wavelength of structures is about 10 times the density scale height. At later times, even larger structures are being produced in a fashion similar to inverse spectral transfer in helically driven turbulence. Using ILES, we find that magnetic flux concentrations occur for Mach numbers between 0.1 and 0.7. They occur also for weaker stratification and larger turbulent eddies if the domain is wide enough. Using MFS, the size and aspect ratio of magnetic structures are determined as functions of two input parameters characterizing the parameterization of the effective magnetic pressure. DNS, ILES, and MFS show magnetic flux tubes with mean-field energies comparable to the turbulent kinetic energy. These tubes can reach a length of about eight density scale heights. Despite being <= 1% equipartition strength, it is important that their lower part is included within the computational domain to achieve the full strength of the instability. Conclusions. The resulting vertical magnetic flux tubes are being confined by downflows along the tubes and corresponding inflow from the sides, which keep the field concentrated. Application to sunspots remains a viable possibility.
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| 4. |
- Dewan, Ramita, et al.
(författare)
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Pathogenic Huntingtin Repeat Expansions in Patients with Frontotemporal Dementia and Amyotrophic Lateral Sclerosis.
- 2021
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Ingår i: Neuron. - : Elsevier BV. - 1097-4199 .- 0896-6273. ; 109:3
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Tidskriftsartikel (refereegranskat)abstract
- We examined the role of repeat expansions in the pathogenesis of frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) by analyzing whole-genome sequence data from 2,442 FTD/ALS patients, 2,599 Lewy body dementia (LBD) patients, and 3,158 neurologically healthy subjects. Pathogenic expansions (range, 40-64 CAG repeats) in the huntingtin (HTT) gene were found in three (0.12%) patients diagnosed with pure FTD/ALS syndromes but were not present in the LBD or healthy cohorts. We replicated our findings in an independent collection of 3,674 FTD/ALS patients. Postmortem evaluations of two patients revealed the classical TDP-43 pathology of FTD/ALS, as well as huntingtin-positive, ubiquitin-positive aggregates in the frontal cortex. The neostriatal atrophy that pathologically defines Huntington's disease was absent in both cases. Our findings reveal an etiological relationship between HTT repeat expansions and FTD/ALS syndromes and indicate that genetic screening of FTD/ALS patients for HTT repeat expansions should be considered.
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| 5. |
- 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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| 6. |
- Jabbari, Sarah, et al.
(författare)
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BIPOLAR MAGNETIC SPOTS FROM DYNAMOS IN STRATIFIED SPHERICAL SHELL TURBULENCE
- 2015
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Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 805:2
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Tidskriftsartikel (refereegranskat)abstract
- Recent work by Mitra et al. (2014) has shown that in strongly stratified forced two-layer turbulence with helicity and corresponding large-scale dynamo action in the lower layer, and nonhelical turbulence in the upper, a magnetic field occurs in the upper layer in the form of sharply bounded bipolar magnetic spots. Here we extend this model to spherical wedge geometry covering the northern hemisphere up to 75 degrees latitude and an azimuthal extent of 180 degrees. The kinetic helicity and therefore also the large-scale magnetic field are strongest at low latitudes. For moderately strong stratification, several bipolar spots form that eventually fill the full longitudinal extent. At early times, the polarity of spots reflects the orientation of the underlying azimuthal field, as expected from Parker's Omega-shaped flux loops. At late times their tilt changes such that there is a radial field of opposite orientation at different latitudes separated by about 10 degrees. Our model demonstrates the spontaneous formation of spots of sizes much larger than the pressure scale height. Their tendency to produce filling factors close to unity is argued to be reminiscent of highly active stars. We confirm that strong stratification and strong scale separation are essential ingredients behind magnetic spot formation, which appears to be associated with downflows at larger depths.
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| 7. |
- Jabbari, Sarah, et al.
(författare)
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Magnetic flux concentrations from dynamo-generated fields
- 2014
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 568
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Tidskriftsartikel (refereegranskat)abstract
- Context The mean field theory of magnetized stellar convection gives rise to two distinct instabilities; the large-scale dynamo instability, operating in the bulk of the convection zone and a negative effective magnetic pressure instability (NEMPI) operating in the strongly stratified surface layers. The latter might be important in connection with magnetic spot formation. However, as follows from theoretical analysis, the growth rate of NEMPI is suppressed with increasing rotation rates. On the other hand, recent direct numerical simulations (DNS) have shown a subsequent increase in the growth rate. Aims. We examine quantitatively whether this increase in the growth rate of NEMPI can be explained by an alpha(2) mean field dynamo, and whether both NEMPI and the dynamo instability can operate at the same time. Methods. We use both DNS and mean field simulations (MFS) to solve the underlying equations numerically either with or without an imposed horizontal held, We use the test-field method to compute relevant dynamo coefficients. Results. DNS show that magnetic flux concentrations are still possible up to rotation rates above which the large-scale dynamo effect produces mean magnetic fields. The resulting DNS growth rates are quantitatively reproduced with MPS. As expected for weak or vanishing rotation, the growth rate of NEMPI increases with increasing gravity, but there is a correction term for strong gravity and large turbulent magnetic diffusivity. Conclusions. Magnetic flux concentrations are still possible for rotation rates above which dynamo action takes over For the solar rotation rate, the corresponding turbulent turnover time is about 5 h, with dynamo action commencing in the layers beneath.
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| 8. |
- JABBARI, SARAH, 1981-
(författare)
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Origin of solar surface activity and sunspots
- 2014
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In the last few years, there has been significant progress in the development of a new model for explaining magnetic flux concentrations, by invoking the negative effective magnetic pressure instability (NEMPI) in a highly stratified turbulent plasma. According to this model, the suppression of the turbulent pressure by a large-scale magnetic field leads to a negative contribution of turbulence to the effective magnetic pressure (the sum of non-turbulent and turbulent contributions). For large magnetic Reynolds numbers the negative turbulence contribution is large enough, so that the effective magnetic pressure is negative, which causes a large-scale instability (NEMPI). One of the potential applications of NEMPI is to explain the formation of active regions on the solar surface. On the other hand, the solar dynamo is known to be responsible for generating large-scale magnetic field in the Sun. Therefore, one step toward developing a more realistic model is to study a system where NEMPI is excited from a dynamo-generated magnetic field. In this context, the excitation of NEMPI in spherical geometry was studied here from a mean- field dynamo that generates the background magnetic field. Previous studies have shown that for NEMPI to work, the background field can neither be too weak nor too strong. To satisfy this condition for the dynamo-generated magnetic field, we adopt an “alpha squared dynamo” with an α effect proportional to the cosine of latitude and taking into account alpha quenching. We performed these mean-field simulations (MFS) using the Pencil Code. The results show that dynamo and NEMPI can work at the same time such that they become a coupled system. This coupled system has then been studied separately in more detail in plane geometry where we used both mean-field simulations and direct numerical simulations (DNS).Losada et al. (2013) showed that rotation suppresses NEMPI. However, we now find that for higher Coriolis numbers, the growth rate increase again. This implies that there is another source that provides the excitation of an instability. This mechanism acts at the same time as NEMPI or even after NEMPI was suppressed. One possibility is that for higher Coriolis numbers, an α2 dynamo is activated and causes the observed growth rate. In other words, for large values of the Coriolis numbers we again deal with the coupled system of NEMPI and mean-field dynamo. Both, MFS and DNS confirm this assumption. Using the test-field method, we also calculated the dynamo coefficients for such a system which again gave results consistent with previous studies. There was a small difference though, which is interpreted as being due to the larger scale separation that we have used in our simulations.Another important finding related to NEMPI was the result of Brandenburg et al. (2013), that in the presence of a vertical magnetic field NEMPI results in magnetic flux concentrations of equipartition field strength. This leads to the formation of a magnetic spot. This finding stimulated us to investigate properties of NEMPI for imposed vertical fields in more detail. We used MFS and DNS together with implicit large eddy simulations (ILES) to confirm that an initially uniform weak vertical magnetic field will lead to a circular magnetic spot of equipartition field strength if the plasma is highly stratified and scale separation is large enough. We determined the parameter ranges for NEMPI for a vertical imposed field. Our results show that, as we change the magnitude of the vertical imposed field, the growth rate and geometry of the flux concentrations is unchanged, but their position changes. In particular, by increasing the imposed field strength, the magnetic concentration forms deeper down in the domain.
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| 9. |
- Jabbari, Sarah, 1981-
(författare)
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Origin of solar surface activity and sunspots
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Sunspots and active regions are two of the many manifestations of the solar magnetic field. This field plays an important role in causing phenomena such as coronal mass ejections, flares, and coronal heating. Therefore, it is important to study the origin of sunspots and active regions and determine the underlying mechanism which creates them. It is believed that flux tubes rising from the bottom of the convection zone can create sunspots. However, there are still unanswered questions about this model. In particular, flux tubes are expected to expand as they rise, hence their strength weakens and some sort of reamplification mechanism must complement this model to match the observational properties of sunspots. To compensate for the absence of such an amplification mechanism, the field strength of the flux tubes, when at the bot- tom of the convection zone, must be far stronger than present dynamo models can explain.In the last few years, there has been significant progress toward a new model of magnetic field concentrations based on the negative effective mag- netic pressure instability (NEMPI) in a highly stratified turbulent plasma. NEMPI is a large-scale instability caused by a negative contribution to the total mean-field pressure due to the suppression of the total turbulent pressure by a large-scale magnetic field. In this thesis, I study for the first time NEMPI in the presence of a dynamo-generated magnetic field in both spherical and Carte- sian geometries. The results of mean-field simulations in spherical geometry show that NEMPI and the dynamo instability can act together at the same time such that we deal with a coupled system involving both NEMPI and dynamo effects simultaneously. I also consider a particular two-layer model which was previously found to lead to the formation of bipolar magnetic structures with super-equipartition strength in the presence of a dynamo-generated field. In this model, the turbulence is forced in the entire domain, but the forcing is made helical in the lower part of the domain, and non-helical in the upper part. The study of such a system in spherical geometry showed that, when the stratification is strong enough, intense bipolar regions form and, as time passes, they expand, merge and create giant structures. To understand the underlying mechanism of the formation of such intense, long-lived bipolar structures with a sharp boundary, we performed a systematic numerical study of this model in plane parallel geometry by varying the magnetic Reynolds number, the scale separation ratio, and Coriolis number. Finally, I investigate the formation of the current sheet between bipolar regions and reconnection of oppositely orientated magnetic field lines and demonstrate that for large Lundquist numbers, S, the reconnection rate is nearly independent of S – in agreement with recent studies in identical settings.
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| 10. |
- Jabbari, Sarah, et al.
(författare)
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Sharp magnetic structures from dynamos with density stratification
- 2017
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Ingår i: Monthly notices of the Royal Astronomical Society. - : OXFORD UNIV PRESS. - 0035-8711 .- 1365-2966. ; 467:3, s. 2753-2765
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Tidskriftsartikel (refereegranskat)abstract
- Recent direct numerical simulations (DNS) of large-scale turbulent dynamos in strongly stratified layers have resulted in surprisingly sharp bipolar structures at the surface. Here, we present new DNS of helically and non-helically forced turbulence with and without rotation and compare with corresponding mean-field simulations (MFS) to show that these structures are a generic outcome of a broader class of dynamos in density-stratified layers. The MFS agree qualitatively with the DNS, but the period of oscillations tends to be longer in the DNS. In both DNS and MFS, the sharp structures are produced by converging flows at the surface and might be driven in non-linear stage of evolution by the Lorentz force associated with the large-scale dynamo-driven magnetic field if the dynamo number is at least 2.5 times supercritical.
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| 11. |
- Jabbari, Sarah, et al.
(författare)
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Surface flux concentrations in a spherical alpha 2 dynamo
- 2013
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 556
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Tidskriftsartikel (refereegranskat)abstract
- Context. In the presence of strong density stratification, turbulence can lead to the large-scale instability of a horizontal magnetic field if its strength is in a suitable range (around a few percent of the turbulent equipartition value). This instability is related to a suppression of the turbulent pressure so that the turbulent contribution to the mean magnetic pressure becomes negative. This results in the excitation of a negative effective magnetic pressure instability (NEMPI). This instability has so far only been studied for an imposed magnetic field. Aims. We want to know how NEMPI works when the mean magnetic field is generated self-consistently by an alpha(2) dynamo, whether it is affected by global spherical geometry, and whether it can influence the properties of the dynamo itself. Methods. We adopt the mean-field approach, which has previously been shown to provide a realistic description of NEMPI in direct numerical simulations. We assume axisymmetry and solve the mean-field equations with the Pencil Code for an adiabatic stratification at a total density contrast in the radial direction of approximate to 4 orders of magnitude. Results. NEMPI is found to work when the dynamo-generated field is about 4% of the equipartition value, which is achieved through strong alpha quenching. This instability is excited in the top 5% of the outer radius, provided the density contrast across this top layer is at least 10. NEMPI is found to occur at lower latitudes when the mean magnetic field is stronger. For weaker fields, NEMPI can make the dynamo oscillatory with poleward migration. Conclusions. NEMPI is a viable mechanism for producing magnetic flux concentrations in a strongly stratified spherical shell in which a magnetic field is generated by a strongly quenched alpha effect dynamo.
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| 12. |
- Jabbari, Sarah, et al.
(författare)
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Turbulent reconnection of magnetic bipoles in stratified turbulence
- 2016
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Ingår i: Monthly notices of the Royal Astronomical Society. - : Oxford University Press. - 0035-8711 .- 1365-2966. ; 459:4, s. 4046-4056
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Tidskriftsartikel (refereegranskat)abstract
- We consider strongly stratified forced turbulence in a plane-parallel layer with helicity and corresponding large-scale dynamo action in the lower part and non-helical turbulence in the upper. The magnetic field is found to develop strongly concentrated bipolar structures near the surface. They form elongated bands with a sharp interface between opposite polarities. Unlike earlier experiments with imposed magnetic field, the inclusion of rotation does not strongly suppress the formation of these structures. We perform a systematic numerical study of this phenomenon by varying magnetic Reynolds number, scale-separation ratio, and Coriolis number. We focus on the formation of a current sheet between bipolar regions where reconnection of oppositely oriented field lines occurs. We determine the reconnection rate by measuring either the inflow velocity in the vicinity of the current sheet or by measuring the electric field in the reconnection region. We demonstrate that for large Lundquist numbers, S > 10(3), the reconnection rate is nearly independent of S in agreement with results of recent numerical simulations performed by other groups in simpler settings.
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| 13. |
- 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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| 14. |
- 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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